Giving Effective Breastfeeding Help

Giving Effective Breastfeeding Help

Helping the Mother Working with Her Doctor

mother with doctor

When Suggestions Differ from the Doctor’s Advice

Sometimes a counselor’s suggestions may differ from those of a mother’s doctor. For example, a doctor may tell a mother not to nurse her slow-gaining baby more often than every three hours. If the baby is healthy and the mother seems comfortable with the idea of nursing more often, suggest she try it for a week or so, or until the next visit to the doctor, and see if the baby’s weight gain improves. If she decides to do this, she should be encouraged to tell the doctor that the improved weight gain was the result of more frequent nursing. This way the doctor will learn more about breastfeeding in a positive way.

If the baby has a health problem, encourage the mother to stay in close touch with the doctor, discussing the suggestions you have given her. The doctor may want to monitor the baby’s progress while the mother tries new breastfeeding management techniques. For example, if the baby is gaining weight slowly, suggest the mother offer to bring the baby to the doctor’s office for regular weight checks every week or two until the doctor is satisfied with the baby’s progress. Be sure the mother knows the background that supports your suggestions so she can discuss them with the doctor.

When mother and doctor disagree, it is important to keep the channels of communication open and try to separate feelings from facts. Encourage openness and honesty between the mother and her doctor. The health and well-being of the baby are the goals of both mother and doctor. The doctor cannot treat a patient with incomplete or incorrect information. When a mother does not tell her doctor what she is doing, she risks incurring the physician’s anger, feeling guilty for disregarding his or her advice, and losing some self-respect by not being honest. Remind her that the doctor needs to know what she is doing since they are working as a team in safeguarding the health of the baby. If the mother feels pressured to hide things from her baby’s doctor, suggest instead she seek another medical opinion.

Help the Mother Express Her Feelings and Goals

It will help the mother to communicate with her doctor if she expresses her feelings and goals. She might say something like, “I want to do everything I can to continue breastfeeding.” This may make the doctor more willing to consider different approaches.

Most people, but especially a pregnant woman or new mother, find it very stressful to be in conflict with a doctor. If the doctor advises a treatment that the mother is uncomfortable with, give her the communication tools she needs to come to some agreement with her doctor. The basic tools are tact, honesty, respect, knowledge, and patience.

Suggest the mother think through her approach before she speaks to the doctor. There are many ways she can make her encounter with the doctor more positive. The mother can:

Practice her responses before she talks to the doctor. Offer to take some time to discuss the mother’s concerns and to practice with her so she can express them aloud before she talks to the doctor.

Ask the doctor for a complete explanation of the treatment. If the mother is unsure of the reasons for the doctor’s recommendations, encourage her to ask him or her to take the time to explain them to her thoroughly. In evaluating the doctor’s advice, it may help to ask, “Is this your general policy with regard to my baby’s condition or is this specific to my baby?”

Repeat the doctor’s statements in her own words. By paraphrasing what the doctor says, the mother can avoid confusion and show the doctor what impact his or her words are having on her.

Share her feelings with the doctor. It is best if a mother has been clear about her feelings from the beginning, but if not, it is never too late to start. A doctor cannot know what an individual mother’s preferences and priorities are unless she expresses them. The mother might tell the doctor, for example, “Our family has a history of allergies and I feel strongly about exclusive breastfeeding. Are there treatment options that allow for continued breastfeeding without giving formula?”

Project self-confidence. Writing down questions and concerns in advance may be helpful, as well as being friendly and willing to consider alternatives.

Make statements in a positive way. Another way to foster a friendly atmosphere is to make positive statements, for example, “I would like to try encouraging my baby to breastfeed more often before offering supplements,” rather than “I don’t want to give my baby supplements.”

Try the “broken record” technique. When disagreements arise, the “broken record” technique can be an effective way of getting a message across. The mother simply restates her basic position, calmly and quietly at each opportunity. “I appreciate your concern about her health, but now that she’s breastfeeding well, I’d like to monitor her weight for another week before considering other options.”

Use tact, give respect, and expect them in return. If a mother feels that her doctor is being judgmental or overly critical, it may be helpful to recognize his or her concern for her baby (for example, “I understand your concern for my baby’s health and well-being”) but still calmly insist that the doctor offer current medical information to back up opinions. Most physicians are not inflexible and would be willing to meet a mother halfway.

Keep in mind that the ultimate responsibility for the baby’s health lies with the parents. Although the doctor is the medical expert, the parents are the ones who are ultimately responsible for the decisions made about their baby. A mother can shift a discussion to emphasize parental responsibility by saying, “You’d like my permission to… ?” or “Your recommendation is….”

If not satisfied, seek a second medical opinion. After discussing her feelings and possible approaches with her baby’s doctor, if a mother feels that the doctor is not as supportive of breastfeeding or her feelings as she would like, it is almost always possible to get a second medical opinion.

How to Help in a Medical Situation

When a mother asks about a medical situation that affects breastfeeding, first determine what the problem is, what the doctor has advised, and how the mother feels about what the doctor has said. Answering the following questions may help a mother focus on how she feels about the doctor’s recommendations, which is a necessary first step in communicating her feelings to her doctor.

What did the doctor say?
Why do you think the doctor said that?
How do you feel about those suggestions?
What do you want to do?

Other ways to help the mother in a medical situation are:

  • quoting accurately and objectively from written resources;
  • sharing stories of mothers who have encountered similar situations;
  • offering current information pertaining to breastfeeding and her medical situation.

For lay breastfeeding counselors, it is especially important to know the difference between sharing information and giving medical advice.

If the doctor recommends a treatment for a health problem that will negatively affect breastfeeding or has been invalidated by research, offer to share references with the mother that she can give to her doctor. Also, keep in mind:

  • In a complex medical situation, the mother may not have explained or completely understood everything about her or her baby’s condition. First impressions may not be accurate, and there may be more to the situation than is apparent.
  • Openly disagreeing with the doctor’s advice will not help the mother. In fact, it may confuse her even more. What she needs is help in coming to some agreement with her own or her baby’s doctor.

In addition to discussing ways to communicate with her doctor as described in the previous section, the safest approach is to offer to share references with her that she can give to the doctor. For example, if the baby’s doctor suggests a course of action that is not backed by current research, say to the mother: “Some doctors do take that approach, but research has shown…” and then ask the mother if she would like a reference to give her doctor.

Summary In Points

When Suggestions Differ from the Doctor’s Advice

  1. If a suggestion differs from the doctor’s advice and the baby is healthy, ask the mother if she would like to try the suggestion for a short while before sharing it with her doctor.
  2. If the baby has a health problem or if the mother is reluctant to go against her doctor’s advice, suggest she call the doctor and discuss the suggestion before she tries it.
  3. Encourage the mother to be honest with her doctor about what she is doing, as the doctor cannot treat a patient with incomplete information.

Help the Mother Express Her Feelings and Goals

  • Suggest the mother express her feelings and preferences to her doctor and, if there is a conflict, offer communication tools she can use to work more productively with her doctor.

How to Help in a Medical Situation

  1. When asked about a medical situation, begin by using active listening and asking questions about the doctor’s recommendations and the mother’s feelings.
  2. Other ways to help the mother are to give information, not advice, discuss how other mothers have handled the situation, and share written resources.
  3. If the doctor’s advice seems questionable, offer the mother help in coming to an agreement with her doctor by using communication skills and by sharing references.
Table Of Content
Introduction – Using Active Listening
Asking Questions
Giving Information and Suggestions
Respecting Differences Among Mothers
Helping the Mother Working with Her Doctor
When Breastfeeding Doesn’t Work Out