"Anticipatory guidance and individualised care," described as "important
for all mothers" and something "we can do with only benefit to all mothers"
is exactly what I mean by "information" [which I contend never hurt
anyone].  It is exactly what I mean by "Please fer cryin' out loud -- let
us all as clinicians impart information in an empowering (not diminishing)
manner."

On Wed, Oct 28, 2015 at 6:12 PM, Karleen Gribble <[log in to unmask]>
wrote:

> I disagree that information hasn't ever hurt anyone. Having spent years
> talking to adoptive mothers who were told  that they were not going to be
> able to make enough milk for their babies and having seen first hand how
> that information is conveyed and how that impacted them and how that
> information morphed into lactation texts and breastfeeding books for
> mothers despite what the research actually said, I am very cautious and
> suspicious about the idea of telling women anything based on looking at
> their breasts when we know so little about IGT! And so little about
> insufficient milk in general- honestly, being female is a risk factor for
> insufficient milk. Lets just tell every mother that she might not make
> enough milk because a fair proportion are going to believe that this is so.
>
> Diana didn't actually look at the population that we are discussing, she
> didn't look at women who had funky looking breasts during pregnancy or on
> the first couple of days after birth who may or may not have had
> difficulties with making sufficient milk. She looked at women who had funky
> looking breasts and did turn out to have milk supply problems. Of course
> most of them would want to know about it beforehand. But what proportion of
> women who have funky looking breasts end up with IGT??? Actually we don't
> have a clue. We have no idea. And as with all things breastfeeding there is
> an interaction between the infant and the mother to consider as well as the
> mother's beliefs about how breastfeeding should occur.
>
> I do not see it as being about withholding information given how little we
> know. I do see that anticipatory guidance and individualised care is
> important for all mothers. That we can do with only benefit to all mothers.
>
> Karleen Gribble
> Australia
>
>
> On 28/10/2015, at 11:14 PM, Elizabeth Brooks wrote:
>
> I absolutely agree: "implying that there is something wrong with a woman's
> body before it is evident is not a benign intervention."
>
> I hope any parent who has a discussion with me, about any red or yellow
> flags for milk production issues, who walks away feeling that I have
> informed them that there is "something wrong" with their body, gives me a
> good swift poke in the ribs.
>
> My post encouraged "a good clinician [to] use excellent parent-centered
> communication skills."  My approach (greatly abbreviated here, of course,
> compared to a real face-to-face consultation) is to cover "You might have
> supply isues, here is why I say that, and here is what to look for."
>
> With IGT-signalling parents, I also spend a whole boatload of time
> affirming and validating what marvelous things are happening (because
> something marvelous always IS happening--we have a newborn!), and stress
> over and over again that appearance is not proof -- it is a marker.
>
> I go back to Cassar-Uhl's book.  She did the research; she interviewed the
> parents with IGT.  They said: We want information about our bodies, and we
> are entitled to get information about our bodies.  I am persuaded.
>
> To repeat: information never hurt anyone.  But, please fer cyrin' out loud
> -- let us all as clinicians impart information in an empowering (not
> diminishing) manner.
> Liz Brooks, JD, IBCLC, FILCA
> Wyndmoor, PA, USA
>
>
>
>


-- 
Liz Brooks, JD, IBCLC, FILCA
Wyndmoor, PA, USA
Secretary, U. S. Breastfeeding Cmte (2014-16)
Director, Human Milk Banking Assn of North America (2015-18)
"IBCLCs empower women and save babies' lives!"-Ursuline Singleton

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