My youngest was sick yesterday and I took her to see my local ped.  I live in
a small, rural area.  There are two peds in the local medical group  of 12
physicians (to which my husband, a gastroenterologist, also belongs).  I have
lived here for eight years and have been a practicing LLL leader for all that
time.  The two peds SAY they support bf, but neither of their wives bf and I
spend a lot of time "mopping up" from bad info.  I have known them
professionally and, of course, socially and neither of them have ever
referred a mom to me (or to any other bf supporter in the community) although
they have both admitted that I know more about bf than they do.
Anyway after the appt the ped asked if he could speak to me privately.  It
turns out that the only local LC in town, who works with an organization for
young and high risk families, was seeing a mom of his with a four day old
baby.  The babe was still hospitalized, was feeding poorly, and was
dehydrated.  The LC said to this mom and ped in the presence of each other
that the baby was nipple confused and needed to receive no artificial
nipples.  The ped said that he was "concerned" (read "annoyed") because he
felt the baby needed a bottle and possibly an IV, because he turned out later
the baby had Hirshbrung's (sp?) disease.  He felt the LC was not being a
"team player" and because of her advice it made it very difficult for him to
convince the mom to let them bottle fed ABM to the baby.  I asked if he had
told the LC that the baby had other medical conditions and he kind of
sidestepped the question which leads me to suspect he did not.
He wants my advice on how to approach the LC and tell her that he is "not
happy" with the way she advised the mom, how it made his treatment more
difficult, how she needs to work with the healthcare team, but to make it
clear to her that he supports bf.  He went on to tell me that he respected me
and though we may not always agree, he thought I respected him and knew he
supported bf.  As we spoke we were sitting in his exam room with stacks of
ABM and a pad of handouts (the only handout) on bf by a formula manufacturer.

I frankly think that she handled the situation correctly given what little
information I, and probably she, had to go on.  He wants me to get back to
him on how he should approach her to "correct" this situation.  Any
suggestions?  I certainly don't want to damage what little rapport I have
with the physicians here, and I do want to support my bf colleague.  I really
feel caught in the middle here.  Diplomacy is not my strong suite.
I would dearly appreciate any help/advice you all could give me.  I would
particularly be interested in hearing from physicians about what you do when
you have a difference of opinion re a patient's treatment.  I feel that part
of the problem in the perceived heirachy of the physician and the LC.  Help!
Cynthia D. Payne, LLL