Tips for choosing a breastfeeding friendly pediatrician- I talk a lot of shit about pediatricians sabotaging your breastfeeding journey. Remember they really only came into existence to give moms formula. (!)
Some mamas eschew the traditional pediatrician and take radical responsibility for their child's health.
That's awesome. I think if you're that confident, aren't interested in giving YOU KNOW WHATS, and want to track your child's growth and development at home and use your own natural remedies that's a-ok.
There are a couple reasons why I want to find a pediatrician that supports breastfeeding and fits my "semi-crunchy" philosophy for several reasons. I have a history of health anxiety. I used to pop into urgent care like it was a favorite watering hole. I have a long history of looking to doctors to validate and quell my anxiety. And I'm working on it, but I don't think it's ever left completely.
Here are some questions you want your pediatrician to "answer correctly". If the answers contain red flags it's a clue that you may not be able to trust them to support you.
1. Ask them when they believe a child should be night weaned.
You can night wean whenever you want to (after 12 months IMO)- there's no rule and there's no reason to night wean unless it's not working for you- but if your pediatrician starts saying something like "after 4 months they don't need to eat at night, they do not know anything about how breastfeeding works.
2. Find out what growth chart they use and what indications for supplementing are.
You want a ped who uses WHO growth chart instead of CDC, which is based on formula fed babies. Anything over 10% weight loss by day 4 of life takes some breastfeeding investigation (not just immediately handing you formula- it should be referral to an IBCLC with a detailed feeding plan). Breastfed babies gain about 5.5-8.5 oz a week in months 4-6 and 3.35-4.5 oz a week from month 4-6 and then 1.75 – 2.75 ounces per week from 6-12 months. Typically a breastfed baby should be given 14 days to return to his birth weight.
3. Ask the protocol for supplementation.
I hear a lot of people say their pediatrician told them their milk wasn't "fatty" enough and that they NEEDED to use formula when supplementing. This is false. Pumped breast milk should be the first choice used when supplementing, then donor milk, then formula. And any supplementation should be accompanied by pumping or removing milk from the breasts in order to maintain supply with a individualized care plan to get back on track and/or find the root cause of low supply.
4. Ask when they recommend starting solids.
Current evidence supports waiting until baby is around 6 months and able to sit independently, no longer uses tongue thrust reflex and can pick up and eat the food using palmer grasp. Baby's gut is not mature to take anything but breastmilk or formula for the first 6 months. Besides, cleaning up food is messy lol.
5, Straight up ask them if they have any breastfeeding education or have someone on staff that does- or know someone to refer to.
Sometimes you'll get lucky and your pediatrician will have proper breastfeeding education. Or sometimes offices have someone on staff to consult with. At the very least make sure they know of a local IBCLC to refer you to. Pediatricians aren't supposed to be experts on breastfeeding but the least they can do is know where to send you and not just hand you a can of formula.
6. Ask them if they breastfed.
They are more likely to have personal bias against breastfeeding if they didn't have a successful journey and downplay it. Obviously if your doctor is a guy he has not breastfed. But ask if his wife has. If he has no experience with breastfeeding at all, I would look to see if he is able to admit that it isn't his area of expertise and not give you misinformation about it and appropriately refer out.
Pediatriciansand doctors in general are held in high regard in our society; however not all of them have training in breastfeeding. So before you ask them their opinion or expertise, educate yourself and also
figure out what training they have so you're making an informed decision.
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