You can congratulate them on the great position paper on breastfeeding by their very own AAFP (someone told me one of the authors was married to an LLLL)
http://www.aafp.org/about/policies/all/breastfeeding-support.html

Good luck with your talk.  The doctor's support is so important to keeping families in the breastfeeding game.  Whatever I say in the consult can be instantly thrown overboard if the doctor says something different (sigh…).  In fact, you might make headway with this group with the opposite angle -- not how easily they discourage parents who are overreacting to their well-intentioned words, but by playing up the power of the doctors' words if they say something even remotely positive about breastfeeding.

They need to convey to their patients that breastfeeding is important.  If they ask "Are you breastfeeding or formula feeding" -- parents hear that as two equal choices -- no big deal.  If they ask, "Do you have any concerns about feeding?" it leaves the door open for discussion.

If family practice doctors/pediatricians take breastfeeding seriously -- as a basic survival function, an ordinary thing that babies should be able to do -- parents feel this is worth working on.  If a baby isn't breastfeeding, let's feed the baby somehow, but recognize that something needs to be fixed -- this functional difficulty deserves investigation. Not just the milk, but the physical act of breastfeeding is part of the baby's development.  If a child was having difficulty breathing or walking -- sure, we'd supply a respirator or a wheelchair, but we wouldn't leave the situation there.  Just because a baby can take a bottle, it doesn't mean that all is well.

Breastfeeding is instinctive, but it's even more a learned behavior for a mother.  In places where everybody breastfeeds, women grow up observing breastfeeding,  and busybody grandmas and sisters and aunts help her learn hands-on (and feed her and fold her laundry). 
 If a doctor says "Some women have a lot of difficulty breastfeeding" the mother automatically assumes she is one of those unlucky mothers who can't do this.  If the doctor can sympathetically say to the distressed parent, "You're right -- all mothers have to learn how to breastfeed -- you're working hard on this, and here are some resources to get help if you need it," -- so she doesn't feel like a freak/failure because she is having learning curve difficulties.  She's on common ground, and she has resources to work through to her goal.

Doctors need to recognize they can't work through a breastfeeding problem in 15 minutes while addressing all sorts of other vital body systems.  They can ask -- "How do you feel breastfeeding is going?  "is feeding reasonably comfortable" and "is the baby swallowing?" and of course everyone is watching the weight gain.  And they have to be quick to refer out to mothers' support groups and IBCLCs if a mother needs to address a breastfeeding problem in more depth.  

Sometimes it seems that doctors feel that the are "lifting a burden" off of the family by discounting the importance of breastfeeding (at least that is the positive motive I ascribe to it when mothers tell me what the doctor said).

Thanks for your work on this.

Margaret Wills, IBCLC, Maryland, USA




> Date:    Wed, 22 Feb 2017 19:06:59 +0000
> From:    Lisa Marasco IBCLC <[log in to unmask]>
> Subject: Soliciting input
> 
> I'm going to present to some family practice residents tomorrow and want to help them understand that well-meaning comments and advice can undermine maternal confidence and contribute to early abandonment of breastfeeding. I would love to hear your experiences on things mothers are told AND THEN what messages they received/internalized... one example:
> 
> "Some babies just can't breastfeed."  ==  "breastfeeding isn't important after all" or "my doctor isn't interested in helping us"
> 
> What can you add to this?
> 
> TIA,
> Lisa Marasco
> 
>   Date:    Wed, 22 Feb 2017 19:43:13 +0000
> From:    Lisa Marasco IBCLC <[log in to unmask]>
> Subject: My second query
> 
> So one more question... when a family practice doc has only 15 minutes to spend with the patient and do the physical on the baby, what would be your priority questions/issues to address during that short window of trying to include bfg concerns?  Please copy me privately as well as to the list.
> 
> Thanks!
> Lisa
> 
>              

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