Attitudes About Breastfeeding — A Tale Of Two Doctors

I wrote this during a quiet moment when W had hand-foot-mouth, after our first visit to the pediatrician but before she was hospitalized. In the craziness that followed, I didn’t get around to publishing it right away.

Do I have to stop nursing just because it's my birthday?

My poor W is sick. It started on Wednesday with vomiting, and then a high fever by afternoon. The next morning, she had some suspicious-looking sores on her lips and chin, so off to the doctor we went. Apparently, she has hand-foot-mouth disease, which I’d never even heard of. Having a toddler is a crash course in microbiology. Anyway, she has blistering sores all down her throat, which makes it painful for her to swallow. The pediatrician said that we were looking at about 5-7 days of high fever and difficulty eating and drinking, and that dehydration was the major concern. I mentioned that I was still breastfeeding, and her response was, “Oh, WONDERFUL! That will be so soothing to her. She’ll be able to nurse even if she can’t get anything else down.” The doctor was right; nursing is about all W has been able to do, so I’m very thankful we have that option available to us.

Yesterday, I had to leave my sick baby at home so I could go see my orthopedic surgeon for a pre-surgical consultation. Thanks to a skiing accident a few years ago, I have a torn labrum in my shoulder and a capacious capsule. The repair he’ll be doing sounds like a combination of woodworking and dressmaking; he needs to screw the labrum back on, and “take up” the extra capsular space with — as he described it – pin-tucking. Anyway, as we were discussing how the surgery would proceed, I asked if it was a problem that I was still breastfeeding. His response was “You’re STILL breastfeeding? {Insert appropriately horrified face here} At 13 months? WHY!?” It went downhill from there. He told me I needed to wean her because of the general anesthetic during the procedure and codeine afterward, but when I countered with the resources I’d found that stated otherwise, he said he didn’t really know, and to ask my pediatrician. He essentially told me that he didn’t want to talk about it anymore; he’d had enough of talking about breastfeeding. Alrighty then.

Part of me is annoyed by the orthopedic surgeon’s response; after all, nursing is not only still important to W, it’s probably the only thing keeping us out of the hospital for dehydration right now. I thank my lucky stars we’ve got this available to us. Part of me is hurt. I’ve been really lucky to have had no negative interactions as a result of my breastfeeding. This is the first time someone’s made me feel like a freak about it, and it stings. Part of me is scared. I really, REALLY want to do what’s best and safest for my baby. There’s enough information out there for me to know intellectually that it’s ok to keep breastfeeding despite my surgery…but emotionally, I still worry.

I was pretty frustrated yesterday, and kept thinking I felt so good about nursing after seeing the pediatrician; why did the orthopedic surgeon have to make me feel so awful? Last night, though, I rocked my hot-as-lava baby, pushing her damp hair off her forehead and listening to her rapid, shallow breathing. She opened her tired eyes and looked at me, opened and closed her little hand in our sign for nurse. With her first swallow of milk, she sighed. Her whole body relaxed. The peace of that moment swirled up around us both. I no longer feel the sting of the second doctor’s words; in fact, I know now that nursing is how I’ll help explain to W that everything’s ok after my surgery. It’s how I’ll comfort her even though Mama won’t be able to bathe her or carry her, and even though Mama will be sleeping away from her for the first time ever.

That I’m still nursing my baby is not me trying to make a “statement” of any kind, or fit into a particular parenting philosophy. I’m not a “lactivist.” It’s just something we do when she asks, which isn’t often anymore, unless she’s sick. In answer to the second doctor’s question — WHY!? — I now have a response. We’re still nursing because it’s a phase of development that she’s still in. It’s like babbling, or crawling, or thumb-sucking. It’s something she’ll do for a while, but won’t do forever. I won’t push to extend this phase, nor will I try to curtail it. For now, it is something she needs, and that’s enough.

