8: Be Your Own Advocate

This episode is all about encouraging you to be your own advocate when it comes to getting yourself or your baby to the right support person. All too often when a mom finally makes it to me she says she brought up her concerns to the pediatrician multiple times or has been down a rabbit hole of advice that took her far away from her goals. Now I am not trashing pediatricians- they have back to back schedules and I do believe they have your interest at heart. But when it comes to infant feeding, they don’t actually receive much education so advice may be an effort to help but not complete strategy.

Let me give you an example. A mom I worked with went in to see her pediatrician and had brought up concerns baby might not be getting enough to eat but the weight seemed acceptable so she was sent home to follow up later. Then a couple week go by and the pediatrician noticed the breastfed baby wasn’t gaining weight as expected. So in an effort to support baby’s weight gain and give mom a quick tool, they suggested supplementing with some formula after feeds. They even gave her a couple of sample packets of formula to get them started.

Well this Band-Aid fix had several repercussions. Firstly, nothing was done to address why the baby was not effectively and efficiently removing milk from the breast. Secondly, supplementation for a mom who’s goal it is to breastfeed or exclusively feed their baby breastmilk can have negative impacts (or even wreck) her supply. Because breastmilk supply is largely based on nipple stimulation and milk removal, a reduction in these with formula supplementation sends the message that less milk is needed and her body should further slow down production. So now we have a baby who is compensating with feeds, a supply that is getting worse, and possibly some hard emotions on the mom’s end. Will the baby gain weight? Possibly, it depends on what the baseline issue actually is. But instead of finding out, we’re slapping some calories on the problem with the goal of a bigger baby. To add bad to an imperfect plan, this particular mother had a severe dairy allergy which the pediatrician did not know about and baby started refluxing with the formula provided.

Now please hear me clearly, are there times when supplementation is necessary? Of course there is! It can be a very important and strategic tool. However, that family was missing part of the course of action needed to meet their goals. A lactation consultant and possible a speech language pathologist trained in infant feeding ideally would have been suggested as part of the support team. That way, the need for supplementation can fully be evaluated, there can be a plan for protecting mom’s milk supply, and she can be supported to move in the direction of her goals (not accidentally away from them).

Now I believe wholeheartedly that, that pediatrician did have the baby’s best interest at heart but simply is not a lactation expert. Often times a doctor is put in the position of being expected to know it all but no one really does so this is not me putting down pediatricians. (Thank you pediatricians out there for the very hard work you do especially with tightly wound parents like me.)

Consider this when you have a concern about your baby, and the pediatrician says they aren’t concerned. Ask yourself: Was that the reassurance you needed? Or is there still something in your gut that feels off. You can ask to be referred or seek out your own specialist to get deeper in formation on the matter. It’s okay to disagree with the pediatrician, ask questions, and get a second opinions. It’s okay to follow your gut, after all- you know your baby the best!