Sunday, March 7, 2010

Breastfeeding Against Medical Advice




Last week I was told by my daughter's pediatrician to stop breastfeeding. Brianna is already on the lean side and had lost a little weight. "You need to stop nursing her. You are keeping her from being hungry for other foods. It is best if you just stop cold turkey - that will be easiest," she said.




This is not the first time Dr. K has told me to stop nursing. The first time was when Brianna was one month old. She kept having blood in her stool and we couldn't figure out why. I had already cut out all forms of dairy, which is the only suggestion Dr. K offered (other than, "If we can't figure this out then you will need to stop breastfeeding. I'm sorry if that bothers you, but it is what you will have to do"). Desperate to continue nursing, I contacted La Leche League for support. "Sounds like a foremilk issue," the web consultant emailed, "Try expressing a little before she feeds." The result? As soon as I expressed before breastfeeding, the issue resolved itself completely.








The second time I was told to stop breastfeeding was when Brianna was twelve months old. No real reason was given, other than she was twelve months old, and Dr. K said, "It's time you stopped breastfeeding. She should drink whole milk now." ("She is drinking whole milk," I thought, "Human whole milk.") At that point, Brianna had moved down the chart slightly, going from the 50th percentile at 9 months to the 15th percentile at 12 months. What happened between her 9 month and 12 month visit? She began solids. Perhaps I should have waited until she was 12 months to start, but she was so ready to begin tasting.







Now Brianna is 18 months, and according to the growth charts from the CDC, she is in the 3rd percentile for weight. She had lost a little weight from being ill (but still weighs more than she did at 12 months). Weight loss in children is always concerning, but considering the fact that she had the Norovirus and threw up for six days, I think losing a few ounces is normal. She grew taller and actually jumped up a few percentiles in height, going from the 50th percentile to the 90th. Her head circumference stayed on track, showing expected growth. In my view, she is growing. She is healthy. And I think she should continue breastfeeding.

While I understand that Dr. K thinks my milk is preventing her from feeling hungry, I disagree. We have been following child-led weaning and Brianna usually wants to nurse before her nap (which is after lunch) and before bed (which is after dinner). She has already had her fill of solid food and is getting additional nutrients and calories through breastfeeding, not less.

When Dr. K told me to stop nursing this week, I have to admit that I did give it consideration. I had to examine whether my desire to continue breastfeeding is hurting my child's growth. After all, to Feed with Love and Respect means that I need to ensure Brianna is getting precisely what her body needs, and I do not want my emotions to interfere with that. This weekend, I tracked when she nursed vs. eating solids, documented foods that she likes, talked with a nurse (who is also a lactation consultant), and looked at Brianna's weight on the World Health Organization's growth charts (instead of the CDC version offered by Dr. K - see here for more information on the difference). In short, I wanted to get a clear picture of what Brianna needs.

I have decided to continue breastfeeding, focus (even more than usual) on giving nutrient-rich healthy-fat solids, and to find another pediatrician. Dr. K has shown that she views breastfeeding as part of the problem and not part of the solution. Sadly, there are probably many doctors like Dr. K who are uneducated about, and not supportive of, breastfeeding. I wonder how many women have simple (or complex) issues related to breastfeeding and are given a sample of formula instead of supportive, accurate advice. With everything we know about the dramatic and powerful effects of breastfeeding, I wonder why there are so few pediatricians that ardently support breastfeeding. If there was a drug that offered children the same enormous, life-long benefits, you can be sure they would know about it and would push it at every visit.

Because of what I know about my daughter and what I know about breastfeeding, I am absolutely confident that I'm doing what is best for her, even though I am nursing her against medical advice.

This post is part of the 2010 API Principles of Parenting blog carnival, a series of monthly parenting blog carnivals, hosted by API Speaks. Learn more about attachment parenting by visiting the API website.

20 comments:

  1. If you are just nursing at nap and bedtime, I have a hard time believing that that is interfering with her eating. I followed child-led weaning as well. After a certain point, I stopped even mentioning it to the doctors.

    Stopping in to welcome you to SITS!

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  2. Congratulations on your decision!

    Stopping by to welcome you to SITS!

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  3. I'm stopping by to welcome you the the SITS family!

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  4. Good luck! Weight gain and nursing and all that can be a challenge.

    (I'm currently nursing my second - although I stopped nursing my first at about a year because he just seemed ready. He pretty much self weaned.)

    Welcome to SITS!

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  5. Welcome to SITs. It's difficult to go agains your pediatrician but sometimes, you know you child a lot better then they do. Best to you and Brianna.

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  6. Stopping by to say welcome to the SITS community!

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  7. It sounds to me like changing Pediatricians is the right choice.

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  8. I've had similar problems with our pediatrician! Even though M has never lost weight, has continued to grow, is a very smart and healthy baby.
    At his 2 day checkup Dr H was worried because he'd lost weight since he was born (what!?!) and made sure the hospital sent formula home with us & had shown me how to supplement with a syringe. We saw another pediatrician in the practice at his 4 day checkup (an extra one that Dr H had requested). Dr G was impressed with the fact that I'd pumped to supplement with.
    At his 9 month visit he'd dropped in percentiles. Dr H told us to start supplementing with "secondary formula" and push solids more. He had "only" gained 3lbs since his 6 month visit. She also requested another follow up visit.
    At the follow up visit 1 month later he'd gained 1 lb. Which was great! When I showed her the research that I'd done about the WHO charts (where his percentage didn't drop) vs CDC charts she "informed" me that these were the charts that the AAP uses and THEY are the standard.
    I've asked the office about switching to Dr G.

