Mary Ann, your question concerning sending bottle feeders to a Pediatrician
that does not advocate factual imfo for BFers, I am uncertain about how best
to do that but interesting enough my friend ( who is taking my job as the LC
at the hospital I worked with, I retired from my Navy career) and I were
curious about the same issue when it came to OB and 6wk check-ups.  That it
would be nice to hook -up with MDs who support BF with updated and accurate
imfo.  Surprisingly, the ones who know there is a LC just picks up the phone
and refers their client with a telepone consult to us.

  I also have a funny yet annoying story to tell.  I am only hours from
retiring and I have stayed 2 hours past quitting time to assist this family.
 This woman has called 4 times in 2 hours and finally I am able to have
telephone contact with her.  I asked her to bring her husband, baby and pump.
She quickly responds her neighbor will babysit the baby and she doesn't want
to BF.  I tell her it would be nice to see her baby also and I will help her
the best I can.
  My boss knows about the consult because everyone has tried their best to
assist her on the phone while not paging me until they feel helpless because
of her pain in her voice with continuing calls.  My boss says, Karen, now let
her quit if she wants.
  I meet the family and know I will need a hospital room to assist this
mother instead of my office.
The mother walks in and says, I'm not breastfeeding, I'm not pumping, and
don't touch my breasts.
I ask for permission if she will give me 1 hour to assist her in resolving
the problem and would she like to get comfortable in bed.  I told her at
anytime she is in pain we will stop.
Engorgement, sore nipples and latch-on diffficulties (Duh)
Well, she's more sensitive than most but she is feeling better.  She thinks
the M-----
C------ pump is great and I said  you baby would feel even better than that
pump once we assist with correct latch-on.  She BF baby and neonatologist
examines child for jaundice, so baby goes up for lab.  Thats ok.
  In the meantime, I am with my client behind privacy curtains in a private
room with the door closed  and a OB Dr, who I have not met in 10 months
barges in, invading privacy, no introduction, no assessment, and quickly
discusses treatment for sore nipples.

I quickly and most cordially backout of the room while he loudly asks, so
what does  the pharmacy carry for sore nipples.
I reply none.  Colstrum or breastmilk is the primary treatment to heal sore
nipples and then work with latch-on.
What do you recommend?
Colstrum or breastmilk will heal.
What about lanolin?  What about A&D?
Colstrum or breastmilk will heal.
Well, I have 32 years of GP/OB experience. Where were you?
I have been watching women breastfeed since I was 7 and that gives me 32
years of experience.  What percentage of your practice BF?
One third.  I still do not see breastmilk help sore nipples in my practice.
The research states that ointments are not very effective, professionally and
personally,
I know colstrum/breastmilk heals.
It has not been my breastfeeding experience.
How long did you breastfeed? (by the way did you quess the gender?)
You got me there...The doctor left.

The family was most grateful after our 2 hour session of reducing
engorgement,
a map to the breastpump depot, an infant exam and F/U appt for the infant in
the next 24 hours, my name and # for assistance.

Of course, most people don't ask what went on because they see or hear it.
I was sorry the doctor did not know we have a LC on board at our hospital.
 My friend  will send some medically oriented articles to this person on
treatment of sore nipples and a calling card.  I think it is our confidence
in our competence that maintains our compassionate composure to teach and
assist all people who want to learn more about human milk for human babies.
A sense of humor goes a long ways when you job sucks.  Pun intended!
The nurses i work with gave me a farewell party with a cake in shape of a
bust.  Breastfeed or bust.

Latch onto Life...Karen Page