Your Next Patient: Biological Male Seeks Breastfeeding Help

[Birdstrike]

Has anyone had a biological male patient check into the ED and ask for help "chest feeding"?

If so, the CDC has got your back.

CDC gives guidance for trans people ‘chestfeeding’ kids, accused of failing to consider possible health risks

The Centers for Disease Control and Prevention’s official website published advice for trans and non-binary individuals on seeking guidance on how to “chestfeed” their infants.

nypost.com

Link for CDC Chest-feeding Survival Kit (blue box)

You're welcome.

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[VA Hopeful Dr]

So first impressions:

The AAPS is a bunch of nut jobs. I went to a conference they had in Charleston in 2014 and holy moly. I don't think I had ever seen a group of doctors loudly boo a picture of Obama during a lecture on the evils of abortion before.

I'm much more concerned about donor breast milk if I'm being honest. This seems to be an increasingly common practice that seems rife with problems.

 

[Rendar5]

I’m sure I’m going to see more cases of porphyria than cases of these in the ED. Actually, now that I think about it I have seen more cases of porphyria in 11 years than cases of regular postpartum women coming to the ED for breast feeding help.

This is a complete nonissue. Like the law in Tennessee that was designed to stop a grand total of 1 trans patient in the entire state from participating in school sports at a non competitive level, iirc.

I honestly don’t appreciate conservative media creating a mountain out of a mole hill just to get everyone riled up. (I also don’t appreciate plenty of things from liberal media. I’m very much a moderate who thinks everyone is crazy. )

 

[Cinclus]

If anyone checks into my ED seeking lactation assistance, they're going to find out very quickly that out of the many services we offer, this doesn't happen to be one of them. Like the lady who somehow got roomed in the back and was there because she wanted a mammogram...

 

[ScepticSkeksis]

Our society has become absolutely insane.....

 

[RustedFox]

I speak into the microphone:

"Zip Screened Out"

Computer prints:

"The medical screening exam is now complete. No emergent medical condition requiring further evaluation, diagnostic workup, or intervention is present. The patient is safe, stable, and an excellent candidate for outpatient management."

Push DC button.
Byyeee.

 

[Siggy]

1. The term “chest feeding” is utterly stupid.

2. People honestly concerned only about the effects of exogenous estrogen on lactation safety are stupid. Anyone lactating and taking medications should have the lactation category checked… not just transwomen.

3. “Lactating biological man” makes me think of the Family Guy clip where Peter breast feeds Stewie.

 

[thegenius]

If anyone checks into my ED seeking lactation assistance, they're going to find out very quickly that out of the many services we offer, this doesn't happen to be one of them. Like the lady who somehow got roomed in the back and was there because she wanted a mammogram...

Why can't we put these people on a 5150?

 

[Birdstrike]

Why can't we put these people on a 5150?

Too politically incorrect.

 

[Birdstrike]

 

[thegenius]

Too politically incorrect.

Yup.
Someone can identify as Jesus Christ.
Someone can identify as a platypus.
Someone can identify as a section of sidewalk down a windy Italian road.
All of these people above would get a psychatric evaluation.

Yet a guy coming into the ED asking for help breastfeeding his infant is treated differently.

 

[Birdstrike]

Someone can identify as a section of sidewalk down a windy Italian road.

I like this one.

 

[Rendar5]

Yup.
Someone can identify as Jesus Christ.
Someone can identify as a platypus.
Someone can identify as a section of sidewalk down a windy Italian road.
All of these people above would get a psychatric evaluation.

Yet a guy coming into the ED asking for help breastfeeding his infant is treated differently.

No guy is coming to the ED to ask for lactation assistance.

 

[Birdstrike]

Yet a guy coming into the ED asking for help breastfeeding his infant is treated differently.

You're only punished for telling the truth.

 

[Birdstrike]

This lunacy is an intentional distraction from what's important. And it's working.

 

[WilcoWorld]

This lunacy is an intentional distraction from what's important. And it's working.