 

Post-Script — As I review this post before publishing, I am amused at how worried I was about nursing W despite my surgery. The general anesthetic won’t affect her at all; if it’s still in my system, I’ll be asleep. If I’m awake (and able to nurse her), it won’t be in my system anymore. With regard to the codeine…well, as I write this, W is sleeping on my lap, narked out on Vicodin because her blisters from hand-foot-mouth disease have gotten so bad. Before the Vicodin, they tried codeine. She’s been on the drugs for three days so far, and I expect we have at least another day of them. So, am I worried about the bit of codeine she’ll get via my milk for a few days? No.

 

What sorts of responses to breastfeeding have you had from healthcare professionals?

 

 

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32 Comments (+add yours?)

  1. Jem
    Mar 29, 2012 @ 11:40:32

    I actually feel bad that you’ve just experienced exactly what I was getting at in my last comment! (If you ever get really bored I’ll tell you all about the surgeons who insisted my Isabel should be put on formula at 4 months old because I had gallstones…)

    Am so glad that your little girl is home, and I hope she’s all better real soon. Don’t forget to look after yourself, too.

    Reply

  2. Alice Callahan (@scienceofmom)
    Mar 29, 2012 @ 13:11:24

    I had to have my wisdom teeth taken out when BabyC was 3 months old and went under general anesthesia. In my pre-procedure phone consult with the oral surgeon, I asked if it is was an issue to breastfeed my baby following the procedure. He was very concerned and recommended that I plan on bottle-feeding BabyC for 1 WEEK following the procedure. He recommended starting to pump NOW to build up a supply and supplementing with formula if necessary. What he really should have said was, “I don’t know. Ask your pediatrician.” I know he was just trying to cover his butt and since he didn’t really know if the drugs were a concern, he made up a conservative answer. I seriously cried when I got off the phone with him. BabyC had refused to take a bottle up until that point, and I almost canceled the procedure. Luckily, I called OTIS (great resource) and my pediatrician, and they both told me that if I wanted to be extra safe, I could pump and dump once and be back to nursing her within 4 hours. I do think that the attitude about breastfeeding in the non-pediatric medical community is a bit behind the times, and it has the potential to be very harmful to moms and babies trying to breastfeed. My husband is a physician, and even among his peers – young doctors having children now – there is less than whole-hearted support for breastfeeding when it means that doctors need to pump during their shifts or even – gasp – breastfeed their babies during meetings. Its… weird, and sad.

    BabyC and I are still loving breastfeeding as well. I have many friends that weaned around 1 year or before, and I have no judgement for their decision. I think that babies adapt, and parents find other ways to soothe them. But like you, I wouldn’t give it up for the world right now. I love the physical closeness, the magical relaxation effect, and the way it works like nothing else to fill her belly and soothe her when she’s sick. Hope W is back to 100% soon:)

    Reply

    • SquintMom
      Mar 29, 2012 @ 13:37:00

      Thanks for sharing your surgery story; makes me feel better to know you guys managed that and maintained breastfeeding with no problem!

      Reply

  3. Megyn @ Minimalist Mommi
    Mar 29, 2012 @ 13:45:07

    Yep, I’ve gotten the same responses from doctors…and family and friends and random people who learn that I’m still nursing K at almost 2. By now, I’ve gotten over it. When N was young and nursing, I often felt so awkward about it and even had comments about his was STILL nursing at 7,8,9 months! (He weaned himself at 9 months-long story). I thought I was going to wean K around a year, but that never happened. He still asks for “mama milk” and “boobs!” all the time. I oblige. I often think it’s the only thing that has been keeping him from a whole bunch of illnesses (compared to his weaned-at-9-months brother, it’s like night & day in terms of immune systems…but could also be the MHC they’ve inherited too). I’m glad you’ve found peace with the rough words of the orthopedist. My response is usually, “Yeah, well he’s healthy and has yet to be really sick, so it works for us.” Hopefully this will be your last bad experience being an “extended” BF-er 🙂

    Reply

  4. Rebecca Lee
    Mar 29, 2012 @ 14:05:34

    Why are you still breastfeeding her if she is so old? Shouldn’t she be eating food by now?

