Many pediatricians, OB/GYNs and family physicians lack knowledge about the benefits of breastfeeding and do not have the necessary tools to advise women on breastfeeding concerns, says a report in the Journal of Perinatal Education.
The American Academy of Pediatrics (AAP) recognizes the benefits and encourages their members to promote breastfeeding, but a recent survey indicated something that mothers already know: Doctors are not recommending breastfeeding to their patients as per the guidelines set out by the AAP.
For some women, breastfeeding is a challenge, and they rely on medical professionals to lead the way. “It doesn’t help that physicians and nurses don’t receive adequate information that they can pass on to their patients,” says Diane Spatz, Ph.D., RNC, an assistant professor of health care of women and children at the University of Pennsylvania School of Nursing.
She feels that many women are left in the lurch, forced to listen to information that is not necessarily correct. “There is a lot of bad information out there,” she says. “People are just not educated in the benefits and other key issues of breastfeeding. That can be a dangerous thing for infants.”
The Children’s Hospital of Pennsylvania, where Spatz is employed, has implemented a program to combat this lack of information, aiming to educate physicians and nurses about breastfeeding. The program is multi-tiered and unique for doctors and nurses. Spatz feels that the impact of the training will be phenomenal, especially to the high-risk infants she sees most often.
“The training runs the full gamut of breastfeeding information for nurses over a two-day course,” Spatz explains. “When it’s complete, the nurses would then be qualified to help new mothers with their breastfeeding needs and arm them for their future concerns.”
Physicians will go through a comprehensive training program that will ultimately take them from their residency and forward. They will learn informative content on breastfeeding, have lactation rounds and learn what happens in a primary care setting.
Spatz is thrilled that the hospital is implementing this program. “It also focuses on the complex things related to breastfeeding,” she says.
“It seems that none of my doctors, including my pediatrician, know anything about breastfeeding,” says Tina Warren of Tullahoma, Tenn. “I have to inform them of the research, because they are totally clueless.”
When it comes to breastfeeding her child, Warren is frustrated with the feedback she has received over the past two years. “My doctor has been trying to get me to wean my son since he was 10 months old,” she says. “The pediatrician tells me every time that I visit that I need to wean.”
When Warren questions the suggestion, the only answer she receives is: “Because he is old enough.” Warren says she gives her doctor numerous reasons why she should continue breastfeeding, and the doctor simply smiles and nods.
“I know on the next visit, she will repeat the same tired speech,” Warren says. “She is a good doctor and of the many pediatricians we have had over the years, she is by far my favorite, but she is not up to speed on breastfeeding research nor does she seem interested in finding out anything more.”
This has been the claim of many mothers over the years and has led to some serious problems.
“Parents need to be armed with the most current research information,” Spatz says. “Then they should present this directly to the doctor or tell him what the research indicates.” A well-read patient is one that is hard to ignore. A parent who approaches a doctor with up-to-date clinical reasons why breastfeeding is optimal for babies will grab the attention of their physician more easily than one who is unprepared.
“I have brought in research that I pulled up online,” Warren says. “I feel that if I, [a layman], am able to find this information, that a doctor should already have it.”
“In July of this year, we had no less than five babies come into the hospital suffering from dehydration,” Spatz says. “If a mother doesn’t know if her child is getting enough milk, she won’t know if he becomes dehydrated or worse.”
This is the scary part: You leave the hospital with your baby with little knowledge of what to expect and without appropriate information on how to handle problems as they arise. So, you make an appointment at your pediatrician’s office only to discover that he doesn’t have any more than a vague idea about the basics of breastfeeding.
“Having lactation specialists is a wonderful thing, but they can’t be the only source of information for a nursing mother,” Spatz says. “They simply can’t handle the volume. The fact is, that as wonderful as it is to have a specialist in this area, it doesn’t absolve the doctors from acquiring current information on this complex area.”
If talking to your doctor isn’t getting you anywhere, and sharing your well-researched information is not sinking in, you may have to consider changing physicians. If you do, it might be wise to do a little research first. It would be to your advantage to interview physicians to get a feel for their thoughts and education on breastfeeding. Keep in mind it is possible to find pediatricians and family physicians who are also board-certified lactation consultants (IBCLCs).
“I switched obstetricians after my doctor tried to convince me that breastfeeding was causing my postpartum depression,” says Hilary Evans of Fort Dodge, Ind. “I came in very sick and was sent home with a prescription and the advice to quit nursing. When I asked for a more baby-friendly prescription in case I decided to continue to nurse, he was insistent – almost to the point of being angry. That was the last time I went to that doctor.”
Talking So Doctors Will Listen
La Leche League recently set out some tips for parents who are trying to share information with their doctor on the facts about breastfeeding. Here are a few:
- Remain calm. It sometimes helps to lower your tone of voice and speak slowly.
- Make eye contact, which indicates sincerity and resolve.
- Be firm, tactful and friendly – not hesitant, defensive or antagonistic.
- Look for areas of agreement.
- Use “I” messages, such as “I feel strongly about…”
Another wonderful resource to bring along with you is La Leche League International’s Breastfeeding Answer Book.
It can be difficult finding a physician who is current with his information on the benefits of breastfeeding, yet many parents have successfully managed to share research and information with their physician with positive results. Be confident. The information you share will inevitably help another family today, tomorrow and every day after that. It’s advocacy that works.
In the end, if you are not getting good advice and are unhappy with the lack of knowledge or the unwillingness of your physician to learn more about breastfeeding, it is time to seek another health care provider. Don’t assume that Doctor always knows best.