Mira -- Given that you have been asked to speak about bf problems, your
challenge is to avoid giving the impression that all bf is fraught with
problems and therefore likely to fail at any time.    A lecture whose
structure is "What are the problems that make bf difficult or dangerous?" is
likely to send its hearers home remembering mainly that there a lot of
problems with breastfeeding!   This is especially true if you start with

One alternative route is to start with problems whose main danger is simply
that they undermine the bf itself -- especially things that "we" (eg
physicians) do, even need to do, that undermine supply.   Thrush is a biggie
here, I guess.    It might be eyeopening to remind physicians that thrush
resulting from antibiotic treatment is iatrogenic, not some natural difficulty
of bf -- and that just like they had a hand in causing it, they can help
alleviate it by prescribing diflucan etc etc so that *bf is not undermined.*

Similarly, the need to supplement is itself a bf problem -- often that need is
extremely temporary but it undermines supply, or causes nipple-preference
problems, or undermines maternal confidence -- so that your previously
healthily bf baby is now artificially fed and therefore subject to all the
ills that formula is heir to.

And of course the *false* need to supplement -- for physiologic jaundice, or
because "you can't bf while on antibiotics", or "just until your milk comes
in" etc -- is a *major* bf problem, caused mainly by health care providers --
with the best and easiest solution of all: know more, intervene less.    This
is true even for babies who are maybe more "medically interesting" -- cardiac
babies of whom the research now shows that they oxygenate better at the breast
than with the bottle, premies in the NICU who get less NEC with their mothers
milk, etc.

Having dealt with all those *typical* "environmentally cause" bf problems, you
could then, of course, turn to the *much rarer* problems that are caused by
mom's anatomy or baby's, and how docs can help keep babies getting optimal
nutrition even in those unusual cases.

Good luck Mira -- you are fighting the good fight!
(PS where is kibbutz hamaapil -- on the water I'm guessing?)

Elisheva Urbas
NYC