Hello all,

I would like your input about what you think a lecture about BF for doctors
or medical students should include.

On the one hand, it might be insulting to talk about the health benefits of
BF, (they're supposed to know), but by the way many doctors tell mothers to
stop bf for completely wrong reasons - maybe they don't...

Should I talk about positioning and latch on, or will they think this is
"nurses' stuff"? Do you think a doctor can deal with positioning and latch,
knowing the time constraints most doctors face (have you heard about "The 6
minute interview?").

This last week I had two calls from women with mastitis who were told to
stop bf, and given Amoxycillin - both wrong advice, and a mother with a
baby with breastmilk jaundice at 1 week, and another at one month, both
healthy babies, who were told to stop nursing for 48 hours. (All different
doctors).

These are definitely topics for doctors, but will they want to hear? If I
give a lecture on BF, probably only doctors interested in BF will come, and
they probably know the right management for the above problems (or maybe
I'm wrong to assume this?).

One of the hospitals in my area where many women give birth, routinely
advises to stop bf for 48 hours with jaundice of >14 after 5 days of age,
with a healthy, thriving baby. If the mother comes to me before doing this,
I can usually tell her not to, and just nurse frequently, (after being sure
that the baby nurses effectively). Sometimes the new mother is so worried
and confused that she won't dare not to do what she was told by the
neonatologist.

How do you think I could approach this neonatology dept? They would
probably be offended if a community doctor like me tries to teach them.
They have probably read about neonatal jaundice more than me, and decided
that the fastest and simplest way to get the bilirubin down is cessation of
bf (which is true, but why is the value of bilirubin so important?) It
seems they don't care the mother has engorgement, might get mastitis, and
of course all the complications for the baby of getting ABM and bottlefed.

I would love to hear your opinions on this, and especialy the MDs among you
- how do you deal with definitely wrong advice concerning bf management by
other doctors. Do you just tell the mother your opinion? Do you try to
teach the doctor who you think was wrong? Is there a point in trying to
organize lectures on bf for doctors, or would this result in preaching to
the converted? What topics do you think appropriate for lectures for doctors?

Sorry for this being so long. I have been thinking about this for quite a
while. I started by asking about lectures for doctors, but what I really
mean is how to educate doctors about bf.

Thanks,

Mira Leibovich, MD
Family Medicine Specialist
Israel