Absolutely.  Discussing appearance in a fact-based way is far different from using diminishing, marginalizing adjectives.  But of course, many clinicians are just horrid  in their discussions with families ... about many things.

Liz Brooks JD IBCLC FILCA

> On Oct 28, 2015, at 6:26 PM, Karleen Gribble <[log in to unmask]> wrote:
> 
> Yeah and that doesn't include suggesting that there is anything wrong with a woman's breasts...
> Karleen Gribble
> Australia
> 
> 
>> On 29/10/2015, at 9:23 AM, Elizabeth Brooks wrote:
>> 
>> "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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