Problem with doc and cow milk question

[MyBabysMomma]

Hello! I'm new to the mothering community and am looking for some good advice about a problem with my son's new doctor... any advice would be appreciated! I know its a long read!

At his 12 month appt the doc gave some suggestions to wean on to cows milk, but ended it saying that there was nothing wrong with just nursing instead and that I shouldnt feel that I NEED to wean him to cows milk. She said my breastmilk was "far superior" to any other animals' milk. So I gave weaning a half attempt and decided it wasn't for me! Then we moved...

We just went to my son's 15 month well baby appt with his new doc. She about chocked when I said he didnt drink any cows milk and told me that after six months of nursing my milk "no longer has nutrition". She said that he needs the fat and the Vitamin D from the whole milk and while I could get him the fat from other foods if I am really careful, but that I need to give him a supplement for the Vitamin D... =(

I dont know what to think or do! On one hand I KNOW that mothers' milk has nutrition past 6 months so do I trust her information on the vitamin supplement? My husband thinks we should switch doctors because I dont feel comfortable with her anymore (which I agree), but with our insurance we still have to go to the same clinic so all the docs will probably have the same view re:breastmilk.

My other problem is that he is still hard to reason with at meal and snack times. Some days he gets a wide variety of food and some days he will be really pickey and only want hummus, apple sauce and lentil beans or something. It's not like I could tell him, "no playing til you eat your dinner!'... I counted on providing him with a wide variety of healthy foods and my milk adding in what he doesnt eat... is that a bad assumption?

TIA. I'm so confused and heartbroken!

[PatioGardener]

Welcome to MDC!

I'm so glad that you are trusting your instincts. What a funny thing to say - after 6 months your milk has no nutrition? So at 5 months and 29 days it was perfect for baby, and then suddenly the next day, poof, all the protein, fats, stem cells, antibodies and other goodness just disappears? What sort of medical education did that doctor actually get? Can she provide you with evidence to back up that (ludicrous) claim?

No, no she can't, because it simply is not true. Your milk is GREAT nutrition for your toddler! Congratulations, and keep on nursing, Mama!

As for vitamin D, you will be providing enough from your milk if you have good levels of vitamin D. Sadly most Canadians (and anyone in North America living north of Boston, I think) have a really hard time getting enough vit D from the sun. I had my levels tested and they were really low, so I take a supplement, and  I started to give one to my baby once he was eating solids. We use these drops.

If you stay with that doctor, next time she asks about milk you may want to say that your DS gets whole milk (because you make whole milk!) If you are feeling empowered, you could always provide her with the AAP statement (you're in the USA?) There is another policy for family docs that is even stronger - pm me if you want the link!

Pediatricians and parents should be aware that exclusive breastfeeding is sufficient to support optimal growth and development for approximately the first 6 months of life and provides continuing protection against diarrhea and respiratory tract infection.^{30,34,128,178–184}Breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child.¹⁸⁵

and

Although economic, cultural, and political pressures often confound decisions about infant feeding, the AAP firmly adheres to the position that breastfeeding ensures the best possible health as well as the best developmental and psychosocial outcomes for the infant. Enthusiastic support and involvement of pediatriciansin the promotion and practice of breastfeeding is essential to the achievement of optimal infant and child health, growth, and development.

(bolding mine)

[motherhendoula]

Awww....dont be heartbroken....just remember that your ped is a doctor - NOT a nutritionist - and he is wrong wrong wrong about cows milk.  My son is 9 months old - and i will purposefully NOT feed him milk or dairy products until his 2nd birthday.  I am still b-feeding and YES, breast milk fulfills ALL nutritional needs in children up to about 12 months.  And YES it serves to 'fill in the holes' for a picky eater throughout toddlerhood.  Babies do need fat- and you should still try new things with your LO - he may prefer what your having for dinner - just mashed up.   Youll find a few favorites - but dont hesitate to try something new...if it doesnt work - just nurse him!

Your first ped was correct in saying that you DONT NEED to wean him to cows milk.    Cows milk has been a great convenience for our culture but it has never been a food necessity. 

  As for the Vitamin D - I have heard MUCH conflicting advice about it - i hope another momma chimes in with some info we can trust - at this point, my ped told me to give a Vit D supplement and i havent - but i do make sure we get out in the sun for 30 minutes a week.   If you do decide to supplement its usually just a little dropper full - it certainly wont interfere with b-feeding. 

Im sorry you had such a bad experience with this ped - but ultimately ....YOU make the decisions!!

[MyBabysMomma]

Thanks so much! I feel better already! I'm still not sure what I'll do re:his doctor, but just to be on the safe side I think I will look into the vitamin D supplements. Especially since the AAP link does recommend them... and I tend to cover my son up if he's going to be outside for any length of time.

Thanks again!!

[BananaBreadGirl]

Yep, your doctor is wrong. It's up to you whether you want to quietly leave that practice, leave with a letter of explanation, talk to him at next appointment, etc.

