Doctor says I "need" to wean 20-month-old DD

[Linnaea]

I went to a new doctor today and she practically scorned me for *still* breastfeeding my 20-month-old   The fact that I said she only wants to nurse at night to help her sleep just made her scorn it more--saying that she's "using me as a pacifier".  I see where she's coming from and I would like to help wean her off, but I definitely want to go slowly and make it as tear-free as possible.  I'm going to read other threads on the topic since I see there are quite a few, but if anyone wants to include advice here I'd like to read it.  Also, if anyone else has heard something similar from their doctor and what they thought/felt about it, I'd like to know that, too.  She says there's basically no point since she's not getting anything nutritionally from it, which I'm not sure I completely agree with.  I know that the first year is most important but breast milk is so amazing that I doubt it's completely pointless.  I also didn't like her attitude, it was very condemning.  I'm sure she doesn't have many patients who breastfeed longer than a year so she probably was a bit wigged out by it, hence the judgment and tone.  I still don't get it, though, since the WHO recommends nursing for the first two years.  Whatever, I'm not doing anything drastic.

[pokeyAC]

I think you might need to look for a new doctor who's more in tune with your parenting choices.  You gave a lot of good reasons yourself.  WHO does recommend bf'ing until 2 years of age.  You milk does provide something nutritionally.  What I've heard is that toddlers get more immune factors in their milk which is good because they are interacting more with other people.  I'm sure there are lots of good reasons to continue.  You should stop when you want to, not when you feel pressured or shamed.

[ananas]

Your doctor sounds ignorant and condescending. I'm sorry :( The AAP's official recommendation is also as long as baby and mother desire, too, I believe. And yes, the WHO definitely recommends at least two years. All over the world children wean at 2-5 years old, we're the odd ones out.

[RStelle]

I'm sorry you had to deal with that! That Doctor was just downright wrong, any way you look at it! It is really inexcusable how many health care professionals give out the wrong information about breastfeeding.  If you are up for it maybe consider reporting her--maybe someone other than me will have advice about the best way to go about doing that, check in the lactivism thread, because there are people who have had something similar happen to them and have reported it who posted there. It looked like most of them got a good response when they did, too. At the very least it might make you feel better, and she really shouldn't be giving out such misguided advice, and to do it in a condescending way, that is just not OK!    

[transylvania_mom]

Your doctor is an idiot. You can argue with an opinion, you can't argue with ignorance. Keep up the good work
 

[Lisa-Anne]

The content of your breastmilk changes as your baby/toddler ages to suit their needs so they are receiving a true benefit from nursing even if it isn't calorie based nutrition.  I am still nursing my 29 month old DD (Oh my God where has the time gone, I had to count out the months past 24 on my fingers and can't believe she's that old!) and she's never been on an antibiotic though she lives in a home with a plethora of germs from my 2 older children and 3 days a week in day care.  I never intended to nurse this long, it just happened and if you both are still enjoying it then by all means continue and find a doctor that is more in tune with your parenting style!

[erigeron]

I don't know about the immune benefits for toddlers, but even totally disregarding that, I don't see how milk could stop being beneficial for toddlers. Our bodies would stop making it if it didn't confer any advantages for our children. It just doesn't make logical sense to say that nutritionally they need to drink cow's milk and then turn around and say they shouldn't drink the milk of their own species. How can milk from their own mother be WORSE for a baby than milk from a mother COW?

At I think our 12 month checkup, our doc asked about whether baby was still nursing and about what we were giving her in the way of cow's milk; the answer was that she still nursed all the time and we hadn't done or planned to do much dairy, and the doc looked a little bemused and said "Well, I guess you qualify as dairy..." 

In regards to "using as pacifier", that language seems so condemning. What's wrong with a small child wanting comfort from Mom? If you're happy and your daughter is happy, who cares what anyone else thinks. 

[CountryMommy]

My 32 month old is still nursing. Like a previous poster, I never really intended on nursing this long but I'm glad I am. I know it's not the norm in this culture which is sad but it is really sad when a doctor can tell someone there are no benefits to breast feeding a toddler.

[Linnaea]

Thanks everyone for sharing their stories and perspectives.  The more I think about this doctor, the more I feel disgusted and pissed off.  She obviously doesn't understand the benefits of extended breastfeeding and is too thick-headed to listen.  I started to explain but she immediately brushed me off--I guess she views her opinion as the only valid one.  I don't think it would be terribly detrimental if my daughter weaned in the near future, but I'd also like to take it at our own pace, not some arbitrary pace set by a controlling, judgmental doctor.  She seemed more concerned about my sleep, assuming I wake up a lot to nurse her (which I don't).  I told her she doesn't wake up much and she also sleeps right next to me, so I just go back to sleep with her.  She didn't get it.  I really wish it wasn't so difficult to find AP-friendly doctors.  I didn't feel a strong need to go to her, it was my DP's insistence to go because I hadn't been to one in a long time.  Now I dislike doctors even more than I did before.  I'm sure there are good ones out there, but they seem like needles in a haystack.

