Jennifer, I don't think the order matters much if you know the doctor well,
or at least have a relationship....In this case, I guess I wanted to get the
doctor on board as a part of the team. I probably would've said it
differently if I'd called Hale first -- "I was worried about this combo of
meds and thought you might be too...." In a situation like yours, where the
docs had already said NO , I think I might call the doctor first and say
something like, "Ms So-and-So has talked to me about breastfeeding, and she
sure has a long list of meds. She is asking me about it even though you told
her no. I was thinking I might call blah blah just to see what the
interactions would be on this long list of meds. Do you have a particular
concern? I'll ask about that in particular...."

Moms are unpredictable. I've had women decide they're going to breastfeed
and the medical people be da===ed .Otherwise will stop breastfeeding because
they are going to take tylenol. Docs can feel very threatened by the
internet - their patients can look up things so easily, and many make their
own decisions based on that research. What if there truly were bad
interactions, but the mom had looked up each med on the Lactmed site and
decided it was okay? If the doc knows the situation, they can help with good
anticipatory guidance.

So much is in the way you present it. With the case you are talking
about,I'm just thinking it would be easier for me to be collegial ("We will
both learn something together") rather than boling mad if I called them
first. And I hate the powerless position of calling, getting a no, and then
going back to the mom to say, "Grrrr!"

Hope that makes sense.

Dawn Kersula in Vermont

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