Jan,

I truly believe that it is our job, our duty, to advocate for the nursing dyad.  This is difficult in a culture that sees bottle feeding as the norm and one that sets up physicians as all knowing, all powerful demi-gods.  I usually approach situations such as you pose in the same way that I approach the mother who calls me concerned that her pediatrician has told her to supplement her infant who is nursing well but who has lost 7% of birth weight at 48+ hours.  I tell them that I cannot tell them to go against what their physician has recommended but what the doctor says is not law, it is her choice to supplement or not and why don't why look at the pros and cons of the possible choices before her?

Speaking of ethical dilemmas:  what to do when you have discovered that ankeloglossia (sp?) is causing a baby's persistent latch difficulties (or mother's persistent pain) but the pediatrician has told her that frenotomy is unnecessary, that the fremulum will "stretch" or some other nonsense, and you happen to know of an ENT who will do the procedure? 

Stacy Miller-Leonard RN,MS,IBCLC
Chicago suburbs

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