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Monday, April 21, 2008

No Replacement for Breastmilk

At each new mother/baby consult, I almost always remember to tell the mom who wants to continue breastfeeding to call me if she has any medical people tell her she can't continue to breastfeed. It's just some anticipation because you never know what unexpected test, dental work, surgery, medication, etc.. one might need and mothers are told over-and-over that they must or should wean. I hate when my patients come back and weaned without getting all the facts.

So... I have a mother of a nine-month old come in. Breastfeeding is going well and she wants to wean. She's nursed this one longer than her first child. I see this quite a bit. I patiently work through the issues. Most of these moms come around. They've been influenced by previous experience and culture and have a new perspective after getting their concerns expressed.

She brings her back in for the 12 month check-up. I ask mom if her daughter is getting any breastmilk.

"I had surgery and I had to wean."

[Inside, I feel like exploding.] "What kind of surgery did you have?"


"Why did you have to wean."

"They told me I couldn't get anesthetics and breastfeed."

[Very patiently] "What do they think they give mothers who have cesareans?"

"Oh-I didn't think of that."

"Why, didn't you call me and ask if that was necessary?"

"I didn't think of that."

"Well, you said you wanted to wean, so I guess it wouldn't of mattered."

"Oh, but after we talked to you, we were doing well with breastfeeding. The surgery came up all of a sudden and happened so fast. She's adjusted well."

Eventhough, I can't change it, she needs to understand the significance. "I feel like I failed you. I usually tell moms to call me if anyone tells you to cease breastfeeding."

I'm not sure she got it, yet.

We start talking about the baby's diet. She is dairy sensitive. Mom also asks me what formula to use. She won't drink soy either.

I could cry for all that is lost here all because a flippant comment by an otolaryngologist (and anesthesiologist) who knew nothing about what he was advising and didn't even think to tell her to ask the baby's physician! I point out to the mother that all is not really well.

She did feed this baby longer than the first, but there is no replacement for breastfeeding.


Becky R said...

HI! When my now 4 year old was 10 months old I had to have my gall bladder removed. My son had never even had a bottle I was still nursing (with no support from anyone.) While in the hospital I kept telling evryone I was nursing and I pumped 4 times a day until I got home (6 days later, I had some complications.) My son was so happy to have me back. You have to be assertive and let the doctors know your plan, if they do not know about nursing they will try to tell you to stop. I appreciate that as a doctor you are encouraging mothers. A baby on formula for 6 days is way better than a baby who was forced to wean. -Becky in NJ

pearly1979 said...
This comment has been removed by the author.
Allana Martian said...

[Inside, I feel like exploding.] "What kind of surgery did you have?"

You are so calm and cool and collected! It made me smile to read the above statement because I can just see you. Never blinking, very calm and just smiling. :-) I don't think the women you deal with really understand the quality of care they get when they see you. I'm glad you have this blog. Keep writing!

Shaunna said...

I LOVE to read these posts as they are so informative and encouraging!

Permission to Mother said...

Allana, You know me well. When I counsel like this, I do feel smooth. I am unfortunately well-rehersed.

Becky and Sarah, I hardly ever (if ever) tell a mother to wean for a procedure. I have sent mothers for mammograms, cat scans. MRI's, colonoscopy, nuclear stress tests, and surgery. I have found co-operative radiologists and surgeons. The specialists that I have relationships beyond breastfeeding (ei,...geriatrics) tend to be receptive to me taking responsiblilty for the baby's exposure.

When it comes to muclear iodine studies of the tyroid, I often find an alternative and equally acceptable plan.

womantowomancbe said...

My sister and my SIL both were told to wean their babies when they went on antibiotics (their babies were 6 & 9 mo. old, respectively). After I became knowledgeable (a few years later), I asked my sister what they gave her. Zithromax. Which they give to babies -- in much higher doses than could possibly come through breastmilk. Ditto my SIL (although she was ready to wean anyway.... but her son wasn't). Grrrrr.


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