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Health Care Providers
Choosing Your Health Care Team
Kay Batt, IBCLC
Consider choosing a support team to support you when you are
breastfeeding.
If possible, take time before your baby comes to develop positive relationships with a team of people who will support and encourage you. Talking with a La Leche League Leader, a childbirth instructor, midwife, or doula may aid you in locating the kind of health care provider (HCP) you want for the birth or for health care after the birth.
Members of your team may include:
- A physician or midwife who will provide the support for getting off to a good start after delivery. Some families look for obstetricians and pediatricians. Others are happy with a family practice physician who also cares for babies and the rest of the family. Nurse practitioners or other types of health care providers such as naturopaths may also provide excellent well-baby and mother care.
- A birth and/or postpartum doula.
- Get acquainted with a La Leche League group and La Leche Leaders who live or meet near you and attend meetings before your baby arrives. La Leche League provides education and ongoing mother-to-mother support through phone, e-mail, and regular support group discussions.
- Many hospitals provide classes on childbirth and breastfeeding. They may also provide new mothers support groups you can attend after your baby arrives.
Make a list of concerns that are important to you.
What kind of support do you want? For instance, if you are looking for a health care professional to help you deliver your baby, clarify for yourself:
- Do you want a hospital birth? A home birth? A midwife or a physician?
- Are you looking for childbirth classes? What classes does the HCP provide or recommend?
- Do you want the baby’s father involved? If so, you may want to ask how the HCP includes fathers in childbirth education and birth. How does the HCP
educate and encourage fathers in ways they can support the breastfeeding relationship?
Develop a list of questions.
Develop a list of questions you would like to ask as you consider the people you want on your team. Some questions you might ask include:
- What resources would you recommend to help me with childbirth and/or breastfeeding classes, particular books, or support groups?
- Who in your office will respond to phone inquiries I may have
about childbirth or breastfeeding?
- Has anyone in your office had specific training in counseling breastfeeding mothers?
- What can I do during labor and birth to increase the odds of breastfeeding going well?
- What are your standard orders for the care of healthy, full-term
babies while in the hospital?
- Who might you refer me to for a breastfeeding-related problem or
question?
Doctors can’t be expected to know everything about childbirth or breastfeeding, but we can expect them to consult expert resources and, if there is a significant
breastfeeding problem, to refer clients to an International Board Certified Lactation Consultant (IBCLC).
Begin interviewing.
Talk with several care providers be- fore selecting one. If the person is a physician, often you can start with asking the nurse or office staff if they can give you some information before setting up a consultation appointment with a prospective doctor. Often doctors don’t charge for consultation visits.
- When you go for the appointment, take note of the materials in waiting and examining rooms. Are there up-to-date printed resources that encourage and inform breastfeeding mothers?
- When you meet the HCP, try to build a friendly rapport before you begin asking questions. A positive approach works best. The idea is not to challenge the doctor, but to gauge the level of support for breastfeeding in that practice, both in theory and in practical terms.
- Ask if the doctor refers mothers to La Leche League Leaders and LLL meetings or to other support groups for support and information.
- Consider how supportive the office staff will be as they will often be your first line of contact.
*Note: Consider taking a copy of the American Academy of Pediatrics AAP Guidelines on Breastfeeding, Breastfeeding and the Use of Human Milk, which includes 110 references, highlighting the parts important to you, to the physicians you interview, and to ask if their recommendations are in line with each recommendation you’ve highlighted.
This approach takes time and effort but it may minimize time, effort, and conflict in the long run. Finding health care providers who understand and value breastfeeding is not always possible. Insurance companies, health maintenance organizations, or government programs may limit the choice of doctors.
When your HCP gives you sound medical advice but does not hold your values with regard to personal preferences such as discipline, parenting, or nutrition, ask yourself if you feel that the HCP respects you, your decisions, and your child. Do you feel this person sees you as someone able to make good choices if you are given enough information to make an informed choice?
When you’re working with health care providers, it helps to be confident and trust your instincts. You know your child better than anyone and you have the right to make decisions you’re comfortable with. It helps to have a positive approach
and remember that you all have the same goal—preserving your child’s
health.
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