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Date: | Mon, 5 Feb 1996 01:29:46 +1000 |
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Judy in Israel asked about this but I feel that I'd like to share my
learning over 20 years of teaching. When I began teaching, filled with
zeal, I used to spend all my time telling any audience that breastmilk was
wonderful. I soon realised that most medicos believe this to some degree
(they are intelligent humans) but are ignorant and uncomfortable with
making breastfeeding work, and we can make a huge difference by empowering
them with practical knowledge.
Three hours Professor Roger Short and I have to get 4th year medical
students interested in breastfeeding. He does the mostly endocrinology and
a bit of immunology bit (wonderfully). I tell them that it matters
enormously: two overheads with long lists of diseases linked to AF, in
mother and child; one outlining cost of lost reproductive control. (5-10
minutes). I give them all a copy of an article on this- one which was
refused publication by the US nursing journal which explicitly commissioned
it, on the grounds of too few references. (I think there were over 90.)
Then I say something like"but it's pointless you knowing it matters but
being unable to help. What I am going to teach is how babies feed from
breasts and bottles, what that means for getting babies feeding well, and
how to recognise the kid who isn't. At the end of this you will still be
pig-ignorant about every other breastfeeding problem, but you will have
learned just one useful thing that may mean you're some use to a woman in
agony on the wards: or better yet, you may help prevent such problems ever
developing." So they get an hour, very visual, on positioning and
attachment after basic physiology of feeding. Then the rest of the time we
have breastfeeding women (who have been sitting up on the platform facing
studentsfor about half my talk and doing whatever they need to with their
usually very cute toddlers) talk a little about how it feels to breastfeed,
usually while doing it. Then we field questions, often for 30-60 minutes
overtime. The children steal the show often.
Lots of management questions come up; I emphasize that knowing about
lactation is like knowing about pregnancy: a bloody huge area and they'd
better be willing to learn if they've not going to harm women; that
medical ignorance is a major cause of early weaning.I also emphasize the
ridiculous aspects of what was believed about how babies breastfed: tongues
darting backwards and forwards in mouths; thrusting nipples against hard
palates... I get them to imagine repeated powerful compression and abrasion
of their own heavily innervated extremities. (The guys cross their legs.) I
call this topic of feeding physiology a paradigm of what industry has
managed to communicate to health professionals: I use the NUK
advertisements and any other teat ads I can find to illustrate the
absurdity of it all, since NUK is nothing like breastfeeding but says it
is. So I try to politicise as well as educate and skill and entertain these
young ones. (Lots of laughs and sex queries often emerge.)It seems to work.
We get great reviews. And they end up trusting me as the expert because
they prove for themselves that I know what I'm talking about, next time
they visit a hospital ward.
Now this is what I do for any group of doctors who have only an hour or two
to learn something that will make a difference. Once they ask me back (and
they do) we can get on to dozens of other practical topics. And more attend
the practical- than the political-titled talk. Make the practical political
is my motto. If you make them uncomfortable about artificial feeding risks
but they can't help breastfeeding women, they rapidly decide you're a
zealot who should be ignored.
Well that's what I've found: what of others?
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