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Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 21 Dec 1998 14:07:46 -0600
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Carol says:

>but a lot of doctors should know at least as much as we do about
>lactation because nutrition is THE basic platform to support everything else.

And I say a Pediatrician should know at least as much as a couple of
first-time parents.

I just returned from a home visit.  Baby is 3 days old, slightly jaundiced,
well hydrated, already cleared his meconium, feeding like a pro, and mom
has no sore nipples, mature milk came in this morning with full breasts but
without engorgement.  Why was I there?, you are wondering.  They went to
the Ped for reassurance that all is well.  Baby weighed 6# 8 oz at birth
and today weighed 6#2.  That is a 5% drop in weight.

Mother asked about some peeling of lips and doctor said, "Yes, he is a
little dehydrated. I'm all for breastfeeding, but you should give him
formula after every feeding for the next 3 days, because he hasn't had much
to eat for his first 3 days."  She was also to feed no longer than 5
minutes a side because he gets all of the milk in that time; anthing longer
is just pacifying.  They were to take him to the hospital lab for blood
work because he looks a little jaundiced.

These first-time parents had done some reading and thought that all that
the Ped said sounded "weird." I know that doctors are busy, but it
shouldn't take them much longer than a couple of expectant parents to read
up on feeding a baby. And I consider the nourishment of an infant to be of
major importance in the work of a pediatrician.  Proper nourishment goes a
long way toward *preventing* those more exciting illnesses that this guy
stayed awake for in med school.

I do spend [my] entire "professional" career on breastmilk, breastfeeding &
consulting about lactation issues, but these parents don't, and this
morning they knew much more about the normal working of lactation and the
general well-being of their baby than did the "health" care professional
whom they consulted. They decided that if he knew so little about basic
breastfeeding they couldn't trust him if something was wrong. They are
finding a new Ped.

As Andrew said, this physician has to manage the "whole" patient with a
zillion other concerns, worries & "what-if's". But, unfortunately, parents
with *well* babies bring their babies to him and if they follow his orders,
they will join the ranks of "concerns, worries & 'what-if's.'" Is he really
prepared to handle those things? If a Ped wants to spend his time and study
on the crisis stuff, then let him go into the specialty that interests him,
and give over the well baby work to someone to whom a 3-day-old who is
doing GREAT is a most exciting part of his/her day.

This visit surely made *my* day.  I wanted to see the baby feed (Ped
didn't); and to hear the gorgeous swallows and gulping in perfect rhythm,
and then to see that glow of satisfaction after he came of--this is what
infant health is about.

And this doctor has been around for a while--about 8 years.  Surely in that
time he could have educated himself on, at least, the basics of normal
breastfeeding. I can't excuse him by saying that infant feeding just
doesn't peak his interest.

Yes, I find myself rather insensitive to this poor guy's plight, and quite
critical of his ignorance, and, what to him would sound, "know-it-allish."
It wouldn't take much. By comparison, these 25-year-olds sound that way too.

It would be nice if he were rare.

Patricia Gima, IBCLC
Milwaukee, Wisconsin, USA
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