Thought those of you without web access might enjoy reading it too.
We have a few MDs in our area that remind me of the MD described in this
article.
They treat yeast appropriately in mom and baby (and family if necessary)
and
promote breastfeeding every chance they get.
 All I can say is good for him!

Maurenne Griese, RNC, BSN, CCE, CBE
Manhattan, KS  USA...where it's beginning to feel like spring...
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It's OK to Aggressively Encourage Breast-Feeding

Christine Kilgore, Contributing Writer

Pediatric News 32(12):29, 1998.


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FALLS CHURCH, VA. -- Some might say Dr. James L. Ogan is too aggressive in
making sure women breast-feed their children.

On newborn hospital visits, he asks women, "How's the breast-feeding
going?" or "Have you had the baby to the breast yet?" And if he sees a
bottle, he might say, "Did something happen with the breast-feeding?"

The question he gets from some colleagues is whether he makes mothers who
have not started breast-feeding -- or don't want to -- feel guilty.

No, he said, and he implored other physicians to take the same approach.

"Usually [the mother and I] end up having a conversation, and it's not a
punitive thing on my part," Dr. Ogan said at a meeting on breast-feeding
sponsored by the Inova Institute of Research and Education.

"Some will say, 'I never thought about it' or 'I wasn't sure.' I'll often
say, 'Let's give it a try.' And if she says firmly, 'No, I never wanted to
do that,' then at least we've addressed it."

The basic gist of the approach lies in letting women know that he "regards
breast-feeding as the norm." Telling women they should breast-feed is no
different from telling patients they should stop smoking or change their
diets, said Dr. Ogan, who practices in Franktown, Va., and is
breast-feeding coordinator for the Virginia Chapter of the American Academy
 of Pediatrics, which also sponsored the meeting.

The academy recommends that breast-feeding start within the first hour
after birth and continue for at least 12 months. Its policy statement,
released late last year, cites studies showing that breast milk decreases
the incidence and severity of diarrhea, lower respiratory infection, otitis
 media, bacteremia, and other illnesses.

Approximately 60%-70% of women nationwide initiate breast-feeding, but 6
months later, only about 20% are still nursing, Dr. Ogan said. He discussed
 ways pediatricians can help raise those percentages:

"Talk to women early. Most women have made their feeding choice before they
 give birth. When you see them during prenatal interviews, talk about
breast-feeding.

"Help change delivery room procedures. Dr. Ogan helped organize the Eastern
 Shore Breast-feeding Task Force, a community group of physicians and
lactation experts that spurred new delivery room procedures at the rural
Shore Memorial Hospital in Nassawadox, Va.

Ob.gyns. now encourage new mothers to breast-feed in the delivery room, and
 nurses are instructed to delay certain routine procedures like bathing,
weighing, and other "admissions" processes. After an hour, the chances of
successful breast-feeding are diminished, Dr. Ogan said.

"Make sure breast-feeding is observed in the first 24-48 hours. "Someone
has to see the baby nursing ... [and] assess the positioning, the latch,
the swallowing," Dr. Ogan said. "Don't be fooled by the nurses' log sheet
showing that the baby's going to the breast every 2 hours. The baby could
be asleep; it happens all the time."

Pediatricians who are not comfortable making that assessment and physically
 helping a mother and newborn need "to find someone who can," he said.
Assessments also should be done at the early follow-up visit -- 48-72 hours
 after discharge.

"Talk with women about returning to work. "That's where we lose a lot of
mothers [to bottles]," he said. "Sometimes they need a little approval and
someone else to say, 'It's OK if you don't go back to work for awhile. Can
you work this out with your leave?' or 'Can you do with less money?' "

"Realize that yeast is a "big problem." It's painful, and it's one of the
most common reasons women discontinue breast-feeding. Dr. Ogan routinely
prescribes nystatin for women with yeast infections on their breasts and
urged others to do the same.
??I