Many Ob-Gyn Textbooks Lack Good Info on Breast-Feeding

TUESDAY, May 6 (HealthDay News) -- Doctors coaching new nursing mothers will find little practical advice to share from some of the classic obstetrics textbooks, a new study suggests.

Some of the texts omit key information for solving breast-feeding problems and others are inaccurate about the key steps involved, according to a study presented at this week's annual meeting of the Academy of Obstetricians and Gynecologists, in New Orleans.

Three of these bibles of obstetrics are not as "up-to-date or nearly as complete as they should be," contended study researcher Dr. Tony Ogburn, director of the department of obstetrics and gynecology at the University of New Mexico.

Ogburn believes that breast-feeding has been a neglected problem for some time, because some physicians have passed the buck -- each seeing it as the provenance of another physician specialty, or of nurses who specialize as lactation consultants.

While doctors in urban areas may be able to defer to lactation consultants, those who have a broader scope of practice in rural areas will miss the training they need on breast-feeding, added Dr. Adam Aponte, chair of pediatrics and ambulatory care at Manhattan's North General Hospital. He was not involved in the new research.

Breast-feeding is not as easy as people think and "needs a lot of encouragement and support early on," he added, and "with frustration, mothers can switch very quickly to the bottle."

On the other hand, gentle and accurate instruction about how to hold the baby to the breast properly can reduce some of the discomfort some nursing mothers experience, Aponte said.

The new review covered what the authors called "the five most popular obstetrics and gynecology textbooks based on sales." Ogburn gave two of the textbooks in the study -- the 2003 edition ofMaternal-Fetal Medicine, edited by Robert K. Creasy and Robert Resnick, and the 2007 edition ofObstetrics: Normal and Problem Pregnancies, edited by Steven G. Gabbe, et al. -- high marks for providing complete and accurate information on breast-feeding.

But he said doctors' "general lack of interest in breast-feeding is reflected in three other textbooks" --Williams Obstetrics, 2005 edition, edited by F. Gary Cunningham, et al.,Danforth's Obstetrics and Gynecology, 2003, edited by James R. Scott, et al., and the 2006 edition ofBeckmann's Obstetrics and Gynecology, edited by Charles R.B. Beckmann, et al.

"There's not the focus on it or interest that there should be," Ogburn contends.

In their review of five widely used textbooks, Ogburn, along with colleagues at Boston University, found the omission of key information and, in some cases, actual errors, he said.

For example, one text mistakenly advised that putting newborns on a feeding schedule is fine, while research shows that babies should be fed "on demand" -- that is, whenever they are hungry, Ogburn said. Mothers sometimes fear that they won't have sufficient milk if they nurse too often, but nursing actually stimulates increased milk production, he said.