Dear Elizabeth,

I have also been asked to give a 45 minute lecture to physicians. After giving it some
thought I decided to give a lecture on practical problem solving. Most docs think they
know everything about the advantages of bf, and I didn't want to go over the AAP
recomendations - too boring. I get many phone calls on bf - mainly from moms
referred by LCs who got questionable advice from their doctors. The LCs can't just
tell them the doc's wrong, so they send them to me. I made a list of all these calls,
and found the most frequent problems were drugs, sore nipples, sore breasts and
insufficient milk (real or perceived).

I based my lecture on this, and called it "Breastfeeding - New answers to old
questions". This gives the docs an opportunity to listen - it doesn't say they don't
know what they should know, only that there is new information available.

When talking about drugs I made the point that one of the first things we as doctors
have to keep in mind is "primum non nocere", and that stopping bf and giving formula
has proven risks, whereas most drugs have only theoretical risks. I use this to give a
list of the known problems of not bf. It's a "back door" to mention the risks of not bf
(never talk about the benefits of bf - I always tell them there are no benefits to bf -
this is norm, there only are risks of not bf). I also gave a short list of absolutely
contraindicated drugs (chemotherapy and the like) and a list of the best choice for
some of the common drug groups.

When talking about sore nipples I tell them that the most important cause is poor
positioning, and then show positioning and latch on slides. I try to get in a few words
about thrush - nipples and breast.

Mastitis is another important topic to mention - don't stop bf.

This is more than enough to get into a 45 minute lecture.

If you need more detailed information write me.

Good luck,

Mira

Mira Leibovich, MD, IBCLC
[log in to unmask]

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html