When my doctor said I "should" wean to cow's milk at 12 months because it had the "fat kids need to grow" I sent an informative letter to him, the patient advocate at the associated hospital, the other pediatricians at the clinic, the human resources manager at the clinic, and the CEO of the hospital. I got a call apologizing for the faulty advice I received and only got encouragement after that. Send me a message if you want a copy of what I sent.

Kellymom has great info, here is my favorite FAQ that I keep in my diaper bag: http://www.kellymom.com/bf/bfextended/ebf-benefits.html

Yes, look into the vitamin D. I skipped it because of the way my (breastfeeding ignorant doctor) phrased it: "your breastmilk is deficient in Vitamin D". It's not that breastmilk is deficient, but that most people are, regardless of what they eat. Even if you spend time outdoors, if you come in and take a shower or wash up with soap, you might be washing away or dissolving the vitamin D. Or if you use sunscreen, the vitamin D isn't getting to you.

[nstewart]

I agree with PPs!  Your doctor is not an expert on BFing (or obviously wouldn't have given that advice!)  They obviously don't learn much about BFing in medical school, or not enough anyway.  My Dr. made a comment at DS's 9 mos appointment about how I must have weaned because he had all 8 front teeth!   She also keeps on saying that I need to get him sleeping through the night (read: sleep training).  Because it is so hard to find family Dr.s where I live, I just grin, nod, and trust my instincts and the always helpful info I can get from sights like this, kellymom, etc.  BananaBreadGirl, I admire you for informing your doctor and am totally printing off the faq you linked to.

I actually think extended BFing is an amazing way to ensure that toddlers have their nutritional needs met.  Just this week, DS is teething and also has a sore tummy and doesn't want to eat solids.  I feel so good knowing that DS is getting the calories, nutrients and fluids that he needs from me when he doesn't have any interest in other foods and is only nursing because it is comforting!

[sunnygir1]

I agree, your ideas about offering a variety of foods and breast milk is a great nutrition plan for your toddler.  And cow's milk is not necessary (at any age if you ask me).

If you feel you need to change doctors, go ahead and do it, but I don't know if it is necessary simply based on the breastfeeding thing.  I mean, I take my kids to the doctor, find out how much they've grown, talk about things, listen to what he has to say, go home, do more research, and decide what I want to do.  He is one small link in the chain of health care I have in place for myself and my children.  I don't have to agree with him about everything, but he does help me with a lot of things.  I just have to remember that he's a doctor and is trained as such.  I can't, and don't, expect him to be well versed in the kind of health care I practice -- although it would be nice if he were!

[pinky]

And just FYI, your milk gets fattier as your child grows.  This makes sense, right--it's easier to meet the caloric needs of a growing baby.  The thing that decreases in your milk over time is actually protein, so the only legitimate concern that a physician might have is to make sure that your child is getting enough protein.

If I had a dollar for every crazy-a## thing a doctor said about breastfeeding, I'd be a rich woman!!

[sosurreal09]

Just wanted to add back in the day babies were EBF until 2 y/o and then started solids and continued BFing! Biologically speaking humans naturally wean somewhere between 2-6 y/o. With the way toddlers eat they NEED BM to fill in the gaps. I mean heck everyone else does pediasure to "fill the gaps" so they don't even think cows mil is good enough. Human milk for human children makes more sense than cows milk or pediasure!

Great job trusting yourself mama! Welcome to MDC!

[sunnygir1]

Originally Posted by sosurreal09 

Just wanted to add back in the day babies were EBF until 2 y/o and then started solids and continued BFing! Biologically speaking humans naturally wean somewhere between 2-6 y/o. With the way toddlers eat they NEED BM to fill in the gaps. I mean heck everyone else does pediasure to "fill the gaps" so they don't even think cows mil is good enough. Human milk for human children makes more sense than cows milk or pediasure!

Great job trusting yourself mama! Welcome to MDC!

ITA with your post, except for the bolded.  I've done quite a bit of reading, and I haven't seen reports or evidence of solids being withheld until two years of age.  Based on how babies act today, I find it really hard to believe that it was even possible -- the children would be taking the food and putting it in their mouths much earlier than 2yo.

[sosurreal09]

I saw it in a documentary on PBS I think maybe national geogarphic . They said they figured it out through bones and teeth from mummies. Now if I could only remember the name of it...I saw it few years ago before I ever was pregnant and I remember thinking it was "gross" lol now I am nursing my 20 m/o! I totally agree with you though that babies do act that way so IDK but I know I saw it and it was evidence bases using some technology that traced something about the teeth in particular. Well I can't remember the exact details so I suppose you don't have to take my word for it.

[sunnygir1]

Originally Posted by sosurreal09 

I saw it in a documentary on PBS I think maybe national geogarphic . They said they figured it out through bones and teeth from mummies. Now if I could only remember the name of it...I saw it few years ago before I ever was pregnant and I remember thinking it was "gross" lol now I am nursing my 20 m/o! I totally agree with you though that babies do act that way so IDK but I know I saw it and it was evidence bases using some technology that traced something about the teeth in particular. Well I can't remember the exact details so I suppose you don't have to take my word for it.

Cool, now I'm curious and I'll have to do some research.

