Cathy -
I enjoyed your rant.  From my talks with WIC moms, I don't necessarily
think doctors are always saying directly that the baby is allergic to their
milk (although I know it does happen), but I do think that is the message
they are picking up.  Like you said -- the most vulnerable moms -- the ones
who get messages that they are no good are the ones most likely to say
something bad about their own milk.
        One day I had a mom who was told to stop bfing for 1 day because of
jaundice.  I went to the doctor and I said, "Ms. Blue now thinks her milk
is bad."  Our clinic doctor said, "I didn't tell her that her milk is bad."
 I said, "Do you understand that because of what you said to her, she
thinks her milk is bad?"  The doctor repeated her line, and then I repeated
mine, and then the doctor was silent.  It had sunk in.   (baby steps)
        We are now asking our moms on prenatal questionnaires:  **"What have you
heard about breastfeeding?"  AND  "What have you heard about formula?"  The
answers can be astonishing.
         I've started to ask clients:  "Where does formula come from?" -- clients
often do not know.  The 3 step counseling prenatally is helping (an open
ended question like **, VALIDATE mom's feelings, then educate on her
concern or barrier to breastfeeding).
        I was so frustrated with postpartum moms that would not even think about
trying breastfeeding that I did a mini-study in the clinic when they came
to get their formula.  I first let them know I was not going to talk them
into breastfeeding, I just wanted them to help me out.  My question was:
"If I could give you anything you wanted, anything (obviously a
hypothetical!) .. what would it take for you to just think about trying
breastfeeding?"  (I had to encourage most of them several times to give me
an answer - shocked as some moms can be that we are still talking about
breastfeeding at a formula pick-up in WIC)
        All of the moms I asked (except 1 who wanted money) said JUST SOMEONE TO
HELP THEM LEARN HOW TO BREASTFEED (I mean really help them... Many of our
moms know from talking to one another that there isn't the kind of support
they need to jump from formula feeding family to breastfeeding family in
the hospital.  The fact that we have had moms wait until they get home to
try breastfeeding tells me how little love and care is given to them at
times in the hospital -- at home too)   I've had an LC nurse complain to me
that our moms ask too many questions in the hospital and need too much help
or that a phone call is good enough or even that they have all those family
members in their room {can you believe that one?}.  I could cry - in fact I
have.
        How far is a first generation breastfeeder going to make it with all these
odds?  The beauty of bfing is that it can mean so much in the life of
anyone, and many of our moms keep on in the face of all odds.  They make it
in spite of professional misinformation or professionals with elitist
attitudes about breastfeeding or coworkers or family members who tease them
in not very nice ways.  (& lots of our moms see carnation ads daily  -- and
we give out formula vouchers -- working for change from within the system
just like those of you working at hospitals that are not baby friendly yet)
        A little bird told me that I was referred to as a breastfeeding something
or other in a management meeting.  After that I set up meetings with every
management person in that meeting, and I showed them the "National WIC
Breastfeeding Promotion Campaign videotape."  I asked them to wear a gold
ribbon at work to support the campaign, and to my face not one of them
turned me down. (baby steps)
        I went to a workshop (not bfing related) and a woman told me she had
spoken to some of the elder women of a tribe, and she had been told that
for the world to get better, women were going to need to take back their
voices.  Women were going to need to speak up.  Every once in awhile I
think of that because although it can be hard to speak up, our guts tell us
it is really harder to stay silent.
        And the rant goes on.....
Jill Lund, St. Louis, Missouri, WIC


----------
> From: Cathy Bargar <[log in to unmask]>
> To:
> Subject: tangential rant
> Date: Friday, January 01, 1999 4:51 PM
>
> <<How long until we start hearing doctors telling
> moms that they need the Prolina formula because their babies are
> breastmilk-protein intolerant?>>
>
> Hey, in the community where I work I hear all the time (like several
times a
> day, on a busy WIC clinic day!) that "The doctor" (and it is always the
> doctor, BTW - I've never heard this attributed to any other HCP) "said
that
> my baby is allergic to my breastmilk, so I should switch to formula."
