You’d be hard pressed to find an anti-breastfeeding doctor. Breastfeeding is healthier (if you are wondering why, see my page Why Breastfeed?). The facts are there, and the American Academy of Pediatrics, along with all major health organizations, has an official statement to that effect. But how many pediatricians really support breastfeeding?
In my pregnancy, my husband and I interviewed pediatricians to find a doctor we were comfortable with. But we didn’t ask much about breastfeeding. I was 100% committed to breastfeeding and considered myself knowledgeable about it. I didn’t think the attitude of my son’s pediatrician toward breastfeeding would have any influence on us.
I was wrong.
Here is a story of a pediatrician who, although she assured us while I was pregnant that she supported breastfeeding, turned out to be lacking in knowledge, unsupportive and unhelpful when we had problems nursing.
Quick to give a bottle and prescribe formula supplements
It started when my son had some trouble breathing right after birth. I wanted to hold him skin-to-skin and nurse right away, but he had to spend 6 hours in NICU observation. During that time, the pediatrician ordered a bottle for him. After that bottle, he struggled to figure out how to latch onto my breast and resisted my attempts to help him. The pediatrician ordered formula supplements. Knowing I was trying extremely hard to breastfeed, and that I didn’t want to supplement, the pediatrician told the nurse to watch us and make sure we didn’t skip the formula.
I knew that bottles and formula supplements can lead to poor latch, breast refusal, and low milk supply. I was tired and wasn’t getting enough breastfeeding help in the hospital. In retrospect, I wish I had refused to allow the bottle. My doula was surprised that they had insisted on a bottle so early. His blood sugar was normal, he just wasn’t ready to eat, and didn’t need to have his tiny belly filled immediately after birth.
Derailed by a medication
When I had to take an antibiotic soon after delivery, the pediatrician told me I could not breastfeed. I was in terrible pain and in no condition to advocate for myself and do my own research, so I took her word for it. I “pumped and dumped” for a week to maintain my milk supply while my son drank formula. Then, I looked into it myself. I talked to lactation consultants. I brought the pediatrician a printout from Thomas Hale’s Medications and Mothers Milk, which indicated that although there was no official statement from the AAP on that medication, short-term use was safe.
The doctor didn’t agree with any of this, telling me it just wasn’t safe enough. This is another regret that I have, since we lost precious days of breastfeeding at a time when my son needed to learn to nurse. After that week away from the breast, it took months to get him nursing well.
Uninformed about breastfeeding complications
A few weeks after delivery, I developed intense nipple pain. My Lactation Consultant identified it as a thrush infection, based on a number of symptoms, despite a lack of the telltale white patches (Great recent post here at The Truth About Breastfeeding about the difficulty of thrush diagnosis and treatment). Since the baby and I both needed treatment, I took him in so she could write his prescription. She would not write it without checking his mouth, even though I told her it looked normal. Then, she asked to see my breasts. No white patches (but they were shiny and red, which is a thrush symptom!) She told me we didn’t have thrush. I insisted on the treatment and she reluctantly wrote a prescription, but I left feeling doubtful, humiliated and angry.
Keeping baby on the breast wasn’t a priority
At my son’s 4-month checkup, the pediatrician diagnosed reflux. We were expecting this. Spitting up 20 times a day just didn’t seem normal. The first treatment she suggested, however, was to stop breastfeeding, pump exclusively, and add cereal to the milk. When I told her I wasn’t willing, she prescribed a medication instead.
Questions to consider asking a pediatrician:
- If I have breastfeeding difficulties, will you refer me to a lactation consultant? My son’s new pediatrician has a relationship with a lactation consultant that he regularly refers patients to.
- Are you familiar with Thomas Hale’s Medications and Mothers Milk? If I need to take medication, would you support using this as a resource for making decisions regarding breastfeeding and medication?
- How long do you think a baby should be breastfed? There’s no right answer. Just make sure you feel comfortable with the response, and that it is consistent with your plans for breastfeeding. I know of some local pediatricians who encourage weaning at 1 year. I also know of some mothers who nurse into toddlerhood and feel they have to hide this fact from their pediatrician.
- Did you (or your wife) breastfeed? This is personal, and a “no” answer may not be any indication of how supportive the doctor will be, but if they talk to you about their experience or reasons for their choice of infant feeding, this could give you a great idea of their attitudes about breastfeeding.
I share our experience not to shame this doctor, and not to complain, but as a warning. She was not against breastfeeding, she just didn’t know how to support it, and ended up threatening our breastfeeding relationship. I feel that my son and I are still nursing in spite of this doctor, and only because I was informed about breastfeeding and surrounded by professional lactation help. How many other mothers might have lost their milk supply or abandoned breastfeeding because of this kind of experience?
At 5 months, we switched to a new pediatrician who was amazingly supportive of breastfeeding. If breastfeeding is important to you, and you want a doctor to be helpful in case of challenges or complications, ask questions. I wish we had from the start.
Christina that is so disheartening! I’m so glad you persevered. Many (most?) mothers quit after a fraction of the difficulties you’ve had–especially when their doctors or their children’s doctors are unsupportive.
