Doctors and their lack of breastfeeding knowledge...

[ktgrok]

Another small annoyance I've dealt with in ped offices is that EVERY pediatric nurse asks how many ounces the baby is getting at well visits. I appreciate that it's on their checklist to ask, but surely they realize that nursing moms do not necessarily know that. I usually answer with how many minutes they typically nurse. Then they'll ask how often baby nurses and I answer "whenever he wants to." "Yes, but how often?" It varies! Sometimes every few hours, sometimes every few minutes. Fortunately my peds have been bf friendly, so they accept "on demand" as a reasonable answer, but the nurses always tend to get a little annoyed with me. One nurse actually told me I *needed* to pump ahead of our next visit so I could tell he how many ounces he was getting. I *sweetly* told her that I had to pump with earlier children while I was working, but now I was blessed to be able to stay home full time and I wasn't digging out the blasted pump unless it was an emergency. Besides, pumping is not as efficient as a nursing baby, so the data wouldn't be accurate anyway. :D

 

How silly! Our ped would ask how often she nursed. When my answer was "all the time" she would ask "does she nurse more than x number of times a day?" That satisfied them.

[gardenmom5]

I Besides, pumping is not as efficient as a nursing baby, so the data wouldn't be accurate anyway. :D

 

and then there is the fact that the amount of milk varies according to how hungry baby is at various feedings. on demand is not "4 oz every three hours". It might be the equivalent of two or even six so measuring one feedings worth is worthless.

[mudboots]

having access to an on-line source that can be kept up-to-date with the ever growing list of medicines and new things we learn about old medicines...

 

:iagree:

 

 

if my doctor doesn't know for sure, and for whatever reason doesn't have the info at his fingertips, I'd rather him refer me out (to a pharmacist or other source who does know) or err on the side of safety. It doesn't seem lazy to me, at all; it seems cautious and perhaps driven by fear of malpractice should something happen to a patient's nursing child because the doctor gave bad information. But that is fodder for another post entirely....

 

This, too. (ETA: To clarify, a doctor should have this info available. I agree with the importance of referring, in general, when a doctor doesn't have enough information - for example, because it's not his/her specialty.)

Edited February 24, 2012 by mudboots
clarification

[scrappyhappymama]

If you look back at the last bit of what you quoted, I said I didn't think doctors should be expected to know off the top of their head, ie, have the drug interaction info memorized, but that it would be wonderful if they were willing to stop and look it up for you.

 

Owning Hale's book, or having access to an on-line source that can be kept up-to-date with the ever growing list of medicines and new things we learn about old medicines, would certainly fit in with what I said.

 

Having Hale's book memorized cover-to-cover, with instant recall of what medicine is rated with which safety level, would be nearly impossible and is an unrealistic expectation to have in regards to the average doctor not specializing in mother/child health care.

 

But if my doctor doesn't know for sure, and for whatever reason doesn't have the info at his fingertips, I'd rather him refer me out (to a pharmacist or other source who does know) or err on the side of safety. It doesn't seem lazy to me, at all; it seems cautious and perhaps driven by fear of malpractice should something happen to a patient's nursing child because the doctor gave bad information. But that is fodder for another post entirely....

 

I get what you are saying, I just disagree with the emphasis. Obviously no doctor can be completely up to date on all drugs available and their various interactions. I doubt even pharmacists do this job without frequent consultation of resources.

 

But, I don't just think it would be nifty if a doctor treating women of childbearing age had resources available to check whether a drug they are prescribing is compatible with breastfeeding. I think it should be *standard of care.* I think they should be aware of their patient's breastfeeding status and coordinate their care with it, just as they would for a diabetic patient or many other issues.

 

I would be highly annoyed to get a prescription from a doctor who knows I am breastfeeding and go to the pharmacy just to find out there it is contraindicated. What then? Most patients will decide then just to pump and dump or wean rather than go through the hassle of another office visit to get something else that will work. I have been told countless times by friends that they HAD to pump and dump because of treatment for something as simple as an ear infection or bladder infection and it ended up disrupting their breastfeeding to a point that they eventually weaned.

