doctors scarily ignorant about breastfeeding - and I should know, I am one....

[anonymousdr]

Am a lurker and very occasionally post here but have changed my name for the moment - I read mumsnet as a mum, not as a doctor and I like to keep those identities separate.

However, I was just thinking today, there are so many stories here where people were given advice about breastfeeding from GPs and paediatricians, and the advice was basically a pile of poo.

I just want to point out that doctors get NO training about breastfeeding. A doctor's opinion about bf might be well-informed, but it equally might be just a vague collection of old wives tales, things they were told by their hv when they themselves were bf, etc etc etc.

So to anyone who is being told weird things by their GP: stick fingers in ears, say LA LA LA and then go home and read the kellymom site.

And mn of course!

I don't think many women go to a GP specifically for bf advice (I'd have thought that even the less Mumsnetty and informed would target the HV first), but they may go because DC seems unsettled or windy or has a stomach upset or so forth. And they will go for their 6/8 week check and be asked how things are going. In any of these cases bf issues might come up.

I take your point but the 6/8 week check is done in conjunction with the HV and surely she picks up on that side of things?

Hmm, I'm not sure I'd trust a bog-standard HV to pick up on anything, tbh!

What I'm getting at is that you can be in a situation where there is just you and a GP (or just you, your GP and your DC) and a bf-related issue comes up, with a resultant opportunity for the GP to offer well- or ill-informed advice.

I'm sure I touched on bf when talking to the GP at my 8-week check (with no HV in the room) now, in my case it was going fairly well although DS was still feeding very frequently, so I didn't ask any particular questions. But I could easily have done. And when DS was ill I took him to the GP rather than the HV again, bf issues could come up (indeed, at one visit I was advised to cut down on fruit juice and other acidic foods in my diet as that might help what eventually turned out to be whooping cough).

I don't expect a GP to know everything about bf, but they should at least (as pp said) (a) know that they don't know (b) know the basics (e.g. that extended bf is not some weirdo pursuit involving starving your child of solids) (c) know the properly medical stuff that will come up often in general practice (e.g. thrush, mastitis).

I should point out that I don't have any issues with my GP on any of those fronts. I do think those three things should be a minimum standard, though (and I hope that in general they are, although some of the experiences on the thread show that they are not universal).

My GP told me at my 8 week check up this week that "you don't need to breastfeed anymore - 8 weeks is enough, They've got all they need by then" which made me laugh. I wanted to say, well that's not what the WHO think, is it!

In fairness to him, he was very good at prescribing creams for me and DS when I had thrush, and tablets when the cream didn't clear it up, and I think he was trying to stop me from feeling pressured to carry on, as I have been having trouble generally with breastfeeding. I was a bit shocked though. Naively I didn't think they say something so opposite to the message they're meant to give out.

People suck at understanding the limits of their knowledge. And I'm depressed to hear some people mind doctors looking things up. I am very very very happy when doctors look anything up, it means they don't believe they know everything, and are checking things!

Have a listen to the Radio 4 programme about the fact that the UK is now ditching the baby weight charts that made breastfed babies appear underweight - leading to untold numbers of breastfeeding mothers being pressurised to give formula bottles due to the apparent inadequacy of their breastmilk (I was one - I did resist though). The new charts are much better. How crazy has that whole saga been?

Here's the link - have a listen.

Northener - i managed to dwindle an invite to one of the conferences (not been yet) to educate GP's on carers - thats not drug related.

anondr - aren't GP's trained to look after the 'health' of patients? Pregnancy nor breastfeeding are illnesses, but can come with many health related implications and therefore require a GP with knowledge to deal with them.

NQC - don't get me wrong. Now that I know how little some health professionals know about breastfeeding, I am happy that the doc looked stuff up for me. But I was there as a naive first time mother of a 4 week old baby and had kind of expected that the doctor should know what she was doing. Wooops, silly me In fairness to the doc though, whatever she gave me (can't even remember) seemed to work and I haven't had any problems since.

Tbh I've always been much happier to see docs checking that the medication they're about to prescribe is actually suitable for me.

But GPs spend so little time dealing with bf women: most mums don't breastfeed, or only breastfeed for a few weeks. And most of us are edgy about dealing with medics about bf, as we know they are morons about it.

That being said, I've had very good experiences with doctors about breastfeeding. I got a slight case of mastitis when DS2 was nearly one, and got no flak, or suggestions that I should quit. I got a scrip for antibs and a request to give it 24 hours to sort itself out before I take them.

I was also very pleased to see drs checking whether the medicine they wanted to prescribe for me was suitable duirng bf. I would be more worried were they not to check! OK, I'd expect them to know some of the more common drugs off by heart, but when, as for me, you're allergic to the drug of choice, then it seems unreasonable to expect the dr to remember not only all the alternatives but also all their interactions and contraindications.

Though I had to laugh once when a GP was concerned that I was still bfing dd at 18m - she seemed to think that I was depriving her of food! Poor suffering, undernourished, little dd, she was only on the 91st centile for weight and height .

Interesting about looking things up - to me, one of the most important markers of a good doctor is whether they are comfortable sayng, " I don't know but I'll find out".

Hattie05, you've touched on a very tricky issue in GP-land, ie where "prevention is better than cure" ends and "interfering with normal life" begins. GPs are feeling very pressurised by the fact that they spend so much time doing health promotion work (dictated by the govt) that they have too little time for patients who really need their help. Much debate currently about where to draw the line.

Getting back to bfeeding, I agree that GPs should definitely be very keen to promote it as there are so many health implications. But I think that for GPs to teach women to breastfeed or advise on problems of technique wouldn't be a good use of their time. Other professionals (such as midwives and HVs) are in a much better position to do this IMO.

Agree that Drs need the basics but otherwise should leave the detail to the other professionals, assuming that HVs etc give the correct advice!

Incidentally, my lovely GP fed her daughter til she was 3 1/2... we had a long chat about how wonderful BF was and how she would do what she could to promote it. I think that she is the exception though!

I haven't read all of this ,but the best people to give advice on BF are people who have done it!

Doctors & Midwives who haven't shouldn't give advice. Mums, grannies, or other mums are the best people to ask!