Boy do I share your frustrations, Magda.  However, I seem to have been born
optimistic, and having been in the field in the US for over 20 yrs.  I see
LOTS of progress in elevating the standard of care.  So I know it can be
done, and it always starts with small groups or even individuals raising
their voices in a call to the higher standards.  So your articles will
contribute to the pressure that has to build before change is accomplished
with regard to elimination of sloppy practices.  Think about the amazing
initial resistence there was to the idea of physician hand-washing!!  Think
about the poor guy who tried to convince the medical establishment that
pylori bactor  (sp?) caused ulcers -- not stress!  He was almost laughed off
the planet.

Lots of ideas that today are commonly accepted started out as heresy and
seemed impossible to institute.  We need good research to back up any
proposed standard of care, and clinicians help researchers by sharing what
works in practice and calling for scientific exploration.  If the research
bears out, it provides the platform for the change to become integrated into
wider practice.  So we all work together.  If we keep open minds and work
very hard, we will make slow progress.  That's as good as it ever gets, and
it doesn't do to get too discouraged.  I long ago decided that if I didn't
take an attitude of detatchment I would go nuts from irritation.  If our own
conduct is scrupulous with regard to providing careful service, then we can
at least feel good about our own contribution.  And I believe careful work
lays the groundwork for positive change.  At least that is what history
tells us.

Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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