 

So yeah, in my opinion (you're free to disagree), I do think it is lazy, or irresponsible, to not have the information readily available to support breastfeeding moms. Sure they need to protect themselves, but that's what information does! Instead, too many providers default to recommendations to wean or abstain from nursing for the duration of the prescription, without regard to the unnecessary harm they cause for breastfeeding moms. That, to me, is unconscionable.

[Stayseeliz]

We're fighting the norovirus here and my 11mo has been the sickest of the bunch. We took her to the ped yesterday to make sure she wasn't dehydrated and she was fine but the dr said if she wasn't able to keep stuff down soon hospitalization for fluids might be needed. I told him I was trying to nurse her every so often in little amounts and he said "Oh well, if you're nursing this should be short lived. The breastmilk will flush all those bad germs out and she'll be fine." :) And he was right! She turned around right after that and she's much better today. It was nice to be praised instead of shamed for nursing. I've been told by another dr that nursing them past the age of one makes them too dependent and damages them emotionally. Ugh. So much of modern medicine is driven by drug companies and supplements. I hate it.

[VeganCupcake]

If you look back at the last bit of what you quoted, I said I didn't think doctors should be expected to know off the top of their head, ie, have the drug interaction info memorized, but that it would be wonderful if they were willing to stop and look it up for you.

 

Owning Hale's book, or having access to an on-line source that can be kept up-to-date with the ever growing list of medicines and new things we learn about old medicines, would certainly fit in with what I said.

 

Having Hale's book memorized cover-to-cover, with instant recall of what medicine is rated with which safety level, would be nearly impossible and is an unrealistic expectation to have in regards to the average doctor not specializing in mother/child health care.

 

But if my doctor doesn't know for sure, and for whatever reason doesn't have the info at his fingertips, I'd rather him refer me out (to a pharmacist or other source who does know) or err on the side of safety. It doesn't seem lazy to me, at all; it seems cautious and perhaps driven by fear of malpractice should something happen to a patient's nursing child because the doctor gave bad information. But that is fodder for another post entirely....

 

I have a PA friend who works in family practice (so she naturally sees many nursing mothers) and she has a couple of small pocket references to medications that give very basic information about what class a drug is in terms of safety for pregnancy and/or lactation. She looks in one of those guides for basic information and then checks Hale if she needs more details. But she nursed both of her babies for more than a year, so I don't know if she is just more aware than your average family practitioner.

[ChristusG]

Honestly, I wouldn't be giving the supplement. Breastmilk has everything a baby needs.

 

I, like Ellie, got my advice from LLL and not my Dr's. I ignored anything they told me that was contrary to LLL advice and we all got along just fine.

I not have grandbabies whose Mommies have mixed experiences with breastfeeding. Mostly good, but they seem to get their advice from Lactation consultations instead of LLL. And not all of it is great, however, I don't interfere unless asked. My theory is, if they don't ask, they aren't listening.

 

I do have a question tho. My newest darling grandaughter is being breastfed and they are doing great. Her Ped Dr. gave them Vitamin D drops and said that Vit D is the only vitamin that babies don't get from mom's milk. My first response is that they don't it then, so let's just not worry about it! God knows what he is doing.

However, they are giving it to her and she is very very gassy, and her diapers smell. I suggested very carefully they consider not giving them to her. "They did stop for a few days, but are still considering giving

them to her but in a much smaller dose.

 

What do you all say?

[itsheresomewhere]

The vitamin D depends on where you live. If you live in a area that has a lack of sun ( the north for example), they recommend the mom take a vitamin D pill and in some areas the baby should get it too. The good doctors up her start with the mom first unless she is extremely lacking D. Otherwise, it is a CYA type thing. Sadly, most doctors don't test for vitamin D unless a mom requests it. They just prescribe.

[littlebug42]

Actually, I think your doctor was probably right. A lot of techs tell people they can't nurse after drinking that stuff, but my understanding is that it is incorrect information.

 

In defense of radiologists etc that tell to pump and dump after given certain contrast, they give this advice because they have to cover themselves. In the litigious society in which we live, if something were to happen to the baby later on, some could try to trace it back to that radiation given for that bone scan and blame the radiologists. I think, responsibly, they need to err on the side of caution. They are risking their own livelihood if they do not.

