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Subject:
From:
Alicia Dermer <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 19 Aug 1995 11:17:22 -0400
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Dear Terry:  Boy, did I relate to the feelings you've described!  I've
been through that stage of shock and resentment (I still feel those
feelings occasionally, but remind myself that if I can plant some seeds,
and not alienate these mothers, they may feel differently with their next
baby).  I'll describe some of the things that have worked for me to
prevent or deal with these situations.  First off, as a family physician,
I often know the parents and ask them in during their pregnancies to
discuss these things early on (I know a lot of pediatricians who also
encourage the parents to come in for a prenatal consultation).  This is a
calmer situation than the postpartum period to explore their issues and
concerns about breastfeeding, and it allows parents time to think about
it and do some reading, attend breastfeeding classes or LLL meetings(if
they're open to it).  Secondly, I don't shrink from asking even mothers
whom I'm first meeting postpartum why they don't plan to breastfeed.
Rather than lecturing them about all the reasons why they should, I try
to find out what their issues are.  Occasionally, I uncover an issue
that's easily dealt with.  Even if I don't, I let the mother know that
it's still an option and I'm available to help her breastfeed if she
changes her mind.  Thirdly, in my day-to-day practice, I look for
"teachable moments", such as the visit of a baby with a recurrent ear
infection or asthma, to plant the seed that perhaps this may be avoided
with their next child if they breastfeed (I have a number of mothers in
my practice who have breastfed subsequent children and were so pleased
with the difference); or, if a woman who did not breastfeed has had
breast cancer and her daughter is now pregnant, suggesting that the
daughter think seriously about breastfeeding; etc.  Finally, since I have
read that women make their infant feeding decisions early prenatally,
some even before they're pregnant, I make every effort to raise awareness
of breastfeeding with younger people, both in my practice and in the
community.  My breastfeeding talks are open to anyone who is even
contemplating pregnancy.
From my reading about smoking cessation counselling, I became aware that
physicians can double the quit rate among their patients by simply making
a firm, positive statement about the importance of quitting.  Then I saw
that this was true with my patients, as I searched for "teachable
moments" to show them how their smoking was related to their repeated
bouts of bronchitis, etc.  I believe that if all physicians took these
opportunities to give breastfeeding importance, they could have a
significant impact.  Just a sobering thought: the national smoking quit
rate is 10%/year.  So when we double the quit rate, we should be happy
with 20%.  I hope that puts the breastfeeding issue into perspective.
Sorry to have rambled so long, but I hope this helps you.  Alicia (just
back from Hawaii and in fine verbal form).  [log in to unmask]

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