Daycare, pediatrician and Extended Breastfeeding

[Cybercere]

So, DD is one tomorrow. I pump once a day at work (I only work part-time) and between that and the "stash" she's gotten very little formula since birth (maybe 4-5 ounces a week). She is moving to the "pre-toddler" room at daycare next week and I can no longer bring expressed breast milk. She has to switch to whole cow's milk per their policy. (No one can bring in any food or drink). It's organic for now, thank god. But I'm not sure what to do - will the cow's milk fill her up more? Do I still pump? I don't want to wean her until she's ready so dont' want my supply to drop. I'm a little sad about the whole thing. Her pediatrician wasn't super supportive when I asked for a note - I even brought up the WHO recommendations regarding BF'ing until age 2. He said that's only in countries with bad water, unpasteurized milk, etc. Anyway, advice appreciated.  She LOVES "nursey" and still nurses during the night 1-2x, usually once in the morning and within 10 mintues of anytime we're "reunited" after a separation of more than a couple of hours. Seems to me she's not ready to stop? But if I'm wrong, let me know. Thanks, all,

[spedteacher30]

i pumped until my son was 18 months and then stopped pumping at work. He nursed until he was 3 and a half, and still nursed during the day on vacation/weekends.

you might pump for a couple more months just to reassure yourself that your supply is still good, but there shouldn't be a reason that the cups of cows milk at daycare will stop her from nursing at home, and at her age, nursing really is about that moment's demand.

[CheriK]

Oh, I'm not impressed with either your pediatrician or your daycare.  The research is across-the-board showing that a "normal" length of breastfeeding is 2 years or longer.  Of course, the health concerns are greater in countries without good access to medical care and clean water, but does that mean we should give our children something inferior because we can band-aid any problems it might cause?  Most world-wide pediatric associations, including the Canadian Ped Assn, state that breastfeeding should continue for a minimum of 2 years, so it's not a 3rd world country issue!  And the CDC recently changed their recommendations to state that American pediatricians should use the WHO growth charts for children until 2 years of age - "The WHO standards establish growth of the breastfed infant as the norm for growth."

If switching to a more progressive daycare or a more supportive pediatrician isn't an option, then can she avoid bottles and milk at daycare?  She does not need cow's milk at all; as long as she continues to nurse when you're together she's getting plenty of your milk.  She could have other foods and drink water, especially since she's only there part-time. 

I continued pumping with my twins until they were just over 2.  I also work part-time, but caregiver is Daddy so he give what I tell him to give ;-)  By the time I stopped, they weren't drinking my milk when I was gone.  They would eat just about anything, and drink water when I was gone. I could have stopped earlier but it was too uncomfortable for me.  They both nursed for several years, so it didn't impact age of weaning.  With my current nursing, I stopped pumping sometime around 18 months or so.  I have a HUGE freezer stash of milk as I had oversupply, so she still gets my milk when she asks for it, usually only if she's tired and wants to go to sleep.  We did introduce cow's milk to all 3 children at around a year, but not as a drink, just dairy products and on cereal or cooked into foods.  None were particularly big cow's milk drinkers until much later.  The 2-year old probably drinks more than her siblings did, but simply because she wants to do what the big kids do.

[bandgeek]

Originally Posted by CheriK 

Oh, I'm not impressed with either your pediatrician or your daycare.  The research is across-the-board showing that a "normal" length of breastfeeding is 2 years or longer.  Of course, the health concerns are greater in countries without good access to medical care and clean water, but does that mean we should give our children something inferior because we can band-aid any problems it might cause?

I agree!  And I don't understand the daycare policy.  Lots of the babies at the daycare where I work are still nursing and getting pumped milk after a year.  The teachers just make sure they don't get their bottles/sippies mixed up (which is easier to do once they are older and try to "share" everything!).

Does the daycare insist it HAS to be cow's milk?  Like, you can't do soy milk or even just skip the milk and just do juice or water?  Lots of people can't or won't drink cow's milk for a variety of reasons.  Seems silly to demand the kids drink it when milk intolerance is so common and tends to get more and more common as the kids get older.
 

[blessedwithboys]

I think you should remind the daycare who is paying who to perform a service.