When I
> talk with them about that concept (like how do you think the human race
> would still be here if we were allergic to our mothers' milk? Do you ever
> see other mammals that are allergic to their own mothers' milk? - This is
> big dairy country here, so lots of folks know a lot about cows, which I
> think actually really helps our BF rates.), often the moms can see how
much
> sense that idea makes. But when the words carry the authority of coming
from
> "the doctor" (or even more sacred "my baby's doctor"), it takes a
skillful
> touch to suggest that there might be other ways around "the problem"
(which,
> BTW, is usually not what you'd call a problem - most often seems to be
young
> new moms who don't really know what life with a baby can be like, & who
> think that a "good" baby is one who sleeps through the night immediately
on
> return home from the hospital.)
>
> Well, I didn't mean to work into a full-blown rant here, but I might get
> there...What really makes me blow my top when I hear this is that I only
> hear it from the most vulnerable women - women who are young, poorly
> educated, not well-supported for breastfeeding, parenting, or anything
else.
> I know these docs who say this to these poor young girls, and I can no
more
> imagine them saying such a thing to one of our Cornell faculty or their
own
> colleagues' wives than I can sprout wings and fly to the moon! Now, if
what
> the doctor means is "Sometimes foods in your diet can cause your baby to
> feel a little upset - let's look at how much dairy, caffeine, or whatever
> you're taking in", why doesn't he (or she, but I've never heard it from a
> she) say so?
>
> Concievably, in some cases the doc could be thinking that this woman
doesn't
> look like a prime candidate for breastfeeding to him (teenaged, maybe has
> some funny body piercings or tatoos, or less-than-excellent grammar, or
> funny hair colors, or her fingernails are dirty and she smells of
kerosene
> and smoke, or whatever...)When he sees this unpromising soul before him,
I
> think the train of thought goes like this: poor-young-funky-looking mom -
> maybe she does drugs or alcohol, certainly she smokes - shouldn't
> breastfeed - unsafe for baby for her to even try - formula's easier (and
she
> can get it at WIC). To attribute the best of all possible motives, I'm
sure
> that the doctor is concerned for the baby's well-being, and in his mind
> formula will just be simpler and more reliable; because, after all:
> you know what's in it (well, we know what the formula company puts in it,
> which doesn't necessarily translate to the concentration the baby gets it
> at, and it certainly doesn't speak to the conditions of dubious water
> supply, or to the storage conditions or what else has been in that
bottle,
> but he thinks he knows what's in it)
> you can measure it (well, if you can read the instructions, and do the
> calculations, and figure the fractions, and read the markings on the
bottle,
> and have a good enough grasp of time & temp.that the stuff hasn't been
> sitting on the dashboard of the car in hot weather for long enough to
spoil)
> "other people can feed the baby" (that is, of course, if this poor soul
has
> anyone around who's responsible and concerned enough to be willing to do
so,
> although if she were surrounded by so many well-meaning caretakers would
she
> be in this "dangerous" situation at all? And is relieveing her of her
> obligation to care for her baby really the most effective way to help her
> develop the bond she'll need to help her turn into a good mother?)
>
> Oh, please stop me, now I'm ranting for sure...
>
> My point is, if these are the worries behind the doctor's telling her
that
> her baby is allergic to her breastmilk, EVEN IF all these concerns are
legit
> in a given situation, this is absolutely not the way to deal with the
> concerns. An MD, or RN, or IBCLC, or social worker, or a nutritionist, or
> any other HCP has an obligation to follow up if s/he is concerned for the
> baby's welfare. We also have the obligation to share accurate and
> appropriate info with our patients/clients, in terms they can understand.
> And if a physician truly believes that the baby is allergic to its mom's
> milk, we REALLY have a problem! But just because a woman doesn't present
> herself like Martha Stewart in a nursing bra and Madeline Albright all
> wrapped into one does not excuse saying such a goofy thing to a patient!
>
> Now see what that article about the soy proteins made me do! And now my
back
> hurts from sitting at this damned computer too long - and it's all THEIR
> fault, I just know it is!
>
> Cathy Bargar
>