    Reply

    • SquintMom
      Mar 29, 2012 @ 15:17:26

      She does eat food! Lots of it. We still breastfeed sometimes because she asks to. Thank goodness we’re still nursing, too, since it’s what kept her hydrated and fed while she was ill and couldn’t take anything else. In any case, the World Health Organization recommends breastfeeding until at least 2, so I’m following sound medical advice.

      Reply

      • Kate @ Boomerang Mama
        Mar 29, 2012 @ 15:44:28

        Good for you, mama! There is nothing wrong with nursing AND doing regular food. In fact, breastmilk is infinitely better for baby and toddler than cow’s milk, formula, or any other kind of substitute. But I know you know that! My daughter turned one a few weeks ago, and I’ll keep nursing her a few times a day until she’s two and offering her all the delicious foods that a toddler can handle in addition. 😉 And no, I’m not a lactivist either, just a mom trying to do the best I can by my daughter. Hope you all are feeling better!

  5. Kari
    Mar 29, 2012 @ 14:29:32

    Very inspirational story. I nursed my 1st son til he was 22 months old and he self-weaned. It would have broken my heart had I been made to wean for someone else’s reasons. He needed it more than I did at that point and there was no way I was taking it away from him. He’s now super secure and very close to me. You’re a strong woman and keep up the good work.

    Reply

  6. Brandi
    Mar 29, 2012 @ 14:50:14

    Remember women take pain meds after delivery/csection, same as codeiene, and they say you can still BF. It’s lower in your milk than in your blood. Just don’t cosleep on narcotics and all should be good!

    Reply

  7. Liz
    Mar 29, 2012 @ 15:15:45

    I hope W is getting better – sounds awful
    Either I have lucked out with doctors, or the culture is different in Australia. I am still feeding my 23 month old and the only mildly negative reaction I have had was from my ObGyn re doing a frozen embryo transfer while breastfeeeding. But I asked for the evidence and she was humble enough to say she didn’t know (from what I have read it seems that we don’t really know how it will effect things and she has since given me the green light)

    To put things in context about 6 weeks ago I slipped and tore ligaments in my left ankle and in my right foot and cracked 4 bones in my right foot. No one, from the ER staff to the 2 othopedic surgeons I saw batted an eye when I mentioned breastfeeding. And I know my son would have suffered even more from all the time I have spent away from him in bed if it wasn’t for the breast

    I know how emotions can sometimes get in the way, but I think it is wonderful that you are still feeeding, and that you are informed about your options. A girlfriend had her gallbladder out when her daughter was 4 months old and was breastfeeding in recovery

    Reply

  8. Marie
    Mar 29, 2012 @ 15:21:43

    Ohmy, I’m so sorry. Orthopedic Dr.’s are an odd bunch- I have worked with 7 of them (all in the same practice), all male, over a 7 yr period now. Like Alice said, he should have said “I don’t know, ask your ped.”, but probalby few of them would think of that 😦 During the time I have worked one on one with a hand specialist, he’s been with me through my pregnancy, mat leave, return to work, and 11 months of pumping 3xday even during his clinic seeing patients! In fact, there were two of us at the same time that bf’d and pumped for at least the first year. So, it became “normal” around here pretty quick. But he still surprised me the other day, a patient he saw recently is a doula, and we got to talking about birth (he and I) and the topic of water birth came up…and he said “water birth? like in water? in a tub? and I replied… “oh yeah, you can do it in facilities that offer it, some hospitals do, or you can get a set up for a home birth as well.” I got the impression he really was not familiar with it at all so it was a nice “teaching moment”…me teaching the Dr…lol.

    Reply

    • SquintMom
      Mar 29, 2012 @ 15:30:36

      Yeah, I sometimes forget how different the various types of doctors can be from one another. I shouldn’t really even have asked him about it. It’d be like asking a PhD in English to do a titration…or asking me to do literary analysis!

      Reply

  9. Cari
    Mar 29, 2012 @ 16:51:03

    I had a similar reaction from a dermatologist treating me for acne. She was horrified that I was “still” nursing at 9 months and out-loud made the assumption that I’d be weaning at 12 months and therefore be ready for treatment. It was the first time I felt shammed by a medical professional for breastfeeding. Regardless, we nursed for 20 months and by then the acne had resolved itself.

