Just had to add my own 2 cents about doctors knowledge and support of
breastfeeding.  I have to agree with Nancy Wight, that many docs really
don't know much, if anything about breastfeeding.  My medical school offered
more than most, and that amounted to, I think, 1 day with the lactation
consultant seeing patients.  I did have the benefit of spending 1 week in
regular nursery with Dr. Larry Gartner, also, but that was by random chance.
 There was no review of the literature on infant feeding ever offered.  The
little time we spent in peds on infant feeding was focused on how many
calories and ccs of fluid per kilo little preemies need, not on any kind of
discussion of the merits of breastmilk.  Sometimes there'd be a token
statement on how "of course, breast is best, but . . ."  One of my
classmates in medical school, who suddenly realized I was nursing my baby
right there in front of God and everybody actually exclaimed "I didn't know
people still did that anymore!" and he really meant that he didn't know
breastfeeding was still practiced at all.  And usually, no one ever realized
I was nursing my daughter in class, or at social events, because they had so
little experience they didn't even recognize that generally babies probably
wouldn't tolerate being held face-flat against your chest!  They just
assumed that's how I carried her around.
Most of my colleagues know zilch about breastfeeding and have truly
internalized the idea that formula feeding is the norm.  Exclusive
breastfeeding may have benefits and be somehow "ideal," but is viewed like
many "ideals" as being pretty much unobtainable.  Add to this a general
feeling of disdain for non-physician health care providers (nurses, physical
therapists, lactation consultants, dieticians, etc.) that many physicians
seem to feel and you have someone with a lot of power in the medical field
with very little knowledge, and often very little willingness to defer to
someone who does.  I'm not sure where this disdain comes from, or if
Many of us who become physicians, also, are pretty compulsive people.  When
we have our own babies, we often have tremendous time pressures, coupled
with a personality that may make it difficult to relax into the normal
breastfeeding relationship (having the driving need to schedule and control
our lives.)  I have met in my short career thus far only 1 other woman
physician who nursed her kids as long as I did (and I think mine all weaned
fairly early at 15-20 mos.)  Many others "tried" for a few months, and I've
met quite a few who just took the formula rep up on their offer to supply
them with the stuff.  It must be hard to truly support something you weren't
able to do yourself.  Or at least, it's easy to offer formula as a way out
for any problem, if that's how your own kids were fed.  Of course, maybe my
experience is unique and there's lots of breastfeeding physicians out there!
Anyway, in my experience there's not so much a conspiracy, as there is just
a strong formula feeding culture, as there is in so many other areas of our
society.
Jennifer Tieman
Family Physician
Mom to 3, and new baby #4 expected 5/31/03

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