Fellow LNs, I am desparately in need of moral support. Lately, I have been
swamped with lactation calls that have been generated by a few doctors
giving really horrible advice. The letter below was my response to one such
issue after this doc told a mom of a premie (36 weeks) that bf was not worth
the effort and that formula was "just as good". I made an appt to see the
doc and handed her this letter with copies of ILCAs statements and The AAP,
plus my CV and other articles. She did not reply, so I'm sending it again
via certified mail.
Please share your thoughts and experiences with me. I'm feel very low and
don't know where else to turn (BTW, dh is out of town and my three little
ones aren't helping this state).
ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒ§ƒƒ§ƒ§ƒ§ƒ§ƒ§ƒ
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC
INFANT CUISINE & MOTHER CARE:Lactation Consulting, Perinatal Health
Education, and Attachment Parenting Classes
1807 NW Beca Avenue, Corvallis, Oregon 97330
541-753-7340 #2 541-908-6000 [log in to unmask]
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RESEND: February 5, 2001
December 28, 2000
Dear Dr. :
I am writing to you in response to some confusion over breastfeeding
recommendations and my qualifications. In the spirit of professionalism
and commitment to what is best for patients, please take a moment to read
this, as I am seriously concerned about comments made to XXXXXX regarding
my professional approach to their case and their subsequent decision not to
continue breastfeeding their baby BABY X. I have also enclosed a copy of
the International Lactation Consultants¹ Assoc. Standards of Practice, The
American Academy of Pediatrics Policy Statement on the Uses of Human Milk,
and the World Health Organization¹s Innocenti Declaration which are all
based on mounds of sound clinical research published in peer reviewed
medical journals.
I am enclosing a copy of my CV for your review and reassurance of my
training and experience as an International. Board Certified Lactation
Consultant and Certified Health Education Specialist, credentials earned in
addition to my doctorate and masters degrees in Public Health from UCLA. I
graduated with high honors from the UCLA School of Public Health in 1992,
after being inducted to the Delta Omega Public Health Honor Society. You
may be unfamiliar with programs such as the Robert Wood Johnson-Pew Trust
Clinical Scholars Program, but even as a PhD student I completed clinical
rotations in Pediatrics, Family Practice, Internal Medicine, General Surgery
and OB/GYN. My own research has been published in a wide array of journals
including JAMA, J. for Amb Care Management, Amer. Behavioral Scientist, J.
for the Poor and Underserved, and more. In the past several years, I have
been published in several Who¹s Who publications, including Who¹s Who in
Medicine and Healthcare, Who¹s Who in America, Who¹s Who in Women, among
others, and have received numerous post-doctoral grants for research and
awards, including from the American Assoc. of University Women,
Fullbright-Hayes Fellowship, Social Science Research Council and the US
Public Health Service . Currently, I also serve on the Benton Co. Public
Health Advisory Board and the American Public Health Association¹s Medical
Care Section Council and Governing Council.
While attending 11 full time years of University of California education, I
was employed full-time in the health care field in various positions, as
well as in research and teaching posts. For a full description, I refer you
to my CV. If you have concerns regarding the content of any of these, I
would gladly review them with you. I now balance a private clinical
practice with teaching, performing outcomes research, speaking
internationally on breastfeeding and my parenting role. My patients have
24/7 access to me and, if necessary as in the XXXXXX case, are not charged
for daily visits to their home and round the clock phone support. When I
accept a patient, they have my complete commitment toward achieving their
stated breastfeeding or parenting goal.
It is absolutely true that I have a passion for breastfeeding, but I NEVER
push any mom into breastfeeding, as may have been insinuated by a staff
member in your office (this is as it was reported to me, so I understand if
it is not completely accurate, and I apologize). I require moms to call me
(as I¹ve told your nurse lactation educator, nurse X, when she has requested
that I phone patients, I want it to be ³their decision²) and in the case of
re-lactation I always ask them very clearly, ³Is this what you want to do
because it will require full commitment and hard work?² There are no
guarantees, and when a mom has been given incorrect information regarding
breastfeeding and establishing milk supply, it is often a bumpy road. In
over a dozen years of practice, I have successfully helped hundreds of women
breastfeed so that their babies received at least half of their nutrition
from human milk. Only in two cases--both referred late in the course from
your practice--have we not succeeded using the tried and true methods.
