--
Suzanne Berman, M.D., FAAP
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Plateau Pediatrics
49 Cleveland Street, Suite 210
Crossville, TN 38555
(931) 707 8700 voice
(931) 456 0802 fax
(931) 484 9511 after hours




I agree, those statements are *not* in compliance with AAP subcommittee
standards!

However, pediatricians taking exception to certain AAP statements isn't
uncommon. You might be surprised to know that some of Dr. Sears' columns in
Parents magazine have made statements that go against AAP guidelines -- in
particular, about appropriate antibiotic use for viral illnesses.  While
certainly not as famous as either Dr. Natterson or Dr. Sears, I myself disagree
with some AAP statements that have been issued in the past few years.

What surprises me is that such a recently trained pediatrician (she graduated
med school in 1997) isn't more pro-breastfeeding.  Residency programs in the
past few years have done a lot more in terms of having residents round with
IBCLCs, breastfeeding education, etc.

I wonder (and truly, I mean this non-judgmentally) if Dr. Natterson herself
attempted to breastfeed, and had a dissatisfying experience.  Unfortunately,
many physicians tend to roll their own experiences into practice instead of
relying on evidence based medicine.  As Dr. Horn at UT Memphis says, "The
plural of anecdote is not data."

The first five days of breastfeeding my son were miserable.  He lost 1#9! (so
much for 10-12%!) If I had quit then, as I was tempted to, I would probably
have had the same thing to say.  BUT the lovely and talented Betty Rose of
Cookeville, RN, IBCLC, helped us out so much that the little guy is now a
sturdy nursling of 17mo.

What really crystallized the breast vs bottle issue for me was a statement at
the 2003 national AAP conference where a seminar was led by -- nuts, can't
remember their names -- husband and wife team, really phenomenal couple; he's a
FAAP, she's an IBCLC.  They stated (wish I could get this exactly right...)
"Breast and bottle feeding are about as equal as parents smoking vs not smoking
at all."

And that really drove it home for me, because I have so many bad asthmatic kids
whose parents are nicotine addicted.  They justify it by saying "But I only
smoke a few per day," or "But I only smoke outside," but of course it still
comes in on their clothes, hair, etc.
Smoking outside is better than smoking inside, but comparing either one of
those
with not smoking at all -- well, there's really no comparison.

If you are dealing with resistant peds, I would suggest taking this tack, as it
totally opened my eyes!

Suzanne

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