[flyrabbitfly]

Immune benefits: your breastmilk is full of IgA- which sticks all over bacteria, making it much much easier for your child's body to expel the bad guys and avoid infection. Your child's immune system is not fully developed until around age 5, which is probably why the world average for weaning is around 4 (if you didn't count western countries it would be even higher).

Emotional benefits: if your toddler is "using you as a pacifier" that is exactly what she is doing. She is gaining some emotional peace by nursing. Why a doctor should have a problem with that is pretty baffling.

Breastmilk is also considered, like some medications, to have a "dose-rate response". Meaning the more she gets, the greater the benefits. Aside from immune benefits, this includes higher IQ. You are also more protected from breast cancer the longer your breasts are doing the work they were designed to do.

Your doctor's medical education unfortunately included very little information about breastfeeding. She probably doesn't even have children of her own, and may indeed discover what a lot of crap she has been telling parents for years when she does. I had totally different, and very uninformed opinions about many parenting issues before I had children, and I felt pretty strongly that I was right about them. Unfortunately, the same is true for pediatricians. They aren't actually trained as parenting experts. You are there for their medical advice, not parenting advice. Why they get so confused about this is something I don't understand...but I think many Americans expect that they ARE parenting experts and ask constantly for their advice on the subject, so they themselves get confused over their own qualifications.

I have found when forced to see that type of pediatrician, that if I am pretty clear that I am the parenting expert when it comes to my son, they leave that area alone entirely, and are actually pretty happy to confine themselves to the areas of their actual expertise.

This site has an email list helping parents find attachment-parenting friendly physicians: http://www.attachmentparenting.org/faq/html/preparefaq.php.  Or you could get a new doctor recommended by some La Leche League moms in your area.

Good Luck!

[MichelleZB]

I don't get it when people say nursing past a certain time has "no" nutritional benefit. I mean, it must have some. Breastmilk at least has calories and protein and fat and all those things, right? I mean, it's food. What's wrong with eating food?

Just ignore your doctor.

[crunchy_mommy]

Originally Posted by MichelleZB 

I don't get it when people say nursing past a certain time has "no" nutritional benefit. I mean, it must have some. Breastmilk at least has calories and protein and fat and all those things, right? I mean, it's food. What's wrong with eating food?

Yes, this.

My DS didn't really eat solids until 2 years. Once in a while he'd have a bite or two of solid food, but very very little, he was about 95% breastfed. If breastfeeding past a year has no nutritional benefit, how did my DS survive to age 2 without other food/drinks??? He would have withered away to nothing without breastmilk. The argument makes no sense whatsoever. Nurse as long as you want to, she obviously has no clue what she's talking about.

[loveandgarbage]

This reminds me of when a doctor told me I was putting my 9 month old at risk for type 2 diabetes because he still nursed on demand. It seems that so many doctors will shut their brains off after medical school.

[Asiago]

Breastmilk composition is just as nutritious during the second and third year.

http://www.ncbi.nlm.nih.gov/m/pubmed/261532/

Pediatrcians should be reported to their licensing board each time they dispense incorrect information on the subject of breastfeeding. They would be held responsible for their lack of education and either do something about it or cease giving their personal opinions under the guise of medical advice. Peds just are not educated to counsel on breast feeding and AAP acknowledges this. AAP encourages them to seek education through lactation counselors and Le Le League leaders. The unprofessional advice that can be doled out can endanger the health of patients. Your ped, just like most of us, has access to the studies on breast milk composition beyond first year, fat, protein, carb, antibodies, lysozyme, lactoferrin,etc. it's all there and and as plentiful as early infancy. To discourage breast feeding increases morbidity and mortality rates. Children who are breastfed two years and beyond have better survival rates facing diarrheal disease...not to mention respiratory disease.
Some educational material for your ped:
http://www.biomedcentral.com/content/pdf/1471-2458-11-S3-S15.pdf

breastmilk is also an important source of energy and nutrients in children 6 to 23 months of age. It can provide one half or more of a child's energy needs between 6 and 12 months of age, and one third of energy needs between 12 and 24 months. Breast milk is also a critical source of energy and nutrients during illness and reduces mortality among children who are malnourished.

http://www.who.int/mediacentre/factsheets/fs342/en/index.html
Edited by Asiago - 11/13/12 at 6:11pm

[flyrabbitfly]

Hi again OP- a friend of mine posted this image today on facebook- might be a great one to share with your pediatrician:)

[Floretta]

Even if the "no nutritional value" were true, how does this equate "must wean"? I just don't get it. I am my child's pacifier, whether they nurse or not. I cuddle and hold my children when they are tired, upset or when we both feel like it. Some parents bed time rituals involve massage, some involve tickling, some invlove nursing. Why is it anybody's business?

[Asiago]

Originally Posted by Floretta 

Even if the "no nutritional value" were true, how does this equate "must wean"? I just don't get it. I am my child's pacifier, whether they nurse or not. I cuddle and hold my children when they are tired, upset or when we both feel like it. Some parents bed time rituals involve massage, some involve tickling, some invlove nursing. Why is it anybody's business?

Agreed

Non-nutritive sucking is so important and natural..................for years.