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.
She Has My Eyes 