Ann asks for suggestions for diplomatic response to recommendations from a doctor in whom the mother has "complete trust." Complete trust in the infalibility of any HCP is not a good idea. One of our steps in maturity is to learn that noone knows it all, but that's ok. We can completely trust that our HCP will do the best he/she can to be well informed and to treat with the greatest knowledge available. But when there is an area that this HCP lacks knowledge we go to another who knows, ideally by referral. This doctor's orders are based on a little bit of knowledge (antibiotics/yeast) and a lot of ignorance. For starters he believes that oral yeast is caused by something that happens in the mouth, and that this something can be washed away by abm. WOW! You probably know all the areas of "misunderstanding" in this treatment; but how do you tell this mother that her doctor is wrong without shaking her complete trust in his infalibility? What is our role in perpetuating the myth of infalibility? What is our duty to our clients to pass on accurate information to the best of our knowledge? Is it to this mother's advantage to continue to believe her doctor can't be under-informed? If she discovers that there is something about yeast, immune protection of exclusive b'feeding, etc that this doctor doesn't know, where does that leave her? Is it necessary for her to believe that he knows everything before she can trust him to be the caregiver for her baby? We all have similar dilemas with erroneous advice and I believe we must address it. But how? That was you question, wasn't it? Sometimes I do it better than at others, but I usually make it clear that I understand that busy doctors can't read all that comes their way and I compliment him/her on something if I can. And I make it clear that if there were a room full of highly competent doctors they would disagree on many treatment recommendations. In this case I would tell her what I know of the systemic nature of yeast overgrowth and also about the effect abm would have on her baby's immune system, and consequent vulnerability to yeast infection or further colds and sinus congestion. If I were being very gentle I might tell her that some people recommend rinsing the baby's mouth with water after feeds. I would also assure her that just because her doctor doesn't know all there is to know about yeast doesn't mean that he isn't an outstanding doctor for her baby. There are A LOT of doctors who don't know much about yeast. I would do all of this in a dialog, not a lecture, while getting a feel for how she is taking it allas we go. Every mother is different.(Surprize!) This is a very wordy way of saying that I believe we need to impart the knowledge that we have and sometimes that may change the way parents view their child's doctor, and in my opinion, for the better. Patricia Gima, IBCLC Milwaukee