Physicians' influence & responsibility..

iVillage Member
Registered: 03-19-2003
Physicians' influence & responsibility..
28
Mon, 05-19-2003 - 9:46pm
I'm not sure if we've discussed this or not....

What influence do doctors have on women when it comes to ff vs bf? And, what is their responsibility when it comes to giving correct & current information regarding either?

I don't have any hard stats to back me up, but it seems to me, from what I have heard/read IRL, that doctors are giving out A LOT of mis-information when it comes to breastfeeding. It also appears that this mis-information is leading them to recommend/cause mothers prematurely wean their babies. It seems that if anything is going wrong with baby (gassy, spitting up, fussy, not gaining quickly, etc) breastfeeding is automatically to blame & the first recommendation is to wean to formula - instead of looking more closely at what is going on with mom/baby and trying to correct that (whether it be bf'ing related or not) first.

Shouldn't doctors be responsible for KNOWING what they are talking about if they are going to spout off advice & information about breastfeeding? It seems to me that there are a lot of doctors are giving out breastfeeding advice and don't have adaquate knowlege about it. The may *think* they know - but they really don't (yes, there are exceptions). Of course, I don't expect surgeons or other specialties that don't deal with babies and/or mothers on a regular basis to know these things (but they should be the first to admit it & defer the questions to those who do know) - but I would expect that Pediatricians, Ob/Gyn's and even Family Practice docs to have a basic knowlege of breastfeeding issues - and know where to get information if they don't know the answer, instead of just assuming or faking it.

What do you think? If breastfeeding is "best" why don't more physicians take the time to actually learn about it before they start giving advice on bf'ing issues? Instead, it seems they are generally quick to blame bf'ing if something is not going quite right & are fast to suggest either supplementing with formula or weaning instead of trying to solve the problem. Shouldn't they be responsible for having at least a basic knowlege? They really do influence mothers' feeding choices - if they don't know much about bf'ing/bf babies, they are more likely to suggest ff'ing or at least not try to encourage a mother to bf (or continue bf'ing if she runs into troubles)....and possibly even (intentionally or unintentionally) sabotage a mother's attempts to bf.

I can't comment on the knowlege of doctors about formula feeding since I don't have any experience with it. But, with all the information that formula companies hand out, I have to assume that docs have easier access to materials on ff & may be more "comfortable" talking about ff'ing. There really aren't that many "issues" surrounding ff - not much to know (or is there?).

Michelle

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iVillage Member
Registered: 03-26-2003
Mon, 05-19-2003 - 10:03pm
I agree, I hear of a LOT of people prematurely weaning b/c their physician blamed something on Bf that was totally up the wrong alley.

Also, I've talked to several MD's who say that unless a MD CHOOSES to take extra supplemental courses or symposiums or conferences (etc) on bfing, most MD's get a total of about half a day on bfing. I mean, there is so much to cover and some MD's (ie the one who decides to specialize in podietry...feet!) are never going to come across bfing troubles so why make them learn about them in med school in case they go into pediatric or family medecine and need to?

I do think that ped's or family practitioners and also ob/gyn's and anyone else who sees MOTHERS should be obliged to go to several bf conferences a year.

Fio.

iVillage Member
Registered: 03-26-2003
Mon, 05-19-2003 - 10:37pm
I think, in general, you are right. It seems so many docs know nothing about breastfeeding and I can't figure out why more importance isn't placed on it. It is common knowledge now (well, I think it is) that breastfeeding is correllated with overall better general health. So why isn't it emphasized more?

As a side note, I must say that my son's peds are both lactation consultants (both are young). I think that's awesome and they have always been very supportive of breastfeeding. I know one of them who personally found a specialist for a friend of mine who almost weaned....and was able to save their breastfeeding relationship. So there is hope that things might be changing for the better!!!

iVillage Member
Registered: 05-08-2003
Mon, 05-19-2003 - 10:41pm
Most everyone I knows breastfeeds and none of have quit due to advice from their doctors. They quit when it was time for them or when they didn't want to bf'd any longer.

My pediatricians and my ob/gyns are not the type to assume or fake information, if they don't know the answer they will find the correct one, they will give you resources. I guess I'm lucky in that after hearing stories.

My doctors have no influence on me on the bf/ff issue. My ob/gyn and the nurses in his office pretty much talk bfing until you tell them no, I"m ff. Formula isn't mentioned as an option.

