Well, I've noticed that others have used Lactnet as a means
of venting, as well as support, so here I go.
We recently sent out a BFing pocket card (discusses basic
steps of positioning, suckling assessment, frequency, breast
care, signs of adequate milk, and maternal self care) to all
the general practioners, family practitioners, pediatrictians,
and OB/GYN and have had, for the most part, a favorable
response.
However, (you knew that was coming, didn't you?) I received
a call from a pediatric endocrinologist who was very
concerned because we didn't specifically address vitamin D
intake for the mother and exclusively BF baby.  She said
She/they (She is in a practice group) have seen a rising
number of infant rickets in their practice, especially when the
infants were exclusively BF for extended times, though she
didn't say what she considered extended, whether or not a
diet history was done on the women, nor did she let me get a
word in edgewise.  She  went on to say that most of the
mother are working and the only exposure their infants get to
sunshine is from the car to the babysitters.  She said that
the use of generic vitamin D was not good, that it wasn't
absorbed as well as Poly.....  She said the breastmilk was a
poor source of vitamin D, it was not absorbed well, and that
BF infants should be given extra vitamin D.
I finally got to ask her what research she was basing her
recommendations on, that I would like to see it so I could
update my files, and she said the information wasn't new that
I could pick up any medical book and find it.
I told her that we based our information on what was
recommended in Nutrition During Lacation by the Institute of
Medicine which said that exclusive BF infants do have
normal infant bone content of vitamin D when the mom's
intake is adequate and she said they didn't, then added they
don't get enough calcium either.
I finally decided it wasn't worth my time to try to talk with this
person and just thanked her for her suggestion.
Being a pediatric endocrinologist, I wonder how often she
even sees an exclusively BF infant.
Grrrr!
Debbie