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  9. Ugh how frustrating! My pediatrician told us at our first appointment to supplement with formula so the baby would be used to it in case something ever happened to me, and has made some other little anti-breastfeeding comments, so I can empathize with having a dr. who is unsupportive of breastfeeding. The LaLeche League or somebody should come up with a list of pro-breastfeeding pediatricians.

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  10. Thanks for the SITS welcome, ladies! I had taken off the thumbnail because it had been on for awhile but no comments...then suddenly here you are!

    Maman- I think local groups do have a list of breastfeeding-friendly pediatricians, but I think the list should be available online, in my opinion!

    Ln - Gosh what a frustrating experience. I am just so saddened that {some}pediatricians are like that. I think they get only a couple of hours (total!) training in breastfeeding awareness/issues/benefits.

    Shell - good point - I should probably just not even mention it.

    Small Burst - thank you!

    Chrystal - I think so, too. Bummer because it is a great office except for the one pediatrician who has it out for breastfeeding.

    K - I'm hoping to have a self-weaner, too. Congratulations on nursing a second!

    Mimi & Robyn - thank you!

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  11. I totally agree with Shell. I stopped bringing up breastfeeding with my doc as well, because it's like they have this imaginary ceiling sometimes and if you go past that, they feel like you're extending it beyond what's acceptable. In the U.S., we don't breastfeed our babies HALF as long as other industrialized nations. People need to just GET OVER the whole "socially acceptable" thing and realize it is best, scientifically, bottom line. Most likely, your doctor is telling you that because she doesn't want to get sued, on the off chance something related to your child's weight loss is more serious than just toddler growth (it's totally a toddler growth pattern and normal). Keep nursing, it's only a small window of time we get this experience with them :)

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  12. Tricia - good thought about the liability component. I hadn't thought of that before! And you're so right about the small window of time. I appreciate your support!!

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  13. I think your motherly instincts were correct. You know your daughter a lot better than some doctor who only sees her every few months. Our doctor tried telling us this month at my son's 15 month check-up to cut back on nursing so he's hungry for other foods and his weight is fine! I'm trying to get him to eat "enough" solids but when he signs to me that he wants to nurse it's kind of hard to deny that need.

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  14. Good for you! I had a similar situation happen with my son when he was about a year. He had lost a bit of weight, and the doctor was concerned that I was breastfeeding too much. (He's seven years old now, and just fine, by the way)!

    I nursed my two kids very late - (until they were three, and two and a half) - and did feel, towards the end, that I had to hide it from some people, lest I get a look and an eyebrow raise. But I never regretted it for a minute, and honestly I think they're healthier and more resistant to illness because of it. Not to mention the bonding that so obviously takes place. They are both really secure children - which I believe in some part has to do with this bonding.

    Glad you're getting a new doctor. I'm sort of appalled at the lack of wisdom and knowledge some doctors still have about breastfeeding. It sounds as if you're doing the right thing.

    Much happiness to you and your little one!

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  15. Go with your gut (sounds like you are!). I am surprised that your dr. told you to stop breastfeeding. I guess they are all different and have different opinions...finding one that has the same views as you can be tricky. I hope you find a great new doctor who believes in the beautiful health benefits to breastfeeding!

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  16. Katie, I also like to trust that my little one's body will tell her what she really needs. I think it is great that you are doing sign with your son. And nursing, of course! How wonderful!

    Mary, it is nice to hear from someone who has come through the nursing process and can look back upon it. Thank you for sharing your perspective!

    Life As I Know It: Thank you for your encouragement! It means a lot.

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  17. Good job taking care of your child!
    Two of my three kids weaned themselves. I weaned my first son early due to work schedules with erratic break times, I would start to leak while working with a client. So I gave up.. But I think I would have done it longer had I known what I learned from my second and third children. It really is so great! And usually problems can be fixed pretty easily with the help of a lactation specialist. thanks for the post!
    I found you on SITS

    Blessings!
    ~Kristin

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  18. Go on much longer and you can discuss it with the kids. You know more than a doctor because you went to school where?

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  19. Anonymous - I can appreciate your comments because, prior to having children, I would have said the same thing. As far as world standards go, the minimum year for weaning is around age 2. The World Health Organization recommends breastfeeding until at least age 2. And, unfortunately, most American doctors are grossly uneducated in breastfeeding. I am not personally comfortable with nursing much beyond age 2, but I would never judge another mother's decision to do so.

    As far as my education goes, I think all people should be proactive with their health and their family's health. This is not 1950 where doctors are the be-all-end-all decision makers. Furthermore, I did not make this decision in isolation. I also consulted with a second physician and a pediatric nurse practitioner. Although the piece is titled 'breastfeeding against medical advice,' I am referring to one pediatrician's advice. The other two medical professionals I consulted with agree wholeheartedly with continuing nursing.

    Thanks for taking the time to visit and comment. You've allowed me to make some clarifications.

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  20. Well done for continuing to BF. Sounds like a great idea to change doctor. How can you trust their advice when it's so anti BF.

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