    Reply

  10. Jessica
    Mar 29, 2012 @ 16:57:50

    I remember needing x-rays for a herniated disc in my lower back and when I asked about how the exposure would impact my milk the chiropractor didn’t recommend weaning or bottle-feeding but to hold off until my daughter weaned naturally. By my next appointment he had actually done some homework on x-rays and breastfeeding and let me know the potential risks. It was rather refreshing as opposed to someone demanding I pump and dump or wean altogether. Those actions aren’t as simple as people would like to think, especially for the child who doesn’t understand and doesn’t care why Mama can’t offer the breast anymore.

    Reply

    • SquintMom
      Mar 29, 2012 @ 18:52:32

      Oh, gosh, it drives me NUTS when people (especially medical professionals!) suggest that x-rays can have any effect on breast milk whatsoever!! I actually wrote a post about that topic (and contrast MRIs).

      Reply

  11. Em
    Mar 29, 2012 @ 17:01:12

    I seem to be a magnet for these situations. It started when my oldest was 6 months old and the nurse practitioner walked into the well-baby appointment, saw me nursing, and said, “You can switch to formula any time now.” Um, thanks? At a year, my daughter was allegedly failure to thrive, and when we went to a required nutritionist visit, she told me that cow’s milk had more calories than breast milk and that it was OK to wean, I had done more than most women. She added, “My boys both spilled out their bottles of breast milk at a year and that’s when I knew they were ready to wean.” Then we took my daughter to a neurologist at about 2 1/2, with me quite hugely pregnant, and he said, “Nursing has nothing to do with her sleep issues, but in my opinion it’s time to wean. Isn’t it bad for their teeth anyway?”

    My younger one, now 27 months, has digestive issues. His allergist told me that “some kids just can’t tolerate breast milk for more than a few months.” His GI has asked me numerous times when I’m going to wean, and when I’ve told her I intend to let him wean himself, she says (every. single. time.), “You know that could be a while, right?” Yup, older one was 4, thanks for the tip.

    And finally, my primary care physician walked in while I was nursing my son, then 4 months, and said, “You know breast feeding doesn’t prevent breast cancer, right?” I’ll admit, it’s rare that I’m speechless, but that did it. LOL.

    Reply

    • SquintMom
      Mar 29, 2012 @ 18:50:36

      Wow. You’re right…you are a magnet! I’m sorry to hear you’ve had so many bad experiences. Good for you for hanging in there and doing what you think is right.

      Reply

  12. Katie
    Mar 29, 2012 @ 17:23:49

    I was pleased to have an orthopedic surgeon and anesthesiologists who were very supportive of breast feeding. My surgeon said his wife breastfed all their kids until 2 and the anesthesiologists seemed knowledgeable. The nurses were also all up to speed on my plan to minimize the use of pain meds because of nursing. I waited until my daughter was 12 months old in case the procedure would mess up our breast feeding relationship but I am happy to say it didn’t and we are still nursing at 18 months. I also have found nursing to be a really valuable tool to comfort my daughter when she is sick.

    Reply

  13. zandria
    Mar 29, 2012 @ 17:54:20

    I think its great that despite the doctor making you feel emotionally uncertain, that when you nursed your baby that made you all the more certain that is the best thing for both of you. also the blisters down her throat would be treated by the breast milk as its antibacterial and a naturally soothing substance and the many different types of stem cells in breastmilk would help speed up the healing process. Also it releases hormones that are natural pain killers.
    im still nursing my 19month old daughter and 33 weeks pregnant with number 2. when i was first pregnant i had all these preconceived ideas of what breastmilk was i planned on weaning by 16months, and was making lists of things we would need skin lotion, nappy rash cream etc. through becoming more informed about the scientific benefits of breast milk i have learnt that it treats sticky eye, nappy rash, cradle cap, ear infections, cuts and scrapes which an active toddler always ends up with, sore or cracked nipples, dry skin, its sterile and perfect for top and tailing a new born, rashes, its nutritional value and antibodies increases considerably past a year as nature knows toddlers come into contact with more germs from exploring their world. And there have been many times i have looked up to the heavens and said thank god im still breastfeeding otherwise that wouldnt of gone as smoothly. ur baby is sick and your amazing body responds by making more water in your milk to combat dehydration and more antibodies even if you’ve never had hand foot mouth desease. you should give yourself a big pat on the back for following your instincts on what is best for your situation and baby.

