what can docs do?

You’re already busier than any human being should be, and now we’re adding yet another patient expectation, right?

But these items are do-able, even in the ever-changing office/clinic scene.

Start with getting a handle on WHY you should do something.  Spend a few minutes perusing the Call to Action.  Often practitioners are sure they are doing all they can to see that their youngest patients get off to the best start possible.  For some very practical stuff on what can be done, take special notice of ‘Doctors in Action‘

This document from the surgeon general’s office can be an eye-opener, and a fresh perspective.  You might just start by taking a closer look at the magazines that are in your waiting room, for example.  Most promote formula feeding–rather than breastfeeding– as normal.  Or, in most cases “just as good as, ” breastfeeding.  Even the so-called, ‘medical’ mags, signed by cyber-doctors, have discussions about how to manage breastfeeding using language and evidence that is out-of-date, and even downright medically incorrect.

Information that we give our moms and dads should be current, evidence-based, and clearly and universally understood–by patients and practitioners alike.  There should be no anecdotal teaching, from one clinic staff member to another, depending on who she sees this week.  There should be no subtle, ‘just in case you can’t breastfeed’ undertone that undermines a woman’s already vulnerable confidence about her body’s ability to get the job done.  Remember: this has been shown conclusively to be one of the biggest predictors of breastfeeding failure

Maternal Confidence

in the United States, by far.

And the bag of free formula samples given away in countless doctor’s offices around the country serves only to do just that–undermines maternal confidence levels.

Why do we do this to ourselves? Yes, to ourselves.  Because when a mom becomes a failure statistic, we all suffer.  It puts an additionally heavy load on our already crushing health care system that cannot adequately meet the needs of the most vulnerable members of our populations.

The best way to get them out of the vulnerable category is to start them out with human milk–and only human milk.  And the best way to do that is to support the needs of the new mom, who is attempting to do the very best thing, but needs help understanding the management of breastfeeding, or in some cases breast-milk feeding.

And we can only do that when our practitioners and our clinic, office staffs, hospital staffs, community organizations and agencies- to name just a few–are all adequately trained in education, support, and long-term care and management of human milk feeding.

http://lactationnarration.com/index.php/2012/06/docs-children-breastfed/

Great article at Lactation Narration, and posted on Kellymom.com as well, from June 16, 2012, entitled,  “Were Your Doctor’s Children Breastfed,” along with the research from studies on this topic.  PLEASE read!

The Intent of This Site

Innocenti Declaration

Why create this site? Well, several reasons.  To start with, there are some no-brainers here.  These last couple of years have been a great time to be breastfeeding, as multiple entities have come on board in support of breastfeeding as never before.  I remember the ‘closet breastfeeding’ that was done, not so very many years ago, and the women who went against medical advice and kept breastfeeding anyway, for various reasons.

That being said, I point to the fact that, even though people may go ‘against medical advice’ occasionally, what their doctors say to them has a very HEAVY impact.  People remember what was told to them by their physicians–almost verbatim–years later, and the info is heard repeated as though gospel, with much emotion and passion attached.

The A.A.P. statement that was published last year (please read this) regarding the positive impact that could be made if higher breastfeeding rates could be achieved, did much to validate what we already knew: that our rising medical costs have been largely self-imposed, by way of not understanding that mankind already has much available to him to heal and maintain good health. (Specifically, human milk.)

So it is with breastfeeding our human offspring.  However, I am not here to re-invent the wheel. There is already so much research at our disposal on the topic that it’s almost mind-boggling.  So what’s wrong? Why aren’t more people doing it?What are the obstacles?

The obstacles are myriad, but one major one keeps stopping me in my tracks: physicians. Yes, physicians.

(Don’t get me wrong–I have great respect for the work that IS being done in this area, and the progress that is being made. It is firmly acknowledged that this is a difficult topic for a predominantly male profession–and I say this with the nod toward the many, MANY men in my family, and the conflict that this generates in our culture with the breast. Even my men, who have lived with this being dinner-table topic for years, and LOTS of breastfeeding going on, still acknowledge what a double-edged sword this is…..It’s part of why dads have a difficult time coming to breastfeeding class.)

So not all, mind you, but a large majority of physicians remain stuck in the notion that they are the experts in infant feeding, and resist any notion of furthering their knowledge in the subject. Old habits die hard, and it sometimes seems to be an affront to their professional integrity to acknowledge that the body of evidence is changing, (daily!) and so too must their level of education, and the very language that they speak, in order to do an adequate job.

You would expect a physician to keep his/her level of knowledge up in other topics in medicine, i.e., the latest in arthroscopic diagnostic technology, for example, or the latest in pharmacy resources for particular maladies which his patients come to see him for.  Yet often, family physicians, OB/Gyns, and pediatricians–the very ones which are the closest providers to families during childbearing/child-rearing–are the ones to lag behind in information, education, resources, language–every ESSENTIAL component for supporting the breastfeeding dyad. They may leave the breastfeeding info to their nurses, or nurse practitioners to do the education, thinking that they have it covered.

And maybe it is covered, but more likely it is not.

BabyFriendly International and BabyFriendly USA have published recommendations and requirements which say that a hospital or clinic staff must have a minimum of 20 hours of education to be considered up to par in this area of maternal/child provider-ship.  So for hospitals who choose to pursue this designation, dollars are set aside for this aspect of the clinical education to take place, and the nurses will probably be the ones to go through this process of clinical education.

But what about the the physicians? Where will they be? For whatever reasons, they will probably leave it to the hospital and clinic nurses to do that part, being unaware of the huge impact their words will have on their patients. And what about the hospitals who are maternity hospitals, but who are NOT choosing to go the BabyFriendly route?

One of the largest predictors of failure in breastfeeding is low maternal confidence, sometimes brought on by low milk supply, but more often by perceived low milk supply.  We know this from the research.  Many, MANY things contribute to this, not the least of which is what a doctor says, or DOESN’T say to a new, under-supported mother.  When she lives in a culture with low breastfeeding rates, and few breastfeeding women around her from which to learn positive parenting behaviors, she is considered under-supported.

This is fixable! There are a multitude of avenues for physicians/providers to get more training on how to support breastfeeding families, build their confidence, encourage them in their difficulties.  Training can take on many forms, be in large chunks or small ones, and can include all members of the staff/team.

The trick is to make the commitment to do it!

Remember: there were breasts before there were bottles.

Good Morning!

I am a writer, Board Certified lactation consultant, educator, labor and delivery nurse, wife, mother, grandmother.  The joke in our large family is that I was either pregnant or breastfeeding for upwards of 15 years, so all my dresses came and went out of style, more than once, by the time I was able to wear them again.

My professional goal is to expedite improvement of breastfeeding initiation and duration rates, by way of education, promotion, and protection, so that women, children and families may be stronger, healthier, and better able to sustain their positions in their families, communities, and training centers (or workplaces,) for the long haul. This is what will strengthen our communities, our country, and our world.

Bainne Misean, pronounced Bah-nya, Miss-e-an, loosely translated to mean Milk on a Mission, has an approach that is slightly different–namely, to help the providers who help women.

Please leave comments, ask questions, debate, and, in general–discuss!

Stay tuned, while we build.

Yours, Maria

Bainne Misean