Did Your OB Talk to You About Breastfeeding?

by Glenni Lorick, IBCLC

Most mothers make the decision about whether they will breastfeed or not during their pregnancy. The one health-care provider who is most likely to be able to influence that decision is the mother's own doctor or midwife. Yet many times, despite the recommendation from their own organization ACOG that they encourage mothers to breastfeed, some OB/GYN's remain strangely silent on this subject.

Why the Silence from Some Providers?

Although many OB/GYN's are quick to encourage mothers to breastfeed, some take a very neutral stance on the subject, despite the proven benefits of breastmilk and risks of infant formula. Why is that? We think there may be several possible reasons.

1. Lack of Education about the Benefits of Breastfeeding   Depending upon when and where your OB/GYN attended medical school, he or she may have had little to no instruction about breastfeeding. What instruction was given may have focused on problems related to the lactating breast as opposed to the benefits of breastfeeding for both mother and baby. If your physician is closer to retirement age, he or she may have actually been taught that formula is the "modern" way to feed babies.
2. Relationships with Formula Companies  In a recent survey we did, many mothers reported receiving formula company gift bags from their OB's office. While it may seem like a nice little "gift," these samples coming from a physician actually tend to undermine a mother's confidence in her ability to exclusively breastfeed her baby.
3. Her own lack of breastfeeding experience  If your doctor formula fed and has healthy children, then she may truly not believe that breastfeeding is all that important, despite what all the professional organizations say about it. She might also feel like all of this talk about breastfeeding being so important somehow casts her in a negative light for having formula fed. Or perhaps she had some real difficulties with breastfeeding and just didn't have the support she deserved.

The Physician's Role as a Health Advocate

One of the primary roles that all doctors have is to advocate with their patients for healthy practices. Nearly all Ob/Gyn's strongly discourage expectant mothers from smoking because the health risks are very obvious for both mother and baby. Did you know that there are actually risks associated with formula feeding?  So often we frame our pro-breastfeeding language in terms of the "benefits of breastfeeding," when in actuality all babies deserve to have reduced rates of upper respiratory infections and juvenile diabetes. The truth is that babies NOT receiving breast milk, but receiving formula instead actually increases the likelihood that they will get ear infections. diarrhea, eczema, asthma, and even childhood leukemia. 

If their simple recommendation to breastfeed could help make all the babies in their practice healthier, then why aren't doctors everywhere telling every mother they see to breastfeed? When I was born, my mother's doctor literally did NOT give her a choice. He told her that she would breastfeed me because that was her only option. I am not advocating such a heavy-handed approach with mothers, but certainly all expectant women deserve to know the truth about infant feeding methods. It should be the responsibility of every maternal health-care provider to educate every patient about breastfeeding. 

Bringing About Change

How do we effect change? If those mothers who are passionate about breastfeeding would initiate a dialogue with their doctors, it might be a good first step. Make sure your doctor is aware of the tools
available to him or her. In a recent survey over half the mothers said that their Ob/Gyn did mention breastfeeding. But that leaves many, many doctors who aren't saying a word, as well as many doctors whose offices are handing out formula gift packs like candy.

If your doctor's office gives you a sample (usually it will be a receptionist, not the doctor) make sure to bring it to your next appointment along with information about breastfeeding. Ask your doctor why they are promoting formula feeding when their own organization wants them to promote breastfeeding. Share positive resources with your doctor to aid in the formulation of a positive approach to breastfeeding promotion.

If a lactation consultant works at the hospital where your doctor is, try to enlist her help in providing positive breastfeeding resources for your doctor's office. If your physician hears enough voices encouraging strong breastfeeding promotion as a pro-health activity, change will begin to happen. It starts with ONE MOM speaking up. Are you THAT MOM??