    Reply

    • SquintMom
      Mar 29, 2012 @ 18:49:16

      Thanks for your supportive comment. Because this is a science website as well as a parenting website, though, I need to make a few points. The blisters were caused by HFMD, which is viral, not bacterial. Second, while breast milk contains MATERNAL stem cells, no one yet knows what this means. There is absolutely no evidence to support (nor a reasonable hypothesis to suggest) that swallowing another person’s stem cells has any effect whatsoever upon the body. That aside, though, nursing is very soothing, as is the milk itself.

      Reply

  14. Kay
    Mar 29, 2012 @ 18:25:28

    I actually have not experienced negative response from the medical professionals. More from close family members. My DD is 11.5 months, we are still nursing. I am so proud of myself for hanging in there through all the difficult stuff. Spiritually, you was meant to nurse “this long”. Hope you and baby are both getting well.

    Reply

  15. Amy Cohick
    Mar 29, 2012 @ 18:41:22

    I needed an MRI with contrast, but I was told that I had pump and dump because I was nursing my daughter. Because I hadn’t pumped before I went to the ER, they gave me no contrast. I did some research and found out that it is only in my system for a few hours and if I wanted to feel very safe I could substitute one feeding. A year later when my daughter was 2, I needed another one. This time, I told them that the contrast was fine (not an emergency visit). Found out I had large blockages in my brain. 2 weeks in the hospital and my daughter weaned 😦 but we did have a good 26 month nursing relationship. I hope you have no additional issues. It is so frustrating when the dr makes assumptions and wonders while you are still nursing an under 2 baby.

    Reply

  16. Trish
    Mar 29, 2012 @ 21:27:05

    I was pregnant with my second child and was attending a prenatal clinic for my care. It came up that I was still nursing my first baby who was 15 months old at the time. The nurse running the clinic said “oh we’ll you’ll have to stop doing THAT!” I just stared at her, not knowing what to say. I had no intentions of weaning just because of pregnancy. Oddly enough, the same nurse at my next appointment, when the OBGYN was there said “good for you, no reason to stop” when the OB was clearly unconcerned by it. I thought about confronting her, but left it alone. I hope that the OBs comment educated her a little bit.
    Now that I’m nursing my third child, I’ve grown a tougher skin. The moment anyone brings up weaning I ask why. If they go further, I ask them to show me the studies. I’m not about to deny my children the advantages of breast milk or our bond or the wonderful support it gives us both when they’re sick or upset.

    Reply

  17. Brenda F
    Mar 30, 2012 @ 08:20:28

    Congrats on seeing your baby through such a painful illness with the power of breastfeeding. I have gotten general support from many healthcare providers for nursing through my recent health crisis. I have metastatic melanoma and had to have brain surgery, 2 bronchoscopies, multiple MRIs and CT scans, and most recently a laproscopic lung surgery which included a chest tube. It was extremely painful! All these procedures were hard. After the brain surgery I thought I had to quit nursing as I figured I would be going through chemo or something similar. So far, that hasn’t been needed, My son is 9 months old and I am hoping and praying to get to 12 months. Even through all of this, all my docs have been supportive of my continued breastfeeding. I nursed my first child until he was 17 months and only quit because I had to travel overseas for work for an extended period of time. Breastfeeding has been one of only things that has kept me sane during all this. And my baby seems to love it so much still that I can’t bear the thought of stopping anytime soon!

