I'm really enjoying this discussion. I've received lots of offline requests about how to talk to HCP's. I obviously can't speak for all of us, but I can tell you what's worked for me. Easy things: most people love to hear good things about themselves, and most docs like to think that they can help. First off, I love Mimi's posts, she's so much more gentle than I am. I think what we're saying is that the passion that this community has for breastfeeding precedes your discussions with HCP's. And sometimes that passion gets in the way. One of things that I grew up with in medicine is that LC's can be a bit crazy, and your whole message can get dismissed simply by the HCP falling back that excuse. The doc to whom you may be speaking may expect something from you, some "crazy" aggressive talk that you yourself didn't earn. (Take a look at the posts from the last few weeks and check out how many times docs have been called stupid. And it comes through in lectures I've heard. I shared a story already where a colleague left a conference because the speakers basically said LC's are all right and all docs are dumb.) If they are expecting you to be one of "those lactation people" then your message is already lost. Just something to keep in mind. The LC that got my attention (before I saw the light) said something like "You're just the person I wanted to see. I know you'll know what to do." Of course, I didn't but how could I admit that? The question that needed my "expertise" was that one of my patients wasn't latching and the mother's nipples were really beat up. My hospital LC said "this mother really trusts you and she's sure that you can get the surgeon to fix the baby's tongue -tie." Mind you, I hadn't even looked to see if the baby was tongue-tied, and had I seen it, I wouldn't have thought it was a problem. In the discussion that ensued, I learned about normal tongue movements and nursing and all sorts of stuff that I was fascinated by, I called the ENT, he fixed it, and the mother was profuse in thanking me (which I think my LC had something to do with) and I was sold. I wanted to learn more about how I could help. With Sam's infant under bili lights at 24 hours of age, maybe we can assume a few things. First, it's unusual for a child to be under lights at 24 hours of age unless there's a hemolytic process going on. And then, the doc does need to keep that baby under lights (and the AAP policy statement on hyperbili is more for non-hemolytic processes, so it may not be the best reference here.) So, I guess I would approach the HCP with the idea that you could learn something. I have found that saying "I'm hoping you could help me" or "I need your guidance on this case" is a great way to start, since, most docs can't resist helping (or being a hero) and it's acknowledging this power dynamic that exists with docs and everybody else. I use it all the time with my higher-ups and it works. Maybe you can find out why all this is transpiring-- you said that you were shocked and this was atypical for your hospital. Maybe there's a reason. You could say that you are trying to help this motivated mom and you really want to learn about what's going on so that you are better able to help. And maybe you can slip in a suggestion that protein hydralysate formulas are better for jaundiced babies if they need to be supplemented and if you could use those formulas, it would help mom because those formulas taste bad, are expensive, and seem more like medicine and then your job helping this mom would be easier. Maybe, with the poop scenarios, that doc was worried about a malabsorption process. A conversation could go something like "Mrs. X just called me and I wanted to find out if you were suspecting any abnormalites with the baby. I'm hoping I can give her advice about normal breastfed stools but I was wondering if there was some other issue you were worried about with the baby first." It's hard to lose here-- the info out there supports your position and could be sent to the doc if they were interested. Another suggestion is to get a breastfeeding-friendly doc in your area to be your advocate. Most docs listen better to other docs. Since I have become an IBCLC, I handle these discussions with other HCP's. We created a breastfeeding task force at my hospital, I named myself chair, and with that "authority" I have been able to troubleshoot when the situations arise. My hospital IBCLC's don't have to fight these battles since I do it for them. You could make that doc "director of lactation services" or ask for one to be appointed your "hospital liason." As far as receptionists go, ask to speak to the doctor's nurse. That's the way most people (that don't know my email address) get to me. And if you believe that docs will never learn and continue to take a pessimistic attitude towards our learning ability then it'll never happen. The AAP has tons of stuff on breastfeeding on it's website and lots of docs in the Section on Breastfeeding. We're out there, in growing numbers, and we can help you if you ask. Jenny Thomas www.drjen4kids.com *********************************************** 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 email list is powered by LISTSERV (R). There is only one LISTSERV. To learn more, visit: http://www.lsoft.com/LISTSERV-powered.html