SingaporeMotherhood | Baby & Toddler

August 2013

Communicating With Your Doctor About Breastfeeding

Breastfeeding mothers often receive conflicting advice from doctors. As a nursing mum, you may feel intimidated about challenging your doctor’s advice on breastfeeding. Doctors’ knowledge and personal experiences with breastfeeding often influence the amount of support they are able to offer you.

Rita, 29, works in healthcare and breastfeeds her nine-month-old baby. She shares the following scenarios when nursing mother and doctor may experience conflict: “When the infant is hospitalised, is dehydrated or has inadequate weight gain, a mother may be advised to supplement with formula. Or she may be asked to express and measure breastmilk volume before feeding. This may interfere with exclusive direct breastfeeding. Other scenarios might be if the mother is unwell or hospitalised and needs medications. There may be breastfeeding-friendly options, but the doctor may recommend a temporary break from breastfeeding or formula supplementation.”
Getting care from a doctor who has the same outlook on breastfeeding as you can minimise time, confusion and conflict. But how can you find a breastfeeding-friendly doctor and communicate positively with him or her to negotiate a care plan for your breastfed baby?

Firstly, when pregnant, set up appointments and speak with different doctors. Ask positive and respectful questions about the doctor’s resources and support for breastfeeding mothers. Find out about his standard care for healthy newborns after birth in hospital, and the breastfeeding rates among his patients. You could also ask other breastfeeding mothers for recommendations.

Note that your intention is to find a paediatrician who will support your breastfeeding journey, not to challenge any particular doctor’s views.

Even if you have limited choices of doctors due to financial constraints or your desire to have a doctor near home, you can still improve communication with the doctor whom you are seeing. Consider the following:

Your Breastfeeding Goals

Before you are able to discuss any concerns with your doctor, you need to be aware of your personal breastfeeding philosophy and goals. Once you are clear about these, express
them to your doctor. This helps your doctor to tailor his advice to suit your breastfeeding goals and preferences. It also helps him see where your concerns are coming from.

Your Doctor’s Goals

Your doctor’s goal is your baby’s well-being. Focus on the common goal that you both have, to provide the best for your baby. Collaborate on a course of action.

Feelings & Attitudes Vs Facts

Distinguish feelings and attitudes from established facts or accepted breastfeeding guidelines. Apply this objectively to your ideas as well as to your doctor’s advice. It is okay to make decisions based on how you feel. However, you need to realise that this is the case instead of believing that your decisions are based on factual information.

Parenting Advice?

You may decide that while you rely on your doctor for his medical expertise, you will also turn to other sources for information and parenting advice on issues such as sleeptraining, co-sleeping and discipline.

talking heads

Communicating Better with your Doctor

  • Stay open and honest, even if you have differences in opinion. Your doctor will base his treatment recommendations on what you tell him. Withholding what you know may mean that your baby receives inappropriate care.
  • Listen reflectively to your doctor, repeating or rephrasing what he is saying to show that you have understood and considered his insights. Use phrases such as “From your point of view…” and “So, what you are saying is…”.
  • Ask questions to clarify and offer alternative options that you feel may work. Phrases
    like “Is there some way we could…?: and “Would you consider…?” may help.
  • Share information about breastfeeding that you may have come across and ask your doctor’s opinion.
  • If it becomes necessary, set comfortable limits such as doing nothing and reassessing after a week, or seeing a lactation consultant.
  • Consider role-playing or practising with a friend or breastfeeding counsellor before speaking with your doctor.

“You can open a line of communication by building a healthy therapeutic relationship with your doctor. Trust in the doctor’s professional expertise and an understanding of your concerns are important. If there is disagreement, being open about seeking alternative opinions and sharing alternative viewpoints can be useful,” Rita advises.

Shared Decision Making

Shared decision making between your doctor and you means that you:

  • Stay receptive to information from your doctor
  • Discuss the benefits, trade-offs and consequences of each alternative
  • Keep the best, available medical evidence in mind
  • Participate in the decision-making process with your doctor
  • Reach an informed decision that reflects your personal values
  • Your doctor agrees about the problem and the final plan

Rita explains: “Decision making is a shared process. The doctor provides the necessary information based on current medical understanding and recommends what is best for the child. The parents use this information to act in the best interest of the child. Decision making, like the therapeutic relationship, is a two-way thing.”

Dr Tan Siew Pin, a paediatrician in private practice, says: “I definitely believe in shared care for the best outcome. But it doesn’t work out that way for all mums. A few prefer to let me decide for them. Some come for second opinions and that is fine. Others have already made their choice but want my reassurance that they are not putting their baby at any risk.”

Breastfeeding is more likely to go well if you surround yourself with a village of breastfeeding support. This includes your doctor and his or her team as well as your spouse, family, employer and other mothers. Your effort in building your support network will stand you in good stead, in breastfeeding as well as in other areas of parenting throughout your child’s early years.

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Communicating With Your Doctor About Breastfeeding