    Reply

    • SquintMom
      Mar 30, 2012 @ 09:25:26

      Wow. You are an incredible trooper, and my heart goes out to you. Best of luck to you in your continued nursing relationship, and I hope all goes well in the management of your cancer.

      Reply

  18. Amy
    Mar 30, 2012 @ 19:47:31

    Keep at it Momma!

    I was recently nursing my 14 month old while he was sick (a simple head cold, but it lingered, his FIRST since just after he was born, when his sick 3 year old brother sneezed on him, LOL). Anyway, I had this flashback to when my fist was about this age and still nursing and thinking, “Thank goodness he is still nursing” Neither boy wanted to eat or drink anything, but both kept nursing night and day. I didn’t have to worry about dehydration with either one and it was SUCH a relief.

    Our pediatricians have always been supportive of our extended breastfeeding, but I must say the most positive medical reaction was when I took the then 7 month old to the allergist, getting a (cow) milk allergy confirmed and discovering his egg allergy.

    He was super supportive of my nursing and told me he would never tell a mother to stop breastfeeding. He and his staff were super helpful in telling me how to clean up both our diets to avoid both egg (easier to avoid) and cows milk (it is in EVERYTHING!).

    I had one bad experience when I needed an MRI with contrast when I was nursing my first and they wait to tell me that I’d have to pump and dump when I arrived for the appointment and I had nothing pumped and stored for my baby waiting back at home. PANIC! I can’t remember the details now, but it worked itself out.

    Anyway, keep it up and I hope your baby gets through HMF soon!

    Reply

  19. Kirsten
    Mar 31, 2012 @ 07:51:40

    I’m nursing a 2.5+year old now and we are on the tail end of Fifth disease, which while it hasn’t bothered her much, scared the ever living hell out of me when the rash “blossomed.” I am so very glad that she is still getting her “more” as much as she wants (and sometimes it is like having a newborn again). Her doctors are fine with it and when they were talking about treating the virus with lots of rest and fluids I mentioned she was still nursing the doctor said “oh great! Fluid and LOTS OF LOVE.” Seriously. That’s exactly what she said.

    Earlier this winter I had a case of bronchitis so bad I thought I was developing pneumonia. I had a crippling stabbing pain through my chest and back with every breath and couldn’t stop coughing. I don’t have insurance for myself (only for my spouse and child) and was lucky enough to have a doctor friend see me in her practice’s lounge to make sure I didn’t need emergency intervention. She prescribed a narcotic cough syrup so I could start to heal. I was worried about the codeine too and her response was to laugh and say “would V getting a little more sleep help you get better?” And then said the chances she’d even show much effect were slim, but that I should cross my fingers for a relaxed toddler while I recovered. 😉 (It didn’t do much because I only took the medicine before bed so we were sleeping anyway and I only took half doses.)

    Reply

  20. Ashley @ C is for Cockerham
    Apr 06, 2012 @ 00:00:44

    I love looking at breastfeeding as another developmental stage. I’m going to have to use that, especially now that we’ve passed the 1 year mark.

    Our first pediatrician recommended night weaning when we went in for the 6-month appointment…something about sleep cycles for the baby, blah, blah, blah. I tuned out the second she mentioned it and promptly changed pediatricians.

    Reply

  21. Natalie vL
    Sep 18, 2012 @ 18:57:29

    I breastfed J past 2. It was great when we lived in Boulder but when B joined the military and we moved to Alabama the military doc said (in a sarcastic, cruel tone):
    Well I personally think that all children should be breastfed until they are in high school.

    I was not as diplomatic then as I am now and responded that perhaps he should read more literature that was copyrighted after 1955. Then I complained to his boss.

    Had B joined the military earlier in Js life and I had not had the support of the community in Boulder, I surely would have agonized upon hearing his cruel words.

    Reply

    • SquintMom
      Sep 18, 2012 @ 19:13:51

      Wow. I can’t believe he said that!! I’m all for diplomacy, but I think it was probably good for the doc that you gave him a solid piece of your mind. Good for you! And good for you that you were able to hold it together emotionally and not doubt yourself based upon his (uninformed) opinion.

      Reply

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