If you come to my office I'll ask if you're breastfeeding. If you are, I'll
tell you that's great, etc. "No wonder  you've had only one (or no) sick
visits".  If you said you did, I'll ask you how long and why you stopped. I
always say it was great they did what they did  whether it was a day a week
or a year. Often I end up telling moms that the reason they were told to
stop is not one I would use and that I would have suggested they continue
[that medicine was actually safe or they could have pumped or fed formula
just while they were away, etc]. Sometimes that makes them sad - but it's
the truth and they need to know for themselves if they are in that position
again or for their friends or sister-in-law or whoever.

If they didn't I say that's too bad or ask why they made that decision [oh,
I wanted to but I was going back to work]. Sometimes it gives me a chance to
tell them something about breastfeeding -you can pump or feed formula while
you're away and breastfeed while you're home. I also let them know what
supports will be available if they do have another baby.
***please note*** I did NOT say IF they should CHOOSE to breastfeed the next
baby.
During vomiting season when I ask I explain to them if you were
breastfeeding I would have you continue because that is best in that
situation - since you're using formula you'll need to switch to an oral
rehydration agent for a while.

I'm honest and sincere in what I say. I don't say it to be mean, just to let
people know where their health (or child's health)stands in the big picture.
They teach now in medical school how to give bad news. It is something
nobody likes to do. "I'm sorry to tell you that the xrays confirm that
Lauren's spinal cord has been broken....." or "The blood tests show that
Bobby has cancer...." These are things we don't like to say - they are not
things that can be "undone". They are situations that exist  and will affect
the child's health and healthcare. Not talking about it is not going to make
it go away. In fact, talking about it may help the next child by making the
mom more informed.

Funny  Story: I was seeing a school age child with a bad case of poison ivy
(he'd been camping) and I commented to the mom that he'd had hardly any sick
visits (the previous one had been a few years before, also for poison ivy).
She said yes Andrew had always been healthy, and so had his brother and
sisters. "You breastfed them, didn't you?" She was surprised, but she
beamed. Said they had each breastfed between 1-2 years. The medical student
was quite impressed because we had only looked a few years back in the
chart ---- I told her "It really does make a difference".

Gail S. Hertz, MD, IBCLC
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