Hi there Jennifer. I find your description very accurate from what I
know from my own physician friends.  You describe an upper echelon of
physician managers who have control over the management of breastfeeding
and related difficiulties, who have the power to persuade or dissuade
mothers who are having difficulties, and varying degrees of knowledge,
ranging from nothing to extensive, re: BF. This wide variety of
experience and knowledge spans all specialties. What does not is the
disdain that you so aptly describe, and if there are those on the list
who have an edge in their "voice" when discussing this subject, it is
because they have been knocking their heads against the walls for years,
dealing with mothers crying in their offices, and with no power to
overcome the problems without physician support.  It is admittedly
difficult to be on the receiving end of this disdain, I believe.



It is interesting to try and feel what it would be like as a physician,
with the pressures of the job, pressures of family life, and the
constant reminder that if you did not breastfeeding, you will have to
contradict your own parenting practices every day if you fully support
breastfeeding. Not an easy task.



Luckily, disdain and related attitudes are not ubiquitous.  There are
many professionals in all walks of life who are ready and willing to
learn, to work together to help mothers and babies remain happy and
healthy through breastfeeding. I feel honored to be part of a calm and
respectful discussion on this subject, and I thank you for your candid
response, and I also thank the other physicians on this list for
participating in this somewhat difficult discussion.  Good luck with
your baby!



Warmly, Kathleen



Kathleen Bruce RN IBCLC
Listowner Lactnet listserv
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Archives: http://peach.ease.lsoft.com/archives/lactnet.html





Just had to add my own 2 cents about doctors knowledge and support of
breastfeeding.  I have to agree with Nancy Wight, that many docs really
don't know much, if anything about breastfeeding.  My medical school
offered more than most, and that amounted to, I think, 1 day with the
lactation consultant seeing patients.  I did have the benefit of
spending 1 week in regular nursery with Dr. Larry Gartner, also, but
that was by random chance.  There was no review of the literature on
infant feeding ever offered.  The little time we spent in peds on infant
feeding was focused on how many calories and ccs of fluid per kilo
little preemies need, not on any kind of discussion of the merits of
breastmilk.  Sometimes there'd be a token statement on how "of course,
breast is best, but . . ."  One of my classmates in medical school, who
suddenly realized I was nursing my baby right there in front of God and
everybody actually exclaimed "I didn't know people still did that
anymore!" and he really meant that he didn't know breastfeeding was
still practiced at all.  And usually, no one ever realized I was nursing
my daughter in class, or at social events, because they had so little
experience they didn't even recognize that generally babies probably
wouldn't tolerate being held face-flat against your chest!  They just
assumed that's how I carried her around. Most of my colleagues know
zilch about breastfeeding and have truly internalized the idea that
formula feeding is the norm.  Exclusive breastfeeding may have benefits
and be somehow "ideal," but is viewed like many "ideals" as being pretty
much unobtainable.  Add to this a general feeling of disdain for
non-physician health care providers (nurses, physical therapists,
lactation consultants, dieticians, etc.) that many physicians seem to
feel and you have someone with a lot of power in the medical field with
very little knowledge, and often very little willingness to defer to
someone who does.  I'm not sure where this disdain comes from, or if
Many of us who become physicians, also, are pretty compulsive people.
When we have our own babies, we often have tremendous time pressures,
coupled with a personality that may make it difficult to relax into the
normal breastfeeding relationship (having the driving need to schedule
and control our lives.)  I have met in my short career thus far only 1
other woman physician who nursed her kids as long as I did (and I think
mine all weaned fairly early at 15-20 mos.)  Many others "tried" for a
few months, and I've met quite a few who just took the formula rep up on
their offer to supply them with the stuff.  It must be hard to truly
support something you weren't able to do yourself.  Or at least, it's
easy to offer formula as a way out for any problem, if that's how your
own kids were fed.  Of course, maybe my experience is unique and there's
lots of breastfeeding physicians out there! Anyway, in my experience
there's not so much a conspiracy, as there is just a strong formula
feeding culture, as there is in so many other areas of our society.
Jennifer Tieman Family Physician Mom to 3, and new baby #4 expected
5/31/03




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