One of our OBs recently quit here on very short notice.  I have moved
part-time to her office to take over most of her OB patients.  I just
finished my first 2 days in her office and am exhausted from seeing all new
patients, all day long!

Anyway, several breastfeeding issues have come up.
First, a mom returning for a post-partum check reports that she has returned
to work and is having trouble maintaining her milk supply.  Turns out she is
pumping with some pump bought in a department store.  Not sure what brand,
but it is apparently a single pump that is battery operated.  She also was
planning to start the birth control patch, since the (now gone) OB told her
it was fine with breastfeeding.  We discussed different contraception, and I
gave her many of my tips for successful maintenance of supply with pumping
at work.  My question, does anyone have a hand out they give to moms on what
type of pump to use?  I see so many moms who buy these battery operated
deals, that go on to struggle with supply, start supplementing, and then
give up all together.  I will likely write up a handout of my own if I can't
find one already in use, but if any of you know of a good one, I'd
appreciate it.

I usually talk a lot about breastfeeding during my prenatal care, so feel
quite behind as a lot of these moms are close to delivery.  I asked one lady
expecting her second child if she was planning to breastfeed and she told me
she had "researched all the pros and cons and decided not to."  I think I
then promptly dropped myself from her good graces by stating emphatically
that there are no cons to breastfeeding!  I could just see her bristle and
start to tune me out, and realized I probably spoke a little too strongly.
I have a few more weeks with her, though, so am hoping I can present my
message in a way she can better hear.

It is very frustrating to constantly be going against the local culture.
Many moms do not have even basic knowledge about breastfeeding.  I am a
local oddity, breastfeeding my nearly six month old child while working.
Folks who find out she doesn't even yet eat "real food" think I'm really a
nut case.

At least in my own practice, folks were getting used to me talking a lot
about breastfeeding, now in this new office I feel like I'm starting all
over again.
Jennifer Tieman
Family Physician
Mom to 4, including nursling Caroline Rose born 5/31/03

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