In a message dated 11.14.04 8:18:44 PM, Jennifer writes:


> When I was a resident, I conducted a survey (with LN's Mary Kay Smith) on
> breastfeeding among our WIC patients, who were nearly all African-American
> and poor.  To my surprise, every single woman who completed a survey could
> list benefits of breastfeeding.  Many of them said health care providers had
> encouraged to breastfeed.  But the only thing that was statistically
> significant in association with actually breastfeeding was if the woman's
> mother or other support person in their life encouraged them to breastfeed.
> Without support where you live, it is very hard to do something as
> consuming as breastfeeding
> Of course, I'm still trying to provide as much support as I can to every
> single mother, but I have to acknowledge that I'm not the most important
> factor.
> Jennifer Tieman
> Family Physician
> 
Of course it is hard.   Obviously I 'hear' what your saying   but I'm sure 
that is what Bobbie Phillips and Anne Merewood felt when they initiated the 
changes in the breastfeeding climate at Boston Medical Center . However, These 
changes are the only thing that can explain their huge increase in breastfeeding 
with the same population that you describe. Breastfeeding became the *norm* at 
that hospital. I know that pedi HCPs are worried about alienating patients 
but until *you do what they do* (at BMC) and create a climate that shouts "we 
promote breastfeeding here!" and not "we try to walk the fence " (and yes that 
could include posters etc!~) can you truly know how much of a factor you are.

Lynn Shea Rn,Bsn,Ibclc
formerly Franklin,Ma.......now Lakewood Ranch, Fl


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