Now I've never discussed bfing with either the ob or peds since I made my decision clearly before I saw them. So I have no take on that side of the issue. Haven't BTDT.

iVillage Member
Registered: 03-19-2003
Mon, 05-19-2003 - 11:20pm
We are lucky on the Ped front as well. My sons' ped is married to a Lactation Consultant. He is very knowlegable about bf'ing and has always been supportive & encouraging to me. More than once, he has praised me for continuing to bf my boys & said he wished more mothers would nurse as long (or even half as long) as I have. Gave me warm fuzzies. :o) He's not a really young doc, either. He's in his upper 40s, I think. Great doc. I'm glad we picked him.

Michelle

iVillage Member
Registered: 03-26-2003
Tue, 05-20-2003 - 12:26am
Here is a link to an AAP Survey of Peds on bf attitudes and practices

http://www.aap.org/research/ps30exm.htm

I think part of the problem is the way we specialize care. A ped might not be the best to give bf advice if they only consider the baby as their patient (as opposed to a mother-baby dyad). I had problems bf my first baby in part due to bad advice from our ped (she encouraged me to give my preemie supplemental bottles of formula) and she's supportive of bf. I've learned a lot of things later that would have helped me if I knew them when DD was born. It bothers me that I can get better info on medicine compatability with bf off of the internet, than my Dr can get from the pharmacist. I do think peds should have more lactation training, or refer their patients to a lactation consultant when they are concerned, instead of suggesting formula.

Lori

iVillage Member
Registered: 03-25-2003
Tue, 05-20-2003 - 10:19am
I have never known anyone whose doctor recommended they stop BFing for the problems you mentioned. I always hear about stuff like this - but even in my area, with extraordinarily low BF rates - I just don't hear this. Doctors - pediatricians especially - encourage and support BFing in my experience. I am completely at a loss here - this just seems like a big conspiracy theory to me. I can't find any basis in my own experience, IRL or online, to say doctors don't adequately support BFing.

-Deb

 

iVillage Member
Registered: 03-25-2003
Tue, 05-20-2003 - 10:24am
Several conferences a year??? "Obliged"??? I totally disagree. Several a year is a LOT, and there are so many important issues for these doctors. Should peds also attend several conferences a year on every other child related issue too? Do you know how MANY issues there are? OB/Gyns??? Should they get several conferences a year on every important issue? They'd never see any patients!!! BF is important, sure - but it's not the most important thing above and beyond all other issues. I'd rather my OB spent more time at gynecological cancer awareness seminars.

-Deb

 

iVillage Member
Registered: 03-26-2003
Tue, 05-20-2003 - 10:31am
Have you been to a bf support board?

There are lots of posts questioning Dr's advice (supplementing with formula for jaundice, poor weight gain etc). I do think most Drs are supportive of bf, but they don't always give the best advice to bf mothers.

iVillage Member
Registered: 03-19-2003
Tue, 05-20-2003 - 11:02am
A post on the BF'ing Support board is what prompted me to post this question. A mother just posted that her baby is gassy, etc & doesn't seem to tolerate when mom eats dairy. Her ped's recommendation was to wean the baby (1 month old) to soy formula. On another board I frequent, a mom posted that her 9 mo old is a light-weight...bottom of the charts for weight, but average length & the doc wants her to supplement with formula because obviously he isn't getting enough from bm alone (baby won't eat solids) - but the doc didn't seem to take into consideration that mom is tall & skinny. Genetics play a large roll in babies' growth patterns. The doc was quick to blame bf'ing instead of looking at the big picture.

As co-leader on the bf'ing support board, I see/read questions regarding bad advice given to moms regarding bf'ing all the time. It is very frustrating to me. Someone else mentioned that they can find info on taking meds & bf'ing easier on the internet than her doc can get from his resources (ie the pharmacist). I answer MANY questions on the compatability of medications & bf'ing using my handy book by Dr. Hale. It is a book that I think should be a standard resource in all pharmacies - but it is not. So many women are told they must either wean or pump & dump while on a medication when it really isn't necessary. It is just another example of the mis-information given by doctors & their unwillingness to educate themselves about the issues.

Michelle

iVillage Member
Registered: 03-19-2003
Tue, 05-20-2003 - 11:06am
I'm not sure several a year is necessary, either. I can see maybe once a year or even every other year. Maybe requireing them to attend a LLL conference would be a good idea. Those are held every other year. There are usually local conferences in every state, but there is also a national/international one every couple years - there is one this summer in San Francisco, actually (July 3-6).

Michelle

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