[akind1]

I pumped at work (I work FT, but only 2 days OH) until DS turned 1. The days I am in the office, DH takes care of DS, but he mostly doesn't get any mama milk while I am gone, just solids, OJ, and water. (before I stopped pumping, he got one bottle of milk - 4-5 oz - and solids)

As there are most likely other kids with milk issues at DC, I would see if they can give your LO water instead. When I worked at a DC we always had both milk or juice and water on the table.

FWIW - I have seen ZERO difference in supply since I stopped pumping. only difference is DS nurses more once I am home the days I am in the office - but he did that also before I stopped pumping . . . I think he just misses me.

[Cybercere]

Thanks all. We are military so pediatrician change not really an option and I usually really like him. It's also ironic to me that he grew up in India, slept with his parents til he was 7 and I'm sure breastfed for ever and didn't drink cow's milk. I'm battling pretty severe PPD so I really couldn't address it with him as I thought I would cry.  Daycare is also military and it's a grea facility except for this issue and it's EXTREMELY affordable (about 1/3 of the cost of the same daycares in our community).  I had thought about changing her to Montessori school in a few months but have decided not to for some financial reasons.

I'll talk to the daycare director and see if they can just do water. She's had some growth issues (3% weight but now up to 24% height) so ped. might yell about the lack of calories in water. I would love to bring her rice milk or something but not an option.

Thanks for the support.

[spedteacher30]

Originally Posted by Cybercere  I would love to bring her rice milk or something but not an option.

Why would you want to do rice milk? My son had to have rice milk (soy, milk and nut allergic) and that is the main reason I pumped as long as i did--rice milk is basically just flavored and fortified water. Organic cows milk has fat and protein in it that is good for her brain (not better than breastmilk, but better than rice milk!)

[PGTlatte]

At this point you may be able to stop pumping without it affecting your supply enough to impact your nursing relationship.

If you don't want her to have cow's milk, you can absolutely put your foot down on that.  Our son was in daycare and very allergic to cow's milk.  They had a licensing issue that did not allow anything sent unsealed from home in the toddler room.  With the director, we came up with two ways to resolve it without violating the regulations.   1. I could send containers (like bottles or sippys) from home but they could only be stored and consumed in the infant room per state regs; so he would have to go back in there for 15 minutes to drink it.  2.  I could bring them an unopened, sealed commercial container of a milk substitute.  Their staff could label it for him and open it and keep it in their general fridge to serve him from, in the toddler room.    First we tried option 1 but it was disruptive to have him go between rooms, so then we switched to option 2.  I just brought them an unopened container of soy milk.  If you are really opposed to cow's milk, discuss the regulations with them, have them spell the exact regulation out for you so they are not just throwing their own preferences into the discussion, and suggest these other ways to meet the letter of the recommendations, meet your child's needs, and not violate your own standards.

We choose to use soy milk with calcium equal to cow's milk.  It works for us.  If you do not want cow's milk or soy, there are a few other options.   There are brands of calcium-enriched oat, hemp, and almond milk, and I am not sure but there may also be some enriched coconut milk products now.   I personally would not give a child this age rice milk because it has no fat and almost no protein.  Our son did not mind at all the switch to soy milk during the day.  It also did not affect our nursing relationship - he nursed until he was 4.

[somelady]

Ooooh this sounds familiar.  I was happy to quit pumping so I didn't push it too much with my daycare, I just wanted to phase out slower, but anyway.... I know at my (military) daycare that there was a kid in my ds's room that was having organic milk brought in before they switched over, and I know there are kids that get soymilk (provided by daycare).  I don't know if you'll get anywhere without the ped's cooperation though, and sometimes even then you'll get arguments (my ped very happily wrote me a note to not give him juice and they still wouldn't cooperate).  

Oops, eta: And I did quit pumping around a year, and I just weaned him a little after he turned 2.
 

Originally Posted by Cybercere 

Thanks all. We are military so pediatrician change not really an option and I usually really like him. It's also ironic to me that he grew up in India, slept with his parents til he was 7 and I'm sure breastfed for ever and didn't drink cow's milk. I'm battling pretty severe PPD so I really couldn't address it with him as I thought I would cry.  Daycare is also military and it's a grea facility except for this issue and it's EXTREMELY affordable (about 1/3 of the cost of the same daycares in our community).  I had thought about changing her to Montessori school in a few months but have decided not to for some financial reasons.

