Really Bad time with GP who openly doesn't want me to continue breast feeding - but not sure what alternatives I have

[Wills]

Hi, I don't have a particularly supportive GP. I've had breast feeding thrush since dd2 was born 4 and half months ago and have had enormous difficulty getting her to prescribe decent drugs to get rid of it. I am now getting blocked every three days and promptly engorging. When I went to her this morning to discuss more drugs she was extremely reluctant, she looked up the quantities suggested by the breast feeding network and explained that levels like that were only for invasive thrush and that she wasn't convinced that mine qualified as invasive. No she felt the best thing I could do was give up breast feeding. She asked me how long I intended to continue breast feeding. When I said I'd hoped for a year she responded with "Oh no dear, you can forget that no no no. Better think about giving up soon, the sooner the better". I was reeling a little from this comment, I've always had my suspicions however this is the first time she's been as open as this. Probably stupidly but I went on to say, well I have to clear this thrush at some point I want to have a third (baby). Her response was "Oh no dear, you don't want to do a silly thing like that, no no no, you want to stick to two. Remember all your fears of miscarriage, then there was your asthma, then the hypertension (high blood pressure) - oh no you can't put us all through that again".

The whole thing has really upset me and made me resolve to do something about it. But what? Changing doctors in my area is not easy, most of them have closed their books. A new surgery has opened but it currently only has one doctor and he's notoriously bad with children. The only thing I can currently think to do is to move house which is a little too dramatic simply because I don't like my gp. Any thoughts/help?

Don't you just love people like that!

Is there someone else you can discuss this with?
What about your HV - I know they get a bit of bad press on here but personnaly (sp?) mine's a gem. Why not try ringing a breast feeding councillor yourself, they might be able to have some more positive advice than you GP, and would have more experience with the problem.

Good luck!

Speechless, Wills, and incensed for you. I know I am not qualified to say what your rights are but I BELIEVE that there is actually quite lot you can do about changing GP... Anyway, I will be keen to hear what others say since I know I'm not expert. What Health Authority are you in? Rural, I guess?

I'm not surprised you are upset - she doesn't seem to have your best interests at heart at all. Are there other doctors in the same practice to whom you could move ? In the first instance can you talk to a b/feeding counsellor to establish whether there is any factual basis for what she is saying regarding the thrush.

There should be an area family practitioner office (can't remember what they are offically called but they handle note transfers etc when you move) and perhaps they could at least tell you which other drs'lists are available in the area and save you phoning around yourself.

good luck

Gosh, how shocking and awful wills. What a terrible gp she is. Is there a nicer doctor in the same practice? Sorry, no advice but I'm sure someone else will know who can help.

Thats really harsh...and quite frankly I would be very offended if my doctor started telling me I can't have any more children...I mean "oh no you can't put us all through that again" how rude!!!

That paediatrician you saw at the hostpial...any chance they could prescribe the right thrush drugs or at least talk to your GP about the course of treatment they would recommend?

I would also consider asking if you can place yourself on the waiting list for those that have closed books at the moment, especially is you try for a third. I mean she sounds like she would be very disapproving if you were pregnant again.

Get some more medical info and throw it her. Talk to the practice manager about wanting to work as a partner in your health care not a passive guinea pig.

God it must feel like banging your head against the wall.

Hugs, I hope you get the right support soon.

pie xxx

She is definitely the best doctor of the practice (doesn't say much does it!). Am also in contact with a breast feeding councellor who is incredibly supportive but feels, as do I, that I need drugs to help me shift this thrush. I've also got a lot of support from the breast feeding network but only my gp can prescribe the drugs and she wont! Have thought about going to another doctor at the same surgery but know that they have collectively discussed me. Am also aware that the drug I'm after is very expensive - now possibly I'm doing them an injustice but am very very suspicious . with my asthma drugs and my thrush at the moment I'm probably a very expensive patient.

How expensive? Would they consider writing a private prescription, or would you consider seeing a doctor for a one off consultation privately?

Pie - disscused my treatment with the paed and he wrote a letter to her (seen the copy) saying that he was happy for me to have this full quantity of these drugs. I discussed this with her this morning. Have also taken in the breast feeding network's leaflet - but again no joy!

So shes going against the recommendations of a pead?

