I'm at a loss *updated in #28 w/ 2nd draft of complaint letter* - Page 2

[Equuskia]

Originally Posted by meganmarie

Even if you ignored the fact that her weaning advice was ill-informed and inappopriate, you would still have a strong basis for filing a complaint with her supervisors simply on the basis that you FELT MORE DEPRESSED walking out of her office than you did going in! What the heck is the justification for criticizing and putting down a person struggling with mental health issues - when you are there ostensibly to help such people?

This story is maddening. I hope the support from this board lets you know that you are right so you can feel better. You're a committed mama doing the best you can - stay-at-home motherhood is a d*mn tough job. We should all find ways to take better care of ourselves - you are not alone in that, and you are trying! Hugs to you -

Goodness. I think the last thing you tell a depressed person is that they're fat, they're doing everything wrong, they don't know a damn thing and a basic "what are you thinking" attitude. I mean, geez, how uplifting! You know, this could have driven someone to suicide. Was she going to make herself responsible for that? I doubt it.

Please, for your sake and for the sake of other women, write that letter. Don't let this woman get away with this blatant abuse. What she did was wrong wrong wrong!

[Caittune]

Originally Posted by misseks

It was a doctor? A psyciatrist? A lactation consultant? A fertility consult? What was going on here? What a psycho! What does still nursing have to do with anything?

She is a psychiatrist and an ob/gyn. I was there for a medication consult to find something that is compatible with nursing and pregnancy. Unfortunately she is regarded as one of the "gurus" of women's reproductive mental health.

[Caittune]

I updated in the original post with the letter that I've begun to write.

[Lil'M]

I really liked your letter, but I would take out the last sentence. It just sounds like unsubstantiated rumor and your own personal experience is much more compelling. Also, I would add your own feelings to her behavior (where you don't already include them) and explain why what she said was so upsetting (for example, with regard to your weight and putting your child in daycare). You came to her for recommendations for a medication compatible with breastfeeding and pregnancy. She did not do that. Instead, she made uninvited comments about your physical appearance and your parenting choices. Completely unprofessional. She also betrayed her ignorance about breastfeeding and bias against it. You could add statements supportive of breastfeeding a toddler from the AAP, WHO or another reputable medical organization to show that she is uninformed and not current with recommended standards of care.

Good luck and good for you for standing up for yourself! I'm sure other women will benefit from your actions as well.

[elanorh]

Caittune,

I like your letter - I do agree that the last pp (about hearing that she has been this way with others) probably doesn't need to be included. Focus on what you can substantiate via your own experience, and your letter will be most credible/least likely to make the readers feel defensive for Dr. M's behalf.

Also, you describe the recommendations she makes as 'reasonable' - although not what you wanted. (I'm paraphrasing here). I'd take that out/rephrase it. Because her recommendations weren't reasonable. In a nutshell, she took the Tom Cruise approach to depression by saying that all you need to do is get some exercise and lose weight (!!) .... highly irresponsible of her IMO. And, her recommendations weren't based at all on any science when she said that you should wean; cite WHO, UNICEF, etc. on their bf policies so that the readers, even if they are as ill-informed as Dr. M., can become aware that in fact while bf beyond 2 years is unusual in our culture right now, it is NOT aberrant, harmful to children, etc. and is in fact healthy for children (and their mothers).

[PatioGardener]

I agree with what the last 2 posters have said.

I want to add my support. You are amazing to be doing this! It is difficult to speak up to 'authority', especially when you are feeling vulnerable. Way to go!

[Caittune]

Excellent points. I was hesitating about the unsubstantiated parts, so I will take those out.

I agree the recommendations were not really resonable, so yes, I will change that part to.

I was actually getting sweaty palms while reading this. She will eventually be getting a copy of this and somehow I'm scared of retaliation...unfounded fears but fears nonetheless.

[Irishmommy]

She also recommended putting my child in daycare, so that I could be free from her. While these seem to be sound recommendations they do not address the original purpose of the visit.

