Dear Friends:
    I have already done a talk to physicians about medical reasons for 
supplementing the breastfed neonate, and I am preparing one on diabetes and 
breastfeeding. As a nurse (in my day, student nurses stood up, let the docs enter the 
elevator first, gave them the chart we were working on, gave them the chair 
etc. etc.), I was nervous about speaking to physicians. I also hold some rancor 
in my heart for how physicians can sabotage breastfeeding.
    After listening to Carol Melcher's talk (on CD) from last year's ILCA 
conference, and after a consultation with Molly Kellogg, a registered 
dietician/licensed social worker that specializes now in how to educate, I changed my 
approach.
    Instead of trying to teach physicians the important details about 
breastfeeding, why not teach them what to do? The majority of them can't learn enough 
about breastfeeding to help mothers directly. They can:
    1) recognize that there is a breastfeeding problem
    2) know where to make a referral in the community
    3) encourage mom to see that lactation helper
    4) keep the milk flowing until the mother sees the helper
    5) know where the closest milk bank is and use it

    I wonder if we, in our zeal and because we share similar medical-style 
training, have overwhelmed physicians with expectations that they should know 
enough about breastfeeding to take care of basic problems. Maybe they don't want 
to, or can't learn enough about all the sub-specialities that are part of 
their practice because they are too busy?

    I wonder if pediatricians have a hard time with breastfeeding because 
their work is about the baby, and breastfeeding includes the mother. 

    In talking about medical supplementation I covered the ABM protocols that 
were relevant (and gave them as handouts). I showed how to get milk (using 
the Danish CD-ROM) from a postpartum woman (s2s first, then hand express.) I 
showed pictures of ways to feed babies (spoon, syringe, cup, and finger feeding), 
saying that one reason to use an alternative feeding method is to tell the 
mother/parents that breastfeeding is important. I told where to find donor milk. 
I showed the processing of donor milk, how it is the safest substance we can 
use from anyone else. I showed pictures of the machines used to process human 
milk and gave them all a resource guide to find local help.

    This presentation received excellent feedback, both from the participants 
and from a pediatrician/IBCLC that communicated privately with me afterwards.

   warmly,

    

Nikki Lee RN, MS, Mother of 2, IBCLC, CCE, CIMI

www.breastfeedingalwaysbest.com

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