Today a cousin, who is also a physician, called me. She is nursing her 11
month old daughter. this is her fourth child, and she has nursed twins, and
another daughter sucsessfully in the past (twins 15 yrs old).
The baby is mostly nursing, and not too interested in other food, and she
has gained almost no weight in the last 4 months, but is happy and
healthy.(Born 3,350, now 7,400). The mother is also very small.

 The mother contacted a friend of hers, head of pediatric gastroenterology
(GE) in a big university hospital. The baby was checked, celiac disease
ruled out, and the gastroenterologist diagnosed caloric deficiency. She
told the mother that she has to stop nursing immediately, because she is
harming the baby, and why is she nursing an 11 month old anyway. According
to her the baby isn't eating because she knows she'll get the breast
anyway, and she'll start eating only if she will be denied bf. There just
are babies who don't eat enough as long as they are nursing. The mother
should start giving formula, because then they'll know exactly what the
baby is getting, and breastmilk is probably too thin.(ARGHHH)

 The mom wants to continue bf, and tried to tell the gastroenterologist (a
woman, BTW) that the baby wasn't sick all winter thanks to bf, even though
the rest of the family were all sick - but the doc wasn't impressed at all.
The mom is harming the baby, and the baby has to be fed. My cousin was
almost persuaded - this doc is a very experienced GE, and she should know
what she's saying. She decided to call me (the bf expert...) for two
reasons - one - what do I think about this, and two - she hasn't nursed the
baby all day, has terrible engorgement, is binding her breasts, which hurt
terribly - and what can I suggest...

I got so angry at the GE. I tried to be very diplomatic, but it was real
hard. I tried to explain about breastmilk being the best food in the world,
absorbed most efficiently, and how lucky she is that the baby is at least
getting this, if she doesn't like eating. I told her that stopping bf will
do the baby no good. She should offer iron rich foods, finger foods etc. I
explained about gradual weaning - if that's what she wants to do. I think I
convinced the mom - she told me that she has removed the sheet binding her
breasts while talking to me.

What else would you suggest in such a situation?  How do you get a baby to
eat more than she wants to? What references do I recomend for the GE? I
feel this is a stupid question, because it is so obvious that breastmilk
has no substitute, and is the most nutricious food.

Sorry about the long post, but I had to vent. I thaught about all the poor
moms who get such poor advice. This is an experienced mom, a physician
herself, and she was almost convinced by the GE - what can other moms do?

Mira Leibovich, MD, IBCLC
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