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Questionable things “experts” say #3: “Stop breastfeeding at night.”

Posted by on May 5, 2011 in Blog Posts | 13 comments

Now, we’re not talking a 4o year-old, we’re talking a four-month-old...

This latest anecdote comes from a mom of an “obese” exclusively breast-fed four-month-old. The child was experiencing “rapid” weight acceleration, which concerned the child’s doctor. Child’s Doctor gave stern warnings about obesity, diabetes, and said baby was gaining weight too fast. His answer? Stop breast-feeding at night.

The result? Loss of milk flow and having to switch to formula, a terribly upset mom, child and dad. This is not the first time I’ve heard this…

Here’s what other parents of “overweight” or even “normal weight” (50% but increased from 10%) exclusively breast-fed under 6 months-olds were told:

“Skip one breastfeeding a day,” or “Make your baby wait an extra half hour when she seems hungry which will mean one or two less feedings a day.”

Aside from the sheer misery for mom and baby of making a hungry baby wait, that advice is horrible, messes with milk supply, makes parents view infants as flawed, voracious, and needing intervention. It makes parents mistrust their own feeding instincts and the baby’s cues, and ironically restriction tends to make infants and children gain more weight (not less) and become more food-preoccupied.

Also, breast-fed babies tend to have different growth trajectories (there are specific growth charts, and it is felt that the standard chart might not be best for exclusively breast fed babies who tend to have more rapid early growth but slower by later infancy.) In any situation, the growth chart is the beginning, not the end of determining if a child is thriving in terms of growth, feeding practices, sleep, emotional, physical development…

Breastfeeding moms? Have you gotten wacky advice from a health care provider?

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  1. Jess

    My second is now four months old. With both kids, my pediatrician has said “If you want to keep nursing at night and it’s working for you, go for it. If you really want to sleep through the night, know that a baby can physiologically make it without eating in the middle of the night by six months of age.” My fourth month old is doing the sleep regression thing, wherein she’s waking up three or four times a night to nurse (up from two to three). My pediatrician told me today that if I wanted to try to cut down on feedings, it was going to be difficult as long as we’re sleeping in the same room. Basically, she left it up to me and advised me to do what works for us– putting her in her own room and cutting down on night feedings is fine, sleeping in the same room and continuing to night nurse is also fine. Baby will likely be ok either way and in any case we’ll be back in two months for another checkup to make sure all is well. This is why I adore my pediatrician– she is utterly non-ideological about issues that are opinion (rather than evidence) based.

    In any case, my daughter measured 50-%tile weight and 90-%tile height today and my pediatrician didn’t say a word about her weight– just that the baby is healthy and seems to be doing great. My ped told me I could start solids any time between four and six months and that the baby would let me know when she was ready by her responses to food (turning away and tongue thrusting, not ready; eyes lighting up and saying ‘mmm’, ready!). This makes sense to me since I planned to wait until six months with my older child, and he was literally grabbing the food off my plate at 5 months. Again, a common sense non-ideological response! Why can’t all peds be this way?

    • katja

      I love this! I am toying with the idea of making a “regisrty” of sorts for fd and HAES friendly pediatricians… What do you think? Sounds like yours is a great find!

  2. Regina T

    I’ve had two children. One I bottle fed (because I was 19 and my father forbade it in his house), and the other i nursed until she was 2. Both children did this ” magical” thing every now and then……they had growth spurts! When that happened, they ate more and slept more. Isn’t that “normal”?

    • katja

      yup, growth spurts… Often kids gain a little weight before height. Seems like we have no tolerance for supporting and trusting the process.

  3. The WellRounded Mama

    “I get sick at the idea that Doctors, etc, are telling parents that any *baby* has a ‘weight problem’ that needs to be adressed.”

    THIS. Oh, so much this. This just makes my eyeballs explode.

    I remember with my first I was worried about overfeeding her by nursing “too much” or “too often.” Not because of what my pediatrician was saying (she was great and very supportive) but because of remarks I was getting from others and from stuff I was reading early on in books. Fortunately over time I realized how stupid this was and let my baby regulate herself. She’s fine.

    To hear that some doctors are telling parents to omit night feedings (or any feedings) during the day in order to cut down their weight just makes me want to SCREAM. It messes with milk supply, it deprives baby of important immunological protections, and it sets up a potential starving baby/going to overeat as compensation pattern. How stupid can they be?

    Thanks for pointing examples like this out.

    • katja

      I too got all the “she doesn’t miss a feeding!” and “What are you feeding her?” comments. Not helpful. moms of lean babies also feel bad, they tell me, when they are constantly being told the baby is a “peanut” or so “tiny” or “does he eat?” All these comments about size fan the flames of worry and concern, and the implication from others that you must be doing something wrong bc the baby it “too fat” or “too skinny.” I make it a policy NEVER to comment on a baby’s size…

  4. Tanz

    I get sick at the idea that Doctors, etc, are telling parents that any *baby* has a ‘weight problem’ that needs to be adressed. My neighbour’s baby is 3 months younger than my twins and at the top of the scale for both height and weight. She’s in proportion, just large. My babies, however, are at the bottom of the scales – in proportion, but short and small. The same Doctor told me my babies were fine but told her she needed to feed her baby less! Again, perpetuating the idea that small is ideal no matter what. Grrr.

    • katja

      i get more than sick, I get furious. it’s malpractice to intervene unnecessarily, and with counterproductive advice. I hope you tell your friend to get a new doctor, or point her to this blog…

  5. Elizabeth

    I’m happy to report that I didn’t get any flack from my pediatrician at all for my huge breastfed baby. (One of the other pediatricians in the office that we saw for an ear infection did strongly urge me to start him on solids at 5 months. I started him soon after, but it was because he was grabbing for my food and trying to stuff it in his mouth, not because she told me to.) He was 38 inches tall and 36 pounds at his two-year checkup. We’ll find out “official” statistics at his three-year checkup in two weeks, but measuring at home, he is 40 inches and still 36 pounds.

    • katja

      sounds like he is growing steadily, larger than average. Uch, starting solids early to get breastfed babies to slim down. Don’t get me started. There was just a study out on this. Bad practice overall… My M was off the charts for years, and slowly but surely (as most will do if we don’t mess with them) is trending down. Who knows where she will end up…

  6. Ines

    Good post, Katja! The other issue with this topic is genetics, genetics, genetics, of course.

  7. Erica Schaub

    I’m breastfeeding my second son right now who is going to be 4 months old in two days. He has the pudgiest little legs and I couldn’t be happier. Statistically speaking, breastfed babies will be above the weight curve for months 2-6, and then slim down eventually where formula fed babies do the opposite. I’ll keep feeding my baby on demand any day, and hopefully he will follow in the steps of his healthy, active 3 yr old brother who eats a balanced diet, and was begging for cucumber slices yesterday.

    I’ve never gotten bad advice from my pediatrician, but I have a doctor I really trust with my childrens’ health (Dr. Andrew Rzepka at Park Nicollet), however he was always shocked when I would come in at appointments with my older son and I made it over a year breastfeeding. Apparently it’s pretty rare. Also, he did seem to “expect” that I would start solids before 6 months, and I have no intention of doing it yet.

    • katja

      Thanks and lucky you! There are AMAZING doctors out there, but alas, I hear far too many horror stories, or maybe not “horror” but where some bad advice can really screw things up! I do workshops with hundreds of moms a year, and I am always shocked by some of the advice they get…