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.