Great thread!  I think Rosemary's post about selection and confirmation bias is right on target.  Who talks to the doctor about BF at any age if everything is fine?  (Who is at the doctor's office if everything is fine?)

A while back I was contacted by the mother of a child between 6 and 12 months of age.  Somehow her doctor had become involved in her breastfeeding relationship, because the child had begun waking several times every night to nurse.  (She had recently begun working part time while her partner was taking his share of the child care leave so she was away for hours on end during the day, something I learned when I asked her whether anything had changed in the child's life recently.)  I am not clear on why the doctor was consulted; it seemed to have been incidental while they were in the office for some other reason.  The doctor's solution to this 'breastfeeding problem' was clearly informed by a biomedical view of All Things Corporeal: a prescription for bromocriptine to the mother.  The reasoning was that if the assumed reason for the awakenings was eliminated, the child would sleep through the night.  As though it was the presence of milk in her breasts causing the child to wake - quite amazing, really, sort of like the wandering uterus theory of mental disturbance in women.

I hope none of you will be surprised to learn that the mother was now facing having to prepare bottles of formula several times every night, since the nightly interruptions had only increased after she started the medication and dutifully refused the child's wish to nurse.  The child was now not only awake, but distraught as well.  The icing on the cake was that she was also suffering from rebound engorgement after completing a short course of bromocriptine. 

The reason she phoned me was to ask whether the child would be in any danger if she relented and let her nurse.  I was so pleased to be able to tell her it was fine, and for once I was glad the doctor hadn't kept up with current recommendations for pharmacological suppression of lactation, because if she had been given the first choice drug, cabergoline, it would have been much harder to salvage things.

This woman was no fool and she realized that the best thing she could do was go back to the way things were before the doctor got involved.  I also gave her the name and the ISBN for The No-Cry Sleep Solution and suggested she give it to the doctor for the practice's reference library when she finishes with it herself.

Doctors are who I go to about the kinds of ailments I trust they have expertise about.  Very few doctors are trained to treat problems with family dynamics, and probably even fewer are knowledgeable about breastfeeding AND family dynamics.  In Norwegian there is a saying: 'As you shout in the forest, you shall be answered.'  Corollary: if you want a valid answer, ask someone who knows something about the subject!

To Linda, about what might change this doctor's mind: probably nothing you could say, present, or refer to.  But you might be able to have a mutually fruitful conversation if you try to put yourself in the doc's position of only hearing about the cases in which there are also problems with family dynamics.  Simultaneity of two factors is not the same as causality.   When I was very small, I believed that wind was caused by trees waving their branches.  Being the observant sort, I noticed that every time the trees waved their branches, the wind blew, and the more they waved, the harder it blew.  I don't remember how I was convinced at the age of three or four that this was fallacious, but I have abandoned my original theory in favor of a more meteorological one.  In this example the two factors always occur together; in the case of BF beyond a year and disturbed family dynamics, they don't. but if you have never 'seen' normal family dynamics in the presence of normal breastfeeding, it's hard to believe it exists.

Rachel Myr
Kristiansand, Norway

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