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From:
Gail Hertz <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 30 Apr 2013 00:37:31 -0400
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I thought I would be able to let this post go without comment, but now I can't resist. Thanks for the good word on the Little Green Book, Cathy. That was the reason I wrote the book in the first place. There isn't enough time to teach everything that someone needs to know. When I teach medstudents I have 45 minutes. I asked myself WHAT if I could only get them to learn one thing DO I WANT them to take away. I decided, based on the things that I see done incorrectly by health care professionals that I want them to learn how milk supply works. I start with breasts make the milk you take out of them, talk about free, unlimited access to the breast, what happens when you use up baby's appetite with formula (milk gets left in the breast), why this occurs (formula gift bags, lack of anticipatory guidance with moms) and how to help moms avoid this. I talk about stomach capacity (with marbles), colostrum, lactogenesis II, naked baby weights, the rule of fours (poop) and oversupply.

I've found most people know Breastfeeding is good, so I don't waste my time on that (right or wrong, that's what I do). The students and residents I deal with want practical stuff: how can I tell if baby's getting enough? How do I tell if mom is making enough? What does mom need for anticipatory guidance? How do I know why mom has sore nipples? Where can I find out if a medication is ok for mom to take? That sort of thing. Then I teach them how to teach RPS, give them a little green book for reference and send them on their way. It's not a lot of time but we cover a lot of important territory.

Gail Hertz
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On Apr 29, 2013, at 9:35 PM, "Catherine Watson Genna BS, IBCLC" <[log in to unmask]> wrote:

> I'd talk about the health importance of breastfeeding for a few minutes to motivate them to care. Alison Steube's articles are great reviews to cite for them.
> Then, I'd tell them that recommending that moms bf is powerful - that mothers who felt their doctors were positive about bf were more likely to bf and be successful. (Have an answer prepared about guilt, they will ask!)
> Then I'd talk briefly about helping mom get started- how important the first feeding is (baby self-latching, that it takes drugged babies twice as long (Widstrom and Bystrova's studies), how many bfs in the first few days calibrates the milk supply, that bf should not hurt, and where to get basic information (Gail Hertz's little green book is a great resource to point them to).
> Normal feeding management (how mother and baby co-construct feeding patterns based on mother's storage capacity and baby's growth needs), how to find good information on medications and bf (LactMed and InfantRisk), and how to refer to an IBCLC when there are problems. I think they need to know that milk production can be increased, moms can supplement at the breast and with their own pumped milk, and that nipple injury and engorgement require quick care to avoid poor outcomes. Sneak in a little about tt if you can.
> 
> I know this is ambitious, but docs are used to fast info dumps. G
> 
> Catherine Watson Genna BS, IBCLC  NYC  cwgenna.com
> 
> On 4/29/2013 8:50 PM, Peg Merrill wrote:
>> I have been asked to talk to a group of residents at a local hospital in
>> May  Only have 45 minutes.  Looking for suggestions as to what to talk
>> about.  The women who called me is a GP residents currently nursing her
>> second baby and knows that she learned nothing about breastfeeding in
>> medical school.
>> what would you think would be most important to cover?
>> Peg Merrill
>> 
> 
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