Okay, this node was empty and I know all the answers, so--


1. If he/she has a big poster in his office that says "ENFAMIL: For the Life of Your Child!"

2. If he/she gives you large amounts of narcotic prescriptions for no real reason.

3. If, when you try to breastfeed in his/her office, they ask you to "Take it to the restroom."

4. If, when you DO take it to the restroom, he/she follows you with a blanket.

5. If you insist on breastfeeding in his/her office, they put the blanket over their head.

Par example:

I went to my regular physician when my son was two months old. I was suffering with a breast infection, and could not seem to work it out. (Just for reference, the common practice now is to breastfeed through an infection, rather than stop breastfeeding and pump until it is over.)

The doctor was very unsympathetic to the fact that I was trying to continue lactation, and wanted me to take an antibiotic that was unsafe for my child and secreted through breastmilk. When I adamantly refused, he became belligerent, and told me that he was the doctor, and that I should listen to him regardless of my views, as I had not attended medical school.

He then went on to inform me that since my son was already two months old, he had already received any benefit he was going to from being breastfed, and it didn't really matter.

I took the prescription that he had written down for me, picked up my child, and left his office in tears. I went immediately home, and began a process of grieving that I cannot really explain. I was racked by sobs, and could barely think. I called my husband, (who is wonderful, btw!) and explained what had happened in mostly fragmented sentences, amidst a lot of caterwauling.

It was then that he said the most AMAZING thing: "Well, goofball, call another doctor." You would have thought that he had just suggested that I jump to the moon. Another doctor? What a great idea!

I called my OB and explained the situation to him. He called in another prescription for me, and even called my regular doctor, explained the new practices to him, and berated him for upsetting me so.

The truth of the matter is, no matter how sympathetic the medical community claims to be to the process of breastfeeding, there are always the few doctors who are old school, and do not want to be told that times are changing.

Breastfeeding is a very emotional issue for most women, whether they choose to do it or not. That, in itself, is an emotional issue. I believe that no matter what your decision is, once you make it, you should find a doctor who is supportive of that decision. And if your Health Care Professional isn't, then find another one! There are thousands of doctors in any given state to choose from.

So, if you health care professional isn't all he/she is cracked up to be, then ditch them for someone with whom you can share the entire experience with, without fear of retribution or recriminations. It's worth the effort!

Written by Jack Newman, MD, FRCPC (my guru) who states it may be copied and distributed without further permission.


How to Know a Health Professional is not Supportive of Breastfeeding By Jack Newman, MD, FRCPC

All health professionals say they are supportive of breastfeeding. But many are supportive only when breastfeeding is going well, and some, not even then. As soon as breastfeeding, or anything in the life of the new mother is not perfect, too many advise weaning or supplementation. The following is a list of clues which help you judge whether the health professional is supportive of breastfeeding, at least supportive enough so that if there is trouble, s/he will make efforts to help you continue breastfeeding.

How to know a health professional is not supportive:

  • S/he gives you formula samples or formula company literature when you are pregnant, or after you have had the baby. These samples and literature are inducements to use the product, and their distribution is called marketing. There is no evidence that any particular formula is better or worse than any other for the normal baby. The literature or videos accompanying samples are a means of subtly and not so subtly undermining breastfeeding and glorifying formula. If you do not believe this, ask yourself why the formula companies are using cutthroat tactics to make sure that your doctor or hospital gives out their literature and samples and not other companies’? Should you not also wonder why the health professional is not marketing breastfeeding?

