How many of us with breastfed babies have gone to a wellness visit to find out our little ones are really low on their growth charts? From how many moms I’ve heard talk about this, I’m guessing there is a good show of hands! And for first time moms, or first time breastfeeding moms, or- heck- even us experienced mom, it can be startling to have a pediatrician look at your baby and think they are underfed! Rest assure, though, if your breastfed baby is low on the growth chart– there could be a good reason for it. Your doctor may be using the wrong chart!
There are two charts widely used in the US. The CDC’s growth chart is the more widely used chart and reflects mostly formula fed babies. Then there is the WHO growth chart that uses Exclusively breastfed babies. It may not seem like it would be a big deal which chart a pediatrician uses but breastfed and formula fed babies grow and thrive differently. Formula fed babies grow more rapidly and growth doesn’t slow down as drastically for them after 6 months of age, while the breastfed baby has slow steady weight gain that decreases even more as they get more mobile. So, when using the CDC chart on a breastfed baby, it’s quite easy for the baby to look like they are having insufficient growth or irregular growth patterns.
The problem with breastfed babies falling on the growth charts is that the moms will often get pressured to use formula very early on. Milk Supply goes into question and pediatricians, who are often lacking in sufficient breastfeeding knowledge, give misguided advice to the mom, like pumping to see how much milk she has or giving formula after each nursing session. Or the pediatrician may quickly recommend a visit to an endocrinologist, where baby will have to undergo intrusive testing, when it may not even be necessary. Even my own pediatrician was giving out booby-trap information and saying that babies urine output had nothing to do with if they got enough milk (which is incorrect)
Many pediatricians also do not take size of the parents and their family genetics into account. I have known mothers who barely skim 5 feet tall and are married to 5 foot 6 inch tall men that are concerned because their doctor said their breastfed baby is only at the 5% line. Typically, tiny couples do not have enormous babies. Many families have told me that their doctors didn’t even take the size of the parents or their families into account when decided that their baby was suffering.
While doctors are being urged to switch to the WHO chart, since breast milk has been universally agreed upon to be the healthier option and should be the standard for infant diet, many doctors have not yet gotten on board since the AAP has not made any updated guidelines specifying chart use. Some pediatricians have begun tracking BMI, which seems to be a balanced way of measuring all babies, whether breastfed or formula fed but it has continued to give parents stress about their child being in a healthy range for their age, since a toddler at 50% for weight and 10% at height will now fall under obese.
Try not to stress too much. Ask your pediatrician what chart he/she is using and what other factors he is taking into consideration before getting worried about baby size. And If you breastfed infants health is in question- please, Go to a Lactation Consultant! IBCLC’s are 10x more trained to deal with and help you with breastfeeding issues, including evaluating your milk supply, over the pediatrician. Good Luck mama!
Part 2 of the “Your Kids are Worth it” series.
I know breastfeeding is hard. It can be really uncomfortable. It can be awkward when around others. It can take a lot of getting used to, physically, mentally and emotionally. It can cause clogged ducts and mastitis. It can cause family members and friends to start problems with you. It can cause strangers in the mall to give you attitude, even. And, most of all, for a tiny 2% of us (but a REAL 2%) it can be impossible. There is sacrifice involved to breastfeed our babies.
If you can overcome and fight through the awkwardness and learning to latch right and learning to trust your body to make enough and get through those hardships, your child is worth it. And there are people around who can help you and support you and WANT to help and support you while you battle through the hardships of figuring out breastfeeding.
Why is breastfeeding worth it? It’s natural. That may not mean a ton but lets put it this way- it is babies perfect food. Your breast milk is perfectly balanced for your baby. It even changes for your baby as their needs change. Breast milk gives your baby all of the vitamins and nutrients they need, even if your diet is far from perfect. Your breast milk also changes in fats as your baby gets bigger and needs more fatty milk. When there are germs around, your breast milk is a constant source of antibodies going right to your baby to protect them from illness. Also, it is full of hormones that induce thyroid growth and get the babies body up and functioning the way it is meant to. While breast milk is not the only solution for your baby to meet their dietary needs, it is by far the best and most nutritionally dense option. Click Here for ingredients in breast milk
Not only does this mega source of nutrient dense food give baby a better start, it also effects long term health. This does not mean formula fed people are all unhealthy and malnourished for the rest of their lives. I understand that many of us were formula fed and are doing quite well now. It means, we could be doing even better than well, had we been fed differently. Babies who are breastfed show to have lower rates of high blood pressure, cholesterol, obesity and type 2 diabetes.
A concern for many parents is work. Most moms today need to work and breastfeeding and working full time can be really difficult to swing. Pumping isn’t fun but with the breast pumps we now have access to today, it is quick and possible to pump at work. Plus, state laws are written in your favor to make sure you have the time and space you need to pump milk while you are at work. If buying a pump is too costly, most hospitals and IBCLC’s have hospital grade pump rentals available.
For moms who cannot breastfeed, this can be a huge heartache of a subject. My heart goes out to you if you are one of them. Please know, though, that your options are not limited to strictly formula. There are milk exchange programs. I know the thought of handling some else (especially a strangers) breastmilk can be uncomfortable and safety is even a concern for some. Most moms who breastfeed and take the time to pump and donate to those in need, typically aren’t the type who are also participating in drugs or dangerous activities that negatively effect breastmilk. Rest assure, though, you can interview and find out info about your donor. Also, some organizations will screen their donors as well. If you are in need of donor breast milk here are some places you can begin your search. milkshare , Eats on Feets , Human Milk 4 Human Babies. Also, you can contact you local Le Leche League group. Many moms pump and have extra that they would be more than happy to donate and an LLL group is a fantastic way to find those moms who are local to you. Even if you can’t get enough milk from donation to meet 100% of babies milk needs, it will benefit them to have part of their diet from breastmilk. For a mom who is struggling with supply and needs to use another source, whether it’s another mothers milk or formula, but still wants the bonding and closeness that comes with breastfeeding or is still trying to induce lactation or a higher milk supply in herself, there is also the option of using an SNS, which allows the mother to feed baby at the breast still.
So, while breastfeeding is not always easy, it is often possible. There are lots of places to go for help with breastfeeding. You can even just start asking questions on twitter to amazing, knowledgeable people like Desirre Andrews (CLE) and Nancy Holtzman (RN IBCLC). Or you can go to Kellymom where there is tons of reliable, evidence based breastfeeding information. For concerns, questions, fears, or just needing encouragement to breastfeed, there are also amazing organizations like Best for Babes, where they always speak the truth in love, are gentle and completely understand your hesitations about whether breastfeeding is something you want to do. If you need hands on support or you just want to go see what breastfeeding is really like, you can attend a Le Leche League meeting. You do not have to have a baby already to go. They will welcome you with open arms even if you are just going to learn more before you make a decision. You can also call your hospital or do a google search to find IBCLC’s in your area who can work with you on any breastfeeding concerns or issues you are experiencing.
Breastfeeding is not always easy but with proper help and support, it does get easier. And these babies, who we conceived, grew in our wombs, birthed and now love so much- they are worth all that work and all that sacrifice. Their short term and long term health are worth trying. Whether that means trying to put stereotypes and awkward cultural ideas about our breasts aside so we can see our bodies and their relationship with our infants differently or means trying to overcome latching problems or unsupportive family and friends- these babies are worth it. And if you can’t, have peace in knowing you tried and did what you could. This post is not one of judgement but one of love, strength and encouragement.