>I need some references, please.  There is an OB/GYN practice in the small =
>town where I practice, all relatively young physicians and a nurse =
>practitioner who has practiced for 20 years.  They tell moms that they =
>MUST stop breastfeeding when they become pregnant - no matter how old the =
>nursling is - and how the pregnancy is progressing, I wrote a very nice =
>letter to them suggesting that recent research shows that nursing during =
>pregnancy is OK and included a Ruth Lawrence reference.=20
>I just received a letter back stating they definately tell moms to stop =
>breastfeeding during pregnancy and plan to continue that advice.

Well, OK, so write another very nice letter back saying that you definitely
tell moms that it is THE PARENTS decision on whether to stop breastfeeding
during pregnancy or to continue breastfeeding, and that in order for parents
to make INFORMED DECISIONS they (the parents) need to know on what basis the
doctors are recommending they wean, and what the possible risks are if they
do not wean.  They are welcome to continue their advice -- we pay them the
big bucks for their advice, but we expect it to be backed up by research or
significant clinical experience.  You can point out that many mothers in the
United States have successfully breastfed throughout pregnancy and then
tandem nursed, and that if there *are* certain circumstances that would make
continued lactation risky for either the fetus or the mother, they need to
be clearly delineated so that parents can make informed decisions.  I'm
thinking here, for instance, of a mother who has had several miscarriages
due to very premature labor or problems with her cervix (such that
breastfeeding in the latter stages of the next pregnancy might trigger
premature labor), or a mother who is anorexic and not eating enough even for
herself and the fetus, let alone the toddler.

Just be very polite and ask for their references, all in the name of what
everyone (hopefully) wants -- good outcomes for mother and babies, informed
choice for the parents.

Kathy Dettwyler

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