Hello all,
 For those who don't know me I'm Gail Hertz, the pediatric resident (2nd
year as of today) who wrote the little green breastfeeding book and my
disclaimer is that I own pocket publications. Now, I have several thoughts
to share with you - feel free to email me privately at [log in to unmask]
or address your answers through Lactnet.

I relation to the emails of the past day or so regarding MDs  and those
from earlier in June about who's an LC and how should they get there...  I
would like to point out that nothing builds cohesiveness in a group like a
"common enemy".  And that is how MDs/DOs are generally dealt with on
Lactnet. (I know, I know.... we DO like Dr. Jack and Dr. Rob...)

But think about it... How would you feel about learning more about BF if
people who know a lot about it treat your attempts to deal with BF issues
with disfavor or outright hostility?  Isn't Lactnet a wonderful place to
explore issues and discuss the success (and failure) of certain approaches
to BF situations?  Would you maintain a Lactnet subscription if the "Target
du jour" was a group that you had spent  11 (or more) post high school
years of hard work to become a part of???

Let's address a myth: Doctors are taught about BF in med school/
residency...... Often not, actually. Formal teaching is often out of
textbooks that deal with physiology and nothing more.  It is often taught
by  someone who doesn't have a well rounded experience with BF, or is "old
wisdom" that has been "passed down" from physician to physician.

So what can you do about it?  Offer to teach -- a lunch time lecture, a
grand rounds,  a med student lecture or workshop.  Provide good resources.
Make a concise hand out available for attendees - if its simple it will get
used-- if it's complex it will go on someone's article pile and get buried.
  Find an organization that would donate a copy of one of the top BF books
to a resident's library,  apply for a small grant (yes it takes some work,
but an organization that gives out thousands of dollars will probably be
quite willing to give  $250 for a project that will positively impact so
many important situations).

Unwritten myth #2: BF is the one thing that THE SPECIALIST [LC in our case]
does "right" that the generalist "can't seem to do right".  Got news for
you... it seems EVERY specialist [ENT, rheumatology, surgery, pulmonary,
etc..] has a different perspective on how their particular problem SHOULD
be handled.  Often there's more than one RIGHT way to do something, even if
it's not the right way you would choose.

So what can you do about this?  Become a resource instead of an adversary.
Specialists that act as resources get phone calls and get LISTENED TO.
Adversaries get an argument.  So how do you get to be  a resource?  Be
professional - don't "bad mouth" anyone you want a referral from -- word
gets back to them believe it or not. [You wouldn't refer a patient to
someone that said YOU were an idiot who didn't know what you were doing!]

Communicate positive things, even in situations where you don't agree with
the plan, " Dr. Jones, it was  wonderful of you to take the time to work
with Mrs. Smith on her breastfeeding issue, she speaks very highly of you.
She shared something with me that made me think that XYZ may work quite
well for her even though you had tentatively discussed weaning completely.
Shall I help her to XYZ and share my follow up with you?  I have some
references available that may not be in your current file.  I can mail them
to you or fax them - which would you prefer? By the way , if you're a
computer person, you'd enjoy web sites A,B&C as well as Lactnet, it's a
professional..... blah blah blah... I'll include them with the papers I
send you. THANK YOU FOR TAKING THE TIME TO SPEAK WITH ME. I look forward to
speaking with you in the future."

There have been several great posts with what to say to patients in
situations and I won't repeat them - except to say that the people that
posted them sound like the kinds of specialists I would trust to send
patients to.

Let's keep Lactnet a useful tool to help in educating MDs - it's a
wonderful resource for communication with experts from all over - it would
be a shame to reduce it to an avenue for "target practice".

Thanks for the soapbox time.
Dr. Gail [pediatric resident, mom of 5 yo who breastfed 2+ years,  who
pumped for 18 months, and who will sit for IBCLC this month]