Dumb Remarks and Standards of Breastfeeding Knowledge
Linda J. Smith, BSE, FACCE, IBCLC
Many have been frustrated by "dumb remarks" related to breastfeeding offered by health care providers, especially physicians. Some are outraged, while others support the professionals and urge them to "keep trying" to learn more about breastfeeding.
Point #1: In our society, doctors are held to higher standards than just about any other health professional by nature of their extensive education and training. Governments, employers, and the general public expect doctors to be very, very expert in how the body works and hold them legally accountable for such expertise. IMHO, I think the "dumb remarks" are a tragic and embarrassing result of an educational system that has not yet systematically and thoroughly include knowledge of human lactation in its body of knowledge, yet places the responsibility for such knowledge upon its practitioners. Nobody would tolerate this lack of knowledge of, say, the normal workings of the heart, from graduates of a cardiology program. IMHO, this just isn't fair, especially to the graduating medical students. I call upon the "system" of health care provider education - that has ignored breastfeeding in all its aspects until very recently - to take immediate and proactive action to correct this gap. One goal could be to implement the Wellstart curriculum in all medical and osteopathic schools within the next five years. (I know a manufacturer of automobile rags that sends its salespeople to six weeks of training before they can start selling! Certainly breastfeeding is as important to the global economy as red cloth rags to wipe up oil spills.)
Point #2: IMHO, if a person expects to be treated (and paid) as a health "expert," they have a moral and ethical obligation to "do their homework" and learn about the subject. The science of breastfeeding is available to anyone interested in learning it. I'm very grateful for those who have written and produced the fine books and materials on the subject that are growing in number every year. My congratulations and THANKS goes to those doctors (and nurses, dietitians, etc) who have "gone the extra mile" to educate (or re-educate) themselves on this topic, often at substantial political risk in their institutions. I call upon all health care and breastfeeding care providers to partake generously of the excellent research and professional literature on breastfeeding. (And NOT the stuff published or taught by those with a conflict of interest.)
Point #3: I once saw a computer poster with the words "If you don't know how it works, don't fool with it." A true expert knows when he/she is out of his/her depth and refers/collaborates with someone with more knowledge. It's tolerable for a doctor (nurse, dietitian etc) to not be an expert on all bodily systems as long as they know when they DON'T KNOW and refrain from "making up" answers as they go along! Congratulations and THANKS to those health professionals who listen to and learn from mothers and others with direct knowledge of breastfeeding. And congratulations and THANKS to those breastfeeding care providers who know their limits and work collaboratively with licensed and other health care providers. I call upon everyone interacting with breastfeeding mothers and babies to remember that "teamwork" goes both ways. Someone else probably has a piece of knowledge that you don't have and the mother & baby really need. Know your limits.
Point #4: Like swimming, breastfeeding is done by lots of people with and without scientific knowledge of the activity. And like swimming, breastfeeding usually works pretty well even without much instruction, and it works even better with some basic information. Not all good swim coaches are good swimmers, and just being a good swimmer doesn't necessarily make a good coach. However, if you are a coach who has never been in the pool, don't expect a competitive swimmer to listen to you unless you've REALLY done your homework on the topic including learning "what it's like" from the swimmers. I call upon all of us to listen to and trust the mothers and babies with whom we work. They are the true experts and our teachers.
Point #5: Let's continue to focus on the statement (not the speaker) and patiently teach our colleagues, even (and maybe especially) the ones who have let slip a "dumb" remark or two, in as kind and generous a manner as possible. "Catch 'em doing something right" early and often. This applies to colleagues as well as clients.
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