Our Patients Can't Read Our Minds

Breastfeeding, for example
Charles R. Attwood, M.D., F.A.A.P.

y great, great, great grandfather, Dr. Curtis Burke Attwood, who practiced medicine in Newberry, North Carolina, during the late 1700s, wouldn't have believed that we have people today who specialize as breast-feeding consultants. They are certified by their own board, the International Board of Lactation Consultant Examiners. In my grandfather's day practically all women breastfed their babies, but today only 59.7 percent start breast-feeding in the hospital, and by 6 months all but 21.6 percent had given up. The Healthy People 2000 breast-feeding objective is to have 75 percent of women leave the hospital breast-feeding and 50 percent continuing to do so 6 months later. Obviously, we're falling far short of this goal.

The advantages of breastfeeding are enormous. Babies have less acute illnesses and allergies. The bonding between the mother and her baby is enhanced far beyond that between mothers and bottle fed babies. So why are only one-fifth of six-month old children still breastfeeding?

I've always complained to my colleagues that we don't take enough time to explain these procedures and other good health practices to our patients. Usually, this means we don't give them time to ask questions. Let's take breastfeeding for example.

These days new mothers barely spend 24 hours in the hospital, so we may not have the opportunity to explain things adequately -- and often they don't ask. It's no wonder we think we're misunderstood. Doctors should spend a little more time with their patients -- give them more time to ask questions. I had a patient recently, who, although intimidated by our business-like manner, desperately needed some basic information. She tried.

Gloria, the young mother, had just given birth to her first child at my hospital. She called the nursery and asked if she could still breastfeed the baby, even though she had a cold. "I'm sneezing and coughing," she said, "and I'm worried." She was going home that same day, and she wanted some answers.

Pleased that she had chosen to breastfeed, I told the nurse to tell her to go ahead. I suggested that the nurse leave a couple of face masks on her bedside table. That way she wouldn't worry so much. We should have personally talked to her about breastfeeding, but she was being discharged and there wasn't much time.

Later, during rounds, I dropped by her room. "Hello, Gloria," I said as I sauntered into the room, and then I saw something that I'll never forget as long as I live. Now, put yourself in my place. I could hardly retreat from the room with a straight face. I found Gloria with a confused expression on her face and a face mask on each breast.

After the story was repeated throughout the hospital and the laughter final died down in the doctor's lounge, I thought of Gloria's humiliation and her sincere need for the information we didn't have time to give her. Grandfather Curtis Burke Attwood wouldn't have thought it was so funny.

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