Nine Months

We took Eve to the doctor this morning for her nine month checkup. As much as I do love our pediatrician Dr. B, and as satisfied as I’ve been with her before, today’s experience was a bit of a disappointment.

Eve’s weight gain has slowed down. She’s still well within normal ranges, she just hasn’t gained as quickly as she had before. This actually isn’t unusual for breastfed babies, who tend to be much heavier in the beginning than their formula-fed cohorts, fall behind formula-fed babies for a while, and then even out with formula-fed children around 18 months of age. The problem is that the growth charts that many pediatricians use are in fact calculated using the means and averages of mostly formula-fed babies; the CDC has tried to correct this by adding more breastfed babies to their averages, but it’s still significantly skewed.

Dr. B wants us to bulk Eve up some because of her slowed weight gain. Now, anyone who has ever met our child almost always comments on how CHUNKY she is. You don’t look at my baby and think, “Whoa, get that baby some food.” She is THICK as well as tall (95th percentile for height, in fact). She’s talkative, active, playful, energetic, bright-eyed, has a healthy glow to her skin, pees and poops frequently, and has met all of her developmental milestones WELL ahead of schedule. She is the absolute picture of health, yet Dr. B wants us to quickly increase her solids (including adding chicken broth to all of her vegetables) for the purpose of fattening her up. She wants us to replace some of her milk intake with other foods, and friends, let me tell you…that ain’t happenin. For the first year of her life Eve is to get the majority of her caloric intake from my milk, and the solids that she’s eating are a supplement to her milk intake, not a replacement. After twelve months we can talk about [gradually] decreasing her nursing, but at nine months? No way.

Dr. B also wants us to start giving her a bottle of water overnight instead of letting her nurse. That doesn’t make any sense to me; if she wants us to give her MORE calories, why would we replace the few ounces of breastmilk she gets in the night with water, which has no nutritional value and no calories? In any case, my breasts get painfully full after 5 hours; if I didn’t nurse the baby at least once in the middle of the night, I’d have to pump, which would interrupt my sleep significantly more than just nursing does (I’d have to clean the equipment, go into another room to use the pump, label and put the milk away, THEN come back to bed), and also wouldn’t maintain my supply nearly as well. Replacing her night feedings with water as well as cutting back on her day feedings to give her more solids would pretty much guarantee an early weaning, which is not happening as long as I can help it.

I do love Dr. B, but today’s visit left me feeling pretty blah. I realize that many, many pediatricians are misinformed when it comes to the growth patterns of breastfed babies (since so few babies at Eve’s age are still nursing), but somehow I had hoped that Dr. B would be different. Marcus and I talked and we feel very confident that Eve is doing just fine as she is. There’s no need to fatten her up and we’re gonna keep doing things as we have.

As far as I’m concerned, if it ain’t broke don’t fix it. And Eve is mostly certainly not broke.

This whole situation has me thinking about all of the women who wanted to breastfeed for at least a year, but found that their milk supply just couldn’t be maintained. They think that there is something wrong with their bodies, that their breasts just couldn’t do it. I work with one such woman, whose milk supply is steadily dwindling even though her daughter is only 8 months old. The fact is, a woman’s breasts WILL successfully feed a child for a year and longer, but that nursing relationship is threatened when she doesn’t have the knowledge, the resources, or the support to utilize practices that will maintain that relationship.

The instructions that Eve’s doctor gave to us today would be a threat to the nursing relationship that I share with my daughter, and I am fortunate enough to have access to the resources that allowed me to recognize that threat; otherwise I could be in the same situation as my coworker, wondering why my breasts “don’t work”, all the while encouraging an early weaning without even knowing it because that’s what the doc said to do (not that I’m saying that doctors don’t WANT women to continue nursing; only that, like many of their patients, they just sadly don’t know any better and aren’t familiar with all of the consequences of some of their recommendations).

Ugh. The whole thing just has me so bummed.

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6 Responses to “Nine Months”

  1. Nicole Says:

    This is terrifying to me – how can a doctor be less knowledgeable than a patient on this issue? I mean, if YOU can find the information, how does a DOCTOR not have it? Did you talk to the ped about it, or just grin and bear it? This is sooo surprising to me. Maybe you should start advocating. You know, one thing you could do is write up “fact sheets”, save them as PDFs, and have them available as downloads through your blog. Or, something. I don’t know. You’re just so damn smart. 🙂

    • Marcus Says:

      We were talking about this afterwards, and i have the feeling that in the end, most doctors are just doing what they’re told, and/or just following what’s always been done, as opposed to following the evidence they’re presented with, and weighing it up against their previous experience to come to an appropriate conclusion.

      On another note, it strikes me that a sizable majority of doctors, daycare providers, other parents/peanut gallery is trying to discourage breastfeeding, which is something i find so strange. I mean, humans as a species in their current form have been around for 20,000 years, but somehow NOW we’re above doing what it is natural for us to do? Also, they seem to be all about schedules, and against adaptability. WE’re supposed to be adapting to take care of our young; they’re not supposed to adapt to make our lives easy. At least not until they can intellectualize and maybe start to see WHY we do some things the way we do them.

      Sigh… the scientific community is just as corporately driven as everything else though. If the natural way were profitable, then they’d be all about it, but alas, they’re not.

