I've been thinking a lot about what mothers can do when they get unsupportive or uninformed care around breastfeeding from their doctors. Some of you have left comments on this blog about providers who tell you to wean or pump and dump unnecessarily, who state that breastfeeding has no value after a few months, who blame all dental problems on breastfeeding... the list goes on and on.
So I decided to ask a few breastfeeding-friendly doctors what they think we can do when we get bad advice.
This response is from Dr. Jenny Thomas, a pediatrician and lactation consultant in Racine, Wisconsin. She offers great breastfeeding advice on her website, (see especially the section labeled 'soap box'), and even has a 'page of fame' gallery of babies who were breastfed for a year (who also get special t-shirts). This summer she will become Chief of the Chapter Breastfeeding Coordinators for the American Academy of Pediatrics.
I think we’ve given away a lot of what “mothering” is to experts and books. My wish is for mothers to take that incredible power back. It is not the responsibility of that mother to make herself heard. As doctors, it is our responsibility to listen.
Here’s the thing: we are the hired help. We are the people that family has chosen to help them through their journey. We are not the arbiters of right or wrong, good or bad. We are the people who are supposed to give the information they need to make an informed decision, to help aid in the encouragement of and confidence in parenting instinct. So much of what we do as providers, so much of the advice we give, is counter to maternal instinct which makes me sad to my soul. If there was a right or wrong way to parent, like six of us would make it to adulthood and that’s not good for a species that wishes to continue to exist.
My first day of medical school, one of my deans told my class “fifty percent of what we are teaching you is wrong - we just don’t know which fifty percent,” a phrase that has stuck with me when I begin to feel like I have it “right” or I know what is “best” for a child in my practice. It keeps me humble and open to change. All we can do as providers is give the information or make a recommendation (not make a command) based on our current knowledge base and be willing to learn and adapt when the fifty percent starts to change. I hope the parents are then enabled to integrate that advice into what works for them as a family.
I am a big fan of giving messages that make sense to a family, of encouraging the course of action they have chosen (as long as it doesn’t involve juggling chain saws near the kids or parenting while on heroin or something else we can be pretty sure is going to stay a non-recommended parenting practice!). I can’t and shouldn’t dictate a course of action or stifle a dialogue on topics where we might have differing opinions. In the end, as long as the debated parenting practice is not illegal, I am the paid employee. If that kind of dialogue is not encouraged, if that freedom to parent is somehow curbed by a provider who is sure they have it right, if that mother feels as if she somehow has to modify what she says or outright lie about how she parents for fear of backlash from a physician, that family should fire that provider and hire a new, more-compatible employee.
And if she is stuck with only one doctor on the planet, then well, she should speak up. Take the power of motherhood back. If that isn’t going to work, I would suggest using another doctor to help. For example, my families will ask me to intervene if they have been asked to discard milk after surgery or if they have been given other advice with which they don’t agree. I can advocate for those families by engaging their provider.
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