  • S/he tells you that breastfeeding and bottle feeding are essentially the same. Most bottle fed babies grow up healthy and secure and not all breastfed babies grow up healthy and secure. But this does not mean that breastfeeding and bottle feeding are essentially the same. Infant formula is a rough approximation of what we knew several years ago about breastmilk which is in itself a rough approximation of something we are only beginning to get an inkling of and are constantly being surprised by. The differences have important health consequences. Certain elements in breastmilk are not in artificial baby milk (formula) even though we have known of their importance to the baby for several years—for example, antibodies and cells for protection of the baby against infection, and long chain polyunsaturated fatty acids for optimal development of the baby’s vision and brain. And breastfeeding is not the same as bottle feeding, it is a whole different relationship. If you have been unable to breastfeed, that is unfortunate (though most times the problems could have been avoided), but to imply it is of no importance is patronizing and just plain wrong. A baby does not have to be breastfed to grow up happy, healthy and secure, but it is an advantage.
  • S/he tells you that formula x is best. This usually means that s/he is listening too much to a particular formula representative. It may mean that her/his children tolerated this particular formula better than other formulas. It means that s/he has unsubstantiated prejudices.
  • S/he tells you that it is not necessary to feed the baby immediately after the birth since you are (will be) tired and the baby is often not interested anyhow. It isn’t necessary, but it is very helpful. Babies can nurse while the mother is lying down or sleeping, though most mothers do not want to sleep at a moment such as this. Babies do not always show an interest in feeding immediately, but this is not a reason to prevent them from having the opportunity. Many babies latch on in the hour or two after delivery, and this is the time which is most conducive to getting started well, but they can’t do it if they are separated from their mothers. If you are getting the impression that the baby’s getting weighed, eye drops and vitamin K injection have priority over establishing breastfeeding, you might wonder about someone’s commitment to breastfeeding.
  • S/he tells you that there is no such thing as nipple confusion and you should start giving bottles early to your baby to make sure that the baby accepts a bottle nipple. Why do you have to start giving bottles early if there is no such thing as nipple confusion? Arguing that there is no evidence for the existence of nipple confusion is putting the cart before the horse. It is the artificial nipple, which no mammal until man had ever used, and even man, not commonly before the end of the nineteenth century, which needs to be shown to be harmless. But the artificial nipple has not been proved harmless to breastfeeding. The health professional who assumes the artificial nipple is harmless is looking at the world as if bottle feeding, not breastfeeding, were the normal physiologic method of infant feeding. By the way, just because not all or perhaps even not most babies who get artificial nipples have trouble with breastfeeding, it does not follow that the early use of these things cannot cause problems for some babies. It is often a combination of factors, one of which could be the using of an artificial nipple, which add up to trouble.
  • S/he tells you that you must stop breastfeeding because your are sick or your baby is sick, or because you will be taking medicine or you will have a medical test done. There are occasional, rare, situations when breastfeeding cannot continue, but often health professionals only assume that the mother cannot continue and often they are wrong. The health professional who is supportive of breastfeeding will make efforts to find out how to avoid interruption of breastfeeding (the information in white pages of the blue Compendium of Pharmaceutical Specialties is not a good reference—every drug is contraindicated according to it as the drug companies are more interested in their liability than in the interests of mothers and babies). When a mother must take medicine, the health professional will try to use medication which does not require the mother to stop breastfeeding. (In fact, very few medications require the mother to stop breastfeeding). It is extremely uncommon for there to be only one medication which can be used for a particular problem. If the first choice of the health professional is a medication which requires you to stop breastfeeding, you have a right to be concerned that s/he has not really thought about the importance of breastfeeding.
  • S/he is surprised to learn that your 6 month old is still breastfeeding. Many health professionals believe that babies should be continued on artificial baby milk for at least nine months and even twelve months, but at the same time seem to believe that breastmilk and breastfeeding are unnecessary and even harmful if continued longer than six months. Why is the imitation better than the original? Shouldn’t you wonder what this line of reasoning implies? In most of the world, breastfeeding to 2 or 3 years of age is common and normal.
  • S/he tells you that there is no value in breastmilk after the baby is 6 months or older. Even if it were true, there is still value in breastfeeding. Breastfeeding is a unique interaction between two people in love even without the milk. But it is not true. Breastmilk is still milk, with fat, protein, calories, vitamins and the rest, and the antibodies and other elements which protect the baby against infections are still there, some in greater quantities than when the baby was younger.
  • S/he tells you that you must never allow your baby to fall asleep at the breast. Why not? It is fine if a baby can also fall asleep without nursing, but one of the advantages of breastfeeding is that you have a handy way of putting your tired baby to sleep. Mothers around the world since the beginning of mammalian time have done just that. One of the great pleasures of parenthood is having a child fall asleep in your arms, feeling the warmth he gives off as sleep overcomes him. It is one of the pleasures of breastfeeding, both for the mother and probably also for the baby, when the baby falls asleep at the breast.
  • S/he tells you that you should not stay in hospital to nurse your sick child because it is important you rest at home. It is important you rest, and the hospital which is supportive of breastfeeding will arrange it so that you can rest while you stay in the hospital to nurse your baby. Sick babies do not need breastfeeding less than a healthy baby, they need it more.
  • Questions? (416) 813-5757 (option 3)

    Handout #18. How to know a health professional is...Revised

    Written by Jack Newman, MD, FRCPC who says: "May be copied and distributed without further permission" on all his handouts, being the wonderful man that he is.


    Dr. Newman does not maintain a web page of his own but his 24 breastfeeding related handouts are mirrored with permission on many webpages. One I particularly like is:
    http://www.bflrc.com/newman/articles.htm

    CST Approved

    Breastfeeding is a very personal decision so it is always painful to be reminded how influential the opinions of health care providers can be on a new mother.

    A physician is not the only health care professional a woman may come in contact with when beginning breastfeeding. After delivery, the obstetric floor nurse will spend more time with the new mother than the doctor who delivered her baby. She should be supportive and helpful when questions and problems arise. If available a lactation consultant can also be very helpful the first few days especially in difficult situations.

    Fortunately most physicians and nurses are more informed on the benefits of breastfeeding today and are usually supportive. However only 20 years ago that was not necessarily true.

    After my daughter, Sarah, was born at 32 weeks gestational age (GA) she was taken to the Neonatal intensive care nursery (NICU) where she remained for 3 weeks. My Norman Rockwell image of a happily sated baby in my arms, hours after delivery, dissolved away with the morning dew.

    Scared for my baby's survival and insecure about my skills as a mother of a preemie, I needed to do something to help my tiny child. I found my answer in breastfeeding. A friend of mine had also had a premature baby, so I knew it was possible to keep up the milk supply and eventually nurse when the baby was old enough.

    Knowing very little about breastfeeding I didn't realize that it takes time for your milk to "come in." The first milk expressed is known as colostrum, a liquid gold for infants because it is higher in protein and antibodies than mature milk. Great stuff but it comes in small volumes for the first few days.

    After using an electric breast pump I was only able to get about 4 oz my first go round. Unsure of myself I asked my nurse if that was normal. "Why honey, you aught to throw that away there's not enough there to do anything" was her response. As you can guess she did not win my vote for nurse of the year. That could have ended it for me right there if I wasn't such a tenacious bitch (ask my husband).

    Upset but determined I set about doing everything I could to produce more milk. Fortunately for Sarah I didn't throw out that first milk but stored it in a freezer so that it could be given to her when needed.

    With the help of my midwife and a member from La Leche League I was able to successfully establish my milk supply and nurse Sarah in the NICU when she was strong enough. Although a slow starter she caught on quickly and thrived.

    The moral is not to let anyone be it medical personel, family or friend convince you that you cannot breastfeed your baby.

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