On Tuesday, I saw a mother of a 3-week old, as a favor to a colleague/friend
who had been seeing the mom, but had the flu. She had been seen twice before
and positioning/latch were the main problem. I spent 2 hours with the
mom/baby and it seemed *highly* likely to me that the baby was suffering from
food allergies, probably cow milk at the least. Baby had a diaper rash, was
*extremely gassy*, pulled on and off the breast constantly, was fussy when
awake, took a very long time to complete a feeding. Mom is a very heavy
consumer of cow's milk products. The concern has been slow weight gain. The
baby, at 2 weeks, had not regained birth weight and at last check had gained
3oz in a week. Mom's supply is very good. Baby stools at almost every feed,
but the mustardy colored stools are very mucousy.
    I explained to the mom the importance of maintaining bf, due to
difficulty in finding an AIM the baby would tolerate, if allergic to cow's
milk. I also told her that if she removed the allergens, she would likely see
a very different baby.
    Anyway, yesterday, she went to the ped. Baby again gained only 2 oz in a
week. She asked the ped about allergies and the ped said, "so far I see no
signs of allergy in your baby"! She then told the mother to supplement, by
finger feeding, after every nursing with Nutra___. BTW, this practice has
magically increased its bf discharge rates in recent months--now lots of
mothers go home still bf--if you count finger feeding AIM as still bf! Also,
mothers are taught a method of finger feeding which involves passively
feeding the baby.
    I asked mom why she wasn't supplementing EBM, and she said no one had
suggested it (also typical for this practice). So, I made a Herculean effort
to get her to understand why she should *not* be giving AIM and about the
risk to her milk supply.
    I asked why she was using Nutra___, if the ped wasn't concerned about
allergies and she said, "b/c she had free samples of it." So, are medical
decisions based upon what the ped has free samples of hanging around the
office?
    Everything I said the day before about allergies was completey undermined
by this ped's careless approach to supplementation. I made it very clear to
this mom that this approach was not supportive of her expressed committment
to bf. Of course, in a very "careful way".
    But that is my issue--why do we, the lactation experts, think we have to
win over the docs? Why don't we assume they have to function in accord w/
their own guidelines--you know, something about protecting and promoting bf?
IMO, this feels like collusion on our part, and in the meantime, mothers and
babies suffer.
    I personally feel we need our own marketing campaign--make sure the truth
gets out in the media--keep sending press releases with info about the
hazards of AF, with LC's as the experts to respond to questions. So long as
doctors can "give orders" and mothers are more driven by fear of disobeying
orders than anything else, things will not change. We need to accurately
inform consumers and get into the mass consciousness the idea that lactation
consultants and Leaders are the bf experts (and midwives are the birth
experts), that is, when an expert is needed besides the mother.
Jennifer Tow, IBCLC, CT, USA

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