I would change "While these seem to be..." to "While these MAY seem to be...they are not because...", emphasis mine. Don't give them any reason to think the dr. was justified.

[Caittune]

Ok, here is the whole bleeping thing again. Edited and enhanced for your enjoyment!

I am writing to lodge a formal complaint against Dr M. I saw her on the morning of February 11, 2008, at the Reproductive Mental Health Clinic at Women’s and Children’s hospital. Dr C, a psychiatrist who I have been seeing for therapy for many years, referred me to her. The appointment with Dr M was to be a consultation regarding antidepressant medications while breastfeeding with a look towards potentially becoming pregnant in the next year. I had previously seen her for a medication consultation before becoming pregnant with my daughter. I remembered her to be brusque in manner, but informative. Unfortunately my experience this time was far worse.

My main concern with the current medication that I am taking is that it is causing me undesirable side effects. At the time of the appointment, I was taking 15mg of Paxil daily. While I was pregnant with my daughter, I took 75mg of Effexor, but changed to Paxil, because I felt that the Effexor was damaging my milk supply and my ability to breastfeed my daughter. I was hoping that she would be able to recommend something that was safe for breastfeeding and pregnancy.

She dismissed my desire to continue breastfeeding my child and instead insisted that nursing a two year old “is not normal”. She questioned my motives for continuing to breastfeed my daughter, stating that it is often the case that mothers continue breastfeeding to satisfy some need of their own, not the needs of the child. She questioned if I thought it was “fair” to my daughter to expose her to medications in my milk. When I replied that the amount of medication was minimal, and that the dose was extremely low, she said that I was “rationalizing”. She made vague references to the “rights of the child” hinting that someone has to stand up for her. Contrary to her previous comment that I was breastfeeding for my own personal gratification, she also stated that she felt that breastfeeding was causing me to be more depressed – two statements which are contradictory. When I stood up to her and questioned her comments, she changed the subject and started berating me about my weight.
She stated that the sexual side effects that I was experiencing were, in her opinion caused not by the medication, but by my lack of self-esteem and my level of obesity. I do not believe this to be the case. I have always been heavy and it has not affected me in the past.

During the consultation I became very upset. I felt bullied and intimidated. Dr M jumped from topic to topic seemingly with no coherent plan and in the end I felt like I would say anything she wanted me to in order to end the appointment. Why I did not walk out, I do not know. She was condescending and treated me as if I was uneducated. At one point she asked if I had brought my daughter with me. I said yes I had, and immediately she looked alarmed and asked where I had left her. She seemed to think I would be careless enough to leave a two-year-old child running free in a waiting room. For the record, my Mother in law was caring her for in the waiting room.

She did ultimately recommend a medication, but would only do so if I would agree to wean my daughter. She condescendingly said that the medication she would choose also is secreted in breast milk. I’m not certain what the intent of the comment was, but it did seem as if she was suggesting that I do not breast feed my as yet to be conceived baby while on this medication. More than once she made reference to “formula” and said it was just as good as breast milk, a statement that is patently untrue. I had asked about returning to Effexor, and she said she wouldn’t want me to do that because she thought I would continue breastfeeding my daughter.

I found the fact that she seemed to me to be so obviously prejudiced against extended breastfeeding or even breastfeeding in general to be disturbing. This blatantly disregards the mission of Women’s and Children’s Hospital which “is committed to promoting, protecting, and supporting breastfeeding. We recognize that you have the right to make informed choices about feeding your infant, to have those choices respected, and that breastfeeding promotes healthy babies and mothers.”

Her final recommendations were that I join Weight Watchers, wean my daughter, and begin an exercise program. She also recommended putting my child in daycare, so that I could be “free” from her. I did not go to Dr M's office for advice on weaning my child, my weight or her opinion of my life style choice to be a stay at home mother. I was simply in need of a recommendation for a medication that would be compatible with a future pregnancy and compatible with breastfeeding my children. She disregarded that and instead left me feeling more depressed. I went into her office excited to hopefully find something that would help me feel better, and left I left the office feeling despondent and bullied. I question what could have occurred if she had dealt with a seriously depressed person in the same abusive manner she used with me.

