I have tremendous sympathy for Kathleen Bruce's frustration when she wrote:

<< I have also seen many folks demand for research based practice before they
 change practice, protocols, etc.  These are the same people who have NO
 evidence to back up their own practice, but who stubbornly refuse to change
 their own practice, to update, etc.  The reason for this, I think, is that
 breastfeeding is a singular issue. It is a woman's issue that strikes deep
 to the bone. >>

Surely that is one reason.

But it is also true that for most humans, if you don't have a specific -- in
this case, research-driven -- reason for how you should be doing something,
intuition tells us to keep doing it the way it has always been done.

And what qualifies for each of us as "always been done" depends on what you
have seen.

Many of us on this list frequently post comments like "the species has been
doing this for thousands of years, and we shouldn't change unless we have a
good reason."

But for professionals like those NICU nurses  who have been taking care of
babies the same way for 20 years, their practice feels -- I'm not saying IS,
but to them it FEELS -- like that kind of default.

And again, we often post things like "Moms shouldn't accept authority
statements that clash with their mothering intuition unless they are solidly
supported (say, by the doc)."

But these nurses are in the same position as that mom -- they have built up
human intuition on a topic, and we are coming with authority statements to
challenge it -- and we are often not, in their view, a very important
authority, much less one to challenge their professional intuition!

I don't think we have to even reach macro-philosophical issues to explain the
slowness of progress.  People just don't change lightly, and I don't think we
really want them to.  They need their minds persuaded, and they need their
intuitions persuaded -- in either order.

My hat is off to the many on this list who are making a difference in
hospital environments (Hello Nancy Wight!  Hello Esther Grunis!  Hello, many
others!).
Your example and consistency and willingness to teach, one mom and baby and
nurse and doc at a time, is what will bring change -- indeed, brings change
every day.

Your fan, Elisheva Urbas
easy for me to be so patient -- I'm not working in a NICU!  The last time I
was actually in a hospital I was tearing out my hair...

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html