Whats the drug btw if you don't mind me asking...if you don't know the cost I could look it up for you.

Trying to find links for you, Wills:
This is a general page on how to complain , but seems like most Health Authorities have their own info about how to complain, and what you can do. Presumably you don't want hassle of changing GP surgery, just want a GP who agrees to prescribe what Paed said was ok?

In which case wills, it sounds to me like she has an extreme nerve. can you face complaining, in writing, to the practice manager and then the family practitioner committee if that doesn't get you the drugs you want? Agree, it sounds suspicious re money but maybe asking for a written explanation will push them towards deciding it's not worth arguing with you?

Agree with WWW, that isn't very professional to go against the recommendations of a specialist.

Wills - is there a Breastfeeding Clinic any where near you? It might be worth finding one and getting referred. Does anyone know if Chloe Fisher still runs one?

Wills, i think you should change your G.P as you obviously don't get on and she seems very abrupt and rude! She sounds bloomin awful really!! I changed dd's G.P when she was a year or so as she talked to me as if i was a moron and if i asked questions, she looked horrified!!
Good luck and hope you get some good advice

Have you decided what to do, Wills?

Wills, this doc is appalling and guilty of unprofessional practice in refusing to prescribe treatment you need and that has been confirmed by a paediatrician. Look up your local Primary Care Trust in the phone book - they will be able to give you information about other docs and whether their lists are closed or not. Explain that your doc is refusing to prescribe drugs recommended by paediatrician and b/f counsellor and trying to make you give up b/f which any fool knows is the best thing for your baby. Also your local Patients' Forum should be able to advise you on complaints ? again, in the phone book or PCT should give you details. What's your health visitor like? Mine has organised prescriptions for me when I've needed antibiotics for mastitis and just got any available doc in the practice to sign them. Worth also going back to the paed, saying your GP refusing to prescribe and can they? They can write prescriptions but usually prefer to leave it to the GP as then comes out of GP's budget, not hospital's. In this case you may be able to persuade him/her. I know you think it won't work but really worth trying another doc in the same practice, I'd be surprised if a second doc would refuse you a prescription that is clearly medically necessary. Good luck!

lord wills, that is crap isn't it?
If I were you I'd go and see whatever the best GP is in your town, books closed or no, and go and see them. Explain that you have a problem in that your GP isn't supporting you in bf, and that she is refusing to write a prescription that your paed has requested, and that you have lost faith in their practice. Ask them if they would very kindly consider putting you on their books, and if they can't do that, ask if they would give you any advice on how to deal with this. You will have to appear to be very reasonable and nice and relatively low-maintenance yet needy in order for this to work, because their first instinct might be that you are trouble if you are complaining about your existing GP (unfair I know). BUt if you go as someone who is just doing her utmost to bf her baby despite suffering from unresolved thrush for 4.5 months, and looking for some good care and support, and not in any other way neurotic or hypochondriac etc..... it might just work. You'll have to get past the practice manager and talk to a GP in the practice through... ie butter up the practice manager first. BEST of luck!

Is Chloe Fisher's clinic in Oxford too far away wills - could you telephone her? Not all hospitals B/F clinics would offer her level of support. I know we do not have access easily to specialist support. Our midwives run local B/F support groups which is not what you need Wills. You need the support of a specialist in breastfeeding which your GP clearly isn't.

I could do a day trip to Oxford, that's certainly not unreasonable, but can she prescribe drugs? My problem here is that everyone around me EXCLUDING my GP is supportive and great. I have a fabulous bf councellor from NCT, I've spoken to the breast feeding Network who are also very supportive but so far no-one has suggested an alternative means of getting the drugs. Princess... I have certainly considered this route and you have hit my fear on the head, that I will be refused or seen as troublesome. Evansmum and others, my next door neighbour has been "blacklisted" and this has made me very nervous about the complaint route. As for the paed - what he said was that the advised levels of fluconazol would not be harmful for the baby and would probably make bf much happier for me leading to more calorie laden milk (he feels that I've been a little stressed about the thrush and that this is causing my milk to carry less calories than normal - but although dd2 is thinner than normal it is not harming her). The problem with the paed is that my dd2 was sent to him not me. Although he hinted in his letter to my gp that my pain levels through the thrush were probably interferring with the calorie content of my milk my gp appears to be ignoring this.