[dirty ethel rackham]

<snip>

 

But, I don't just think it would be nifty if a doctor treating women of childbearing age had resources available to check whether a drug they are prescribing is compatible with breastfeeding. I think it should be *standard of care.* I think they should be aware of their patient's breastfeeding status and coordinate their care with it, just as they would for a diabetic patient or many other issues.

 

<snip>

 

So yeah, in my opinion (you're free to disagree), I do think it is lazy, or irresponsible, to not have the information readily available to support breastfeeding moms. Sure they need to protect themselves, but that's what information does! Instead, too many providers default to recommendations to wean or abstain from nursing for the duration of the prescription, without regard to the unnecessary harm they cause for breastfeeding moms. That, to me, is unconscionable.

 

:iagree: Absolutely. Standard of care is key. Anything else is laziness.

[Terabith]

It's probably asking too much for every doctor to have a copy of Hale's Medications in Mother's Milk on their desk. But it's not asking too much for them to have the number of a lactation consultant who has the book, so when you have a question, call up the lactation consultant and ask, "Is this safe? Or would this work?"

[KatieJ]

The vitamin D depends on where you live. If you live in a area that has a lack of sun ( the north for example), they recommend the mom take a vitamin D pill and in some areas the baby should get it too. The good doctors up her start with the mom first unless she is extremely lacking D. Otherwise, it is a CYA type thing. Sadly, most doctors don't test for vitamin D unless a mom requests it. They just prescribe.

 

Michigan where the sun doens't shine an Vit D deficiency is quite common. I personally was DX a couple of years ago and we supplement daily. (DH and I)

I will suggest to my DIL that she get her levels checked when she has her check up next week.

However, her Dr. told her that Babies don't absorb it from Mom's milk, so she may not agree with that plan either.

[KatieJ]

Honestly, I wouldn't be giving the supplement. Breastmilk has everything a baby needs.

 

 

 

I wouldn't be giving it to her if she was mine either, but she is not.

I just get to hold her and sew & crochet beautiful things for her. :001_smile:

[KellyGirl]

Actually, I think your doctor was probably right. A lot of techs tell people they can't nurse after drinking that stuff, but my understanding is that it is incorrect information.

 

When I called the doctor back to ask what to do (since I'm nursing) they went a totally different route. From what I saw, the radioactive stuff does get passed on in the milk

[Momof3littles]

I wouldn't be giving it to her if she was mine either, but she is not.

I just get to hold her and sew & crochet beautiful things for her. :001_smile:

I did not supplement D with my first two children, but I have for the third. I found out I was low at the start of my third pregnancy, which was the first time I was ever tested. I was already supplementing myself with D3, and my numbers were still low even though I was taking the d3 in a decent dose for over a year.

 

In that pregnancy I added more d3, and then when DS2 was born I made sure I was taking 5000+ iu of D3 per day because there's some research that 5000 iu will transfer to the baby via a breastfeeding mother. THe researchers that have done work on that are out of the Medical Univ. of SC (Charleston).

 

While DS2 was exclusively BF, I did not directly supplement him but made sure I was taking my supplements at a level that would transfer into milk. Once he started solids I started supplementing him with Carlson's vit d3 drops.

 

My opinion is that breastmilk didn't have to confer much vitamin D historically because moms and babies did got sun through chores outside, gardening and growing food, being gatherers, etc. Now we spend more time indoors, we don't put our kids out in the sun for extended periods (especially not babies), we may live at latitudes where we don't get enough sun to make adequate D, etc. Because our lifestyle may not be what was the same as our ancestors, I think our milk just isn't made with enough D in every case. For that reason, by the time my third child came along, I decided to supplement myself and later him directly.

Edited February 24, 2012 by Momof3littles

[Rivka]

Another small annoyance I've dealt with in ped offices is that EVERY pediatric nurse asks how many ounces the baby is getting at well visits. I appreciate that it's on their checklist to ask, but surely they realize that nursing moms do not necessarily know that.

 

My ped never asked that. "Still nursing? Well, he looks great." :D

 

We're fighting the norovirus here and my 11mo has been the sickest of the bunch. We took her to the ped yesterday to make sure she wasn't dehydrated and she was fine but the dr said if she wasn't able to keep stuff down soon hospitalization for fluids might be needed. I told him I was trying to nurse her every so often in little amounts and he said "Oh well, if you're nursing this should be short lived. The breastmilk will flush all those bad germs out and she'll be fine." :) And he was right! She turned around right after that and she's much better today. It was nice to be praised instead of shamed for nursing.