These methods include, but are not limited to: correction of latch and
position; breast massage and compression techniques; Marmet¹s patented suck
training; pumping; increased skin to skin contact through trained massage
and baby-wearing; water therapies; guided imagery and music triggered
relaxation for let down; pharmacologic assistance (prescribed by the
patient¹s primary care MD); nutritional support therapies; breastfeeding
devices/supports such as shields, shells, Supplemental Nursing Systems,
Evert-It, Haberman and Hazelbaker Feeders--all with informed consent. These
difficult cases are much more easily reversed if I receive the referral
early, as opposed to a month after problems arise. In the cases of
premature babies or teen mothers, our guidelines and the AAP state that a
prompt referral to an experienced IBCLC should be made--not managed by
someone with a 40 hour course in lactation (vs. 4000 hours before sitting
for the IBCLC Board exam).
During this process, I refer moms back to their Pediatricians and OB/GYNs
for diagnosis and treatment of conditions I suspect, but do not diagnose. I
do not prescribe pharmaceuticals, but if available I do inform patients that
there are OTC supplements that may be of help in their particular situation.
If external substances are needed, Homopathic drops are my first line of
outside augmentation because they have absolutely no known side effects
(this is documented and again, I will discuss and produce this information).
Homeopathic medicine is widely used around the world by highly regarded,
trained professionals. It is a process of repeated titrating of substances
shown to trigger the body to heal itself. Nutritional supplements (point of
interest, I teach Nutrition--among other courses-- at the college level) may
require more counseling regarding possible side effects of herbs, but even
strawberries can be a culprit in allergic reactions, not to mention
prescribed pharmaceuticals such as Reglan (which is contraindicated in
patients with depression history); thus, I prefer a homeopathic approach
given first, herbs second, pharmaceuticals third. Patients are free to
obtain these anywhere or from me at cost.
The research information that I present to patients is all published in peer
reviewed, well-respected medical journals such as PEDIATRICS, JAMA, NEJM and
others, as summarized by ILCA¹s HAZARDS OF INFANT FORMULA and many other
publications. Neither ILCA nor La Leche League International actually
conducts their own research, but rather they gather findings from respected
peer reviewed published medical sources. As I am always seeking to further
my knowledge, if you have information (in particular, the information that
you presented to XXXXXX) that refutes the data and findings stating that
formula increases the risk of infant mortality and morbidity in the US, I
would like for you to share these with me. I do not consider data or
findings published by Ross Laboratories to be objective, scientific or
credible. If a mother¹s milk is somehow lacking--an exceptional situation,
not the rule--then it may be enhanced through various means such as
Neutramins to boost DHA content.
I also pride myself in following the published breastfeeding guidelines of
the American Academy of Pediatrics, the AMA, the International Lactation
Consultants¹ Association, and the American Public Health Association. If
you need clarification as to what these are, please don¹t hesitate to ask.
I consider it my privilege to share such information with other health care
professionals. For two years, I served as the sole Director of Research
Review for La Leche League International (LLLI) and for two years prior to
that, I served as Oregon¹s Area Professional Liaison for LLLI. I have
reviewed mountains of research on the topic of breastfeeding and I am always
delighted to review any research that covers this topic. Please allow me to
reimburse your practice for the costs of photocopying ANY research that you
have presented as evidence against breastfeeding. Thank you in advance for
this professional courtesy. I will gladly do the same for you.
PLEASE RESPOND IN WRITING TO THE STATEMENTS MADE ABOVE AND TO THE REQUEST
FOR PRODUCTION OF INFORMATION REGARDING YOUR POSITION THAT ³FORMULA IS
EQUIVALENT TO BREASTMILK². I would be happy to meet to discuss these after
seeing written citations sent to my address above.
Respectfully,
Chris Hafner-Eaton, PhD, MPH, CHES, IBCLC
INFANT CUISINE & MOTHER CARE: Lactation Consulting, Perinatal Health
Education, and Attachment Parenting Classes for parents, health care
practitioners and policymakers
cc. Practice Owner, MD
[log in to unmask]
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