Anyone wish your GP knew more about breast feeding?

[zzzzoey]

I've gotta give a presentation to GPs on breast feeding (crikey) - is there anything you've found your GP should know but doesn't?
(one GP told me to stop breast feeding on the affected side when I got mastitis!) Have yours been great or is there something they need to know?

It would be good to tell them that it is allowed for babies to breastfeed after 6 months, WHO guidelines apply in developed countries as well - after being told to it was time to stop feeding a 9 month old. Also was told to stop feeding on the affected side like you.

I went to mine recently for my fifth course of thrush treatment this pregnancy.

She dismissed my point that baby getting a mouthful of thrush on the way out could potentially set us up for breastfeeding problems.....

Give them the up to date advice on treating thrush as it changes often.Best if you can give them a simple aid memoire to pin on their notice board.

Good ideas. Mind boggling that a dr could tell anyone to stop breastfeeeding a baby! Thrush very important I agree. Breastfeeding network seems good for advice on that, should be the latest I hope. Thank you! Any more ideas?

They would probably appreciate practical things like phone numbers for local breast feeding groups/advisors so that they can give them to mums.

The difference between mastitis and blocked duct
Thrush, symptoms and treatment for both mother and baby

zzzoey according to the b&bf boards gps are very happy to tell people to stop bfing for the most ridiculous reasons.

my gp freely admitted she didn't know anything about bf. didn't stop her dismissing all the info i brought in as 'you expect me to listen to something from the internet?!'

that is very sweet lemsiprocks, in my experience of doctors the last thing they'll do is give you the number of someone else, it is like a personal admission of failure for them. particularly if it is (oh horrors) a voluntary helpline.

ok good things to tell them: where they are prescribing a medication where bf is contraindicated that there is often another drugs to give which mean that bf can be continued and how to find out about this.

Mass generalisation fishie
Some doctors might hate giving Helpline numbers but not the majority I suspect.

I think an attitude transplant might be a suggestion (have encountered the attitude that 'laymen' know nothing, the internet is a completely unreliable source of information, doctors are all-knowing).

And they should leave their deep-seated fears at the door when it comes to bfeeding baby boys. It doesn't turn boys into mummy's boys. You know who you are, Dr. H... ("What would his little girlfriend say if she saw him doing that, hahaha?" His exact words; DS was 6 weeks old.) I'm not addressing Dr. Hibbert here, btw.

please - not the mass generalisations. It is pretty insulting. A presentation will attract those that are already interested so don't go getting their backs up. As a pregnant GP who has previously breast fed my DD to 14 months and 6 months exclusively I am very pro breast feeding but have never received any teaching/training about it professionally. Usually by the time I see mums at the 6 week check it is too late for me to encourage those who have already given up - often because of misinformation from other HCPs or their mothers/mothers in law. Evidence based guidelines of the treatment of mastitis/thrush would be great and the numbers of the helplines which I could add to the other numbers I hand out when relevant eg women's aid, relate, support organisations for carers etc etc

Thank you all! Lemisprocks - I will dig out some phone numbers for them. I'm sure some will use them. And Darrel R, I will definitely try to cover difference between blocked duct and mastitis; and thrush. I expect most will have good attitudes like Mollybob - just not enough information. I can see why you were put off forever by Dr H though Mathanxiety.
Mollybob did you know about www.ukmicentral.nhs.uk/drugpreg/guide.htm for prescribers - it's really useful.
Just hope I can cram this all into one session!

The number for the BfN drugs helpline and not to just follow the standard line on meds.

please give them this link to Dr Hales forum re medications and breastfeeding

he has some very very good advice/research on there for all types of meds and answers specific questions from healthcare providers

I had milk blisters/ blebs with both DD's. They caused blocked ducts and mastitis, but no-one would examine my breasts. I guess most felt they would not know what they were looking for. I also had a GP fail to diagnose thrush, without a physical examination, only to be put straight by a brilliant HV who had examined me a few hours later.

Show them what to look for and how to examine breasts for the key problems.

no, not mass generalisation by me. i referred to my own experience or (re being advised to give up bf) my reading of other people's accounts on this board.

i needed a great deal of support with bf and got fuck all from gps. in fact i was actively dissuaded from contacting a bf counsellor.

although of course you are right mollybob, the gps who most need a presentation on bf are very unlikely to turn up to one.

So far I have syllabus of:
Attitude ? and especially towards feeding older babies
Diagnosing and treating thrush, blocked ducts and mastitis. Examining breasts.
Prescribing medications
Information resources, helplines and websites for doctors and for mothers

Thank you all for your help! Will do my best to impart all this and then hopefully we?ll have a few better informed doctors around. Anything else anyone want to add?

My two pennorth:
WHO growth charts and how breastfed babies grow differently from formula fed babies
How to tell if a baby is growing and developing well without the use of scales
How demand and supply works - so that they can advise increasing milk intake if necessary by INCREASING EFFECTIVE BREASTFEEDS and not by ADVISING FORMULA (sorry for shouting)
The damage caused by cavalier formula top-ups
The effectiveness of domperidone to support struggling milk production

What everyone else has said - women shouldn't have to argue and cite their own Medline searches for the relevant papers in order to get anti-thrush drugs.

Remind them that most drugs ARE OK with breastfeeding and looking up drugs in the BNF doesn't take long (I know it's conservative but it would still be a great improvement).

How to contact local specialists (helplines etc).

And that any woman with a young baby should be recognised as having done loads of fantastic stuff under great strain in the last few weeks and they'd better be supportive of her - apart from anything else postive interaction at a vulnerable time could help ward off future depression, enable more bf and more healthier babies, and mothers more postive about GPs will present themselves/babies before problems get too entrenched and also help GPs tick boxes like getting routine screens done.

GPs tend to see a lot of minor childhood illness, which is time-consuming & tedious. Conveniently, there's some pretty strong evidence that breastfeeding is associated with decreased consultation rates. Much of the research is USA based but this study was done in Scotland and published in the British Journal of General Practice.
eprints.gla.ac.uk/2680/

Possibly remind them that thrush on the nipple is the same as thrush elsewhere and the mother doesn't need antibiotics and does need thrush treatment.

Sounds stupid but I was complaining about a GP to my HV and she said she had to tell him just that!

Nope, My gp is german, and female. She was very pleased when I said I was tandem feeding and told me to keep it up, ds1 is over 2 now she's very suportive, she knew where to find the bfn thrush leaflet too. Abrupt! but very supportive!

Very strangley I also met a hv this week who asked me where the best b/f cafe was in the area and suggested that my 6 month olds weight gain was fine and not to wean him unless I was sure he was ready!

Oh did see an idiot doctor at the out of hours who disbelieved that I had thrush. Can I make a personal point too? When said idiot gp asked to look at my breasts to see evidence of thrush he had not washed his hands had been typing on his ( probably germ ridden) laptop and reached out to touch my nipple which is where my 2 week old would be having his lunch! No I don't sterilise my nips for my babies but I don't want the gp to touch them without washing his hands either.Most gps wouldn't recognise the colour change that is associated with thrush in the breast so I don't really see wht the point was anyway and ds had visable signs.... The loud shout of "do not touch my Nipple" which was apparantly heard in the waiting room may have been excessive but

rofl kitkat, I bet you had people worried!