Ignorant pediatrician's comment - help please

[momofadella]

Okay, I am so offended! I'm nursing my 15 month old DD, and she's a very avid nurser. She loves to nurse for comfort. She had a doctors appointment the other day, and I nursed her in the peds office because she was sick and scared and needed comfort. Our doctor then informed me that there "really weren't many benefits to nursing into toddlerhood." He then said that "she was no longer getting any of my antibodies or immunities and that nursing through toddlerhood created a negative attachment to mother that prevents them from developing normal toddler behaviors!!" Yes, that's exactly word for word what he said! I was flabbergasted! When I tried to explain/educate him with all the infomation that I've read on the benefits to nursing through toddlerhood, he then told me that "well, you're reading breastfeeding friendly books and I'm reading medical journals!" Needless to say, I've completely switched doctor offices. I'd like to write a letter to him explaining why I was offended and why I've chosen to leave his practice. Does anyone have any really reliable "medical" articles or facts that I could include in my letter to try to enlighten this doctor? I want to prevent him from saying this to other less "informed" mothers and inturn persuading them to wean before they're actually ready because of some stupid comments from a doctor. Thanks and please help!

[Plaid Leopard]

Well, I'm nursing my 2yo now so can't write a long reply.
However, the World Health Org recommends that babies nurse for at least the first two years, and then as long as is mutually desired by mom and baby after that.

Check out Dr Jack Newman's site. Also breastfeeding.com, promom.org, and I'm trying think of the name of the woman who did a lot of studies on breastfeeding...Kathleen somethingor other....hmmm

that ped was not only ignorant but arrogant - and obviously reading the wrong medical journals!

be back soon with links and such.

[Dingletwitz]

I did a surf of JAMA--the generally accepted peer-reviewed medical journal he probably reads--


Here's one that may help with the ped understanding why you're dumping him....

National Assessment of Physicians' Breast-feeding Knowledge, Attitudes, Training, and Experience

Gary L. Freed, MD, MPH; Sarah J. Clark, MPH; James Sorenson, PhD; Jacob A. Lohr, MD; Robert Cefalo, MD, PhD; Peter Curtis, MD

JAMA. 1995;273(6):472-476.

and I'd include this one as it might point out commonalities between your ped and a "newbie" ped (!)

Williams EL, Hammer LD. Breastfeeding attitudes and knowledge of pediatricians-in-training. Am J Prev Med. 1995;11 :26 –33



and some more:
American Academy of Pediatrics, Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics. 1997;100 :1035 –1039

Goldman A, Goldblum R. Immunologic components in human milk during the second year of lactation. Acta Paediatr Scand. 1983;72 :461 –462

[Plaid Leopard]

this is not about breastfeeding per se, but about "people knowledge vs. professional knowledge"

Jack Newman

article adressing reasons to bf a toddler

[momofadella]

These are great ladies! Thanks and keep them coming

[Plaid Leopard]

Unicef infant and young child feeding

"It is well recognized that the period from birth to two years of age is the “critical window” for the promotion of good growth, health, and behavioral development. Therefore, optimal infant and young child feeding is crucial during this period. Optimal infant and young child feeding means that mothers are empowered to initiate breastfeeding within one hour of birth, breastfeed exclusively for the first six months and continue to breastfeed for two years or more, together with nutritionally adequate, safe, age appropriate, responsive complementary feeding starting at six months..."

[2goingon2]

I switched pediatrician's too because of ignorance on breastfeeding. I would have wanted to say that when he gets IBCLC behind his name then we could discuss breastfeeding. Or, when he starts to lactate and feed then we could talk. Or, when the so-called medical journals update their antiquidated information, we could talk. So glad you switched pediatricians.

[Plaid Leopard]

more...

"According to the Lancet, optimal breastfeeding in the first two years of life, and particularly exclusive breastfeeding for the first six months, can have the single largest impact on child survival of all preventive interventions, with the potential to prevent 12 to 15 per cent of all under five deaths in the developing world."

