Survey for BF moms

[ppshah]

Hello! I'm a pediatrician and work with a group of about 20 other pediatricians. We are a hospitalist group and round on newborns in the hospital ( those babies whose pediatricians don't come to that hospital). I'm working on a conference for our group - the goals of the conference are to promote breastfeeding & to set up practice guidelines based on the latest recommendations. I know little things we say or decisions we make may influence ( although often unintentionally ) mom in their decision to continue BF. Keep in mind we will only see these babies and moms 2-3 days ( never before and never again). Our patient population is generally well educated and motivated to BF. The majority of our moms choose to BF. I'm hoping to have a lactation consultant speak at the conference. At this particular hospital every BF mom gets a visit from the lactation consultant who then gives them names or support groups i.e. LLL.

I'm looking for commments based on your experiences....

What do you wish your pediatrician had told you before you left the hospital?

Any decisions your pediatrician amde influence your decision? ie. supllementation, timing of BF etc.


Thanks in advance......

[Jacksonvol]

This has nothing to do with BF'ing, but it reminded me of my experience with the pediatrician I had at the hospital (not my regular ped.) On the last day of our stay, the ped. comes in my room to give me an update on DD (she had some drainage from one eye, blocked duct or something) I am in the shower and this ped. (female thank goodness for that) comes into the bathroom and starts talking to me about my child. Words cannot express how angry and offended I was. It was so unprofessional. When the ped's group called me to try and schedule a follow up (like I am going to drive an hour each time my child needs to go to the doctor) I was pretty descriptive in why it would be a cold day before I used their group again.

Please remind the peds. to have the courtesy and common sense to discuss things with moms in a manner that affords some measure of dignity to the mother.

That being said, my friend who is a ped. was so supportive by reassuring me that brest-feeding is not always easy, that there is a learning curve, that LC's are helpful, that I should always call my healthcare provider when I have a question or concern and that if it was necessary to occaisionally supplement it would not be the end of the world.

[deenass]

Well, the ped who saw my son in the hospital (not our reg ped) did not make me aware enough of my son's jaundice (the patient asst who walked us out to the car mentioned it) adn THANK G-D she did! My son ended up being hospitalized for 2 days under bili lights and a bili blanket. Because of his jaundice he was very sleepy and wasn't BF nearly enough. I wish the ped had been very specific about waking him to feed (and to contact MY ped earlier) if I couldn't get him to eat.

As it turns out he was supplemented with formula when he was under the lights (despite my being there and trying desperatley to feed him).

I chose the ped practice I go to because they have a lactation consultant on staff who runs a weekly breastfeeding support group. I think the most important thing is to be around other BF moms... despite being natural, it's not easy adn is often overwhelming. My BF friends mean the world to me, even after a year of doing it I still have questions!

[caleymama]

The doctor we chose for DD was a Family Practicioner (not a ped and the same one DH and I used) and he did not have hospital rights at the hospital where we delivered. There were a couple of pediatric practices in the town I was in and the peds (2 of them) that we saw in the hospital were part of one of them. My experience with them only reinforced my decision to use the other doctor we chose, but fortunately it had nothing to do with breastfeeding. I just didn't care for their bedside manner and did not care for the way they dealt with us. One of them completely ignored DH (and he was rooming in with me and right there!) the entire time they were speaking to us. They did not look at him or acknowledge him at all.

I don't recall any mention of BF from either ped - I know DD had the little card in her bassinet that said she was a BF baby so perhaps they didn't need to ask. My OB/GYN (wasn't on call for the delivery) met with me the next day and she and I discussed BF. That's the only conversation about it that I can recall. The hospital nurse had asked while I was in labor if I was planning to BF and that was it. No mention of formula at all.

We were visited by a LC the next morning (I delivered at 10:40pm). BF was going very well and DD was healthy. She roomed in with me, so there were no concerns about her receiving a pacifier or supplemental bottle in the nursery. The LC was good and she gave me her card. I don't remember much of what she said but I remember liking her and thinking I would definitely call her if I had any issues. I received a lot of informational handouts about BF. Overall I feel that I was well informed about BF, both from reading I had done independently and from our childbirth preparation class. Perhaps if I had been ambivalent about BF or if I had difficulties the hospital ped's influence would have been greater. Since DD was nursing (on demand) like a champ from the get-go, there wasn't much need for discussion.

(That was longer than I meant it to be and I'm not sure how helpful to you after all ...)

[farsk]

Hello!

Thanks for being interested in what we say! It's comforting to know that the medical profession is intent to do better as far as breastfeeding is concerned.

We gave birth at a hospital more breastfeeding friendly than the hospital in the town where we live. So my ped was not there after Ellen was born. I met with my ped before Ellen was born for an "interview" where she told me that she was very pro-breastfeeding and asked if I planned to nurse. I said yes. The topic was dropped. However, there are so many who quit nursing at the first tiny sign of an obstacle, I think if the ped had told me more information about BF vs. FF, I would have been more determined than ever to BF (Which I already was....8 months nursing...yay!)

The other comment I have concerns a nurse in the lactation office (NOT my LC) who wanted to supplement Ellen with formula. After weighing her, letting me nurse for 10 minutes, and then weighing her again (she had only gained a minute amoung), she commented on how hard the baby had to work to get that amount of milk. I left in tears. I still harbor ill will toward that woman!

Good Luck!