Yes, while we rage at each other about Culture Wars we are distracted from material issues that are already causing very serious harm such as climate change and limiting people's access to life-saving health care. Doubly unfortunately, these arguments give implicit permission to people to treat vulnerable people with hate and cruelty.

If someone who lacks ovaries comes to my ED seeking lactation advice, heck, if someone WITH ovaries comes to my ED seeking lactation advice, I do not need to sneer at nor scorn them. Like all other clear non-emergencies I should perform an MSE and discharge them if they have no emergent medical condition. This needn't be political.

 

[thegenius]

If someone who lacks ovaries comes to my ED seeking lactation advice, heck, if someone WITH ovaries comes to my ED seeking lactation advice, I do not need to sneer at nor scorn them. Like all other clear non-emergencies I should perform an MSE and discharge them if they have no emergent medical condition. This needn't be political.

I cannot imagine you would not give a brief wince or "What" or something if a guy came in asking for lactation advice.
Not even a little?
Your voice would not change one bit? Not even a double take? You would be as un-emotional as Data from Star Trek?

I don't see the reason to bring in politics! Not sure why you brought that up.

I would minimally be like



and I hope that would not be construed as a sneer. It kind of is. maybe kind of bordering on one. (There is a little bit of overlap when I look at the images on giphy.com for "WTF" and "sneer")

 

[Rendar5]

I would wince if anyone came in asking for lactation advice.

 

[thegenius]

I would wince if anyone came in asking for lactation advice.

People here haven't had these mother/baby combos? Usually they come in with their 3-7 day old baby who is crying and not feeding well becuase the baby is hungry, and after about 30 seconds of questioning you figure out they are not latching or feeding well. I get about 1/year.

 

[WilcoWorld]

I cannot imagine you would not give a brief wince or "What" or something if a guy came in asking for lactation advice.
Not even a little?
Your voice would not change one bit? Not even a double take? You would be as un-emotional as Data from Star Trek?

I don't see the reason to bring in politics! Not sure why you brought that up.

I would minimally be like



and I hope that would not be construed as a sneer. It kind of is. maybe kind of bordering on one. (There is a little bit of overlap when I look at the images on giphy.com for "WTF" and "sneer")

Well I wince internally at least a dozen times a shift, so sure, just as I react when someone says "my temperature runs low, so 99 is actually a fever" I would have an internal head shake reaction to someone coming to the ED to ask for lactation advice.

As for why I said we don't need to bring in politics - it looked to me like identity politics had been brought into this thread above my post. I was responding to that.

 

[Rendar5]

People here haven't had these mother/baby combos? Usually they come in with their 3-7 day old baby who is crying and not feeding well becuase the baby is hungry, and after about 30 seconds of questioning you figure out they are not latching or feeding well. I get about 1/year.

Not once in my career thank god. I once had a parent not feeding his kid enough but it was a bottle feeding issue. I did have an eye roll at that one.

 

[BoardingDoc]

People here haven't had these mother/baby combos? Usually they come in with their 3-7 day old baby who is crying and not feeding well becuase the baby is hungry, and after about 30 seconds of questioning you figure out they are not latching or feeding well. I get about 1/year.

I have literally never had this as a chief complaint / underlying issue either as an attending or as a resident.

 

[Birdstrike]

issues that are already causing very serious harm such as climate change

Climate Change Shock

If you want to understand the reality of climate change better, learn about 4th generation nuclear power and why climate activists should support it, but don't.

Unlike old nuclear technology, 4th generation nuclear is safe and the reactors can't melt down. It doesn't produce centuries long nuclear waste; instead, the waste is recycled as fuel. It's a cheap, cost-effective, nearly limitless, clean energy supply. It doesn't require tremendous water for cooling. The nuclear material used can't be diverted towards nuclear weapons manufacturing. And it produces zero carbon. By the "climate activists" own standards, it has all the features of a climate change cure. It can literally save the world, from the climate change apocalypse they say is coming, that is, if climate change can be affected and therefore stopped, by mankind. But the climate change activists and politicians don't take about 4th generation nuclear power. In fact, they're actively against it.

