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Sunday, January 8, 2012

Miami Physician's Breastfeeding Summit

 Like a geek, I sat in the front row of this physician's meeting on breastfeeding in Miami. I wanted to make sure I heard EVERYTHING. I didn't even know about this conference til about a week ago. 

I get patients from Miami and when I heard about the meeting, I felt like I should now what is going on there. 

Who's at the table:
Grisel Garcia MD from Miami
Joan Meek MD from Orlando
Julie Kelogg MD from Jacksonville
Liz Westwater from Baby Friendly
Lourdes Forester MD from Miami
Alberto Dominguez-Bali MD from Miami

So Miami has 14 hospitals and 12 are working towards Baby Friendly! Part of becoming Baby Friendly is that your physicians must have 3 hours of formal training in breastfeeding. Attending this meeting was physicians and other staff trying to meet this requirement. How do you get a physician at a meeting on a Saturday morning, on breastfeeding.  FREE CME, FREE breakfast and lunch, and a mug.... the good view of the harbor was a bonus. It got me there!

This was not a lecture to the choir!

Joint Commission a group that hospital quality control has a campaign directed towards mothers to "Speak Up".

That's how the meeting started-- by showing the brochure. What does it mean when your mother speaks up and asks for skin-to-skin. ((It never entered my mind that a physician might not know what skin-to-skin was.)) This was a good non-threatening starting place to reach the participants. Dr. Bali showed a video of attachment after birth and the phases in detail. He emphasized touch, touch, touch... and he was quite passionate about it. He said, if the mother couldn't do skin-to-skin immediately, partner or grandma should. 

He said we forgot something very basic-- WE ARE MAMMALS! No other species survives without breastfeeding. 

We talked about removing warmers from the delivery room
Talked about how damaging suctioning is because it cause aversions, stresses baby, changes the flora.
We talked about how WE interfere with breastfeeding. We ((doctors)) and our policies interfere. 
But the good news is how a little education and a little encouragement form the physician GOES a long way.
The speakers told the other doctors to tell their patients:
"As your doctor, "I want you to know I support your breastfeeding."
A point was made that if you tell mothers this, you should remove the formula display from your waiting room which undermines a mother's confidence in herself and you.

In the hospital, anticpate the baby will be up all night.  The hospitals are implementing a no procedure, restful period from 1-3 o'clock in the afternoon. We talked about how society prepares mother that everything will go back to normal. We need to support mother better.

It was noted that in one area no one came to the breastfeeding support group, but they changed the name and  many came to massage class (and they spoke about breastfeeding).

When the hospital got an estimate to purchase formula, the formula company inflated the estimate.  There was several reasons that actual usage didn't meet the estimated purchase cost. For example- staff passed out extra formula because it was free. As time went on and they used less formula, they purchased less.

We talked about delaying procedures, growth curve, reflux, hepatitis, glucose, jaundice, starting solids. 
The participants got to ask Questions at the end. I thought this three hours was excellent for Physician Breastfeeding 101.

The AAP is coming out with a new breastfeeding statement this year emphasizing the physicians role in management.

At the end Liz from Baby Friendly encouraged the doctors and said that surveys use to come back with negative about the doctors being the barrier, but in more recent years, the surveys come back as the doctors being the one who moved it forward!

I see mothers from Miami for tongue-tie (frenotomy was not discussed) and alternative vaccine schedules (discussed briefly, if any of the speakers supported an alternative schedule I didn't here it). Also, most of my Miami consults have had out-of-hospital births. This meeting should have a positive impact on what is going on in the hospital! A good start has lasting effects!!

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