 

I feel compelled to say here that if you are a nursing mother who can't feel the milk letdown, it's possible for your baby to get dehydrated even while nursing frequently. That's how my toddler wound up in the ER. He was comfort sucking without drinking any milk, and I don't feel any letdown so I didn't notice. (We were traveling, and in the stress of traveling with a sick baby I was not attuned to watching for wet diapers, the way I should have been.) I felt horrible.

 

On the other hand, if you can tell that milk is going in to the baby, you're golden.

[Penelope]

I can understand a surgeon or a specialist who doesn't routinely see nursing women to not know about lactation and medications, but they should know the resources (LC) to find the information when needed.

 

And there is no excuse for OB/GYNs, pediatricians and postpartum nurses, of all people, to be so ignorant about breastfeeding. I have gotten terrible advice myself as well as heard plenty of stories from other moms. Often it is pediatricians or nurses telling mom she needs to give some formula in the first few days until her milk comes in, or supplement a newborn with formula after nursing. :glare:

[Penelope]

 

Another small annoyance I've dealt with in ped offices is that EVERY pediatric nurse asks how many ounces the baby is getting at well visits. I appreciate that it's on their checklist to ask, but surely they realize that nursing moms do not necessarily know that. I usually answer with how many minutes they typically nurse. Then they'll ask how often baby nurses and I answer "whenever he wants to." "Yes, but how often?" It varies! Sometimes every few hours, sometimes every few minutes. Fortunately my peds have been bf friendly, so they accept "on demand" as a reasonable answer, but the nurses always tend to get a little annoyed with me.

 

I've experienced this too, at the hospital after giving birth and at newborn checks at the ped. I've had a couple of nurses get very irritated with me because I did not adequately keep the "chart" they give you in the hospital to write down exactly what time baby nursed and for how long. I don't spend my spare moments the first few sweet weeks obsessively charting feedings and diapers if we are not having problems.

[dirty ethel rackham]

It's probably asking too much for every doctor to have a copy of Hale's Medications in Mother's Milk on their desk. But it's not asking too much for them to have the number of a lactation consultant who has the book, so when you have a question, call up the lactation consultant and ask, "Is this safe? Or would this work?"

 

Why is that asking too much? Having that resource handy would take so much less time than trying to get an LC on the phone. Since there are now apps for that, it is totally reasonable to expect a healthcare provider to have access to this information and to use it regularly. They should then call the LC if they have further questions.

[KatieJ]

Another small annoyance I've dealt with in ped offices is that EVERY pediatric nurse asks how many ounces the baby. :D

 

Back in the day when I breastfeeding my first daughter, it was a relatively uncommon thing. ( 1976)

 

In the hospital they would weigh her before I fed her, and then weigh her again afterwards. If she didn't get as much as they thought she should, they would give them some water.

 

Later when my milk came in ( I had had an emercency C Section and was in the hospital a full week), I became engorged and she had problems latching on. Staff wanted me to use a breast shield. I said no,during the night I had been hand expressing a little bit of milk and then she was just fine. Staff was appalled and said I was going to hurt myself. Can you imagine!

I still refused to use the shield and she took my baby away and told me I had to be more cooperative. I went into the bathroom and hand expressed all that lovely milk and cried myself sick. Then I called my Mom and my LLL leader!

 

The whole staff was told about it as it was so famous that even the cleaning staff knew I was difficult. A particular cleaning staff person was a relative of a friend of mine and my friend heard all about it. :glare:

 

I was not difficult, I just knew my LLL handbook and they were giving me crummy advice!

[mudboots]

Why is that asking too much? Having that resource handy would take so much less time than trying to get an LC on the phone. Since there are now apps for that, it is totally reasonable to expect a healthcare provider to have access to this information and to use it regularly.

 

Yes, like Physician's Desk Reference, which can be accessed on a smart phone. Not hard or unreasonable at all.

