> Mom is tandem nursing a 2 yr old and a 4 yr old - Dr told her that she
> needed to wean them so that they would have "normal" hemaglobin tests.

 Jay,

My first response is not printable.  Therefore I will not print it.

It is nice that this doc is concerned for her children's health.  If these
children were nursing to the exclusion of other foods,  there might be a
concern that the diet was not balanced.

We do occasionally see this in kids who drink cows milk - kids can get a
very low hemaglobin/hematocrit if 80% of their intake is milk.

The reason the doc wants a blood draw vs. finger stick could be termed
"accuracy of testing,  or less politely -hedging one's bet"  A central h&h
will be a lower number than the finger stick variety.

Now - first, if the doc has a concern from physical exam for example a
murmur or pale conjunctiva and feels that too much of the diet is milk,
then an adjustment in amount of nursing time may be advisable.

Repeat - an ADJUSTMENT in nursing time NOT WEANING

I think that it would be good to be honest with your Ped or find a Ped you
can be honest with.  Having been in the finger stick vs blood draw position
as a mom [because of insurance]  knowing what I do now - I would gladly pay
for a finger stick out of pocket.  The hemoglobin is the issue...  you
don't need a CBC [complete blood count] unless you have a good reason from
history or physical exam... and breastfeeding is NOT one of those  good
reasons.

Enough said. I don't think my blood pressure has been quite this high in a
long time.

Gail
Gail Hertz, MD, IBCLC
Pediatric Resident
author of the little green breastfeeding book - disclaimer: owner of Pocket
Publications
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