Dear Kathleen:  As for physicians and their attitudes to breastfeeding, I
have made certain observations.  The first is a general discomfort with
subjects not taught in medical school.  As you probably are aware, there is
very little formal lactation education at the medical school level, and
residency exposure is extremely variable.  This hopefully will change as more
of us come through and push for good lactation curricula at our schools.  I
recently attended an excellent workshop at Wellstart in San Diego, which has
a ready-made lactation curriculum to share with medical schools.  Together
with another few interested colleagues, we are working at incorporating this
into our medical school.  Together with improved attendance at symposia such
as the annual LLLI/AAP Physicians' Seminar, which should help with practising
physicians, we may make some headway.  After all, medical students learn from
practising physicians, so it's equally important for these role models to be
current on lactation and truly supportive of breastfeeding.  Another new
avenue is the recent establishment of the Academy of Breastfeeding Medicine.
This is an international group of physicians whose main focus will be on
helping to educate physicians and help them to promote breastfeeding.  For
anyone who is interested, e-mail to Dr. Elizabeth Williams at
[log in to unmask]  I'm sure she'll be glad to send brochures and
information to any physicians interested in joining.
My second observation about physicians is somewhat obvious, but physicians
are no less a product of their society than anyone else.  In a bottle-
feeding society, we are not likely to be exposed to breastfeeding mothers
until we meet them in our practices.  Our attitudes must be formed by our
upbringing, and after all, most of us were also bottle-fed, "and we turned
out allright" (where have we heard that before).  So when formula companies
suggest to us in their advertising that their product is really very close
to breast milk, we are as likely to believe it as the public.
My third observation is that until recently studies about breastfeeding were
poorly done, often without quantitation of exclusivity and duration, yielding
equivocal results.  This I believe has prejudiced some of the older
physicians against the dramatic recent data.  All these factors and more will
mean slow progress, but I'm confident that progress will come.  Good luck
with your conference. I heard Dr. Newman speak last year.  He's great!  Keep
well, Alicia.