 

I'm sad to hear all the negative experiences. :(

Edited February 24, 2012 by mudboots
tone

[Harriet Vane]

Back in the day when I breastfeeding my first daughter, it was a relatively uncommon thing. ( 1976)

 

In the hospital they would weigh her before I fed her, and then weigh her again afterwards. If she didn't get as much as they thought she should, they would give them some water.

 

Later when my milk came in ( I had had an emercency C Section and was in the hospital a full week), I became engorged and she had problems latching on. Staff wanted me to use a breast shield. I said no,during the night I had been hand expressing a little bit of milk and then she was just fine. Staff was appalled and said I was going to hurt myself. Can you imagine!

I still refused to use the shield and she took my baby away and told me I had to be more cooperative. I went into the bathroom and hand expressed all that lovely milk and cried myself sick. Then I called my Mom and my LLL leader!

 

The whole staff was told about it as it was so famous that even the cleaning staff knew I was difficult. A particular cleaning staff person was a relative of a friend of mine and my friend heard all about it. :glare:

 

I was not difficult, I just knew my LLL handbook and they were giving me crummy advice!

 

SHE TOOK YOUR BABY AWAY?!?!?!

 

There are no words to express how extremely uncooperative and difficult I would become if anyone had the nerve to do such a thing.

 

I'm sorry this happened to you. :grouphug:

[bluemongoose]

We saw two different peds in the same office. One for my DS and one for my DD. My DD's ped wanted us to add all sorts of supplements and early weaning so she would eat more and threatened to label her FTT because she is long and lean. My DH is long and lean, it is genetic, and at 7yo she is still long and lean. The girl eats plenty, it just doesn't stick.

 

My DS's pedi wanted us to put him on a diet because he was about 16lbs at 4mos and 20lbs at 6mos. At the 4mo appointment he was EBF, never a drop of formula or baby food of any sort. The pedi wanted us to give him water in a bottle to sub for all night feedings if he woke up and any other feedings after a prescribed number for the day. I refused. He also wanted to have a CT scan done on his head because he thought it was too big. I refused that too. Well, again it was genetic. He takes after FIL. FIL is built solid like a football player and about 6ft 2. He has the biggest head and hands of anybody I have ever met. He is all muscle though, not obese. DS is now 5yo and still has a large head, big feet, big hands, and is a strong sturdy boy.

 

I also struggle with the nurses at the hospital not believing me that my milk comes in early and that I get seriously engorged for 2 weeks resulting in rusty pipe syndrome. I request a pump every time while in my hospital stay. I just had my 4th baby, this is the first time they actually gave me a pump to use. I was so relieved! (yes, I should just remember to take my hand pump...but somehow I always end up forgetting it!:glare:)

[Nakia]

A lot of these stories make me really sad. It's not a personal thing because I never had any trouble with ignorant doctors. I nursed all my kids and was always respected and assisted by the medical community. But this makes me sad on a professional level. I am a nurse, and I work on a postpartum floor. I work in a large high-risk teaching hospital. As you can imagine, I see it all. We have a high c/s rate simply because we have so many high-risk patients. We also have a really large NICU. My hospital is certified Baby-Friendly. Every single nurse on my unit has had extensive training in breastfeeding, including seminars and bedside training. We have an LC on the floor almost 24 hours a day. The physicians also receive training, and thankfully they know their limits and refer to the nurses and the LCs when needed. All babies room in with mom. The only exception is a DSS case or if the baby is sick and needs to be in the nursery. Every single nursing mother is visited by an LC every day of her stay. There is a breast pump available for every room, if needed. We have no pacifiers and no diaper bags with formula that are sent home with new parents. Those are just a few of the things that go into being baby friendly. This initiative took a couple of years to complete to certification, and it was a lot of work for everyone involved, but I think it was worth it. The number of mothers still breastfeeding when discharged has increased dramatically. We are still looking into the long term effect in the community.

 

Anyway, I guess this got long, but I just want to point out that there are places that are doing better and taking the time and resources to educate the staff. It can be done.

Edited February 24, 2012 by Nakia

[Stayseeliz]

I feel compelled to say here that if you are a nursing mother who can't feel the milk letdown, it's possible for your baby to get dehydrated even while nursing frequently. That's how my toddler wound up in the ER. He was comfort sucking without drinking any milk, and I don't feel any letdown so I didn't notice. (We were traveling, and in the stress of traveling with a sick baby I was not attuned to watching for wet diapers, the way I should have been.) I felt horrible.

