Why do some healthcare professionals remain in the dark about breastfeeding?

[ewpmsw]

I am sick of dealing with professionals who should know about breastfeeding/breastfed babies and still remain ignorant. I am not talking about a difference of opinion, I mean ignorance on the subject of breastfeeding and how to medically treat breastfed babies. At this point, it has to be a choice healthcare professionals make, not a lack of resources or education. Lots of mothers breastfeed, there isn't any excuse for the pervasive ignorance on the subject that I have encountered since my daughter was born last year. In the hospital, there were several nurses in the maternity ward who tried to be helpful but didn't know enough about it to give the right advice. The lactation consultants said not to ask the nurses for breastfeeding support. Great. Sorry to sound so harsh, but come on! The effort to encourage women to breastfeed is surely undercut by the lack of support and correct information provided by some healthcare professionals. I'm talking about ignorance that could be detrimental to my child's health. A few weeks ago, I called the pediatrician's office to make sure we were doing the right thing for our 8 month old, who had the flu for the first time. (First time parents, can you tell?) The nurse who returned my call tried to be helpful, but her advice was terrible: Don't breastfeed for 12 hours if the baby had thrown up because milk would aggrevate the tummy. She suggested Gatorade (didn't tell me I needed to cut it with water) and Pedialyte. I did not take the advice and continued nursing with some Pedialyte thrown in and the child was fine within 24 hours. I really respect and like our pediatrician and the other docs in the office, so I haven't started looking for a new place. I do not know whether this is the same nurse who diagnosed our child over the phone at six weeks of age when we called after hours, frantic because our child was gasping: Milk allergy, stop nursing, put her on formula with some rice in it. That's a responsible way to diagnose an infant. Turns out the baby had reflux, not a milk allergy. I shared my concerns about the advice I'd received from the office's nurses and the pediatrician was very apologetic. She explained that this keeps happening in spite of ongoing staff training. Clearly there needs to be something more than an occasional training class. Rrrrrrrrrrrrrrrrrr!

[wendibird22]

I share your frustration. Even though my ped is "pro-breastfeeding" I too have gotten bad advice from his office. I was sent home with a can of formula when DD was 3 days old and hadn't gained weight.

I have chocked it up to the fact that if you haven't BF yourself you probably can't TRULY offer sound advice on BF. So that leaves out the male docs and unfortunately many of the female docs and nurses. Now, I know their are exceptions to this (Dr Sears for instance), but I think this holds true for many. I stopped asking my ped for BF advice or taking unsolicited BF advice long ago and rely on kellymom and the boards at LLLI.org.

[Piglet]

I have chocked it up to the fact that if you haven't BF yourself you probably can't TRULY offer sound advice on BF. So that leaves out the male docs and unfortunately many of the female docs and nurses. Now, I know their are exceptions to this (Dr Sears for instance), but I think this holds true for many. I stopped asking my ped for BF advice or taking unsolicited BF advice long ago and rely on kellymom and the boards at LLLI.org.

I disagree - one of the biggest BF advocates is D., Jack Newman. I don't think prior success or failure to BF has any impact. My ped BFed her girls for the 1st year (which was longer than the norm at the time) and recommended supplementing when DD stopped gaining around 8 weeks. It proved to be good advice in retrospect, but at the time it seemed like the standard non-BF friendly brush-off. I think there are good and bad docs and nurses and lots of moms that want to BF or don't want to BF and there is often a mis-fit between the two parties.

[Octobermommy]

I have chocked it up to the fact that if you haven't BF yourself you probably can't TRULY offer sound advice on BF. So that leaves out the male docs and unfortunately many of the female docs and nurses. .


I know you said there are exceptions. My dh is the best bf coach I have run in to except maybe the lactation consultants. He learned right along with me while nursing my dd. Unfortunately there is no real training in medical school. He learned in the real world. The female nurses don't seem to know much at all and basically tell patients to wait for the lc. If they are gone for the day they tell them to wait unless the doctor can help (ha ha) and he does fortunately. He surprises a lot of people with his breastfeeding knowledge.

[sste]

On the pedi side, maybe looking for a younger doctor? I think in many training programs NOW (but not 10 or 20 years ago) breastfeeding education is part of the training. My pedi took it as a major part of her job to provide BF advice, support, and education for me. That was her first question at every appt we had in the first six or eight months and she gave me lots of good tips and told me what to expect along the way. She is a great pedi, relatively recent training, and three kids of her own under 5. If you can find someone like that, go for it . . .

