Teaching MDs about breast feeding is hard.  The "advocates" of breast
feeding always tell you that you're preaching to the choir- yet those
'advocates' often give the wrong advice as Mira suggests.  Most MDs give
breast feeding lip service, but don't want to learn about it or deal
with it- it takes time and wrecks your schedule.  We weren't taught
about breast feeding in medical school or residency, so how could it be
important.  And then, there are the same body taboos that the entire
culture deals with... I've had male pediatricians tell me they don't
want to know about breast feeding; they won't observe latch on because
the mom is not their patient and they can't examine her breasts without
a nurse present.....

Recently, the newly formed Physicians Breast Feeding Coalition of WI
(goal to increase Ped, FP and OB knowledge and support of BF in the
state) did a survey of practicing physicians... We only got a 20%
return, and I figure that those represent the most interested
physicians, yet there were still a few that stated they didn't think
there was a significant difference between human breast milk and toxic
byproducts of manufacture re packaged as infant food (my term- not used
in the survey, despite my wishes).. most supported breast feeding many
said they knew enough - but still answered the 'quiz' wrong (i.e. do you
supplement BF babies, etc.)

and most remarkable to me- nearly all of us learned most of what we know
by breast feeding ourselves or watching our spouse breast feed.  This
was true for FPs, OBs and Peds.  Now tell me, all you physicians out
there, what other topic would we claim we know about and can advise our
patients about that we'd learned solely from our own personal
experience- don't we call that anecdotal?

A local OB and I planned an educational talk for our MDs "fitting BF
into your busy practice" and NO ONE came, well, one public health nurse
and 2 medical students came, but none of our OB nurses, an none of our
MDs.  It was world breast feeding week and every one was on vacation or
on call.  I think you need to get an 'expert' from out of town if you
want MDs to hear mundane things like breast feeding.

        I've been harping at our docs about having a 'breast feeding
friendly clinic' and our midwife and I have come up with a memo
containing suggestions that I circulated (no comments) that I discussed
in a staff meeting (no comments) several times (no discussion) till
finally I announced that I was procuring a variety of attractive breast
feeding posters and I would have them framed and placed in each exam
room---- WOW did I get discussion!!  "Now we can't be posting something
on everyone's pet project, pretty soon you'll have heart disease and
cancer screening and blah, blah, blah...."  but I did get them to
discuss and listen on the topic, so I think that's progress.

        So this is a long way of saying that we have a long way to go-
so what else is new in women's health and kids' advocacy?

         we need to be persistent, and we need to support eachother; far
and few between as we are, thank goodness for the net.

Grace Heitsch, MD, FAAP
Duluth Clinic- Ashland
1625 Maple Ln
Ashland, WI  54806
715/682-2358
fax: 715/682-2481
voice mail: 715/685-7582
e-mail: [log in to unmask]

"It is easier to build strong children than to repair broken men."
Frederick Douglas