 

On the other hand, if you can tell that milk is going in to the baby, you're golden.

 

Ugh that must've been hard! Taking a bay to the er stinks! Her diapers have been nice and soggy since she stopped throwing up so she should be fine. She's still super grumpy though! This stuff is brutal!

[TravelingChris]

I never breastfed any of mine but had problems with pediatricians with my kids weights. No, they weren't off the charts, they were low on the charts but not abnormally low. It was as if they didn't understand that since they were born small (all were 6lbs something), they weren't going to be fat babies.

 

Specifically I remember them not believing how many bottles my second was drinking. They kept saying I must mean half bottles or I was not mixing correctly. No, I was doing everything right. Turns out that number two is my severely adhd child and is constantly active. She was really going through more calories than they expected and not gaining very much weight. They finally stopped bothering me since she stayed at her same percentage - around 10-15%. She burns calories like you can't believe and she is still doing that at age 18. Even with rotten very high calorie cafeteria food she is still only 110 lbs as a 5'4.5' height.

[kitten18]

I can understand a surgeon or a specialist who doesn't routinely see nursing women to not know about lactation and medications, but they should know the resources (LC) to find the information when needed.

 

:iagree: I think there are some specialists who rarely see nursing moms but they should know how to (and be willing to) find the information if they need to.

 

My niece fell on the ice and broke her hip and needed surgery. She had a 3 month old nursling. Her anesthesiologist refused to consider her nursling when picking an anesthesia drug, he had a drug he wanted to use:glare: and she ended up pumping and dumping for nearly 24 hours (even the LC said she needed to dump with this particular drug). She is a healthy 28 year old woman, I'm sure there are many other drugs he could have used.

 

 

I personally had good experiences with doctors/hospital staff. My DD was born 6 weeks early and needed surgery two days after she was born. She was at a big Children's Hospital and the people there were pretty great. She was the healthiest baby in the NICU (grower/feeder) and I got a TON of support when I was pumping for her. One of the NICU nurses cried with DH and I when DD latched on and nursed for the first time.:001_wub:

[Bluegoat]

In defense of radiologists etc that tell to pump and dump after given certain contrast, they give this advice because they have to cover themselves. In the litigious society in which we live, if something were to happen to the baby later on, some could try to trace it back to that radiation given for that bone scan and blame the radiologists. I think, responsibly, they need to err on the side of caution. They are risking their own livelihood if they do not.

 

What if something happens that can be traced back to the baby being given something other than breast-milk for 24 or 72 hours?

[Bluegoat]

When I called the doctor back to ask what to do (since I'm nursing) they went a totally different route. From what I saw, the radioactive stuff does get passed on in the milk

 

i just looked it up to check - it looks like it depends on the type of scan and how the radioactive drink is made, and like people may be commonly told to wait longer than is really required.

[Barb_]

With my first baby, his ped told me not to breastfeed him more than a couple of months because "breast milk is to help them grow, if people do it too long they will grow a super human as big as a house."

 

:smilielol5::lol:

 

That is hilarious!

 

Wish he could see my little one. Just weaned at 3.5 and all of 26lbs.

[KatieJ]

SHE TOOK YOUR BABY AWAY?!?!?!

 

There are no words to express how extremely uncooperative and difficult I would become if anyone had the nerve to do such a thing.

 

I'm sorry this happened to you. :grouphug:

 

Yes, she absolutely took her away. Back then, babies lived in the nursery and just came to Mom for feeding time. They were not allowed near your guests, ever.

It would never have happened a second time, trust me.

[Harriet Vane]

Yes, she absolutely took her away. Back then, babies lived in the nursery and just came to Mom for feeding time. They were not allowed near your guests, ever.

It would never have happened a second time, trust me.

 

I'm still shaking my head over this. Let me give you another :grouphug:

[Moxie]

Yes, she absolutely took her away. Back then, babies lived in the nursery and just came to Mom for feeding time. They were not allowed near your guests, ever.

It would never have happened a second time, trust me.

