Re: best practice- much of private practice is slow to pick up what is new in academia. Maintenance of certification helps, of course, but I have been surprised by how easy it has been for me to fall out of touch with new practice bulletins a mere two years out of residency training. 

Additionally, I received virtually no training in breastfeeding as a resident, save the physiology of the lactating breast. I found a phenomenal ibclc after the birth of my son and it's there that I learned virtually everything I know about breastfeeding. 

I will also state that, from the standpoint of many of my colleagues, that there remains a perception that many breastfeeding advocates see *no* role for artificial milk. I am not saying this perception is accurate, just that it sometimes colors conversations and impedes setting common goals. 



Elizabeth Boggs, MD
Women Physician Associates
Columbia SC

(I don't even necessarily clip my c section patients, Gail!)



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