[hellokitty]

It's b/c they don't teach them about BFing as part of their training. I'm an RN, the only thing I was told was, that the lactation consultant took care of teaching women to BF. I had to learn everything about BFing on my own when I had my own kids. If you happen to have a healthcare worker that knows anything about BFing, it's b/c they learned from their experiences, either they BF'd or they spouse did, OR they went though other efforts to learn BFing. It's not a req, which is a shame, esp for those who are in peds and ob not to know barely anything about BFing.

[LexyLou]

It's very frustrating. When I gave birth to DD2 I specifically said she is breastfed only and I really didn't want to send her to the nursery but they convinced me to, by writing Breast Fed all over her bassinet. I told them I didn't care if she woke up every 40 minutes, they needed to bring her to me.

This was at midnight...when I woke up at 4am and realized there was no way she had slept 4 hours, I called the nursery. Oh, the older nurse thought I needed my rest so took it upon herself to write on the chart that she was to be formula fed throughout the night.

I'm not this big anti formula person but it's so crucial to get your milk in to not supplement. Plus, since her stomach had been expanded, I needed to continue to supplement until my milk came in. It was very annoying. The lactation consultant was livid.

On another note. A lot of the children at my older DD's school have dads who are MDs. I am friends with a lot of these woman and NONE of them breast fed ever. Not even for 2 weeks. They just didn't. It's just interesting. You'd think with their husbands' being MD's they would have more of an interest in it, but I've found just the opposite.

Oh, when DD2 was 6 months I had an MS exacerbation and had to get back on my auto immune meds which meant I had to stop breastfeeding and put her on formula. I was devastated. The neurologist could not understand why on earth I would want to breast fed for a year. He said there was absolutely no reason at all to breast fed after 6 months....oh well that's good to know (rolling eyes).

[elephantmeg]

as a nurse I had no training in breastfeeding. I've learned as I went along-mainly by reading my aunt's LC textbooks, reading Jack Newman, LLLI website, the breastfeeding info here (I read through ALL of the posts in the feeding forum BEFORE I was even pregnant, lol). I've taught a couple competency classes for nurses on the unit, before I had a baby! Now I love to work with new moms. But yeah, there really isn't any education and breastfeeding is kind of a foreign topic to a lot of us (peds nurses) unfortunately. Huge hugs to you and I hope your breastfeeding experience continues to be great!

[kedss]

i guess I've been lucky, my dr has been delivering babies for probably 20 years, and he listens to me, and I bfd my ds til he was 2 with the occasional formula when dad would feed him at night- I can't pump with a darn, I've bfd dd almost exclusively, a couple of ounces of formula in 7 months, and our dr is extremely supportive, as were the nurses, both times-

[deborah_r]

I got the scrunched-up-face "how much longer are you planning to breastfeed" from the ped at my last visit. Because DS2 has fallen off the charts for weight. But he is super healthy and active and smart and loves to interact with people and has a fabulous little sense of humor...so I just can't get myself too worried about it. On my second child here and still don't understand why breastmilk would be not be a good thing for a toddler to consume. Isn't it high calories, high fat? I understand he needs to eat other things and he does, but he still loves the Nee-Nees.

And yes he still nurses during the night. And yes we co-sleep. So there.

I feel better now.

I do have to say I was amazed that the phone nurse gave me great advice on how to continue nursing when we went through a couple bouts of what I believe was rotavirus. She explained it in a way I hadn't heard before and it worked (as far as not giving him too much so that he just threw it all up). So my ped practice isn't anti-BFing really. But why do I still get that vague feeling they think I am doing something wrong?

[niccig]

I think it's hit or miss. We had no luck at the hospital as DS was born on Christmas Day and no LC on duty for a few days. But I wasn't too worried as the ped. office had a LC on staff and she had helped a friend with BF. I saw her when DS was 2 days old and any BF questions were directed to her. I thought she was great, and she told DH that he had to help in the first few weeks to ensure a good BF relationship, she had him getting up for ALL night feeds for 2 weeks. And DH did it. Unfortunately when DS's reflux got really bad around 6 months, she was on leave. I went to a private LC and she helped some, but I kept wishing the Ped's LC had been available. So, not even all LC are equally helpful.

[maestramommy]

Aack! Double post, sorry!

