I have decided that my frustration with the medical staff of my little
hospital's lack of breastfeeding knowledge compels me to do something.  (The
last straw was the chart review I did for a poor woman who's mastitis was
initially managed in the office by her obstetrician recommending abrupt
weaning as the sole therapy, and then when her symptoms became severe and
she presneted to the emergency room, she was admitted and treated with IV
metronidazole of all things.  Our CLC (the only breastfeeding support we
currently have) wrote several nursing notes recommending more appropriate
therapy, including at least some milk removal, and was ignored.  She was
treated by both an internist and the obstetrician during her admission, and
fortunately managed to get better somehow, although her breastfeeding
relationship with her very young infant was lost.)

I have printed a copy of the Academy of Breastfeeding Medicine's protocol
for mastitis treatment and forwarded it to the appropriate docs as a first
step.  (The protocol is very nice, actually, and well-referenced.)

As a second step, I have volunteered to give a continuing medical education
talk which is usually attended by a good portion of the medical staff on
breastfeeding.  The audience will be primarily primary care physicians, but
most will be internists, not pediatricians or gynecologists.  I'm hoping to
make it interesting for those folks, while not terribly boring for the few
who do peds or OB.  I will have about 1 hour.

I think I will stick to some basic goals - 1. Encourage docs to understand
the value and importance of human milk for human infants 2.  Encourage them
to understand some very few basics of breastfeeding, such as supply and
demand 3. This is probably most important - Identify resources for
physicians when they are unaware of what to do when treating a breastfeeding
mom, to include print resources such as Dr. Hale's book, and our community
resources which include LLL, an IBCLC at our local WIC office, and our
hospital CLC.

Any other brilliant ideas on what to cover, or how to present it in an
engaging fashion?  I have a couple months to prepare (which I'll need, with
my crazy life!)

Jennifer Tieman
Family Physician
Mom to 4, including my nursling Caroline Rose, age 2 1/2

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