Some people "need" scare tactics? Why? I respect my client more than to
treat them as children who need scolding. If there is EVIDENCE that what
they are doing is dangerous, than is it is NOT a "scare tactic" it is
EVIDENCE! As well as sound Lactation Consulting. As LCs we are bound,
ethically, to share these truths with our clients. If there is NO evidence,
and we are simply supplying our personal opinon of what "seems logical" it
IS a "scare tactic." The word "Scare tactic" is based on nonevidential fear
and personal opinion. When we tell mothers the PROVEN dangers of not
breastfeeding, this is NOT a "scare tactic" as it is true. If we
exaggerate, make things up, or simply use our opinions as fact, it IS a
scare tactic.

I remember years ago, counseling a mother who had to be on an IV blood
thinner after a clotting problem. She was told by the doctor and the nurses
that, if she continued to breastfeed, her baby's blood would not clot and
the baby would "bleed to death." Seemed logical to them. The belief
that "anything the mothers consumes gets to the baby" was beleived by some
(and still is) and a blood thinner "seemed logical" as a very dangerous
drug. Not that there was any evidence to prove that. In fact there was
contrary evidnce. Of course, when presented with the evidence, the doctor
said, "Well, eventually we will find that this drug is dangerous, even if
we can't prove it now." As it seemed "logical" to him as it would be. It
never was. The mother did not wean her child, her child nursed and did
not "bleed to death." I wonder if a decade or so later, this doctor is
still "waiting" for his evidence to prove his unfounded personal opinion,
or if he learned something from this situation. I hope it is the latter.

What "seems logical" is often colored by our social station and our
prejudices. I rely on evidence. Although I do not approve, personally, of
certain types of birth control, or alcohol usage in any form (I am a
complete teatotaller) and am personally opposed to using anything in a
smoke form, I still counsel my clients, on their questions,  on what we
know NOW, not something that "may" be proven (in this case, against
MUCH "hopeful" data) in some undefined future, or based on my personal
prejudices of how people should conduct thier lives.

What seems "logical" to one, may seem totally illigical to an other. One
person's inpretation of "Logic" isn't proof. I can't even count the times I
had to reassure a woman that taking her pain meds after a C section
wouldn't do great harm to her baby, it seemed "logical" to her (as well as
to her mother and or sister in law) that anesthetics and pain killers
were "dangerous drugs" and need to be either avoided during breastfeeding,
or milk should be discarded until these substances are no longer being
used. However, we know, via evidence, that these drugs are relatively safe
in moderate doses. And probably beneficial to a woman in great pain.

While using cannibis is a choice, I still counsel according to what we know
now. Followed by a caveat, that reallly, NO drugs should be used during
lactation unless medically neccesary. My clients make up their own minds
then, based on evidence, not based on my personal opinion. The same goes
for alcohol, which I totally disagree with the usage of. I tell my clients
the EVIDENCE, I do not counsel her according to my personal distaste for
booze.

My hope is that we can all be "logical" and place our personal opinions on
the back burner, especially when the evidence disagrees with it.

Respectfully,
Mary Jozwiak IBCLC, RLC
Private Practice

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