Dear Lactnetters:

I understand that frustration has reached a high point on Lactnet recently
with the lack of physician knowledge of lactation management.  This is an
unofficial post, but I share your frustration and want to offer some
thoughts.  In fact, that frustration and desire to "make a difference" for
other women is what has fueled my energy to represent ILCA in public affairs
for the past several years.  Let me tell you of some of the progress "at the
top" and of some suggestions for more grassroots work that might capture some
of the fire of YOUR energy for change, too.  (In fact, I know you all are
doing a lot already!)

Beginnings of change:  The AAP since 1990 has faithfully acted at the
Breastfeeding Promotion Consortium at USDA to encourage progress in all
professions to learn and incorporate good breastfeeding information.  Their
representative worked with me as cochair of a Health Professional sub
committee which began work on suggested consistent lactation management
messages for mothers.  The physicians who know and care most about
breastfeeding formed the Academy of Breastfeeding Medicine to try to fill the
gap in physician education.  The AAP formed a special committee on
breastfeeding which has produced a bold statement that is working its way
throught the system for publication.  Dr. Gary Freed has published research
showing the need for further education.  Wellstart International continues to
offer opportunities and curricula for physican education.  BestStart is
developing a kit for health care professionals to go with their FCS sponsored
Promotion Campaign.  These examples are those that come to mind
spontaneously.

As you know, breastfeeding is not high tech or high dollar.  It is labor
intensive and interpersonal.  The cost of NOT breastfeeding has been hidden
until very recetnly.  So really the progress is pretty amazing.  In fact, I
unashamedly beg your support of ILCA's representation at public fora that
encourage these efforts.  Please renew or initiate your membership in ILCA.
 Supporting this kind of representation is part of what your dues go for.
 Speaking for thousand of lactation consultants carries an impact.  (By the
way,  the ILCA Board has made a remarkable recovery from last year:  the
conference was very successful, expenses have been slashed, the new
management company is a delight to work with, and there is a CPA/IBCLC
overseeing all the finances now.  You can be confident in your support of
ILCA.)

Anyway, besides supporting your professional organization, what about some
other ideas for all that energy:  How about a goal of 10%  that is, just 10%
of the physicians in our local area of practice to have basic knowledge and
skills?  AAP has a state coordinator of breastfeeding in each state now.
 Many of them attended a conferrence last April.  Maybe get something going,
such as a joint presentation at chapter meeting with and MD/LC team.  (NABA
has an up to date list of breastfeeding contacts state by state.)  Choosing a
goal or activity that is "do-able"...that is, going through the doors that
are ajar, instead of smashing into the ones that are slammed... easiesr on
the cranium!  What about calling together a task force with multiple
professional representation to decide on the consistent management messages
for mothers in your commuinity and then publish and distribute them.  What
else?

If anyone has had some success with building physician referrals (mutual) or
offering physician information or if any of the physicians on Lactnet could
share some ideas of how to better approach this frustrating situation ...
please post.  I heard that 75% of new pediatric residents are women now.  One
of them is my god-daughter who grew up in a "breastfeeding culture" of LLL
Leader families.  She doesn't even knkow how much she knows.  There is hope.
 While we are waiting ... what can we do?

Nancy Schweers
ILCA Consultant for Public Affairs