Lori -
No, you're not being "difficult" by sharing information in your classes!
It's just like everything else - how are women supposed to make informed
choices when they aren't given the information? And, hey, some "information"
(especially around birth/BFing/parenting issues) contradicts with other bits
of "information" - the docs need to get over it! Is this not also the
situation with other aspects of their practice as well?
Which brings me to the other thread that's pestering my mind: what should
doctors in a family practice or OB or peds know about BFing? Speaking only
for myself, as a nurse/IBCLC, here's my wish list:
1) know the basics of lactation anatomy & physiology, so they don't say
ridiculous things to their patients (like the baby "blowing air" into his
mother's breast, for crying out loud!).
2) understand the risks of ABM, and the reasons why breastmilk is important
to normal growth and development.
3) know where to look up what's known about specific meds/substances r/t
BFing (Hale, for example, Ruth Lawrence's phone resource, or even the AAP
table, as flawed as it is). And be aware that best practice, when faced with
something you aren't right up to date on, is not to say "you'll have to stop
BFing"!
4) recognize the indicators of adequate milk transfer, or absence of same.
At a very basic level (output, general appearance, growth, behaviour - the
same stuff we expect the new moms to learn within the first couple of days)
5) KNOW WHO TO CALL IF THERE'S A PROBLEM, or even a question, or if a mom's
questions are taking too much time, or if she seems "needy" or "anxious".
KNOW THAT NEITHER MOTHER NOR BABY IS WELL-SERVED BY A PIECE OF
MISINFORMATION TOSSED OFF BECAUSE THE DOCTOR DOESN'T IMMEDIATELY KNOW THE
ANSWER! We IBCLCs don't always have a ready, glib answer either, but we'll
research or confer or refer until we do, or till we find someone who does,
or at least till we have a variety of options to present.
I don't care if doctors know how to help with latch-on - I do want them to
recognize when a faulty latch may be causing a problem. I don't need to have
docs who will sit for hours with a distraught, weepy mother and a numbed
sleepy baby; I do need to have physicians who will refer to me. Don't need
the MD to be an expert; do need the MD to make an expert available. THAT'S
WHAT WE DO!! (yes, shouting! and not apologetic about it either!
I don't *think* that these few requirements are all that unreasonable or
difficult. Most of the time, BFing isn't a medical process. When an
endocrinologist has a pt. with a broken leg, s/he refers that pt. to the
ortho, at least for the "management" of that aspect of care.
And I hope that those of you on this list who have the "MD" letters after
your names know that I don't mean that *you* should have any less zeal for
helping women BF! It's those other ones I'd like to have know enough to not
give out stupid "advice", but to refer appropriately or look it up.
Cathy Bargar RN IBCLC Ithaca NY
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