Rue-ing the Goat

Thoughts On Exclusive Breastfeeding From A Dr. Mom

There was never any question that I was going to try to breastfeed my baby. As a pediatrician I wanted all the health benefits. As a sufferer of the economic crisis I wanted the cost savings. As a Mommy I wanted to hold my little warm sweet smelling baby and know I was doing something special. Plus formula smells gross, stains clothes, and makes baby poo look and smell like poo.

When he was just born and failing to gain weight, I was obsessed with not having to give him formula, and I never did. That was despite telling numerous patients and friends that formula was not the end of the world, said nothing about their parenting, and all the accurate blah, blah that makes no impact on an estrogen crazed new mom.

With the benefit of slightly more rational hindsight, I know it would not have been the end of any one's world if I had given some formula. That did not, however, keep me from going insane and spending an entire night sobbing when I started fellowship, my supply plummeted, and I thought I was going to have to give him formula before my arbitrary and self-imposed goal of 6 months.

There I was, a newly minted fellow, busy, nervous, trying to balance home and family with education and the needs of families whose kids have cancer, for goodness sake. So I didn't have enough milk, we went through my frozen supply, and shortly after the short one turned five months old, we decided we had to offer him some formula. My ego and sensitive sense of smell aside, I really just wanted him to be nourished. My son with the highly refined palate who finds sunglasses, carpet, and restaurant tables to be de-licious, basically refused to take formula. He'd be clearly hungry but would prefer to chew on the nipple, spit out the formula and grin. With persistence on the part of the feeder he progressed to disgusted facial expression and finally pitiful mewling. One of his daycare providers said she just felt bad because she wouldn't want to be forced to eat something she doesn't like.

After a month of struggling and never getting more than 2 or 3 ounces into him, we have finally decided that this is OK. He is growing along his own curve. While he is a little guy, he is not genetically programmed to be big and he is gaining weight, height, and head size. Plus he's smart and happy, and gives no indication that he'd like to eat more than he does. He eats what I pump plus some cereal and a few veggies. He supplements this with a hearty daily intake of plastic turtle chew toy, crib rail, and human fingers (hopefully fairly clean). At daycare they still lament that he does not eat enough but his pediatrician and his doctor mom agree that as long as he is doing well, it is not worth the struggle. We have thus decided that if he is hungry and there is no leche de madre we will offer formula and if he is not hungry enough ti take it, so be it.

And so, little man, you have won. Your will is stronger than that of the grow-ups in your life. Mommy will continue take the fenugreek/goat's rue concoction that tastes far worse than formula (and yes, I have sampled) but that also does increase supply. She will also continue to feed you at 1am even though most babies can sleep through the night by now because mommy and your pediatrician agree you need the nutrition and mommy needs the help keeping up the supply. We will watch your weight and decide what to do if you start to fall below your curve.

You will eat only what pleases you. (And though it has now pleased you for 2 days in a row to take a small bottle for formula, we will not discuss that out loud in case it is a fluke.)

The trouble I am having is this. Since we have been having this struggle, I have heard countless stories from other moms whose exclusively breastfed babies refused formula when the milk dried up. What, if anything, do we do about this? Again, as a pediatrician and a mom I know that breastfeeding as much as you can is best for mom and baby. I also know that giving formula early on can decrease mom's supply leading to more formula and less breastfeeding. But what about this? What about the inevitable fact that a working mom's supply will drop and this woman who has been martyring herself with pump and herb will come head to head with the inflexible will of a five or six month old? What about the fact that early baby foods provide basically no protein and the only source for that is milk or formula? Are we doing the wrong thing for our babies by trying to do the right thing?

Input is welcome.

Roses and Thorns . . . It's been a while

Thorns:

- There is water leaking from the bathroom into the dining room. We think it's the toilet so we are going to the basement to relieve ourselves. This is the second time since we moved in here that going to the bathroom in the middle of the night has required shoes. This time it also requires disabling the burglar alarm.

- We continue to catch mice in the trap in the living room - I think we're up to 5. Plus 2 or 3 in the kitchen and 2 in the laundry room. All this after the wildlife expert/exterminator assured me, in a friendly but vaguely patronizing way that mice don't hang out in houses during the summer. They like it better outside. I guess we are breeding domesticated mice.

-The driver's side window on my car is stuck open again - 4th time since I got the car, 2nd time in 6 months. I don't think I make extraordinary demands of the window - just that it roll up and down roughly twice a day.

- This is week two after the Great Dishwasher Explosion of 2009 and we are still without a dishwasher. Why are white kitchen appliances special order??????

- Due to the day care plague that nearly killed Dave and I, we missed floppy hat night at PNC Park - a game the Pirates actually won, and a mighty cool hat.

Roses:

- We are contributing to the education of American youth by putting our plumber's son through college.

- We are no longer finding mouse poop on the kitchen counters in the morning.

- My car's mutinous actions have not resulted in any more near death experiences, just inconvenience

- I have managed to hand wash our newly sharpened knives without slicing off any appendages.

- We have recovered from the day care plague and I finally have my voice back (after a week of squeaking and being referred to as Dr. Froggy by the hospital page operators).

- Nathan is 6 months old and per his pediatrician doing all the growing and learning he is supposed to for his age. We think he is doing a teensy bit more - learning, that is, not growing.

Heard at My House Today

"Please don't smear the carrots with the hand Mommy just washed"

"Oh my goodness, you have carrots in your eyelashes!"

"Your hair smells like sweet potatoes . . . but you ate those yesterday"

Mommy: "Yum, yum, yum, yum, yum"
Nathan: slurping, sucking, smiling

All in all, starting solids is a lot of fun.

Not Just Another Proud Parent

I'm pretty sure my 6 month old isn't actually supposed to do this. He's not supposed to cruise either but he's starting to do a little of that, too.
Yep, he's motor advanced.
He rolled over at 3 months and I actually looked askance. After all, the pediatrician in me knew that early rolling could be a red flag for neurological problems. But he seemed to be otherwise normal, so I just shrugged and smiled. He sat at 5 months. Not super early but surely not late. And now this. According to "What to expect . . .", by the end of this month, he "should be able to bear some weight on legs when held upright". Some weight. By the end of this month.
He can't read yet, so he doesn't know he's exceeding expectations, but he looks mighty proud of himself when he manages to creep from monkey to frog on his rain-forest-play-house-of-wonder. We're proud of him too.
Neither I nor Dave is sure of the source of his skills, but we have a few theories.
1. He has superpowers.
2. The freeze thaw process selects zygotes that have superior physical strength.
3. (And probably most likely) We have always challenged him. He had all the tummy time he could handle early on. We plop him on the floor with a toy just out of reach and let him work for it. We put him in the Bumbo chair when he was 2 months old and the Jumperoo when he was 3 months. We have airplaned him and held him sitting and standing as much as he seemed to be enjoying it. We always smile and laugh and clap and encourage and let him know we're proud of him, he's perfect, and it's all for fun.

He is a source of awe and joy to me every day. Every thing he learns to do, from smiling, to cooing, to raking the proverbial raisin, looks like a miracle. He seems so big and grown up and then, at the end of the day, he curls up on my chest and sings himself to sleep, and I am reminded that no matter how soon he learns to walk away, he'll always be my baby.