I have mothers who are seen by highly "BF Un-Friendly" doctors.  To be honest, the last thing I want is for these doctors to write an RX for formula.  Now I have a mother believing formula is *medicine* for her baby.  

The best thing I can figure to do, is to ask the mother what her preference is for- did she hope to breastfeed exclusively?  If she says yes, then I tell her WE can help her be successful with that choice.  Then once we explain how the formula interferes with HER OWN GOAL, she may work with us, instead of the doctor, who is clearly not offering to help her breastfeed.

This takes care of the ones who are able to state a clear choice.  “If you had what you wanted, would you want to just breastfeed?” 

So, as long as I can get her to state her own choice, I feel free to help her.    I can make it work in my favor by saying to her “Did the doctor tell you “how much” to give?  Did the doctor tell you “for how long?” to give?  When she says “no” I can say “Oh- so it sounds like the doctor was not actually giving you specific medical instructions?  Do you think he was suggesting the formula instead of offering you help with your breastfeeding?”  I frequently get a very clear "yes" to this question.  And, it is important to tell the mother that we are not going to suggest she go against doctor's orders.  Again, this is why I don't want vague formula suggestions formalized.

Now there IS one category of formula supplementation that I came up against at first, and I had to accept that it is not something I am going to do much to fix….  It’s the premies who have graduated home and are kept on formula for months and months, effectively destroying the breastfeeding, if it ever got started in the first place. WE know there are ways to provide necessary additional nutritional supplements and protect breastfeeding, but since these doctors are not well versed in breastfeeding management (that's an understatement!) I already know that they are not comfortable following any other protocol.


Those are tough, but the BAD ones are the late preterms, who probably do NOT NEED any supplementation, but the doctor does not know how to guide an exclusive breastfeeding mother through those early months.  So he/she insists on formula at the expense of breastmilk.    Arrgh!  For just those ones, I DO tell her to find out at what point the doctor will believe she can stop supplementing, and by the way, is it really necessary??  If it is a doc I had a good relationship with, I would call and ask, myself, but then, THOSE docs don't usually tell such moms to use formula for very long, if at all.

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