Amy, you asked, "Do any of you have a short 'speech' which you use to
briefly explains why some meds can be safe during BF?...How do I go about
explaining this in a manner which doesn't put their MD in a bad light?"

I have encountered this during help calls also and I usually encourage the
mother to talk to her pediatrician about the medications also.  I emphasize
that pediatricians are more likely to understand how the medication will
affect the baby and I believe that pediatricians are more likely to own a
copy of Hale's than are family practitioners.  (Maybe I am wrong about
this.)  In any case, the pediatrician will at least have access to the list
of medications approved for use in breastfeeding mothers by the AAP.  You
could also refer the mother to the AAP Table entitled "Maternal Medication
Usually Compatible With Breast-Feeding" at
http://www.aap.org/policy/00026t6.htm .

I also read the information to the mother and offer to make a photocopy for
her and her doctor.  I try to avoid getting into a discussion about why the
doctor may not have this information.  I just try to empower the mother to
take an active role in her own healthcare.  I think most mothers who have
the presence of mind to ask a LLL Leader or LC about the safety of a
particular medication also have the will to act upon that information.  I
don't think we can ever know about why the mother's own physician does not
have up-to-date information about lactation and pharmacology.  We can only
guess.  I think it may relate to priorities in the sense that a doctor may
not feel compelled to become knowledgeable about a topic which he/she
believes applies to only a small percentage of his/her practice (i.e.,
lactating women).  Personally, this is one reason I think breastfeeding
mothers need to identify themselves to their physicians - so that we are not
invisible.

I believe there are doctors willing to learn from patients who provide them
with a credible source of information such as Medications and Mother's Milk.
I also sometimes encourage mothers to call the pharmacy at one of our local
hospitals which I know has a copy of Hale's.  The mother may feel more
confident sharing the information with the doctor if it comes from a
pharmacy rather than from me.  And I think that is OK.

This is one instance of why there is a need for recognition of the Lactation
Consultant as a distinct, accredited profession.  If there are any physician
offices in your city which employ LCs, that is one place to refer the mother
whose physician is not willing to hear new information.  Or you may also
want to encourage the mother to contact an LC at the hospital where she give
birth, as most hospital-based LCs should also have access to a copy of
Hale's.  Then the hospital LC may be willing to have a dialogue with the
physician.

Sara Dodder Furr, breastfeeding advocate and volunteer
Lincoln, Nebraska

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html