Everyone knows breast milk is the optimal nutrition for infants. There’s a reason why the American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first six months of infancy and then continued breastfeeding for 12 months with complementary foods. But the truth is, medical schools don’t teach much about breastfeeding beyond the biological process and explaining the benefits. That means even well-intentioned pediatricians may be not well-educated in offering practical support for mothers who want to give their babies (and themselves) the proven health benefits of breastfeeding.
How can you know whether your pediatrician is knowledgeable enough to help you meet the AAP recommendations for infant feeding or your own breastfeeding personal goals? We’ve got you covered. We asked two nationally-recognized pediatricians who are also members of the Academy of Breastfeeding Medicine, a worldwide organization of breastfeeding supportive physicians, for important questions to ask and recommended answers to know if your doctor is truly breastfeeding-friendly.
1. Question: What education or training regarding breastfeeding have you had?
Answer: Not just medical school. Physicians should have received some sort of additional certification in lactation consulting, are members of the Academy of Breastfeeding Medicine and state that they follow ABM’s recommended office and practical protocols.
2. Question: What is your recommended age for weaning?
Answer: “The correct answer is, whenever a mother and child choose to wean,” says Laura N. Sinai MD MSCE FAAP, a pediatrician in private practice in Gaston County, North Carolina and the state’s breastfeeding coordinator for the American Academy of Pediatrics.
3. Question: When do you recommend starting solid foods?
Answer: Six months (4-6 months is also acceptable). “Complimentary foods should be introduced after 6 months of exclusive breastfeeding since breast milk is sufficient to meet all of a healthy full term baby’s needs until then (Note: All exclusively breastfeeding babies should receive a daily vitamin D supplement of 400 IU shortly after birth),” says Dr. Sahira Long, a board certified pediatrician and lactation consultant.
“There are special considerations for premature infants and those who have medical issues that preclude exclusive breastfeeding but these are the exception and not the rule,” adds Long, who is also president of the DC Breastfeeding Coalition.
4. Question: Which growth chart will you use to measure my baby’s weight development?
Answer: Both the AAP and the CDC (Centers for Disease Control) recommend using The World Health Organization’s (WHO) Growth Curve Standards for 0-24 months. (Note to parents: Many doctors use growth charts that are sponsored and developed by the infant formula companies and they make breastfed babies look underweight when they are not. Healthy breastfed infants tend to grow more rapidly than their formula-fed peers in the first 2-3 months of life and less rapidly from 3 to 12 months.)
5. Question: What do you do if a newborn loses too much weight?
Answer: This answer is very complicated, says Sinai who is also founder of the Gaston County Breastfeeding Coalition, but notes that the answer should never be to automatically suggest supplementing with formula. Instead, Sinai, says the range of considerations and possible actions should include: referral to IBCLC, assessment of entire picture with emphasis on gathering detail about whether the mother feels she has full breasts and is producing milk, whether the baby is jaundiced, excessively sleepy or satisfied after feedings and whether the infant is voiding normally versus with reduced frequency and if stools are still meconium (green) versus yellow and seedy and many other elements.
6. Question: What do you recommend about supplementation or using bottles and pacifiers?
Answer: “Bottles and pacifiers should be avoided until breastfeeding is well established which typically takes about 2-4 weeks,” says Dr. Long. “Supplementary feeds should only be used if medically necessary and the World Health Organization has a great list of acceptable medical reasons to supplement,” Long notes.
7. Question: Do you distribute gift bags or coupons from the infant formula companies?
Answer: No. Studies show that women who receive gift bags from physicians or hospitals do not meet their stated breastfeeding goals. When physicians and hospitals act as marketing distribution vehicles instead of as healthcare providers it undermines women’s efforts and sends a message of an implied endorsement of products that do not provide the best health benefits for babies.
8. Question: Who in your office can help with breastfeeding challenges?
Answer: Both doctors agree that while having a certified lactation consultant on staff is ideal, it is not always possible for every physician, particularly in small practices. However, the office should have a readily accessible referral available to a certified lactation consultant and local support groups.
Beyond these eight questions, Sinai recommends observing the doctor’s office for signs of infant formula “swag” from note pads and sign in clipboards to visible formula samples, posters and growth charts.
Visit the BlackDoctor.org Baby’s Health Center for more helpful articles and tips.
Kimberly Seals Allers is an award-winning journalist, author and a nationally recognized media commentator, consultant and advocate for breastfeeding and infant health. A former writer at FORTUNE and senior editor at Essence magazine, Kimberly is widely considered a leading voice in the counterculture movement in infant feeding. Follow her on Twitter @iamKSealsAllers.