[PatioGardener]

Originally Posted by sosurreal09 

I saw it in a documentary on PBS I think maybe national geogarphic . They said they figured it out through bones and teeth from mummies. Now if I could only remember the name of it...I saw it few years ago before I ever was pregnant and I remember thinking it was "gross" lol now I am nursing my 20 m/o! I totally agree with you though that babies do act that way so IDK but I know I saw it and it was evidence bases using some technology that traced something about the teeth in particular. Well I can't remember the exact details so I suppose you don't have to take my word for it.

I have vague memories about this too - I think the tests showed when kids started to eat more solids than milk, or something like that, which proved that they were still getting much of their caloric intake from breastmilk until age 2 or after. There's some neat info here: http://www.thebabybond.com/NaturalWeaningAgeFORWEBSITE.pdf

[Asiago]

Sorry I think I quoted your other post sosurreal09. (oops!) I read that the process by which weaning age was determined may be stable isotope analysis, using nitrogen and carbon.

(sosurreal09: " They said they figured it out through bones and teeth from mummies. Now if I could only remember the name of it.")
 

Edited by Asiago - 5/31/11 at 12:19pm

[sosurreal09]

I have no clue! lol

[MyBabysMomma]

Originally Posted by sunnygir1 

If you feel you need to change doctors, go ahead and do it, but I don't know if it is necessary simply based on the breastfeeding thing.  I mean, I take my kids to the doctor, find out how much they've grown, talk about things, listen to what he has to say, go home, do more research, and decide what I want to do.  He is one small link in the chain of health care I have in place for myself and my children.  I don't have to agree with him about everything, but he does help me with a lot of things.  I just have to remember that he's a doctor and is trained as such.  I can't, and don't, expect him to be well versed in the kind of health care I practice -- although it would be nice if he were!

I love the way you put this. Thanks!
 

[annan617]

My daughter is 2.5 years old and will not drink cows milk, I tried and tried and I tried, Goat, Soy, Almond, Rice and even Hemp milk and she wouldn't take any of it. She will not eat diary, cheese, yogurt, eggs, anything! I give her a multivitamin and she drinks calcium fortified orange juice and she loves her meat and her iron levels are normal. There are other cultures in the world who do not drink cows milk-like Chinese-they do not not drink cows milk but their race does not have a higher rate of bone disease then the western world, its just they get their nutrition from eating other things like lots of greens. For example did you you know there is more calcium in a cup of broccoli then in a cup of milk. You do what you feel comfortable with, if you don't want to wean then don't-human milk is for human babies, cows milk is for baby cows!

[sosurreal09]

After 2 kids don't need any milk regardless - unless of course you want to give it to them.

[mariacm]

Our ped (a nurse pract, actually) is a LC and totally supportive of extended BF.  But we did start giving DS cow's milk, in addition to nursing, at 12 mos.  I did this bc we planned to get preg sometime after he turned 1, and I have had issues with low BM supply, so I wanted to make sure he was used to milk in case I had to stop nursing.  Now I am 9 wks preg and DS is 18.5 mos old and he still nurses about 6 times a day for 8 min or so.  Cow's milk has NOT replaced BM at all for him.  He drinks a good amt of cow's milk, but he is very attached to nursing and gets more BM than cow's milk.

Our ped DID recommend giving him vitamin D drops since birth, she recommends it to all she said bc so many Americans are deficient.  So we give him Carlson's Baby D drops, when I remember.  LOL.  It's only 1 drop a day for the 400 IU dose.  I figure it can't hurt even if he got enough from me, but I bet I'm deficient since we don't get out enough in the sun, esp in the winter.  He's alos really light skinned so I don't let him stay uncovered for long for fear of sunburn.

[Shanny2032]

You have gotten some great advice on dealing or not dealing with the doctor issue and the vitamin D issue as well, but I wanted to address the part of your question on solids.  I read once that it takes 16 times for a child to be presented with a food, try it and decide if they like it (or not, we all have things we just don't care for).  So if you put things in front of him and he turns his nose or spits it out don't give up after just a few times.  In fact, true story - my sister has a pretty picky eater - not the worst I have ever seen but picky for sure.  When she was 3 my sister gave her raw carrot sticks every day for ages, maybe 3-4 weeks.  Every.  Single. Day.  At least one meal a day.  There was no bribery or attempts to get her to eat them, no discussion at all.  She would just put them on her plate with the rest of her meal.  Carrot sticks are now one of my nieces favorite foods.  Just keep offering a variety of healthy choices throughout the day and keep offering them whether they get eaten this time or not.  You mentioned that he is hard to reason with regarding meals but there shouldn't be any negotiations with a 15 month old (or any kid for that matter, IMO) concering food.  As long as he isn't holding out becasue he'll get less than desireable/nutritious food after refusing the healthy options (which from the foods you listed does not seem to be the case at all) then you just present more healthy options at the next meal.  And don't be afraid to get creative, offer him meals that the rest of the family is eating and include him in the process of obtaining and preparing foods - those are 3 sure fire ways to get kids interested in what is going in to them and it is never too early or late to start!