As a LLLL and nothing more at this point (except that I have plans to
become an IBCLC when my kids are older... long way off at this point) I
often feel frustrated because it seems that lately I get a lot of calls
and e-mails from mothers who have been told something so completely
off-the-wall by an HCP that I want to scream!  Some are more difficult to
deal with, but with the straightforward ones like "your baby needs iron
supplements becuase breastmilk doesn't contain enough" (without having
actually tested the baby's levels) or issues involving mom taking
medications, I have always offered to photocopy pages out of THE
BREASTFEEDING ANSWER BOOK that reference medical literature, and in the
case of medications, we have photocopied relevant parts of Hale's (along
with the cover, publication information, and page of the risk level
explanations) and the AAP list for the *mother* to give to her HCP.

Any honest provider should want to be current, and should want to
practice "evidence-based" medicine, and should want to know all the
information about a given subject before carelessly suggesting things
like weaning or other things that would disrupt or undermine
breastfeeding.  Even though I know some HCPs might be offended by a
mother brining in references, other than finding a whole new provider
which is not always possible and which may not change the situation,
letting the HCP know about the sources that are out there for
breastfeeding information seems to be the only option in many cases.  In
fact, it seems that most HCPs aren't aware at all about what sources of
information are out there about breastfeeding and can only benefit from
knowing-- as it seems, at least to me, that most haven't even heard of
the BAB or Breastfeeding: A Guide for the Medical Profession or the JHL
or Hale's or even the AAP list of medications.  Just letting them know
that these sources of information exist can be very beneficial.

Which brings me to another issue that has been burning a hole in my
brain.  Why is extreme ignorance of breastfeeding tolerated in the
medical profession, and particularly among pediatricians and others who
work with infants?  In calls I have received, my personal experience
bouncing from pediatrician to pediatrician for my own children after
having breastfeeding-related "issues" with them, not to mention in things
I have read here on LN, I have heard insane things coming out of the
mouths of HCPs--pediatricians, OB/GYNs, hospital nurses, and even
midwives.  How can we demand that doctors get better educated about
breastfeeding?  What are they learning in medical school?  Can we change
it?  Should I bother writing a letter to the AAP, just as a concerned
mother, asking why the AAP has not come out with a firm statement that
all HCPs who deal with infants need to be properly educated in
breastfeeding physiology and management and here's how to do it?

Something is really wrong with this picture when a mother gets bad
breastfeeding advice from her pediatrician and then *I* get the fallout
from it weeks later.  A typical scenario is this:  mother of 1-week-old
has sore and bleeding nipples, HCP tells her to "pump and give it to the
baby in a bottle for a few weeks until your nipples have healed".  Mom
does this not knowing she won't be able to latch that baby back on in a
few weeks, then can't get baby back on breast at age of 4 weeks and calls
me for advice after she told her WIC counselor what happened and the WIC
counselor gave her my number.  Now mother has a hard road ahead of her.
Fortunately in our area we have an excellent clinic of IBCLCs who are
free that I can refer such mothers to, but that doesn't take away the
fact that she has to drive there probably multiple times, do the hard
work of getting the baby back on the breast, and in places where there is
no free clinic, I would be hesitant as many of the mothers who call are
low-income.

Any comments?

Tasneem Jennifer Crooker
LLL Leader in Norman, OK


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