<  I believe that our greatest hope lies with the next generation
of physicians (although I'll keep working on the older ones).>

Alice,

>From my experience of over 4 decades, I think you've hit the nail on the
head.

I have seen this borne out many times in observing residents evolve and
mature over a 3 year time period, especially when that time period
includes new parenthood. Helping these couples in their journey into
parenthood ends up a very powerful way of effecting the future clinical
practice.

Increased formal education can't hurt either, of course.

There is a reason why it's called "clinical practice". It is a dynamic
process. Every client's case, each interaction with a supportive (or
unsupportive) nursing staff, or positive (or negative) interaction with
an LC,  builds on the foundation of the personal experience of nearly
every HCP. This subtlely continues to shape the attitude toward future
clients' breastfeeding management.

Helping a mother grieve a less-than-successful breastfeeding experience
is hard enough and time-consuming enough for even the most sensitive and
ardent advocate. Not everyone recognizes it as grief, or knows how to
facilitate it. If the physician has personal issues not thoroughly worked
through, < denial, transference, etc.> easily take over. Maybe that in
itself is a good point to include in continuing education presentations.

< We live and grow up in a bottle-feeding society. IMHO, it's not
surprising that so many react to breastfeeding issues the way they do.>

They take the "easy" way out as a method of emotional self-preservation.
I've been there and done that myself, more often than I care to admit.

<  As health care professionals, physicians (and nurses and lactation
consultants- emphasis mine) are expected to
keep their emotional reactions largely to themselves, but don't always
succeed.>

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio

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