    • August Says:

      One of the problems is that a pediatrician is not a lactation specialist: they don’t get much (if ANY) training or education about lactation, and to top if off, the majority of the children that they care for are either exclusively fed formula or are weaned early, so they are not as familiar with breastfed babies and their development. A certified lactation consultant has years of hands-on experience and training under her belt because there is a LOT more to breastfeeding than most people know, so even if peds were to required to take a class on lactation (I don’t know if they are or not, but I would bet not), it would still not be enough. What I would like to see would be partnerships between lactation consultants and pediatricians’ offices, offering on-site support and guidance for both parents AND doctors. Hopefully such a thing exists SOMEWHERE, but I don’t know.

      Our society does not support breastfeeding. We like to say that we do, but we don’t. Just in my own life, this is what I’ve dealt with:

      – Many people told me to stop nursing when I caught the swine flu. This despite the fact that the antibodies I was producing against the flu were being passed onto Eve through my milk. I nursed her frequently and she never caught it.

      – I’ve been pressured by many people to stop her night feedings because “she should be sleeping through the night by now.” Going 8+ hours without nursing would threaten my milk supply considerably.

      – When Eve was 3 days old, the hospital moved her into pediatrics because of her jaundice and refused to let Marcus stay overnight to help me. I was only a few days postpartum, had barely slept since two days before she was born, and I was forced to care for her (feeding, pumping, changing) completely by myself for that entire night. By the next morning, I was severely dehydrated and ravenously hungry (both threatening to milk supply, as was the sheer stress of that night) because I didn’t physically have the ability to care for her and myself at the same time. Doing such a thing to a new mom is cruel, but doing it to a new breastfeeding mom is torture.

      – Various folks keep telling me that it’s almost time to wean (it isn’t). It’s almost like they just can’t WAIT for my daughter to stop nursing, as if it had anything to do with them.

      – There is no place for a new mother to pump at my job. I was doing it in an empty office, but now have to do it in the nurse’s office now that my old pumping spot has been occupied. The only other option is to pump in the bathroom, which some women actually do (not me).

      – I was summoned for jury duty when Eve was only a couple of months old. I called to ask about private places to pump and where I could store my milk during the day, and I was told that there were no such accomodations. Fortunately in my city, breastfeeding moms are exempt from jury duty for a year after the baby’s birth (still not long enough, but better than most); this is not true for the state, where an attempt at enacting a law to exempt all breastfeeding moms for a year from jury duty was defeated (this was on the heels of the prosecution of a new mother who had not attended jury duty due to her nursing obligations).

      – My insurance, like most, will not cover the purchase or rental of a breastpump UNLESS the child is very ill or a preemie and only then for a few months. This is despite the fact that, in the long run, the health benefits provided by breastfeeding would more than make up for the initial expense of the pump, making it a less expensive investment.

      – Every time someone finds out that I’m not weaning Eve at her first birthday, they start talking about some five-year-old they know that breastfeeds or about that woman in England who is still nursing her 9-year-old daughter in a not-so-subtle attempt to scare or shame me into weaning.

      – I nurse in public, and I don’t cover up. Ever. I frequently see snarky comments from folks on Facebook about how disgusting nursing is, how moms who don’t cover up are attention whores, and how any random jackass’s right to inappropriately sexualize my breasts trumps my daughter’s right to eat when she’s hungry and without a blanket over her face.

      That’s just a few, but all of those things are situations that either directly or indirectly undermine, discourage, or prevent moms from nursing their babies. This whole experience with Dr. B is just more of the same.

      And yeah, I couldn’t do anything more than just smile and nod when we were in the room with her doctor, especially when I told her that I was getting plenty of rest at night despite Eve’s nightly feedings and she said, word for word, “You think that you’re well-rested, but you’re not.”

      As far as advocacy, all of this has me thinking about becoming a lactation consultant. It’s definitely something that I’m passionate about, and it even pays well (unlike being a doula, which was something else I’d been considering, but would not realistically support my family). I’m going to a La Leche League meeting this Friday to look into becoming a LLL Leader, which is an experienced nursing mom who provides one-on-one support for new breastfeeding mothers, as well as leads groups and teaches classes on lactation. It’s a volunteer position, but it would give me a chance to see if this is really the career path that I want, and the work I do there would count towards my accreditation as a lactation consultant.

      Whoa. Long comment is long.

    • August Says:

      Oh hey, here’s one more example that didn’t include me personally.

      One of my friends works with a woman who is a smoker and is also nursing a child. My friend vented to me about how her coworker needs to quit breastfeeding because she’s just passing the nicotine and nastiness along to the baby and what a terrible thing that is.

      The problem? Breastfed babies of smoking moms have fewer respiratory problems than formula-fed babies of smoking moms. Breastmilk itself has such protective qualities that it is still the healthiest option for the child of a mother who chooses to smoke.

      I’m sure that the woman in question gets a lot of shit and judgement, and I’m sure that many people attempt to pressure her into weaning and using formula instead, but the plain fact is that, short of quitting smoking altogether (and we know how easy that is), she is doing exactly the right thing.

    • August Says:

      Ooo, last comment, I promise:

      Another barrier to breastfeeding? Formula companies. There is a LOT of money to be made in formula, and some companies (*cough* Nestle *cough*) have done some very despicable things in the name of profit, actions which have led to infant deaths that could have been prevented.

  2. New School Jitters « She Has My Eyes Says:

    […] is all kind of unreal. On May 17th, when we had that disappointing encounter with Eve’s pediatrician, this whole school thing was not in The Plan. I had no idea a month ago that I’d be enrolled […]

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