Why?

Learn the answer to this question and you'll know all you ever need to know about climate change.

 

[thegenius]

Maybe they are waiting for 5th generation nuclear power? I dunno?

Is there a punchline here? I never even heard of 4th generation nuclear power. What is the answer to your question?

 

[thegenius]

I did a google search “do climate activists support 4th generation nuclear power” and it appears most of all the top hits are articles that suggests they DO support it, or support is increasing. I did not read the individual articles though.

 

[VA Hopeful Dr]

Maybe they are waiting for 5th generation nuclear power? I dunno?

Is there a punchline here? I never even heard of 4th generation nuclear power. What is the answer to your question?

I'm guessing he's pointing out that nuclear power is the best way out of our climate change predicament, but many, if not most environmentalists ignore it at best or vilify it at worst.

 

[thegenius]

I'm guessing he's pointing out that nuclear power is the best way out of our climate change predicament, but many, if not most environmentalists ignore it at best or vilify it at worst.

Yea I figured that…I just never heard of 4th generation nuclear power and then I did a quick search online and many of the top hits suggest burgeoning support from environmentalists, and then I read a little of the one of the non-paywall articles, and it appears to just be an educational issue. People need to be more educated about it I suppose.

It’s probably not the panacea that bird strike wrote about, but maybe it is, I don’t know.

 

[WilcoWorld]

I can only speak for myself, but I am someone very concerned about climate change - I walk to work, bike to the grocery store, drive a hybrid when I have to drive, have solar panels on my home and have even voted Green Party at times...and I support exploring alternative energy sources. Safe nuclear power is certainly among them.

So, count me as a counterexample.

 

[BoardingDoc]

Learn the answer to this question and you'll know all you ever need to know about climate change.

That most people are incapable of looking at things rationally and dispassionally? Coal kills millions slowly. Nuclear kills few but does so quickly and dramatically. The average idiot sees bad things happening and votes against it while simultaneously allowing their own demise because it's happening too slowly for them to notice.

 

[bravotwozero]

Climate Change Shock

If you want to understand the reality of climate change better, learn about 4th generation nuclear power and why climate activists should support it, but don't.

Unlike old nuclear technology, 4th generation nuclear is safe and the reactors can't melt down. It doesn't produce centuries long nuclear waste; instead, the waste is recycled as fuel. It's a cheap, cost-effective, nearly limitless, clean energy supply. It doesn't require tremendous water for cooling. The nuclear material used can't be diverted towards nuclear weapons manufacturing. And it produces zero carbon. By the "climate activists" own standards, it has all the features of a climate change cure. It can literally save the world, from the climate change apocalypse they say is coming

What I thought was particularly asinine was when the the German government decided to shut down it’s only 2 remaining nuclear plants, in the midst of an energy crisis, and switched to coal!

 

[thegenius]

Learn the answer to this question and you'll know all you ever need to know about climate change.

I love it when people say or write this. It’s like a line from a movie. Imagine someone whispering “everything you ever wanted to know is right here, in this one little pamphlet. Or behind that door. The answer to all your questions is right up that hill over there.” LOL

 

[Birdstrike]

"Green" energy is as much about making money, and as far removed from saving humanity and virtue as the fossil fuel industry.

“Saving humanity” and virtue are the persuasion tactics. They are the means, not the end.

Who's lining the pockets of the players?

If your pockets are lined by the oil industry, you look the other way on pollution of air.

If your pockets are lined by the “green” energy industry, you look the other way on the polluting fossil fuels used to generate electricity for your batteries, pollution from toxic chemicals in battery waste and solar panels which can’t fully be recycled. You also look the other way, regarding your massive wind turbines which end up in landfills. You look the other way ignoring the rampant use of forced labor, child miners and payment in drugs, heavily employed in the “clean” energy supply chain.

