When Elfin was five weeks old we were referred to a paediatrician by our GP. It was for an issue which turned out to be fine (she didn’t have the condition the GP was concerned about). But while we were there, my poor baby was diagnosed with cow’s milk protein allergy (CMPA). This was on the basis of her terrible skin, which I’d put down to baby acne.
I learned a hard lesson that day…
I have people in my life who are prone to exaggeration or hypochondria, and there are many more around us all who seem to jump on whatever bandwagon appears to currently be in vogue. I’m so cynical that because of these facts, I’d not sought help for what in hindsight was clearly a nasty rash. But that’s a side note to what I actually want to talk about.
A week later we returned to a different doctor for our six week checks. I wasn’t very impressed.
At that point, I’d only been asked about my mood once, and that was by the health visitor within a week of giving birth (I’ve since seen the HV again and had many more questions about my frame of mind). My postnatal anxiety is in my notes from last time, yet this was not touched upon by the GP. Luckily it’s not something that’s affecting me at the moment; nonetheless I think it’s pretty poor. But that’s not what I want to talk about either.
Breastfeeding Difficulties With Second Baby
I’m quite sad to say that Elfin had had lots of problems feeding. Initially it was the allergy (and I’m still in the process of eliminating and confirming that it is CMPA with no other additional allergies); but as the allergen left our bodies and her skin improved, I started to suspect there was something more going on. She can be incredibly fussy when feeding and I can count on one hand the number of times she’s fallen asleep using me as a dummy:
She’s far more often distressed by feeding than she is comforted by it.
Which, as a seasoned breastfeeder and huge advocate, is really horrible for me. And of course for her too.
Anyway, this behaviour is not normal, and neither is the fact that she often slips off when feeding, ie. her latch is not as strong as it should be. We’ve also had symptoms of colic and silent reflux (though these could equally be attributed to the allergy), and I suspect posterior tongue tie. At my wits’ end I decided it would be useful to visit my local breastfeeding peer supporter for a second opinion.
Gemma watched me feed and agreed that based on all of Elfin’s symptoms, there appears to be something not quite right. Given the fact that I’ve successfully breastfed before for nearly two years, by six weeks in we’d expect Elfin to be doing a little better. Oddly, she’s gaining weight well – which doesn’t support our theory – but either way Gemma recommended an assessment for tongue tie, even if only to rule it out.
I discussed my concerns with my GP and explained that though Gemma is not qualified to give a formal diagnosis, she is trained and has an ongoing, working knowledge of breastfeeding.
I did not mention the fact that I’ve done a great deal of research on the subject myself and written about it extensively; nor the fact that I was recently invited to participate in a press call with UNICEF and the World Health Organisation to discuss the topic.
My point is that I’m not ignorant – I’m well-informed. I’d suggest Gemma is even more knowledgeable about breastfeeding than I am. And here is what I do want to talk about:
I’d suggest we’re both more knowledgeable than the GP who carried out mine and Elfin’s six week checks.
A Lack of Knowledge and a Lack of Empathy
My doctor asked me if I had any questions, and I brought up my concerns regarding breastfeeding. When I said we’d seen a paediatrician I watched her pull up Elfin’s notes and I cannot tell you how ridiculously relieved I was to see the words ‘cow’s milk protein allergy’ appear on the screen. This meant I was validated in what I was telling her because there was a formal diagnosis – not merely a conversation she could doubt had ever taken place.
And yet – despite her having taken on the role and responsibility of conducting Elfin’s six week check – she clearly had no understanding of what CMPA actually meant for us.
MY GP could not comprehend how I’d eliminated dairy and soya from Elfin’s diet if she was being exclusively breastfed: I had to spell out that I’d cut them from my diet. Too often a lack of specialist training means our doctors are failing breastfeeding mums.
Requesting a Referral
Arguably worse though is the attitude she demonstrated: I find there seems to be a real air of superiority in many doctors these days – at least that’s my personal experience. On this occasion I felt doubted, having to justify everything I was saying and asking – even in spite of Elfin’s notes.
Ultimately, my referral request was denied on the basis that Gemma is not qualified. She refused to act without a Health Visitor agreeing it was necessary, and I wasn’t going to have argument with her considering my next HV appointment was just a few days away. However I did think her stance came across as arrogant and completely undermined the fabulous job Gemma and her team do. (For the record, the HV concurred and is recommending the referral I sought.)
There was little compassion and I felt like the GP was trying to trip me up in the same way a police officer does: say little and allow the suspect to tie themselves up in knots. In an effort to be gracious, I’ll say I can understand where that comes from, actually – but it’s not helpful, appropriate, or acceptable.
The Current Problem Facing Doctors – and Patients
I am conscious of several issues facing doctors in this new digital world:
- Firstly there’s the problem with people turning to the web before consulting their qualified practitioners, which seems to have led to a lack of faith in the very people who have trained for years to help us;
- Secondly, the accessibility to symptoms of various illnesses and ailments we’d never have previously heard of (thanks Mr Google), appears to have caused a wave of hysterical hypochondria;
- And thirdly, these inevitable self-diagnoses have meant many people jumping on the bandwagons I mentioned earlier.
I find it all a bit sad and pathetic, and yet in the past couple of weeks I’ve found myself constantly questioning whether I’ve fallen prey myself?! It’s why I didn’t seek help for poor Elfin’s sore skin, and why I left it so long to see the GP about the other concern we were referred about.
I get that the above issues have inevitably caused GPs a great deal of frustration, and that they’re often left feeling hugely disrespected.
However, we’re not all like that, and it’s no excuse for those in a position of privileged trust to behave with arrogant condescension towards patients – particularly when actually, their knowledge is lacking or insufficient – then it also becomes patronising.
How Doctors Are Failing Breastfeeding Mums
This is especially true for those breastfeeding – I’ve faced it myself and I know many others who have too.
Gemma is one of many fantastic women who give up their time to volunteer to help me and others in my situation – where our formal healthcare providers are failing us. Yet those very same healthcare providers can’t even extend the courtesy of professional respect towards Gemma and her team – let alone towards the lowly patient.
Don’t get me wrong – doctors cannot and should not be expected to be omniscient – but that’s surely the reason we have specialists. And I’d argue that a breastfeeding peer supporter is exactly that: a voluntary breastfeeding specialist.
Something to bear in mind: any intelligent woman will go to any length and measure to ensure we give our vulnerable newborns precisely what they need. If there’s any patient who can be expected to have done their research thoroughly, it’s us, on behalf of our babies.
And yet you’d better believe going dairy and soya free is hard and I’m confident I speak for every exhausted, sleep-deprived breastfeeding mother when I say I would not embark on this CMPA diet lightly or without genuine cause: it makes already difficult circumstances more difficult.
It means my favourite treats are off limits. Some wine even contains bloody milk! (If you’re also affected, you may enjoy these delicious dairy free truffles!)
With a little more respect all round, breastfeeding mums might feel better supported to continue doing one of the hardest jobs we’ll ever undertake.