After talking to some friends here I've decided to try the private route. I was not aware of this but it seems that you can walk into any surgery and ask to see a gp privately. A friend has recommended a gp of theirs who has a young family and would be far more supportive of my breast feeding. The problem with this route is that the cost of the drugs may prove to be too prohibitive for us. I am trying to stay on maternity leave as long as possible - I'm also trying to start up a new business so that I don't have to return to work - all of which would make large medicine bills impossible. The private gp is going to investigate the cost of the drugs and get back to me tomorrow so fingers crossed. If this route doesn't work then I either need to find somewhere that can prescribe these drugs to me on the NHS or I need to start a complaint. In the long term we as a family really need to change doctors and I will ask around and put us on a waiting list.

You can't really be blacklisted; that's a bit of a myth. NHS has an obligation to provide you with primary health care, no matter what. If your GP struck you off you'd end up writing somebody -- I think it's the Primary Care Group/Trust (can't remember whether it's PCG or PCT, after ongoing restructuring!) and request that they find you a GP within reasonable travel distance. Even if every GP within 20 miles refused to have you, the PCG could force you onto one of their lists (rare, but they have the power; they might even assign you to a locum doctor, but point is, you have a right to a GP).

Have thought long and hard about this... I think if you can't get the drugs at a reasonable price... I would get an appointment with your current GP. Put aside everything but the thrush issue. Why isn't she willing to prescribe the drugs you want, given she doesn't have a more effective treatment to offer you, and the Paed said it wouldn't hurt the baby. Be absolutely persistent about it. Keep repeating what you want (an effective treatment for the thrush, or the next best option on offer which is the drugs at the dosage you have asked for) until she gives in or throws you out.

Only if she still refuses would I then go the route of writing very polite letters both to her & the PCG/T to the effect that you don't see how she can continue to be your GP, and can the PCG/T find you another GP. By the time you've been reassigned to another GP, that new GP will be so scared of you they'll probably just say yes to whatever you ask for to try to have an easy life.

Good post, Zebra It's a Primary Care Trust and as you say they have a legal duty to provide medical care and will add a patient to a 'closed' list if there are no other docs available. It's not as uncommon as you might think, especially in rural or inner-city areas where there are shortages of GPs. But this tale illustrates how the really bad docs get away with it because most patients are too afraid to kick up a fuss. (For any GPs out there, I know 99 per cent of you are incredibly caring and hardworking)

Hi Wills, I'm new here, so I hope you don't mind me joining the discussion.
I'm a breastfeeding peer counsellor (LLL) and help run a local support group. We have the same problem with GP's in our area, and are currently approaching some of them in the hope of interesting at least one in each practice to become more knowledgable about breastfeeding in the hope of helping to avoid these problems. (That was the background stuff )
We work closely with other local groups, and I know there was a lady locally who had severe thrush for an extended period. For her, it was only resolved when she saw a new GP who realised that both the mother (inside and out ) and the baby needed treatment. Another route that might be worth considering (I don't know if you have already) is homeopathy. I have found good ones through word of mouth, or the faculty of homeopathy provide lists of healthcare professionals (locally) that are also trained in homeopathy. Maybe if the conventional route is failing you, it might be worth a try? (Though, I know it isn't the basic issue!)
Good luck

Hi there hope things are getting better but i can wholely agree with the frustraions of Uk Gp's!!! in Australia a drug called motillium is prescribed to increase milk production and my aus gp said its ok it availible in the uk so i wont write you a big script you can get it there!! ha ha.. even with a note from my aus gp, an information leaflet on how , when and what the drug does from the hospital... still it was refused on the grounds that it is unproven in the uk and passes into the milk in a minute quantity. the fact i was allready taking the drug seemed irrelevant to her!! no side effects for jnr and surely the benfits of breastfeeding should outweight that? anyway i resorted to a homeopath and can say with great glee it was a great succsess. to add as student nurse now, i just did a stint on maternity in the community and saw a women with a similar condition to you who had had reccurent thrush and mastitis treated by a homeopath and all better! so give it a whirl and please change gp's!!!! it is allways possible. you can amke the poit that she is unwiling to support your next pregnacy... just for a start!