I think one reason is that the "obvious" is not always true. That is why, as 
Lactation Consultants, we have to rely on Evidenced Based Data, as well as 
the experiences of thousands of women. (And when I relay a piece of data to 
a client, I often will say whether it is research based, or it if has simply stood 
the test of time, which, in some cases, is a form of research.)

Let's look at "obvious" things many women believe about breastfeeding that 
we KNOW are simply not true, thus research is necessary (or at least fact) to 
reassure her:

a) "I'll pump my breasts and that way I'll know just how much the baby is 
getting." SEEMS obvious, but it isn't. Many women do not understand that 
pumping and actual breastfeeding are completely different events and that 
they extract milk in different ways, and that pumping to "see how much I get" 
also seemingly obvious, simply is wrong.

b) "Everything I eat, and every drug I take gets into my milk and effects my 
baby. So, I have to eat a limited diet and have to pump and dump or wean if I 
need to take medicine." Again it SEEMS "obvious" but we required research to 
find out that in most cases this just isn't true. According to Dr Hale, the AAP, 
and other researchers, we know that most drugs and foods are safe during 
breastfeeding, and thus a breastfeeding woman has more freedom than many 
would like her to have concerning everything from eating chocolate to treating 
a medical condition to an infection while nursing. This makes breastfeeding 
more available and workable for most women. Too many restrictions make 
breastfeeding appear to be an effort that "only a few" can make. When, in 
actuality, a woman can lead a normal life, in regards to her diet and health 
care, while breastfeeding. 

c) "Babies need to be "nippled" by bottle in the hospital, to see if they 
are "strong" enough to breastfeed." Again, this seems "Obvious" to many, yet 
research has shown us that not only can many babies (especially high risk and 
PreTerm and Low Birth Weight babies) go to breast BEFORE they can "bottle 
feed" but that O2 saturation is better, the suck-swallow-breathe reflex is more 
organized and more muscles are exercised by breastfeeding. 

d) "I probably can't breastfeed because I have small breasts." SEEMS obvious, 
as it SEEMS like large breasts would "make more milk" than small ones, but 
research has proven that breast size has nothing to do with milk production. 

e) "I can't breastfeed after a C Section, because my body doesn''t even know 
I had a baby." Maybe to many of us this seems not at all an "obvious 
statement" but I have heard it again and again, over many decades. Research 
proves to us that the removal of the placenta, in addition to the preparation 
of the breasts by the pregnancy cause Lactogenesis I, not how the baby "got 
out." Yet, we are still hearing this excuse, even by some HCPs, who should 
know better. 

f) "My baby is 2 months old, and my breasts don't feel full the way they used 
to. My milk dried up." Usually not true, the breast changes shape and 
gets "used to" making milk and doesn't feel the way it did the first few weeks 
postpartum. Yet, I get at least a few panic calls a month, with mothers whose 
babies are nursing well, between one and three months old, and the mother is 
freaked out, because her breasts, often suddenly do not feel as full and firm 
as they did before. Research and fact gathering on this phenomenon proves to 
us, that in the vast majority of cases, if the out put is good, and the baby is 
growing adequately, there is no place for concern. 

g) "My baby just nursed 20 minutes ago, and now he is hungry again. That 
means I don't have enough milk, and have to supplement him with AIM." 
Seems "obvious" (Maybe not to us, but to a first time nursing mom, who only 
has AIM, bottle fed babies in her circle and family, who only "eat" every 4 
hours, and "stay full.") Again, research has shown not only how small an 
infant's stomach is, but how QUICKLY it can empty human milk into the 
intestine at times. Also, "growth spurts" just don't seem "obvious" to many 
adults who are not familiar with the development of breast fed babies. SO, 
again, we need research to prove what is known to not be "obvious" to SO 
many. 

Not only these, but more, and the idea that what may be "obvious" to one 
person may not at all be obvious to an other.  Many "wives tales" and 
misconceptions based on "obviousness" simply contradict each other (ie "Birds 
of a feather flock together." VS "Opposites attract." only one example of 
millions which could be used.) 

Research not only clears up misconceptions, it also clarifies WHY things 
happen, and gives us strong tools in a world where many people want every 
excuse available to make breastfeeding as impossible or difficult as possible. 

Also, we are *Professionals* When I go to my doctor and he tells me 
something, I am more inclined to believe him, if there is research available to 
back up what he says, rather than the old fashioned "Trust me, I know what I 
am talking about." with NO explanation why or how. Also, I absolutely  don't 
want to a HCP who simply patronizes my clients by saying, "Trust me, honey, I 
just know more than you do. You don't need proof, just what I tell you is 
true." 

We are also less well known and perhaps less well trusted than physicians, so 
Evidenced Based Data is essential to our Professionalism. And, that 
Professionalism is essential to our clients in order for them to trust us, so they 
can do what is necessary to breastfeed in many cases. 

Mary Jozwiak IBCLC, RLC, LLLL
Private Practice 

             ***********************************************

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