I'll talk to the daycare director and see if they can just do water. She's had some growth issues (3% weight but now up to 24% height) so ped. might yell about the lack of calories in water. I would love to bring her rice milk or something but not an option.

Thanks for the support.

[Lamashtu]

Cybercere, I see that you are in the Annapolis area.  My father is the managing partner of a large pediatrics practice down there and I know that they accept Tricare.  His staff is very, very supportive of EBF.  If you're interested in contact information, please drop me a PM!

[transylvania_mom]

Personally, I would stop pumping. At that age, I think your dd will be ok with nursing before and after daycare, especially as you say you work part time. I wouldn't insist on her getting cow milk either, unless it's a drink she really likes.

I went back to work when ds was 18 mo old, then I had dd and I went back to work when she was one. I'm too lazy to pump. They got water or cow's milk in a cup when I was away (not because they needed it, but because they like cow's milk). Ds weaned at 4 y/o, dd is still nursing at 15 mo old. So it didn't impact our nursing relationship.

[evabea]

Both your doctor and daycare sound unsupportive... I grew up in a military family and remember the inflexibility and my mom made sure to send me off-base to avoid a crappy pre-school. Just wondering if you talked to the local montessori school about sliding scale for single-parents etc?

[PiggyPiggyOinkOink]

It may be that the state regulations are dictating what your daycare may allow. When I worked for Early Head Start we weren't allowed to let the children have bottles or formula/breastmilk past 12 years. We had to give them cow's milk (or soy, etc, based on doctor's notes). We still had many young toddlers who breastfed or had formula at home, and it was never an issue that they didn't have it at child care. Sometimes they'd be upset we couldn't give them a bottle but we worked through it. Don't be too hard on your daycare. They may only be doing what they are required to by law.

[NEastMomma]

OP, I'm sorry you didn't have much support from your ped/daycare.  I too am disappointed that the daycare has these regulations.  I'm sure you'd switch if you could, etc.

I agree w/ the PP who wondered if your supply would even go down at this point.  I think you might be safe.

FWIW, I teach part-time (18hrs/week) and stopped pumping at 9mos - my mom passed away, I was super stressed and wasn't getting much from pumping, tho DS got plenty when he'd nurse.  I started sending DS w/ formula, but continued to nurse at home (no formula at home).  He went off formula completely at 12mos.  I am STILL nursing DS at 17mos now.  Besides the very short time of stress right when my mom died, my milk supply has never been compromised.  *Caveat: DS co-slept and nursed all night long up until a month or so ago (when he suddenly started sleeping at night, on his own).  Perhaps that helped to keep my supply up?  I also am careful to give DS free-access to the breast.  He can nurse whenever he wants for as long as he wants, so my breasts keep making milk.

Fenugreek works wonders for keeping the supply up!

[Fairsailing188]

My DS is 12 months as of yesterday and I stopped pumping around 9 months due to pumping issues.  DS got a mix of expressed milk that I had stashed and Baby's Only Lactose-Free formula due to dairy intolerance until recently, when we switched him to a mix of formula and almond milk.  I would talk to your child care center director.  I've have a few issues where the care providers told me one thing and when I talked to the director I got a different story (care giver didn't want to do cloth diapers so she told me that DS was getting more rashes in them than disposables).  Anyway, I don't see why they wouldn't let you bring in the milk as long as it is clearly labeled with your child's name and it's already in serving containers.  I love DS' daycare except for their food.  They feed them processed carbs mostly, so we bring his food in every day.  I clearly label everything with his name and what is it (i.e. Cyrus Breakfast, Cyrus Snack, Cyrus Lunch) and they give it to him during the day and I take all containers home every day.  I would look up daycare laws in your state, but that one seems obsurd.  It's one thing to not bring food from home for other children (like birthday snacks) but for your own child?  Rediculous.

[Tattooed Hand]

I am sorry you are dealing with this. My DD also goes to daycare part time. It varies, anywhere from 4-6 hours a day. During that time, she just eats solids and drinks water (she is dairy intolerant and she refuses to drink expressed BM). And she's fine. She eats well there and when she gets home in the afternoons and evenings, she nurses like no body's business. So she's fine. I do pump on the long days, but that's because my freezer stash is low and it's only 2 days a week. I am not sure I would otherwise.