K. writes:
"The problem I have is walking on eggs around others who should be current
on information...making it seem like it is their idea, coddling and as my
14 year old would say, "kissing up."  I do not expect that treatment from
others, and I bristle at the suggestion to do it when in professional
discussions with colleagues.  "
and M. agrees:
"It is good to hear someone who is much more visible than I in this field
say that it is tough to pussyfoot around breastfeeding issues with
professionals whose profession really requires them to be more current on
this topic!  I agree I don't like to be told what to do, but I don't think I
approach
it that way.  When discussing a breastfeeding situation or topic with a
physician or other health professional, I try to be collegial and
approachable, but find that, often, because one is a lactation anything, you
wear a label that gives everyone permission to ignore you and your
information."

And I agree that it shouldn't have to be that way. It is clear to me that
breastfeeding is something that should be able to stand on its own merits
and we as lactation professionals shouldn't have to go running after people
waving our studies just to be heard.  And I'm sure we have some health care
professionals that do listen to us when we speak collegially.

Docs should be current on breastfeeding. It's an important part of what they
do and has ramifications for the future health of our children. But for most
of them that's not all they do. Myself in the past few weeks have dealt
with: a suicidal 9 year old, sleep apnea, a 2 year old devastated by
meningitis as an infant, metabolic disorders, a 3 year old in a car accident
in the front seat without a carseat, autism x3, immune deficiency 3 types,
child abuse, scoliosis, sexually transmitted diseases, developmental delay -
chromosomal and other x5, school avoidance, enuresis, allergies,
constipation, life threatening asthma, ADHD, diabetes, seizures, substance
abuse, hypertension, bipolar disorder, ODD, tourette's syndrome, obesity x4,
hernias, fractures, sprains, heart murmurs, a dozen different rashes, lots
of vomiting + diarrhea (mostly older kids), fevers up to 105.4 degrees
(mostly younger kids), RSV, more colds than I can count and I only work part
time. I can't imagine what it must be like to be a family doc - they have
all that adult stuff to keep up with as well.

In reality, though, as HCPs we are salespersons. We are selling
breastfeeding. I know, we shouldn't have to sell it. Everybody should come
to us wanting to do it because of all the good reasons, etc, etc. ( I
shouldn't have to sell the parent of an asthmatic on not smoking around him
either, but I try to anyway...)   But in reality, these people have been
sold to already -
by the formula companies. Formula cures colic, reflux, diarrhea, lactose
intolerance, too frequent feeding, too frequent night waking, gassiness,
constipation, the work of having to feed your baby, the embarrassment of
feeding in public, the list goes on...  And it really is no different with
doctors.  We are selling breastfeeding to them too. Because they have been
sold to already, too. [see list above] That is why it's easier to teach med
students and residents about breastfeeding than established docs. There's
less to undo.

 But we have scientific studies you say, those should speak for themselves -
those hardheads just won't listen!  Well, those men (and women) in the dark
suits have studies too. And they've been selling to the docs a lot longer
than we have. Yes, our studies are better than their studies, but if we
don't find a way to present our studies so that docs will listen, it won't
matter that our studies are better. But it's "demeaning" to have to "sell"
breastfeeding to people who should know this stuff anyway, right?
Well, look at it this way; if you can sell a person into listening to you
and they find that what you are saying is correct and helpful, they are more
likely to listen to you again. The trick is getting them to be receptive in
the first place.

So, my question for everyone is: What is the goal?

Gail S. Hertz, MD, IBCLC [who spent 10 years in retail sales before going to
med school, can you tell?]
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