I especially enjoy the fact that I can quote directly from their mission statement promoting breastfeeding.

So I need some ideas of what I should put in as my expected outcome of this. I'm drawing a bit of a blank. I know I want her investigated, and I would also like to be informed (if it is legally possible) of the results of this investigation. I'm wondering what else I should ask for? Thanks for reading this terribly long thing!

[widemouthedfrog]

What are you asking them to investigate?

Would you like them to examine her history with clients and her recommendations to them regarding breastfeeding and other parenting choices? The outcomes of these cases?

Would you like the hospital to provide some or additional education for their staff about the benefits of breastfeeding?

Would you like the hospital to provide education about ways to support parents in their desire to become healthier people, parent successfully, and raise healthy children?

Would you like staff to meet with her to discuss these issues?

Just a few thoughts....

[Twinklefae]

nak

Just a quick note, you have words out of order in this sentence

For the record, my Mother in law was caring her for in the waiting room.

Good for you for writing it!

[Caittune]

Those are good questions to add, thanks Tricia.

And I'll fix the little grammar errors too before I send it off, it is really easy to miss those thing when writing stream of thought.

If nothing else, this has helped me feel a sense of re-empowering myself after this experience. Very cathartic.

[redfern]

That is absolutely brutal! How are you feeling now?
Thank you for writing such a great letter - hopefully it has an impact so she doesn't do the same thing to others. I think the tone is excellent - you sound educated and very rational.

[Caittune]

I am doing much better. I'm nervous about what will come of the complaint and but I'm committed to it.

[allgirls]

Just lurking but wanted to offer some support! You are doing exactly the right thing.

She needs to be reprimanded and knocked down a peg or two.

I am so appalled for you. What a terrible experience.

[jaxxy]

Very good letter! I think you should change the order of the sentence. I found her to be informative but brusque, and this experience was far worse. You should acknowlege that she was informative but go on to say that she was brusque and then got worse.. the way you have it now is a negative, positive, negative. It's like it changes the mood back and forth. I think it should be positive, negative, more negative. Just my opinion. Hopefully you understand what I mean! I think the letter is really great and you are awesome for calling her out on her behavior.

[Limabean1975]

Hi there, I've just read this thread and want to add my support. You are so brave for taking this on, in a difficult time for you. Your letter is articulate and, I think, powerful.
I do think you should add some quotes from statements specifically on extended bf from sources like the WHO, AAP, etc. And I thoroughly agree with the pp who advised you to CC it to anyone and everyone (with a list at the bottom of each copy of who it has been cc'd to).
Here are some great, short quotes:

Nursing a toddler is NORMAL

* The American Academy of Pediatrics recommends that "Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child... Increased duration of breastfeeding confers significant health and developmental benefits for the child and the mother... There is no upper limit to the duration of breastfeeding and no evidence of psychologic or developmental harm from breastfeeding into the third year of life or longer." (AAP 2005)

* The American Academy of Family Physicians recommends that breastfeeding continue throughout the first year of life and that "Breastfeeding beyond the first year offers considerable benefits to both mother and child, and should continue as long as mutually desired." They also note that "If the child is younger than two years of age, the child is at increased risk of illness if weaned." (AAFP 2001)

* A US Surgeon General has stated that it is a lucky baby who continues to nurse until age two. (Novello 1990)

* The World Health Organization emphasizes the importance of nursing up to two years of age or beyond (WHO 1992, WHO 2002).

* Scientific research by Katherine A. Dettwyler, PhD shows that 2.5 to 7.0 years of nursing is what our children have been designed to expect (Dettwyler 1995).

From: http://www.kellymom.com/bf/bfextended/ebf-benefits.html There is a link from there leading to the specific resources.