We Love Doctors Who Refer to IBCLC's!

The amazing doctoras from Lima who first became IBCLC's.

During the 17 years I've been an IBCLC I've had the privilege of knowing some amazing pediatricians. When we were serving as missionaries in Peru, I was very blessed to know Dra. Sicilia Bellomo, Dra. Milagros Raffo, and Dra. Sara Vega. (In Spanish if the doctor is a female, she's a "doctora.") Each of these amazing pediatricians became IBCLC's during our time in Peru, and I felt so honored to know them and be able to refer mothers to them.

Since we've been back in Huntsville and I've been with A Nurturing Moment, I have discovered that we have many amazing pediatricians here, as well. When a pediatrician or family practitioner recognizes that a baby has a breastfeeding problem he or she isn't equipped to solve, sometimes they just recommend formula. as a quick fix. However, there are some outstanding doctors who are very quick to recommend seeing an IBCLC for professional breastfeeding support, and very slow to recommend formula.

We appreciate the doctors at Cornerstone Pediatrics who refer moms to us.

Yesterday morning I received two calls from the same doctor at Cornerstone Pediatrics asking us to see two different patients.We were able to see both the same day. The first mother just wasn't making enough milk. The doctor had recommended that she see me and try to get breastfeeding fixed before starting formula. Honestly, in this situation many physicians would have wanted the baby on supplements immediately. But he was more concerned about the breastfeeding getting fixed. After I worked with the mother, the doctor and I agreed that she did need to supplement some at the breast to help baby suck more effectively. I was so impressed, however, that he really wanted this mother and baby to breastfeed well!

We were delighted that Huntsville Pediatric Associates actually hired an IBCLC as part of their staff. There are other doctors who refer patients to us from time to time, but we have very regular referrals from Cornerstone. I've  even had Dr. Michael Powell call me about a specific patient. That tells us that these are practices who are truly concerned about their patients breastfeeding successfully. When you are looking for a physician for your baby, be sure to ask how they handle breastfeeding problems. If they aren't quick to refer to an IBCLC, you just might need to look for a different doctor!

How to Know if Your Baby's Doctor is Breastfeeding Friendly

This week the Academy of Breastfeeding Medicine released a revised protocol  for Breastfeeding Friendly Physicians Offices.  This document offers physicians 19 suggestions that they can implement to ensure that their practice is breastfeeding friendly. Many of the physicians in the Academy of Breastfeeding Medicine are also International Board Certified Lactation Consultants. 

I asked a colleague who happens to be a pediatrician as well as a lactation consultant to pen a guest blog  on this topic. The ABM protocol is great, but it's really written specifically for physicians, not for moms. I thought it would be good for our moms to know what to look for when they are doctor shopping!

Wish List for a Breastfeeding Friendly Doctor

by Traci Lynne Brewer, MD, IBCLC

Dr. Traci Lynne Brewer with her
husband and new baby.

I'm a  homeschooling, stay at home mom, living in Central Asia, pregnant with my third child at 40.  What an interesting turn of events for a pediatrician and lactation consultant born and raised in Huntsville, Alabama.    But, I can't think of a better situation for my family right now. 

In light of my eminent delivery I have been asked to describe my wish list for a breastfeeding friendly doctor for my daughter, due any day now.

Here goes:

Wish #1:  The doctor will want to see me and my daughter 48 hours after discharge from the hospital.  Sure, it's a pain to get the baby and the gear loaded up and make an appointment on little to no sleep, but breastfeeding issues identified early are easier to work on than problems that can develop by 2 weeks of age.

Wish #2:  If my daughter has jaundice, I want breastfeeding to be given a chance.  An elevated bilirubin is not an automatic indication for formula feeding.

Wish #3:  If I encounter a breastfeeding issue that requires more specific knowledge or time than my doctor has, I want to be referred to a board certified lactation consultant.  Evaluations for lactation issues take time, something that doctors frequently lack, even if they are comfortable with breastfeeding advice.  This includes recommendations on how to return to work while continuing to breastfeed.   While I'm wishing, I'll wish for a lactation consultant working in the doctor's office.

Wish # 4:  I would like a doctor that doesn't put a endpoint on breastfeeding.  Finding support for breastfeeding past a year can be difficult.  Wouldn't it be great to have the doctor on your side?