 

It is amazing how far we've come. When my sister was born back in the 80's, my mom was in a room with 3 other post-partum women, all SHARING A BATHROOM!! I'd die.

[KatieJ]

I'm still shaking my head over this. Let me give you another :grouphug:

 

Thank you. I appreciate it really I do. I only brought it up to show how far along breastfeeding has come. BTW, DD and I got along just fine once we got home. :001_smile:

[dirty ethel rackham]

Actually, a PDR is pretty much useless - it is going to have the usual "do not prescribe for breastfeeding women" type disclosure. The Hale book is pretty much the bible of drugs for bf-ing women.

[littlebug42]

What if something happens that can be traced back to the baby being given something other than breast-milk for 24 or 72 hours?

 

I think I would rather take my chances with giving my baby a bottle of breast milk or formula for a few days than potentially ingesting harmful radiation. I think each mother has the responsibility to research and weigh the risks for themselves.

[joannqn]

To the OP...wow! I can certainly imagine it, but for all the trouble I've had with nursing in public, I've never had trouble about nursing from the medical community. Our pediatrician's wife breastfed their five kids for eleven years. One doctor I had carried Dr. Hale's book in his coat pocket. My current doctor has the app on his phone. I've never been given a a hard time for extended breastfeeding by any doctor, nor have they unknowingly given me a drug incompatible for breastfeeding.

 

ETA: I did have one negative experience. After giving birth to my oldest, the baby nurse wanted to give my DD a bottle right away even though she knew I wanted to breastfeed. Her argument was that DD was a big baby (8lb 10oz) and it was a long labor so her blood sugar would be low. My midwife, who had accompanied me through a transfer, told her to check DD's blood sugar first. It was fine. The nurse, who was probably furious about my midwife messing up her plans, brought DD over to me and proceeded to manhandle my breast to force DD to nurse right then and there. She was very rough about it.

Edited February 25, 2012 by joannqn

[mudboots]

A lot of these stories make me really sad. It's not a personal thing because I never had any trouble with ignorant doctors. I nursed all my kids and was always respected and assisted by the medical community. But this makes me sad on a professional level. I am a nurse, and I work on a postpartum floor. I work in a large high-risk teaching hospital. As you can imagine, I see it all. We have a high c/s rate simply because we have so many high-risk patients. We also have a really large NICU. My hospital is certified Baby-Friendly...I just want to point out that there are places that are doing better and taking the time and resources to educate the staff. It can be done.

 

This is how I feel, too. There have been enormous efforts in the medical community to support breastfeeding, so I feel sad when people have bad experiences.

 

With that said...

 

Actually, a PDR is pretty much useless - it is going to have the usual "do not prescribe for breastfeeding women" type disclosure.

 

You're right (at least what I can see from the online version - I'm not a doctor). It has pregnancy risk categories, but for breastfeeding I see that it definitely takes the "safe" route. Comparing it to the same drug info on this peer-reviewed database - http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT - PDR far overstates the risk.

Edited February 25, 2012 by mudboots

[garddwr]

 

I do have a question tho. My newest darling grandaughter is being breastfed and they are doing great. Her Ped Dr. gave them Vitamin D drops and said that Vit D is the only vitamin that babies don't get from mom's milk. My first response is that they don't it then, so let's just not worry about it! God knows what he is doing.

However, they are giving it to her and she is very very gassy, and her diapers smell. I suggested very carefully they consider not giving them to her. "They did stop for a few days, but are still considering giving

them to her but in a much smaller dose.

 

What do you all say?

 

In case no-one has brought this up yet, I have read that the reason breast milk is low in vitamin D is that most women these days are deficient in vitamin D--if the woman is getting or producing enough vitamin D, there should be enough in her milk for her baby. Maybe the mom could take D supplements herself, or during the summer (or if she lives far enough south--winter sunshine north of about Los Angeles latitude isn't strong enough) she can just make sure she is out in the sun without sunscreen for 15-20 minutes each day. Do your research on vitamin D--newer information is showing that optimal levels are many times the currently recommended RDA (or whatever it is called these days).

 

--Sarah

 

ETA: a little sunshine would also be good for baby--they're designed to make their own vitamin D, ya know.

