I had a meeting with my medical director last week about the prenatal
lactation education program I have developed for them.  Overall, she was very
positive and will send out letters to the OB we work with about it.  Nearing
the end of the meeting the subject of guilt was brought up.  It seems that at
the last meeting (I was not present) a doc related a private conversation to
the group regarding formula.  Once I explained that that was a private
conversation (and may I say somewhat heated conversation) that the medical
director felt misled by the other doc.  I also related that of the two
patients I felt that I had come onto a little strong to (one I even
apologized to) both were still happily seeing me.  Then I read the minutes to
the this last Docs meeting and now I realize I have a bigger problem.  The
minutes state,
        " Chris Betzold is excellent at working with patients who are having
a problem       breastfeeding.  At times she comes on too strong that formula
poisons the baby.       There seems to be a tendency to make patients feel
guilty if they don't breastfeed         or stop breastfeeding.  She (meaning
me) needs to convey to our patients that [the   practice] encourages
breastfeeding without making our patients feel bad or   guilty if they choose
not to breastfeed."

I think that this is a bigger problem than just one isolated conversation out
of context.  I plan on presenting Dr. Jack's "BF and Guilt" as well as "How
to tell if your provider is BF friendly" I have been collecting tons of
research that I can pull out.  But, I would really like some ideas on how to
handle this especially from the LacDocs.  We will meet again to discuss this
on Monday the 14th.  Thanks.

Christine Betzold MSN RNP CLE

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