Most parents assume that finding a doctor who is supportive of breastfeeding will be an easy task; after all, the medical field applauds the health benefits of breastfeeding for both mothers and babies. Unfortunately, other than very basic knowledge about the benefits of breastfeeding, this topic is sadly overlooked in medical education. Unless physicians receive extra education on breastfeeding, as well as make a commitment to spend time with breastfeeding dyads, they may not be as supportive as breastfeeding as one would hope.
So how do you know if your doctor is truly supportive of your breastfeeding goals? Let’s look at the big five–GROWTH, SLEEP, SOLIDS, MEDICATIONS, and VIBES.
Did you know it’s normal for newborns to lose some weight in the first few days after birth? Your doctor should! Your doctor should also know that exclusively breastfed babies grow differently than their formula fed counterparts. In the first 2-3 months of life, breastfed babies grow faster than formula fed babies. This growth slows down, and by 3-12 months of age they begin to grow slower. If your doctor chooses to plot your baby’s growth on a chart, it’s really important for him or her to use growth charts provided by the World Health Organization (WHO) because they are formulated by averaging growth of breastfed babies all over the world. The Center for Disease Control (CDC) growth charts that are targeted to formula fed babies, which tend to weigh more, may make exclusively breastfed babies seem underweight. Of course, the most important thing your doctor can do when monitoring your baby’s growth look at your baby as a whole, not just a number on the chart. How is your baby’s mood? Is he or she meeting developmental milestones? Weight gain is just one small part of your baby’s overall health.
Our culture has a lot of expectations about when babies should sleep through the night–but your doctor shouldn’t! And mamas, I hate to be the one to tell you, but it might not happen for a while.
For all babies, but especially breastfed babies, it’s normal, healthy, and necessary for them to wake during the night. If your doctor is telling you that your baby “should be sleeping through the night by now,” consider that remark carefully. There are many reasons why babies wake at night–hunger, teethingpain, desire to be close to mom. For many mother-baby pairs, it’s necessary for babies to wake at night in order to get all of the milk they need in a 24 hour period. And despite the myths running rampant, formula or rice cereal in a bottle before bed won’t help your baby sleep longer. And on the topic of rice cereal…
Is your doctor recommending your baby start solids before 6 months of age? If so, they’re not following the recommendation from the American Academy of Pediatrics (AAP) and WHO that babies be exclusively breastfed for at least 6 months before solid food is introduced. Some doctors are suggesting that solid food be offered at 4 months of age–or even earlier! In addition to taking your baby’s age into account, a quality doctor will look for other signs of food readiness–like being able to sit up without support and use the thumb and finger to pick things up. Some babies may not be ready to start solid food until later than 6 months of age–remember, your baby is an individual! Babies that receive solid food before 6 months of age are at greater risk for digestive problems and have higher rates of iron deficiency anemia (even when given that iron-fortified rice cereal your doctor is telling you about!) One final point to make about rice cereal is that the AAP no longer recommends it as a universal first food, and acknowledges that fruits, vegetables, and meat are naturally nutrient rich, viable first foods.
Is your doctor telling you to pump and dump your milk, or even worse, wean your baby while you take a medication? Unfortunately, some doctors automatically assume that medications given to breastfeeding mothers are not safe for babies, and recommend temporary or complete weaning. In reality, many medications do not pass into mother’s milk in large quantities, or if they do, they are safe for baby. If you’re feeling skeptical about advice you receive from your doctor about breastfeeding while taking a medication, consult the Infant Risk Center’s website or call them M-F 8am-5pm at 806-352-2519. Perhaps you will find that the medication has been deemed safe for breastfeeding women, or if not, consult your doctor about alternate medications that may have the same effects and be more breastfeeding-friendly. A top-notch doctor will understand the importance of prescribing breastfeeding-friendly medications and be willing to have an open discussion with you about the benefits and risks involved.
You know what I mean–you can feel it! Maybe it’s that every time you go to the doctor he remarks that your baby is on the small side. Or there was that time you got mastitis…she told you to pump and dump while taking antibiotics. But you talked to your friend who said she took the same medication and continued to breastfeed. What about when he told you a bit of rice cereal in a bottle would help your four month old baby sleep through the night? Red flags aside, a breastfeeding friendly doctor would use the latest evidence to support your breastfeeding goals. If the relationship isn’t feeling right, it isn’t right. Use your intuition, mama!
In summary, a doctor that is truly supportive of breastfeeding will…
…monitor your baby’s growth with the WHO growth charts AND as just one factor in the overall health of your baby.
…have realistic expectations about infant sleep, and understand the importance and normalcy of night time feedings.
…recommend starting solid food after 6 months of age, accompanied by signs of readiness.
…make an effort to prescribe medications that are safe for breastfeeding and provide accurate information about the safety of a medication.
…make you feel good about the choices you are making for your family.
If your doctor isn’t meeting your expectations, visit the files section of the Breastfeed Chicago Facebook page to find a breastfeeding supportive doctor near you!
Maura Frauenhofer is a birth doula and Breastfeeding USA counselor. After spending a year and a half in medical school, she decided the midwifery model of care was more her style and is currently pursuing nurse midwifery at UIC. She has a passion for women’s rights, especially those related to birth and breastfeeding, and enjoys helping women and families advocate for their healthcare wishes. She is mama to a 17 month old girl, still breastfeeding!