[jd11365]

To answer your question simply...
If a peditrician came into my room and asked ME questions about my thoughts on breastfeeding...to initiate a brief Q&A...while letting me know the fabulous benefits...without preaching...and then answered my questions with CORRECT information, I might be more inclined to continue.

Personally, I got "Are you going to BF?" and that was it...no additional response...just a question for her notes or whatever. Then when I was having problems the first 2 days with latching, I got misinformation or poorly supportive information...like I HAD to supplement with formula immediately or the baby's glucose would drop and get very ill, or was told to trickle formula on my breast to get things started... I had a lot of pressure to FF.

HTH and I think your conference is going to be fabulous...wish my ped would attend! Please let us know what you decide to present and update us on the conference!



Jamie
Mommy to Kayla
5-1-03

[C99]

Well, I never even *saw* the pediatrician who attended my son. He was in the NICU for 8 days and I was only ever given consults with the nurses. The first doctor who talked to us about him was the pediatrician who was on rounds from our ped group, after I put in a few calls to their office to see if we could get him released from the NICU. So I really wish the peds and the nurses in the NICU would have been more supportive or breastfeeding in general. It was a huge struggle to breastfeed my child and I wish that everyone would have been more supportive of the idea that breastfeeding is always best for the child, even if it's not scientific or measurable.

[papal]

Let see...
Two different peds from the clinic I go to visited us on the 2 days we were in hospital. It was a very brief visit (5 mins) and they always seemed like they were in a hurry. If you are going to bill it for a regular visit then imo you should SIT down next to the mom/dad and relax and listen to what they have to say. I just got the 'how is the bfing going' and 'it takes a while to get the hang of it). Oh, and when i returned to the clinic 4 days later because my nipples were cracked and bleeding, i got the 'that happens, it will get better.. keep at it'. How about some empathy, something like 'i have seen this before, it happens..'. Also, i don't think my ped recommended that i consult an LC. I did that on my own.
If i was not hell bent on bfing then i would have been put off with this non-caring attitude.

[ppshah]

Well the conference is only one hour long so we won't have time to go over a lot of information. I haven't really decided on what to present - that's why I posted this survey. I'm so much more pro-BF as a pediatrician after BF DS for 9 months. Alot of the peds in this group are women who have BF so I think that is helpful.

Believe it or not...I never suggest supplementation except for 2 sitiuations:

1. Low blood glucose- and we usually have the mom nurse first and if it still stays low we can give the baby formula ( with a syringe if mom is again bottles )

2. Baby has lost a lot of weight ( >15% of birth weight ) and is jaundiced. But we have the mom always BF at every feed first and then offer the formula.

I also emphasize that the supplementation is a TEMPORARY measure.

I think since time is limited I want to make several handouts and just go over them briefly.

1. The first hand-out will review the medical literature and set up medical practice guidelines. Since the mom will talk to a different doc every day I think it's important for us to be consistent. For exmple someone mentioned jaundice- well the new AAP guideline ( based on recent literature) say all BF babies should have follow-up within 48-72 hours to access weight gain, jaundice and to address any BF difficulties.

2. Maybe the 2nd will be about "Myths" about breastfeeding.

3. I also want to make one for the nurses. Believe it or not I feel a lot of pressure form the nurses to supplement. I often get calls "This baby need to supplement b/c ..... is that okay???"

As far as my personal experience, I did not like th LC who met with me. She asked me if I had read any books on BF or taken any classes. When I said no- she was very rude. Basically she implied I wasn't very serious about BF. Well she hadn't been 9 months pregnant, working 80 hours a week, and moving into a new house all the same time!!!. When exactly was I to fit a BF class into that? I wish someone had told me to expect little bumps along the way and give it a full month before quitting. I almost quit several times- but each time I'm glad I stuck to it. I founda message board of other BF moms which was a life saver!!!

[ericajosh]

Thank you so much for your interest in helping moms BF. My ped. did not discuss the baby's eating at all at the hospital. It was only when I went for a check up with the baby that the ped asked about my plans in terms of feeding him. (By that time I switched to a ped with a nicer bedside manner, who was happy to hear that I planned on nursing for a while). However, most of the ped from the office that I met with did not push BF enough, IMO, especially since the AAP does.

I was lucky to have a supportive staff of LC at the hospital in which I delivered. They helped with latching on the baby and positioning. However, once you get home, it isn't as easy...therefore, I would suggest giving the moms a heads up as to what to expect when they get home and how to deal with BF issues (such as engorgement). Also, giving some information on baby's eating habits in the beginning will help the mom's with BF. I never realized how often DS would have to nurse in those first few weeks.

I did have a LC visit me at home (after calling many ped. to try to get info on BF and not getting any help). I found it hard to get BF advice from doctors (the response was "Call LLL") It would have been nice if the ped had more info. on BF too. Luckily, I was devoted to BF, but I could easily have waivered because of the ambivilance of one ped. who told me that there was no difference between the health benefits of bf and bottles!

What kept me BF was hearing how good it is for the baby. To this day, when I get tired of nursing, I remember how healthy my DS is and will be because of BF. That really was the greatest influence. Also, my husbands support was really helpful. Don't forget to include dads in on the benefits as they are good cheerleaders when the mom's want to give up. (Oh, you can also add how much it helps a mom get back into shape...not sure if that is a rumor or not...but it worked for me and will definitely motivate new moms..lol)

Good luck. Keep us updated. :)
-Erica