[maestramommy]

I switched peds between Dora and Arwyn because I'd heard that ped 2 was much more supportive of bfing. Then Arwyn was jaundiced and the first thing she said was, "well you'll have to give her formula." Luckily I got back in touch with a first rate LC I went to with Dora and she got me on the track to bfing. Arwyn wasn't latching well, which led to her getting a little dehydrated. I had tons of milk, she just wasn't getting it. I swear the ped just couldn't believe I was pumping all this milk. Turns out that my LC has heard of this ped before, as having very poor knowledge of bfing. Wish I'd known that before! After that I decided I'd pick the ped based on purely medical knowledge and practice (the first ped was a LOT better at that), and find out the bfing info myself.

At the hospital where I delivered both girls, the nurses STILL say the "10 minutes per side" mantra. They do help you latch on, but it's not with any real technique. More brute forcing. I don't know how most new moms are supposed to learn how to bf under these conditions. They do have a lactation educator on staff. I met her after the first delivery and she was great. But for real instruction I had to see an LC after I left. And interestingly enough, I took a bfing class (with an LC) before Dora was born, and didn't really learn much. If I had taken the class of the LC that helped me I would've been in better shape. So it seems to me that even among LCs there is some disparity of knowledge and experience.

[DrSally]

IME, I've gotten some bad advice from multiple nurses at the ped's office (over the phone) to the point that it's almost worthless (or worse) to speak with a nurse about an issue. Too bad the peds are so hard to get a hold of. I have respect for nurses and some are great, just the ones that have handle the phone calls for the offices I have had DC's seen at are bad.

[Octobermommy]

On another note. A lot of the children at my older DD's school have dads who are MDs. I am friends with a lot of these woman and NONE of them breast fed ever. Not even for 2 weeks. They just didn't. It's just interesting. You'd think with their husbands' being MD's they would have more of an interest in it, but I've found just the opposite.

How funny, all my friends (who are md wives) here breastfed their children and even my md friends did as well.

[JTsMom]

I feel your pain, OP. There really is no excuse. We all know about the health benefits of bf'ing- you'd think it would be important enough to teach in med school!

My ped is a certified LC, so I can't really complain about her, but I have dealt with other peds who were pretty clueless. I almost got into a knock down drag out with one over not starting solids early.

I was pretty much on my own in the hospital too, unfortunately. The advice I got pretty much consisted of, "Just stick him on there." And I never even got to see the LC. Thank goodness I had done a lot of reading before he was born.

[tnrnchick74]

As an NICU RN, I've taken 1 class on breastfeeding. One. That's all that was offered. Anything else I've learned was through my own research.

When I had DS, I requested our hospital's LC 3 times. I knew DS wasn't latching correctly, but I couldn't figure out what was wrong - it was kinda hard to see the bottom lip when I'd had a c-section and could barely move!

Each time the LC came into my room, looked at me and said "Looks good - your a NICU RN, so you know it all!" HELLO!!!! I CALLED YOU HERE BECAUSE I'M HAVING PROBLEMS!!!

I finalyl got some help at a LLL meeting. I never got any milk...and I mean ANY milk. I ended up supplementing/pumping/etc from early on, but that was with the help of LLL. But I felt totally betrayed by the "LC professionals" in my own hospital!

[sste]

You know, the only way this situation will change is through CONSUMER DEMAND. I think we all need to start asking when we are on the hospital tour, "What is the training for maternity nurses in this hospital in breastfeeding?" "How many hours of training do the nurses receive." "How many LCs are typically on duty?"

And when we interview pediatricians I think one of the first questions should be, "What training or experience do you have with breastfeeding" or "What kind of breastfeeding advice/support do you offer in your practice."

Healthcare providers are sensitive to market demand. We all need to be vocal!

[JTsMom]

You know, the only way this situation will change is through CONSUMER DEMAND. I think we all need to start asking when we are on the hospital tour, "What is the training for maternity nurses in this hospital in breastfeeding?" "How many hours of training do the nurses receive." "How many LCs are typically on duty?"

And when we interview pediatricians I think one of the first questions should be, "What training or experience do you have with breastfeeding" or "What kind of breastfeeding advice/support do you offer in your practice."

Healthcare providers are sensitive to market demand. We all need to be vocal!

I think that's an excellent point, and those of us who have been down this road already, and know about the problem first-hand, should really make an effort here.

As for questioning the ped, I've heard you want to avoid the question, "Are you supportive of bf'ing?" b/c they all will say yes, and instead focus on questions like those above, or things like, "How do you handle a baby who is slow to regain birthweight?"