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Subject:
From:
Rachel Myr <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Fri, 19 Jan 2007 14:30:42 +0100
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By acting as though they assume every mother will breastfeed, reinforced by
the complete absence of formula company props in their waiting rooms and
offices AND a pile of leaflets, cards or fridge magnets telling women where
they can get help with any problems they encounter.  In other words, by
treating BF as the norm and knowing their limits about how to deal with
practical problems along the way and who to refer to when it's out of their
domain.

Worst things a doc (or any other HCP) can do: Act as if breastfeeding
doesn't matter, and as if all problems that can arise are solvable with time
or 'plain common sense' without any solid evidence base, and if that doesn't
work, well, honey, I dunno, maybe you just weren't meant to breastfeed.

I had a query from a mother in another city whose intense nipple pain during
and after each feed, lasting for up to an hour each time, was treated by her
GP with syntocinon nasal spray, explained to her as 'nasal spray to help for
painful milk ejection'.  Her MER was already causing baby to choke and
sputter, esp as other features in this situation make me strongly suspect
tongue-tie, and the nasal spray added an overlay of afterpains to her
already challenging situation.  
Another mother was told by the health visitor (PHN) to put plain cow's milk
yogurt in her two week old baby's mouth for thrush, since mycostatin was
considered too risky for a baby that young.  Right, it isn't even absorbed
into the bloodstream!!  Same mother was advised to use cabbage leaf
poultices for her cracked nipples, by the same health visitor.  She had
sought help for her painful cracked nipples by visiting the well-child
centre three times in the baby's first month of life, no one ever observed a
feed nor WEIGHED THE BABY so when she came to our clinic in week four and
baby still had not regained birth weight, we had another whole set of
problems to deal with.  Heaven forbid I should inform any of these women
that there is more updated knowledge out there to be had, wouldn't want to
violate my IBLCE scope of practice, ha ha ha.

About Depo-provera - a lot of poor young mothers don't show for their
postpartum check.  How many of us would bother coming back if our
practitioners treated us as incompetent to even run our own lives by
injecting us with hormones we don't need before we've even gone home with
our babies?  The saddest part is, once they have had the injection, a lot of
women definitely don't come back, and many women find the irregular bleeding
of Depo-Provera so bothersome that they don't continue the treatment, so
they get pregnant again even sooner than they would have without it, and
just keeping on breastfeeding.  Anyone pointed that out to these
practitioners who misuse Depo-Provera this way?  

I had a boss at the student health service at U of Washington in the early
1980's who was an endocrinologist.  At the mere mention of Depo-Provera she
would nearly froth at the mouth and say 'it's GENOCIDE'.  There is something
to be said for people who aren't afraid to have opinions, I really miss
having a boss like that now :-)  

Rachel Myr
Off to work now, in Kristiansand, Norway

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