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Does my pediatrician know about breastfeeding?
Unfortunately, no. Well, likely no. Though some pediatricians take it upon themselves to learn about lactation, it is not extensively covered in their training. A 2004 survey of 875 United States pediatricians found that 33% of respondents had no breastfeeding education during medical school or residency, 12% had never read an article about breastfeeding management, and 21% of respondents had no interest in gaining further knowledge about breastfeeding.
We know. It’s shocking.
An even sadder truth is that many pediatricians are not upfront about their lack of knowledge when it comes to breastfeeding. At Birthify, knowledge is one of the pillars upon which we stand. We believe you deserve the most accurate information as you make decisions about and for your newborn, and we aim to provide that through our services.
Advice To Be Wary Of
Bottle-feeding as a "fix-all" solution: We understand the necessity of a bottle for some parents and in no way think you should not use them. In fact, bottles are ideal for new parents who are going back to work or if you're delegating feeding to a caregiver of sorts. However, when a person is struggling with breastfeeding, the bottle alone will not fix the problem. It actually can make it worse.
If your pediatrician's only answer to breastfeeding issues is to give the bottle, keep digging. This might be the time where you consider lactation support to help you get the root of your lactation issues. Often times introducing a bottle may not be part of the breastfeeder’s goals and only serves as a band-aid to cover up underlying issues. Let professional lactation support look at the whole picture and help you navigate the challenges you may be having.
Related Article: Lactation support article
The secret to milk supply and supplementation: New parents with supply issues may need to supplement with pumped or expressed breastmilk, donor breastmilk, or formula. Let us be clear: We are okay with whatever choice you make for you and your family. Supplementation may or may not be necessary. And if needed, it may only be temporary and for a short period of time during your breastfeeding journey. One key important matter is to work with professional lactation support to help determine the root reasons why you may be facing challenges with supply. Sometimes the root cause relates to you, the nursing parent. Sometimes it may be due to the baby possibly having tongue ties or oral restrictions. Or it may be both concerns regarding you and your baby.
If a breastfeeding parent is wanting to continue producing milk during a time when they may have to provide their baby with supplementation, it is important to regularly move milk out of the breast. What that means is that if your newborn is not nursing the expected 8-12 times per 24-hour period because of sometimes taking a bottle, it is important for you to hand express or pump your breastmilk to help maintain your supply. If you are supplementing with bottle-feeding, perhaps have your partner feed the baby while you express or pump. Pumping or doing hand expression reduces the chance of developing mastitis (breast inflammation and sometimes an infection that results from milk not moving out of the breasts) or plugged ducts, which can severely impact milk production and supply.
Did you know that your breasts are queued to make more milk when they are emptied? If your baby is not emptying your breasts for various reasons including occasional bottle-feeding, then regularly incorporating hand expression or pumping can help reduce the likelihood of your supply taking a dip. Sometimes, expressing or pumping until empty can also boost milk production.
Note: The amount of milk you see after pumping or expressing is not an accurate indication of how much milk you are actually making nor how much milk your baby takes during an average nursing session. If you have concerns about milk output from pumping, check with a lactation professional. They can help review your pumping routine, check your equipment, and make suggestions if they see something that could change. We are all so unique and different! Be aware that not every lactating parent responds well to pumping or expressing. If you have questions, we encourage you to seek additional lactation support.
Supplementing with formula: If your doctor suggests supplementing with formula and only formula, ask why. This might be a hint that they do not have sufficient lactation training. A doctor with proper training will always err on the side of using pumped breastmilk first if you need additional milk due to supply issues.
Do you really need to supplement?
Many new parents think they aren't producing enough milk, which causes stress and panic and in turn can inhibit milk production. (Go figure!) A good rule of thumb is that you are transferring enough milk to your baby if your baby is gaining weight.
Hunger Cues vs. A Preset Feeding Schedule
If your doctor suggests preset nursing times, again, check in about their lactation knowledge. A trained pediatrician with an understanding of lactation is aware that in general, a newborn baby feeds 8-12 times in 24 hours. However, all babies are different, and it is more important for a parent to understand their baby’s specific hunger cues.
Smacking or licking of the lips
Opening and closing of the mouth
Sucking on lips, tongue, hands, fingers, or toes
Snuggling breast when being held (rooting)
Actively trying to suck on the nipple even though the breast is not exposed
Crying, which indicates late-stage hunger
Though it may be convenient to set feeding times for yourself and your baby, try not to be too married to them and look for the signs of hunger instead. Just as we as adults do not always crave food at the exact same time every day, neither does your newborn.
Lactation consulting is a career in and of itself that many pediatricians have not invested the time or energy into. That said, most doctors are considered to be experts on the matter, which is simply not true. Until enough people start taking their health into their own hands and exploring their options by doing their research to make informed decisions, nothing will change. One way to advocate for yourself is to point-blank ask your doctor if they have lactation training. If they do, great! Use them. If they don't, we suggest you seek additional support. For more information, read the Lactation Support article to see if hiring a perinatal coach with lactation training is right for you!
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