I just felt I had to comment on this item:

> "However, residents and physicians who had themselves, or whose spouses
> had, breast-fed an infant were more likely to feel confident in
> assisting with breast-feeding initiation (residents: 73% vs 38%;
> practicing physicians: 80% vs 50%).

It's been a while since I read that article, but I believe that the
confidence these physicians expressed did not translate into actual better
knowledge or practice.  I believe that having breastfed personally (or
having a s.o. who breastfed your children), may increase your personal
experience with breastfeeding, consequently also your confidence, but it
probably does little to improve your chances of actually helping a mother
with a breastfeeding problem.

First of all, if the physician herself (or the male physician's s.o),
didn't experience the problem, they likely will not know how to deal with
it -- and they may even minimize it or deny that the mother is having that
particular problem.  Secondly, if the physician (or the male physician's
s.o) *had* experienced the problem, they either resolved it (not
necessarily in a standard-of-care way) or they didn't -- in which case
they may not be particularly supportive of the mother with the same
problem or may not believe that there's anything that can be done for her
beyond whatever they tried.

I don't believe that we do breastfeeding mothers a favor by expecting that
the only physicians who can help them are those who have breastfed or
whose spouses have breastfed.  In other medical areas, we don't expect the
physician to have experienced the condition their patient is experiencing.
Although it might help with some empathy if the doctor treating the person
with diabetes also happened to have diabetes, it's not necessarily the
case that he/she would be more empathetic, nor is it the case that a
doctor who doesn't have diabetes can't effectively help the patient.

What we *should* expect, IMHO, is that *all* physicians who deal with
mothers and babies be current on state-of-the-art lactation knowledge, and
be totally supportive advocates willing to either help mothers
themselves or find qualified help for them.  This is no different than
what we expect in all other fields of medicine.  Regards, Alicia Dermer,
MD, IBCLC, in Central New Jersey, USA.

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