Dear Kim,

You asked a very good question about why obs will give meds by the car load
before the baby's born and not give the same meds after.  I worked with a
wonderful group of obs when I started as an LC.  One of the doctors I respected
a lot gave a mother  an antibiotic and told her to pump and dump.  As a new LC I
was a little anxious to go against a doctor but I decided it is now or never.  I
went right up to him and started telling him that this med was not counter
indicated for breastfeeding.  He said "I know but if I tell her to breastfeed
then I would be indirectly prescribing for the infant and I can not legally do
that.  We compromised and he told each mother to  talk to her ped. and to talk
to me.  So before  the baby is born, it is still the ob's patient.  When he is
born, he/she is no longer the ob's responsibility.  In fact the baby is a
liability.  The sad thing is that the group had to dissolve because it was going
to have to pay 1/2 million for malpractice insurance a year.  The 2 best doctors
went into GIFT and no longer deliver.  A sad day for women  in Tacoma.

Pumping
Dear Jon,

The health department here has an open door policy about bringing children to
work.  The head  has a disabled child who comes to work often.  I will talk to
the LC  in the department when  she gets back.  The thing I find is that mothers
and sometimes LCs get caught up in the MILK and not the breastfeeding.  Remind
her that her overall breastfeeding is more important then one bottle.  It sounds
like double pumping is better then running for a quickie.  She might not be
letting down well because of the rush.  As I mentioned a  few weeks ago, I had
an ER doctor get so good at propping the 2 bottles, she could chart as well.

My 3rd child had surgery and was allowed nothing but breast milk for 2 months
while her gut took a rest.  During that time I was able to break a lot of rules
about where babies could be and where they couldn't be.  It is possible she
could make a good case  for the allergy problem.  Good luck

Diane Herforth, BAE, IBCLC, ICCE
Tacoma, WA