Molly
I feel your pain and frustration. I've been doing this for 25 yrs and it's
not getting any better. So if you want to stay in this field, I'll be direct
- get used to it, at least for the near future.  That said, there's ways to
cope and you ARE MAKING A DIFFERENCE.
Here are some ways to cope with "the sacrifice of breastfeeding on the altar
of ignorance."
1. Find a way to look for and say something positive about the situation
before giving the correct information. This will calm you down a bit.  For
example [She was told that the formula concentration would
give the baby more calories. The baby was 1 oz below birth weight (at 2 wks)
] in this situation you could say "it seems like your doctor was really
worried about the baby not being back to birthweight at 2 wks. I would be
worried too. One way to fix that would be to give the baby a known amount of
formula with a known calorie value to get the weight on. That's what your
doctor did. This doesn't get to the reason that the baby wasn't gaining, and
it sacrifices breastfeeding, which is so important to your baby's health in
the long run." You then launch into your exploration of what is going on.
2. Take each situation and dig for further info on it - like the one giving
formula "to flush out the bilirubin." If you've done alot of reading about
jaundice and hyperbilirubinemia, which is a pretty complicated subject if
you ask me, you then understand why a doctor might want to do that, and you
can better explain to a mom why her doctor would advise this, but why there
are other better options. In the process you are becoming a real expert on
all things lactation and neonatal. Make a good resource file so you can get
the info at your fingertips for your refreshing and to show moms.
3. Fight in any way you can against formula marketing, becoz this is where
alot of this garbage-info is coming from.
4. Include some of these common misinformation scenarios in your support
groups pre-emptively. Let moms know that they will hear some of this stuff.
Prepare them in advance.
5. Have a prenatal support group if you don't already, or at least encourage
pregnant moms to come too. Let them hear the above info and warnings. Have
some good pediatricians or family practice docs or NPs in mind to recommend.
6. Get the latest recommendations from several good sources, like AAP, ADA
to have on hand to counteract these crazy recommendations like giving a 2 wk
old cereal.
7. Do some of the math with the moms like giving neosure (it's a 22 cal/oz
formula, right?) 2x per day (at a 2 oz feeding) is about 8 extra calories a
day! That should make a big difference! Let her know her baby needs
something like 260 cals/day, so 8 extra is a drop in the bucket!
8. If yoiu have some local LCs or nurses to vent to, do it. Go to lunch or
coffee, or for an ice cream together.
9. Provide education wherever you can - newspaper, radio, CE presentations,
task forces, etc. Be a mentor.
10. Stay on lactnet. It really helps.
Laurie Wheeler, RN, MN, IBCLC
MISSISSIPPI USA

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