Dear Friends:
    What a great topic.
    My wish list for OBs would be for every OB to recommend breastfeeding to
every pregnant woman they see. I have read studies that showed a doctor's
recommendation was enough for people to change their behavior. So in the
promo packet, put an article that supports the power of a physician's
recommendation.
    Evidence doesn't support prenatal nipple exams as being all that helpful.
Nipples change throughout pregnancy and after delivery. It is far more
important to leave baby on mom's chest until there has been mouth-nipple
contact. (Sepkoski found that it could take as long as 2 hours if there have
been medications used in labor.) So I would put the Righard/Alade article
from Lancet on delivery self-attachment. And maybe the Sepkoski article too.
    The third thing I would put in an OB's promo packet would be a list of
local resources: nursing mother's groups, LCs, pump rental stations. Pregnant
women can go to nursing mother's support groups and watch and learn and be
welcomed. OBs can encourage this.
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI
craniosacral therapy practitioner; childbirth educator
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporting the WHO Code and the Mother Friendly Childbirth Initiative

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