I'm really pumped up today. During morning rounds in the hospital, I was
setting with a number of pediatricians, about 16 residents, and a bunch of
students. We were discussing a litany of GI problems in a small patient,
dehydration, diarrhea, GI pain, etc., etc. when one of my pedi residents
spoke up to say,
" Well, none of this would have happened if the mom has breastfed the
infant".
A number of heads nodded in agreement. Several of my faculty then
looked at me and smiled, because they knew where that came from. I only
bring this up, because in the last month I've noted a lot of discussion on
this network concerning the difficulties you have had educating physicians
about breastfeeding. Because I've been educating faculty, residents and
students for the past 15 years, I thought I'd pass along a few(highly
biased) techniques I use in my institution.
Med students and Residents are absolutely wonderful to teach. They are
highly educated, very dedicated, very empathetic, reasonably skeptical,
and are like little light bulbs... ready to be turned on, all they need is
the information. Trying to change habits in older physicians is next to
impossible, unless you put them in an environment(med school) where their
ignorance is unacceptable, and obvious. Then they'll readily adapt(I've
seen this a hundred times).
I'm not a lactation consultant, and I don't know all these techniques you
use to get a baby to feed properly, so I stick to what I know best with my
students, drugs and the physiology of breastfeeding. During the year I
always give at least 2-3 lectures on breastfeeding, generally to the
incoming residents and students. None of these students or residents have
any concept of breastfeeding and I always find it is best to start with a
lecture on the biochemistry of milk production, where it comes from, all
the wondrous components that are present, and most importantly, what those
components do for the infant. I always try to make the process almost
"mystical", that nature in its infinite wisdom, determined each little
weakness in the human infant, and made a milk component to protect against
that weakness. It is important(to hold their attention), that the ultimate
sophistication of this biochemical process(BFing) be impressed on the
student. They absolutely love the finite details, and they love the fact
that something in nature is absolutely magic and far exceeds mans/womans
ability to understand. Once they understand these "mystical" details,
they're on my train. Then you hit them with all the information on reducing
SIDS, otitis media, viral diarrhea, IQ, etc. etc. The last bit of info I
then hit them with, is the name of our LC and how great she is in helping
moms with all their problems. Students and residents are more receptive to
unique ideas if they know they can find support when they need it.
Some other tips:
1) These kids are mini-scientists, stick to clinical facts, never
introduce unsubstantiated subjects, herbal remedies, cabbage leaves... you
get the idea. Nothing will turn them off faster than these subjects.
2) All residency programs have training hours schedules throughout
the week(we actually have over 6). Ask the Program Director(or better, the
Chief Resident) if you can come talk. We're always looking for someone to
fill that hectic schedule. If you don't want to talk, bring in a famous
person(Auerbach, etc)... that always helps.
3) Never speak for more than 30-40 minutes, most residents are
tired... you'll loose them. Remain clinical, professional. If you start
talking about bonding, and mother-child interactions, etc, they're asleep
in 10 minutes. Lets face it, the physiology of breastfeeding is a story
fit for StarTrek, they'll love it.
4) Try to speak or visit annually to hit the new crop of students,
residents. If you get to talk to the residents, the students will be
present also.
5) A short review on drugs is always good. Drugs are something high
on the "to know" list for students/residents. When you say cephalosporins,
ciprofloxacin, their little light bulb turns on, they know they're supposed
to know this.
6) After the audience is "sold", I have the LC then start the
final education process... latch on, counting wet diapers, etc.
Finally, don't be afraid go after this audience, with all the new evidence
supporting BFing, the facts are on your side. Students and residents are
really nice young people, and are very receptive to your information. It's
simple not true that they believe every drug rep that comes along... they're
far smarter than that. Its just that they hear from the rep... more than
you. Lets fix that.
tom hale
|