Edited February 25, 2012 by thegardener

[Paige]

I had some bad advice too. With my first, while I was in the hospital after a normal delivery, the pediatrician came to meet us and check the baby out. This was my *first* experience as a parent with a pediatrician. She told me that I needed to supplement with formula right away. Baby was less than a day old. I asked why and she said partly because my milk hadn't come in yet (remember, less than 24hrs!), and also because she advised all parents with smaller babies to supplement. My DS was full term and 6lbs 5oz. He was small, but hardly tiny. Fortunately for me, I had done my research and I completely ignored her advice. It took almost 4 days for my milk to fully come in. I wonder if I had taken her advice and DS had been nursing less, if my milk would have come in well at all and if we would have already been hooked on the bottle before we even had a chance to figure out nursing? It could have effectively ruined my breastfeeding career and put me off from doing it with all my kids. When I took DS in for his 1week weight check, he had already surpassed his birth weight.

 

Then, I had preemie twins. The LC at the NICU was a man and I didn't want a man handling my spraying nipples, so I didn't nurse much at all until we got home. Also, for real, they told me that breastfeeding would delay their ability to come home! I can see how someone new to nursing would be put off by this alone. Then, upon discharge, they told me to offer them a bottle after every nursing session until they refused it, and to put breastmilk fortifying powder into my expressed milk. My babies were 4lbs, only allowed 17-19ccs of milk per bottle, and were still premature. The first weeks were hellacious. The babies seemed to nurse well, but they took the whole bottle every time. (I never put the breastmilk fortifier in, fwiw, because I think it's nasty). Then, the babies spit up huge amounts constantly. It was a nightmare of nursing one at a time, bottlefeeding one at a time, cleaning up spit up, pumping so I can make bottles, cleaning the bottles and pump pieces, changing clothes, washing clothes...nightmare.

 

Finally, I called the LC at my local hospital and she had me bring them in for a test weigh. My babies, who had teeny stomachs, were getting 3oz of breastmilk through nursing plus 17ccs from the bottle every time! No wonder they were spitting up so much- they were being grossly overfed. At this point, we were feeding them almost 7 times the amount of milk they had estimated that they could tolerate. The girls were too immature to understand or be physically able to turn their heads and refuse milk, so they kept swallowing as long as the milk came in their mouths. I have a forceful, fast letdown, and preemie bottles do not require sucking- it's a constant drip, so they had to swallow or choke until I pulled them off the breast and the bottles were gone. We stopped supplementing w/bottles right away and I started limiting their nursing by pulling them off every few minutes to see if they were happy or wanted more, and things got a lot better. They still had horrible reflux, but they were happier and it wasn't nearly as bad. Not to mention all the hassle of bottles and pumping that I was ready to give up. The doctor's bad breastfeeding advice was actually very dangerous for my babies. They were spitting up so much that they were choking. I actually found one of them laying on her back, mouth wide open and full of milk, eyes wide open and scared, silently choking on milk because she didn't know how and wasn't reflexively turning her head so she could expel the milk. I wonder if she would have died if I hadn't happened to be checking in on her that minute. That was the day I called to talk to the lactation consultant.

[mudboots]

The whole Dr. Hale/PDR thing left me annoyed with my doctor, because I doubt he has Dr. Hale's book, and I thought he referred to the PDR for most of these things. It's so important to trust your care provider... Thankfully, I was able to ask him, and he said he uses Reprotox as his resource. I can only see their samples, but it does look like Reprotox includes lactation information for relevant drugs.

 

In case no-one has brought this up yet, I have read that the reason breast milk is low in vitamin D is that most women these days are deficient in vitamin D--if the woman is getting or producing enough vitamin D, there should be enough in her milk for her baby.

 

Someone mentioned that breastmilk has everything a baby needs. It should have everything a baby needs, but typical American grocery store food is stripped of many nutrients. Omega-3s are another area where supplementation is recommended, especially for pregnant and nursing women. (Our lack of Omega-3s involves so much more than not eating fish!) It would be better if doctors could prescribe organic whole foods and an outdoor lifestyle, but many people can't do this - or they'd just prefer to take a DHA capsule.

 

ETA: For some of the other terrible stories, I think I'd be looking for a different doctor. There are good ones out there who support and recommend breastfeeding.

Edited February 25, 2012 by mudboots