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.