Hi Sharon
It is hard to understand the decisions that other people make.  The mother
you describe declared that her meds were non-negotiable.  These are the
challenges clinicians face.  For this mother the misery caused by untreated
rhinitis made treatment non-negotiable. (I have some sympathy - a foggy head
makes for a very unpleasant Mummy!)  Here we might support this mother by
asking her whether she would consider trying a different treatment regime
that would be less likely to affect her capacity for milk synthesis.
(Psuedoephedrine is not the most effective treatment anyway - wonder if she
had developed a dependency that she wasn't willing to disclose???) Topical
corticosteroids, nonsedating antihistamines ... Just goes to show that LCs
have to have a very very wide knowledge base, I guess.  I suspct that if the
mother feels heard, that she feels that her Lc understands her need to be
free of 'fog-head' then she is more likely to feel that they are working
together for the same outcome.  Maybe this is one of those mothers for whom
success is defined as some breastfeeding or exclusive breastfeeding for a
time. Sometimes (well often really) when I see medical professionals, I
don't feel that they are working with me towards the same goal. (The
surgeon's goal seems to be to remove the tonsils and solve the immediate
problem.  My goal is to optimise the *overall* health and wellbeing of my
child.  Surgery my facilitate that but on balance, it may not.)  My personal
value-system might be as horrified as yours but my professional value system
has to prioritise support for the mother's own (informed - and I will tell
her about the possible ramifications of her options) choice.  
Cheers
Nina Berry BA/Bed(Hons) Dip Arts(Phil)
Breastfeeding Counsellor
PhD Candidate - "Ethical Issues in the marketing of 'Toddler Milks'"

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