Today, while working in an urgent care setting, I met a mother of a six
month old child who told me that she had weaned her son b/c he had been
diagnosed with "severe attachment disorder" and the "child development
specialists" (whoever they are, I'm not sure whom she was consulting with)
told her she needed to wean him right away.
I had no access to the child's medical records (it was actually a sibling
being seen for an appt that day) so I don't have much information to form
my own opinion of the situation, but I was puzzled and a bit alarmed. It
sounds like the mother and infant had struggled with some early
breastfeeding problems including frequent thrush and mastitis and that the
infant was a frequent nurser and night-time waker. Mom said that the
infant was "very attached" to her and "always wanted to be held and fed by
mom". He was not happy being held or fed by other family members, such
that they were upset that they could not take care of him b/c he would
cry. He also cried "constantly" when left at daycare and the mother said
that daycare providers didn't want to provide care for him. He just wanted
to be with his mother. Mother sounded like she had grown frustrated and
exhausted as well and felt that the situation had a negative impact on her
and her family.
So, she sought help from someone (again, I am not sure what sort of
professional she consulted with) who diagnosed this "severe attachment
disorder" and told her she must immediately wean. They also taught
her "sleep methods" to get him to sleep and now he was sleeping through the
night. The mother actually seemed very pleased with how her son was
behaving (sleeping through the night and happy to take bottles from other
people and be held by them), but she voiced regret that she missed nursing
him and also noted that her older child had been healthiest while she
breastfed and only after weaning had begun to have ear infections and other
illness.
I was a bit surprised by the diagnosis and the advice to wean, but
initially didn't say much, since this mother wasn't seeking medical advice
on this child. She must have noticed some concern in my reaction though,
b/c after the appt, she remained in the hallway and asked me what I thought
of her weaning the baby. I told her that it was difficult to respond
without having all of the information, but that I strongly advocate
breastfeeding and wondered if there might have been another way to deal
with her concerns without having to wean the child. She told me that she
wondered the same thing from time to time and had even considered trying to
nurse him again, since she was "still leaking milk".
I suggested that she contact the lactation consultant at our facility and
encouraged her that if she really wanted to breastfeed again, she could
very well succeed at it and there might be other ways to deal with some of
the "attachment" issues that she and her family were struggling with. I
hope she'll at least follow through to give a phone call and get some
advice.
So, anyway, I am sharing this story b/c I have never heard of anything like
this. I am a family practice physician and so, wanted to seek your
opinions and see if anyone else had encountered anything like this or had
any suggestions for how to deal with such a situation. This whole
encounter occurred in a very busy urgent care setting on a Saturday
afternoon where patients were often double-booked for 15 min time slots. I
can't help but feel that the problem could have benefitted from greater
time and consideration and expertise. I sure hope she calls the LC.
Catharine Decker, MD
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