Action 10: Basic Breastfeeding Support from Health Care Providers

This is the second article in our series about the Surgeon General's Call to Action for Breastfeeding Promotion. Today we're focusing on an action step that we can actually help with significantly.

Action 10. Include basic support for breastfeeding as a standard of care for midwives, obstetricians, family physicians, nurse practitioners, and pediatricians. 

Photo courtesy of the IBLCE   

Midwives, obstetricians, family physicians, nurse practitioners, and pediatricians provide care that supports their patients’ interests and health needs, including breastfeeding. Their full support of breastfeeding may be limited by the use of  practices that unintentionally and unnecessarily interfere with breastfeeding. These practices directly affect mothers’ and babies’ abilities to start and continue breastfeeding.

Implementation Strategies 

Define standards for clinical practice that will ensure continuity of care for pregnant women and mother-baby pairs in the first four weeks of life. The standard of care should include actions that are important for the promotion and support of breastfeeding, including providing prenatal counseling on feeding decisions, setting accountability standards for postpartum follow-up care, monitoring neonatal weight gain, and establishing referral mechanisms for skilled lactation care. Models should be established to integrate assistance with breastfeeding into routine practice settings.

 Conduct analyses and disseminate their findings on the comparative efectiveness of different models for integrating skilled lactation support into settings where midwives, obstetricians, family physicians, nurse practitioners, and pediatricians practice. Skilled lactation support may be provided by trained physicians, by lactation consultants affiliated with a physician practice, through stand-alone clinics, or by referrals. Models of care differ in the degree to which care is provided for all breastfeeding mothers to prevent difficulties and the extent to which care is provided for women already having problems. Identification of best practices and optimal care models is needed.

Getting Involved

We are blessed to live in an area where excellent health-care is available. Many pediatricians are quick to refer mothers to lactation consultants for breastfeeding support. We regularly get calls from their offices requesting consultations for their patients. However, some pediatricians are still quick to suggest that mother's supplement unnecessarily or even stop nursing altogether. Whereas some ob/gyn's are extremely supportive of their breastfeeding patients, others are dismissive at best. 

In many parts of the country lactation consultants are an integral part of the pediatric practice. Therefore, we have designed a program especially for our local doctors to give them the benefit of having a lactation consultant available without having to hire another staff member. Our LC in Your Office program allows even the smallest pediatric or family practice to provide professional breastfeeding support to their patients in the privacy of their office.

5 Steps to Choosing Your Baby's Doctor

One of the many things that expectant parents begin to think about is choosing a doctor for their baby. Many parents want a pediatrician because of their specialized training with infants and children. However, sometimes parents who have a family doctor they really like will choose to have the baby go to the same doctor they do. They like the idea of one doctor who knows the family health history caring for the entire family. Many family doctors love seeing babies and are extremely competent in caring for them.

So how do you go about finding the right doctor for your baby if you don't have a family doctor you're comfortable with? Here are some tips that might help.

1. Write down the three things that are most important to you. For example, maybe breastfeeding is a high priority, or maybe you want to delay vaccinations. Maybe you want a doctor who doesn't charge for after-hours phone calls. Or perhaps Saturday office hours are very important to you. Think through what you want and prioritize your list.
2. Talk to your friends, to nurses you know, to mothers at work or church about the doctors they use. Ask what they do like and don't like about the doctor. Make a list of 2 - 4 doctors that you would like to interview. Recently on our Facebook page, several mothers talked about doctors they like in Huntsville, Athens and Decatur.
3. Call each doctor on your list to make an appointment. Some doctors are less open than others to this, but it's the only way you can decide if you and the doctor you choose will see eye to eye on your non-negotiables.
4. Create a few questions to ask your doctor based on your priorities from #1. For example, if breastfeeding is a high priority, ask what percentage of his 3 month old patients are exclusively breastfed. As you interview each doctor, take note of how you interact with his or her personality. Would you be comfortable seeing the person on a regular basis?
5. Choose your doctor based on your research. But remember, YOU are the expert on your baby. You know your baby better than anybody else. God gave you the awesome responsibility of caring for this new life, but He also equipped you with very strong maternal instincts. Trust them!

If you have a doctor you absolutely love, leave a comment here so other moms will know what makes him or her so amazing! (No negative comments, please)