This is the first in a series of posts on Booby Traps,™ made possible by the generous support of Motherlove Herbal Company.
Oh, those first visits to the OB after you found out you were pregnant.
You remember, right? The crinkle of the paper gown, the nervous anticipation over hearing the heartbeat, encountering your first Booby Trap™…
You probably didn’t know it then, but one of the first breastfeeding problems you were likely to encounter appears during the early days of your pregnancy. That’s when many of us run headlong into the lack of education among obstetricians about breastfeeding.
It’s in these early days that we start to make plans for how we’re going to feed our babies. And research has also shown that when OBs discuss breastfeeding prenatally, more mothers breastfeed. (In fact, one study found that when women are encouraged to breastfeed by their doctors prenatally, 75% do. When they aren’t, only 43% do.)
The problem is that, like the other providers you see on your journey, obstetricians aren’t given much training in breastfeeding. And what they do get isn’t always up to date or evidence-based.
A few sobering facts:
- A 2003 study of obstetricians in one state found that “seventy percent of the respondents were not taught lactation management in medical school or residency.”
- An older national assessment of obstetrics residents found that “between 18% and 54% of residents and practicing physicians lacked knowledge of a health benefit of breast feeding and many provided incorrect advice to mothers with common breast feeding problems.”
- A 2011 study which looked at the five major textbooks used to teach OBs about breastfeeding found that three out of five didn’t even mention that breastfeeding is recommended for at least the first year of life, or that exclusive breastfeeding is recommended for the first six months. Three out of five failed to provide any information about the effects of supplementation on breastfeeding.
The tricky thing is that this Booby Trap™ can be invisible until you run headlong into it. You might not think you’ve been Booby Trapped™ until you realize that your OB hasn’t ever mentioned breastfeeding at your visits, or that he doesn’t know any of the local resources for breastfeeding help, or that he doesn’t know a good latch from a hole in the wall. (In my next post I’ll talk about what your obstetrician should do prenatally to support you in breastfeeding.)
Of course, many obstetricians are wonderful at supporting breastfeeding. But this may be more in spite of their training than because of it. A good doctor knows what she doesn’t know, and tries to fill in the gaps in her knowledge to help her patients. Many have, and you may be lucky enough to have found one. We hope so.
So how do you avoid Booby Traps™ at the OB? Here’s a list of things you can do.
1. Listen. First, if you’re past the halfway mark of your pregnancy and your provider hasn’t even mentioned breastfeeding, consider yourself warned. Remember that this Booby Trap™ may be more apparent in what doesn’t happen at your visits than what does.
2. Ask. Ask your obstetrician what kind of training she has had on breastfeeding. Ask what things she’ll do prenatally to get you ready for breastfeeding, and how she’ll support you around the birth and immediate newborn period to support breastfeeding. And see if she knows what kinds of labor and birth experiences give you the best chances for a good start with breastfeeding (I’ll be writing more about this soon).
3. Look. See formula company materials on the walls, on reception counters, and waiting room tables? That’s a clue as to how breastfeeding-friendly your provider is.
4. Speak. If you aren’t happy with how things are going – you haven’t heard anything about breastfeeding, you see lots of formula promotional material in the office, you aren’t sure if your provider knows much about breastfeeding – speak up. Tell him that breastfeeding is important to you, and that you aren’t happy with what you see. Give him an opportunity to convince you that you’ll get great breastfeeding care.
5. But if you aren’t convinced, Run, don’t walk. If after raising some concerns you aren’t reassured, listen to your gut and take your business elsewhere. Remember, you are a customer of a business, and you and your baby deserve the best care you can find. We know you’re worth it, Babe.
This post is made possible by the generous support of Motherlove Herbal Company.