Great blog Christina!!
Great information for new mom’s here! I hope people will share this.
Christina, WOW! I never knew there was so much to learn and know about breastfeeding! I’m going to definitely keep this in mind when thinking about having a baby, once the time is right!
It’s really great to hear real life experiences. It’s one thing to read about it in textbooks but another to hear it from a real live Mommy! Love it!
Nicole- I’m glad I persevered, too. It’s worth it!
Kyra- the more you know before having a baby, the better! I think in most of the world, you don’t really have to know that much in order for breastfeeding to be successful. It really is a natural process and babies are born with the instinct to search for the breast, latch on and eat. Everyone breastfeeds, and if you have trouble you can go to your mother, sisters, neighbors. But here in the US (and everywhere formula is heavily marketed and has become accepted as the norm), bottles are given in the hospital and mothers turn to formula when there is a problem since there isn’t enough community-wide support. So many doctors don’t know enough about breastfeeding. I think it’s really important for women to network and talk about breastfeeding before babies and after! Anyway, I’m glad you find it helpful!
Julie and Susan- THANKS! Keep reading
Here via PHD In Parenting.
I had a similar experience. At 4 months, my first child was not nursing well and as a result, my milk supply dropped. When I took him to the doctor, she told me that my milk was probably drying up and it might be time to stop BF and switch to formula. It turned out he had an ear infection and wasn’t nursing well because it hurt. After some pain relief and a consult with my LC, he started to nurse well and my supply came back up.
Also, both my children are small. Both were just over 7 pounds at birth, and while I’m tall for a woman (5 foot
I have a small frame, and my husband is a slightly built person too. This pede lived and breathed by the (flawed) US growth charts, and at one point, labeled my son FTT and was going to send us to see a specialist. It turned out he had a milk protein allergy that coincided with my milk drying up (for real this time, he was 11 months old and I have thyroid disease), so removing all traces of milk from his diet fixed the problem. But to this day, he’s small for his age (at least according to the US charts), and so is his sister. We ended up switching to a doctor who doesn’t rely so much on growth charts and instead uses them as a tool along with everything else to determine if a child is healthy.
My LC was my savior, she’s a CRNP and IBCLC, and she had suggestions that my pede never even mentioned. She worked with me and was also the source of my breast pump.
My advice would be to take any wisdom from your pede with a grain of salt. She or he may only be marginally knowledgeable about breastfeeding. Go to a LC instead and if that LC tells you something you don’t like or tries to make you feel guilty, find another one.
Kayris- Wow. Thank goodness for that LC. I’m glad you made it!
Thanks for stopping by. Enjoyed visiting your blog. BTW I grew up in MD.
Thanks for sharing your experience Christina. Isabella’s first pediatrician, although claimed she supported breastfeeding, quickly encourage formula supplements when I took her in for jaundice at 3 days old and told me I must not have enough milk, ignoring that I had just told her I had a freezer full already. She also ignorantly told me that 20-30 minutes was too long for a newborn to nurse and that she would be burning too many calories if I was nursing her that long and not gaining enough weight. ( She advised that a baby should nurse for about 5 minutes! ) She also made me admit Isabella to the NICU for light treatments for jaundice. Luckily I finally got help from the lactation consultants there and was able to breastfeed her during her stay. Thanks for pointing out that it is important to find a supportive pediatrician before the baby is born because those first few days are so crucial and we as new moms are so vunerable and tired it is easy to loose confidence in your ability to breastfeed if you do not have the right support around you. After Isabella was a week old we found a new pediatrician who was much more supportive!
Christine: that’s terrible!! I am shocked at how ignorant that pediatrician is. I wonder how many patients she has had who are NOT breastfed because of her advice. Way to go, following your instinct and getting the right kind of help.
This is excellent. I find so many people will trust a pediatrician over their doctor but peds are trained in children’s health. Children don’t lactate so their knowledge of breastfeeding is actually quite poor sometimes.
Thanks for the article! Another question I would ask a pediatrician is “Do you think infants should be fed by demand, by a strict schedule, or somewhere in between?” I had done a lot of reading before giving birth and knew I did not want a pediatrician who would push for a strict feeding schedule.
Our pediatrician’s opinion was to feed on demand for awhile, and then see if my son put himself on a loose schedule, but not force anything, and this made sense to me. After about 3 months he got into a groove of nursing every 2 1/2 – 3 1/2 hours and the doc said this was perfect. She also spent a portion of each of my son’s well-vists discussing how BFing was going for me. This included discussing how long my son nursed for, how often, what my fluid intake was like, and the encouragement to keep going. She never brought up formula, and encouraged me to hold off on solids until my son was at least 6 months of age, and even then to only feed him 1-2x a day at first so he wouldn’t self-wean. My only complaint is that the last time I was in the office there was free formula everywhere, so that might send a subtle message to new moms, but she encouraged BFing so much I think it’s probably not a big deal. Next pregnancy around I’ll ask her if she has an LC she recommends though; I think it’s great to work with a pediatrician who does!