Dr. Tieman,

I think I've been around Dr. Jane Heinig too much - your data just made me
think of "what a great baseline for a study"...instead of "wow, how I wish
our doctors thought like SHE does!

You're great!  Please don't feel you're not doing "enough"...

Most mothers think the same way...we all want to do more and more for our
children - and sometimes we need them to stub their toes, or get their
feelings hurt.  However, the reality is that breastfeeding is NOT a
"choice" but a public health issue - and just like smoking or car seats, we
need to be pro-active.  As our moms are dealing with many problems - their
own inertia after delivery, assurances from others that "formula is just as
good" and even fear to appear "too" radical...

I will add some thoughts to the great suggestions you have received from
others:

I've learned NOT to depend on giving moms a telephone number or a resource
- they usually don't call for about 10 - 12 days - then we're having to do
LOTS of interventions just to get back to where they were on day 3!  If at
all possible, establish a process of being calling the moms at 72 hours
postpartum and learn if milk is in, breasts are full, baby is nursing
often, nipples are OK...with the ability to offer them in-person visits
(home is best, but office if that is not possible).  Ideally this should be
a home visit by an IBCLC.

and or

Offer weekly support group meetings - I usually had a scale available to
weigh those who needed it, though that was NOT the focus of the meeting -
it was dealing with myths, family pressures and "friendly" interventions.

I could see it now - you might try to develop a study of your patients  -
what a great source of information on what "works" and how it works.

Good luck!

Jeanette Panchula, BSW, RN, PHN, IBCLC
NEW e-mail address: [log in to unmask]

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