[Plaid Leopard]

101 reasons to breastfeed

[pbjmama]

I would keep it short - AAP and WHO say xyz, include source. You were not only incorrect you were rude and I will not longer be supporting your practice.

[momofadella]

Wow, Plaid Leopard - this information is great and very helpful! Thank you so much for taking the time to do that for me

[GoBecGo]

If i were you i would make it very clear in the letter that though it was his lack of correct information on breastfeeding which made you change, it's because it made you question his GENERAL knowledge on child health and that you are extremely concerned that a pediatrician giving out such incorrect advice on child nutrition might have other dangerous gaps in their knowledge and abilities. I would really stress that - terrible advice=TERRIBLE DOCTOR. It might make him realise that his arrogance makes him appear to be an idiot and he needs to be more careful to know his stuff next time.

[momofadella]

That was very well said, GoBecGo - I totally agree.

[Baby_Cakes]

Originally Posted by GoBecGo

If i were you i would make it very clear in the letter that though it was his lack of correct information on breastfeeding which made you change, it's because it made you question his GENERAL knowledge on child health and that you are extremely concerned that a pediatrician giving out such incorrect advice on child nutrition might have other dangerous gaps in their knowledge and abilities. I would really stress that - terrible advice=TERRIBLE DOCTOR. It might make him realise that his arrogance makes him appear to be an idiot and he needs to be more careful to know his stuff next time.

[elanorh]

And just to let you know that addressing this with him can make a difference -

I had a HORRIBLE appointment last year with my wonderful Ped. She's always been absolutely supportive of breastfeeding and is one of the most important reasons that I was able to keep nursing dd1 despite the severe allergies she had, my supply issues, etc. etc. So I was FLOORED when she lectured me about nursing dd2 (then two) to sleep, and told me to wake her up and brush her teeth after nursing!! I told her that didn't follow any of the medical advice or research out there, and she was really quite patronizing towards me while we talked about it (and she's usually very collaborative and respectful of parenting decisions etc.).

I printed out a bunch of information and research to bring to dd1's appointment which was a few weeks later. As soon as she came into the exam room, she started apologizing to me. She said that she had just assumed that breastmilk would work the same as formula or juice on night teeth, and she was wrong, and had researched it, and wasn't going to give out advice like that again. She apologized up and down for it and thanked me for challenging her on it, so that she had decided to research it herself. So I didn't need to bring the research with me, after all.

It doesn't sound like that's what your Ped was like; but sending a letter letting him know the medical research which contradicts him, and that you aren't comfortable with his medical skills and advice if he can get something this basic and this important SO wrong --- there's the potential that he may rethink it and read up a bit more on it. You never know!

ETA: I think Kellymom.com cites a research study that shows that antibodies actually increase during the toddler years, rather than diminishing. Check her site, she cites the sources so you'd be able to find the journal that research was published in, via her site, and could cite the article rather than her (which he'd probably disallow, since she's an IBCLC ).

[mambera]

Originally Posted by elanorh

ETA: I think Kellymom.com cites a research study that shows that antibodies actually increase during the toddler years, rather than diminishing. Check her site, she cites the sources so you'd be able to find the journal that research was published in, via her site, and could cite the article rather than her (which he'd probably disallow, since she's an IBCLC ).

I don't think anybody's arguing that the antibodies aren't there, but do they make it through the baby's gut at that late stage?

My understanding is that the tight junctions in the gut form after 4-6 months (making baby ready to eat solids). After that point, how is ingested IgA going to make it into the bloodstream? Wouldn't it just get digested like any other protein?

[blizzard_babe]

Originally Posted by Plaid Leopard

101 reasons to breastfeed

Nice succinct summmary!

Originally Posted by GoBecGo

If i were you i would make it very clear in the letter that though it was his lack of correct information on breastfeeding which made you change, it's because it made you question his GENERAL knowledge on child health and that you are extremely concerned that a pediatrician giving out such incorrect advice on child nutrition might have other dangerous gaps in their knowledge and abilities. I would really stress that - terrible advice=TERRIBLE DOCTOR. It might make him realise that his arrogance makes him appear to be an idiot and he needs to be more careful to know his stuff next time.

