By acting as though they assume every mother will breastfeed, reinforced by the complete absence of formula company props in their waiting rooms and offices AND a pile of leaflets, cards or fridge magnets telling women where they can get help with any problems they encounter. In other words, by treating BF as the norm and knowing their limits about how to deal with practical problems along the way and who to refer to when it's out of their domain. Worst things a doc (or any other HCP) can do: Act as if breastfeeding doesn't matter, and as if all problems that can arise are solvable with time or 'plain common sense' without any solid evidence base, and if that doesn't work, well, honey, I dunno, maybe you just weren't meant to breastfeed. I had a query from a mother in another city whose intense nipple pain during and after each feed, lasting for up to an hour each time, was treated by her GP with syntocinon nasal spray, explained to her as 'nasal spray to help for painful milk ejection'. Her MER was already causing baby to choke and sputter, esp as other features in this situation make me strongly suspect tongue-tie, and the nasal spray added an overlay of afterpains to her already challenging situation. Another mother was told by the health visitor (PHN) to put plain cow's milk yogurt in her two week old baby's mouth for thrush, since mycostatin was considered too risky for a baby that young. Right, it isn't even absorbed into the bloodstream!! Same mother was advised to use cabbage leaf poultices for her cracked nipples, by the same health visitor. She had sought help for her painful cracked nipples by visiting the well-child centre three times in the baby's first month of life, no one ever observed a feed nor WEIGHED THE BABY so when she came to our clinic in week four and baby still had not regained birth weight, we had another whole set of problems to deal with. Heaven forbid I should inform any of these women that there is more updated knowledge out there to be had, wouldn't want to violate my IBLCE scope of practice, ha ha ha. About Depo-provera - a lot of poor young mothers don't show for their postpartum check. How many of us would bother coming back if our practitioners treated us as incompetent to even run our own lives by injecting us with hormones we don't need before we've even gone home with our babies? The saddest part is, once they have had the injection, a lot of women definitely don't come back, and many women find the irregular bleeding of Depo-Provera so bothersome that they don't continue the treatment, so they get pregnant again even sooner than they would have without it, and just keeping on breastfeeding. Anyone pointed that out to these practitioners who misuse Depo-Provera this way? I had a boss at the student health service at U of Washington in the early 1980's who was an endocrinologist. At the mere mention of Depo-Provera she would nearly froth at the mouth and say 'it's GENOCIDE'. There is something to be said for people who aren't afraid to have opinions, I really miss having a boss like that now :-) Rachel Myr Off to work now, in Kristiansand, Norway *********************************************** 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