To make breast exams less stressful for my patients, I use the time to plant a seed for future breastfeeding (as well as teaching breast self-examination, of course). I point out some of the advantages of breastfeeding for both infant (fewer infections) and mother (convenience, help returning to prepregnancy weight). As a result, when these young women become mothers, more than 99% have already decided to breastfeed their babies instead of bottle feeding them. I find that encouraging breastfeeding early is more effective than educating new mothers in the postpartum suite, 12 hours or longer after giving birth. In an ideal world, of course, every pregnant woman would have a prenatal visit with the pediatrician, but many never do.
Carl E. Smith, MDHarlan, Ky.