Terry writes:

>eet for the first time in the nursery, so they've "already made up
>their minds"  and it really won't do any good to try to talk to them about
>it.  But I have trouble going into their rooms to talk to them, just to tell
>them "hi, I'm your baby's doctor and s/he's healthy"  When what I really
>want to say is "WHY AREN'T YOU GOING TO BREASTFEED!!!!!


I'm not a physician, but I do know that images have a powerful influence on
people.  Depending on the kind of practice you are in, can you put up some
pro-breastfeeding posters in the waiting and exams rooms, the hallways, etc?
INFACT Canada makes a wonderful series of posters that focus on empowering
women to believe their bodies CAN do this.  Maybe if women see these
posters, and LLL calendars, and Learning Curve note pads (they say
"Breastfeeding: Good for you.") on your deskk, then they will think about it
more.

If you do get a chance to see patients before delivery, you might try saying
"I assume you'll be breastfeeding" with a cheery smile, or even "Do you have
any concerns or questions about breastfeeding?"  or "Have you signed up for
breastfeeding classes yet?"  or "Have you been to any La Leche League
meetings yet?"  Let them know that you just assume everyone will be
breastfeeding, and then if/as they raise concerns about why they won't be,
see if you can offer help with those concerns (as Alicia suggested).

A third thing is to talk to the ob/gyns that deliver most of your moms.  Can
you work with them on encouraging women to consider breastfeeding?  At the
HMO I belong to, the pediatricians say "The moms have already made up their
minds by the time we see them" and the ob/gyns say "That a pediatric issue,
not an ob/gyn issue."  The ob/gyn's ask the mom "Are you planning to
breastfeed or bottle-feed" and if breastfeed, they refer them to
breastfeeding classes.  If bottle-feeding, they just note it on the chart.
Things may have improved since 1991 when I had my last child.  I haven't
asked anyone lately.  But the pediatric desk/area is covered with formula
company junk.  They had a pen holder from one of the companies on the
check-in desk and I covered it (with permission) with stickers from the LLLI
conference.

A final thing to consider, when you see the moms in the hospital immediately
after delivery, is to ask "I see from your chart that you are planning to
bottle-feed.  Was there any particular reason you chose not to breastfeed?"
And then if you can work through those concerns, tell them that it isn't too
late to change their minds.  I have known several women who bottle-fed who
later said they wanted to try breastfeeding after the first day or two
(probably those hormones kicking in) but just assumed that they couldn't
change their minds.  I don't remember if they'd had shots to dry up their
milk, or not.  And I don't really know how feasible it is if you have had
the shots, but surely some women could relactate even after several weeks,
if they knew it was an option.  Maybe if you just said, "If you change your
mind about breastfeeding, it isn't too late.  Let me know and we can work on
it."




Katherine A. Dettwyler
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