Both sides are in it for the money, in my opinion. One side happens to be better at the skill of persuasion, by use of the very effective and classic persuasion tactics, the high-ground maneuver, i.e., “save the planet” and fear, i.e., “Act NOW or disaster!” Both sides know that no type of energy saves the planet, or changes climate, but that they all degrade it.

 

[rokshana]

I cannot imagine you would not give a brief wince or "What" or something if a guy came in asking for lactation advice.
Not even a little?
Your voice would not change one bit? Not even a double take? You would be as un-emotional as Data from Star Trek?

I don't see the reason to bring in politics! Not sure why you brought that up.

I would minimally be like



and I hope that would not be construed as a sneer. It kind of is. maybe kind of bordering on one. (There is a little bit of overlap when I look at the images on giphy.com for "WTF" and "sneer")

Lol…I’m not EM, but I would imagine that this would be the least of the crazy that come into an ED.

 

[Birdstrike]

Lol…I’m not EM, but I would imagine that this would be the least of the crazy that come into an ED.

I'm with you,@rokshana

Mastitis in a trans-man's breastlet has to be lower on the scale than "I fell on a toy car and now it's up my bum." No?

 

[WilcoWorld]

"Green" energy is as much about making money, and as far removed from saving humanity and virtue as the fossil fuel industry.

Companies working within Capitalism are motivated by making money, that's essentially a tautology. This does not add to this argument (unless you're arguing against Capitalism, which I don't think you are - correct me if I'm wrong on that).

However, while the fossil fuel industry is increasing greenhouse gas emissions (and has actively flamed fears of nuclear power) - that need not be true of alternative energy source industries. Nothing worth doing is beyond critique. I reject nihilism, so I have to choose between real world options.

 

[Apollyon]

If one thing is true about @Birdstrike , it's that he's cryptic. All I would ask is that you "connect the dots" for me. I am not on some deep Asian vision quest. You raised a question, you kindly answer it.

 

[Apollyon]

What I thought was particularly asinine was when the the German government decided to shut down it’s only 2 remaining nuclear plants, in the midst of an energy crisis, and switched to coal!

Whereas 90% of power in France is from nuclear!

 

[ScepticSkeksis]

Climate change is a global scam so that the elite can sell "carbon shares". Politically favored companies will get more carbon shares, while others will get fewer. You will have to have a certain number of shares to operate your business based on your "carbon footprint". Whole companies and industries will be set up to trade these shares among companies. Billions of dollars are going to be made if this comes true, and it will mean an unprecedented amount of control over the global economy. Essentially a socialist, government-run economy in the name of climate change.

 

[lp430]

Has anyone had a biological male patient check into the ED and ask for help "chest feeding"?

If so, the CDC has got your back.

CDC gives guidance for trans people ‘chestfeeding’ kids, accused of failing to consider possible health risks

The Centers for Disease Control and Prevention’s official website published advice for trans and non-binary individuals on seeking guidance on how to “chestfeed” their infants.

nypost.com

Link for CDC Chest-feeding Survival Kit (blue box)

You're welcome.

Can we please stop the trans outrage? This is not relevant to EM at all and is also not a good faith discussion from the NY Post. It just further serves to try and rile people up. This is a vulnerable patient population that often avoids or has a negative interaction with the healthcare system.

 

[Janders]

(1) agree with the above posters, culture war clickbait distractions make me yawn and eyeroll. No trans person has asked me for help breast feeding. Maybe one woman period has ever checked in on my shift with a pure breastfeeding / latching issue. I have seen plenty of mastitis, bleeding nipples, inconsolable new borns and constipated 1wk olds but much more commonly at an ED I no longer work at…
(2) climate change can be real and can also be an excuse for elites and corporations to make stupid money with faux solutions.

Hickams dictum isn’t just for medicine.

 

[skougess]

This entire thread and the recent trans-mania in general is just right wing outrage porn. All of my very left wing friends have essentially nothing to say, unprompted, on the topic while the right wing keeps inventing scenarios and news stories to keep them angry.

This fake scenario will literally be nothing I ever see in the ED, and if for some reason it is, it will be a 5 minute encounter easy discharge.