Yeah, this.

Originally Posted by elanorh

And just to let you know that addressing this with him can make a difference -

I had a HORRIBLE appointment last year with my wonderful Ped. She's always been absolutely supportive of breastfeeding and is one of the most important reasons that I was able to keep nursing dd1 despite the severe allergies she had, my supply issues, etc. etc. So I was FLOORED when she lectured me about nursing dd2 (then two) to sleep, and told me to wake her up and brush her teeth after nursing!! I told her that didn't follow any of the medical advice or research out there, and she was really quite patronizing towards me while we talked about it (and she's usually very collaborative and respectful of parenting decisions etc.).

I printed out a bunch of information and research to bring to dd1's appointment which was a few weeks later. As soon as she came into the exam room, she started apologizing to me. She said that she had just assumed that breastmilk would work the same as formula or juice on night teeth, and she was wrong, and had researched it, and wasn't going to give out advice like that again. She apologized up and down for it and thanked me for challenging her on it, so that she had decided to research it herself. So I didn't need to bring the research with me, after all.

You know, that's one of the most difficult human qualities to master... admitting you were wrong, especially when your error was pointed out by someone supposedly outside your area of expertise. I give major kudos to that doctor; I know it's hard for me to admit when I'm wrong!

[elanorh]

Originally Posted by mambera

I don't think anybody's arguing that the antibodies aren't there, but do they make it through the baby's gut at that late stage?

My understanding is that the tight junctions in the gut form after 4-6 months (making baby ready to eat solids). After that point, how is ingested IgA going to make it into the bloodstream? Wouldn't it just get digested like any other protein?

They must. Otherwise, why are there correlations pointed out in the AAFP policy about breastfeeding (that infants weaned prior to two years of age will be more likely to become sick), and why the WHO recommendations of breastmilk until the age of at least two?

We are able to absorb probiotics that we ingest ourselves and have those impact our immune systems .... why else would our milk increase in its antibody levels when our kids are toddlers, eating more of other foods, and exposed to more germs? Our bodies are elegant machines (most of the time )- why are we expending our maternal energy making those antibodies of our babies can't absorb and use them?

ETA: We absorb antibiotics which we take orally as children and adults, I would expect that the same component is in play when infants/toddlers have antibodies in their mothers' milk.

[sunfish21]

Originally Posted by pbjmama

I would keep it short - AAP and WHO say xyz, include source. You were not only incorrect you were rude and I will not longer be supporting your practice.

I think this is a great way to handle it!

[Island_Mama]

Ugh! If I lived in your area I would go into his office and let my LO run sircles around him! She can't be more a toddler than she is, outward and friendly, says hi to everyone, she's so active but mindful, she knows what she wants, but she has a lot of empathy. I love having my perfect little example to throw in people's faces when they put things down like breastfeeding, no interventions, vax overload, etc she is 32 months now and still nursing.
As for your doctor, I have no idea what you could tell him to make him understand.
You would know him best, find the weak spot to enter his conscious and go for it. Find information written and backed by pediatricians, maybe even find some very pro breastfeeding peds in the area that might be inclined to voice their opinions.
I wouldn't turn away from letting him know that you won't be recomending him to any of your BFing moms. a peds office is the last place you want to be challenged about BFing!
I once had a nurse ALMOST tell me not to nurse my daughter, she made some comment I forget exactly what, about being in the hallway or something, and I think I said something about HER ( a nurse) not actually going to tell me HERE ( a hospital) not to nurse my daughter, I think she thought better of it, ran off to talk to someone and they must to told her to keep her mouth shut. Shewasn't the only one who felt I was doing something wrong, I got looks from other hospital workers. IT was REALLY sureal to be getting weird looks at a hospital because I was nursing.
I had a toys R Us incident, it really sucks to be harrassed because you are nursing!

You did the right thing finding a new ped