I've forgotten the fun of being in memo attack mode during the 20+ years in international public health and have started to remember how good it feels when you have time and patience on your side. I'm remembering how time and patience won out over our battle with vitamin A deficiency in Niger where it was contributing to a 30+% increase in child mortality and exceptionally high blindness rates due to xeropthalmia (the form of the deficiency that literally melts the eyeballs). It took from 1986 to 1993 to win out over a lot of resistent private voluntary organizations and Ministry of Heath officials but it finally turned around. So, I can do it with one measly recalcitrant pediatrician who hates lactation consultants. I found out from a client (and had it confirmed from other LCs) that this pediatrician actively dissuades her clients from seeking our services and she has bullied her partners into not referring to lactation consultants. She had the nerve yesterday to interupt a consultation I was just about to begin, by saying "let me start this since I have 30 years experience in pediatrics". She has her standard straddle position that she uses to cure all latching problems. I have had two clients for whom this failed. One client said the straddle position worked for a few days, but whose primary problem was low supply and turned out to have exceptionally low prolactin levels. I actually did a pre and postfeeding weight check in the straddle and the transition position and milk transfer was EXACTLY the same. Ultimately, the woman went on domperidone (after her poor baby was hungry and not gaining for the three weeks she was in denial that she had low supply). Her supply responded promptly to the domperidone. Subsequently, I noticed that the other pediatricians in the practice actually started prescribing domperidone. The other client had a baby with macroglossia, was told by the NICU and this pediatrician to NOT pump. The pediatrician spent 10 minutes using the straddle position to latch the baby and it didn't work. The pediatrician insisted it would work and the poor woman struggled for two solid days on her own before she found a position that would work and got her baby onto the breast. He did terrific when I saw her with the smallest of the SNS tubes and went from 0.3 ounces of milk transfer in > 1/2 hour to 1.5 ounces in 10 minutes FROM THE BREAST with the small tube SNS. So, in this current situation where this particular pediatrician totally dissed me in front of the clients, I had the good fortune to be in a room crowded with health care practitioners, including the obstetrician. We introduced ourselves to each other and I mentioned I was board certified and he laughed and said he wasn't (he has an excellent reputation) and I name dropped shamelessly. When I told him about my international nutrition days, he said I must know the Dean of the School of Public Heath at Columbia and said, I didn't but had heard of him. I then told him about my connections with the Dean of Public Health at Hopkins because of his work on vitamin A deficiency and my MHS there. We then got onto Bill Gates and how much money he's dropping into schools of public health and how he certainly could afford to do so. So, while we were making chummy chummy (in a way that I really could never do for social purposes) the pediatrician failed in her attempts to get the baby onto the breast and left me to my own devices. Really, I have to say that it was pure luck that the Aussie latch (thank you Rebecca Glover) worked like a charm and I was able to latch the baby on. I feel decadently evil, but I couldn't help myself. I sent the report to the pediatrician today and I'm going to follow up with a chummy letter about how wonderful it is that she is so supportive of breastfeeding and let her know about all the breastfeeding conferences I can think of in our area saying how much I think she might enjoy the new information presented given her dedication to breastfeeding. I have patience, I will endure, I'm not leaving this woman alone until she finally admits that we LCs have something to offer. Polite, friendly, persistently cheerful letters that won't ever stop until she caves and at the very least allows her partners to refer to us. She has become my personal project. On a much larger scale than my current microbattle - Ditto the formula companies. I could never ever manage this when it comes to the social dysfunction of my son's private Manhattan nursery school which is making me want to move back to Africa or home school (which given my son's energy level would probably exhaust me in about a month). I cannot tell you how resentful I am of these overacheiving moms who have 2-3 nannies, don't work, and don't really spend much time with their kids except to polish their four-year olds resumes for private kindergartens. Best, Susan Burger, MHS, PhD, IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html