About Breastfeeding and Hypocritical Doctors… And, Yes, I’m Finally A MommyBlogger
Pardon me while I interrupt my regularly scheduled programming as well as alienate 40% of this blog’s readership in order to talk about breastfeeding.
I don’t think I’ve mentioned this before, but I’m nursing my son. I also nursed N. until she was two. Yes, two years old.
Anyway. When I mention that I’ve nursed my children for this much time, I get a myriad of reactions. Most of them are generally positive. The bulk of reactions convey the idea that I’m a wonderful mother because I stuck with it for so long.
They’re only partially right, of course.
I am a wonderful mother. But, I suspect I would have been that way if I didn’t nurse my kids.
Nursing my children has been as much my privilege as it has been theirs, and while it has fostered attachement between me and my kids, it doesn’t necessarily have a bearing on whether I consider myself (or anyone else) as a good mom.
But, I’m digressing from the reason I’m writing this in the first place.
Recently, I have had a medical issue that requires the use of a medication that is questionable with regards to nursing. Specifically, without being too specific, prolonged use of this medication is not recommended when nursing an infant.
As a result, my primary care physician and my child’s pediatrician have recommended that I hold off taking the medication until I wean my child.
The thing is… my child is not an infant.
Infants, especially, breastfed ones consume an extraordinary amount of breast milk. My one year old, on the other hand, eats solids about four times a day and drinks 10-16 ounces of cow’s milk daily.
Furthermore, this medicine, as it has been prescribed to me, is “as needed.” I don’t have to take it every day.
So, there’s a gray area here. And what’s interesting to me is that the medical professionals who are charged with my care and my son’s care have decided to recommend that I stop feeding my son or not take the medicine, at all.
In other words, the situation has come down to choosing my health or my personal values regarding nursing.
I am furious that a choice is being forced on me that is wholly uncalled for and completely unnecessary. This choice is emanating from a reluctance to research a specific situation. And is it me, or does it feel kind of, I don’t know, lazy?
What is making me even more furious here is that I have the distinct feeling that the advice being given to me by these medical professionals, specifically my child’s pediatrician’s office, are relying more on the principle of covering their asses from potential lawsuits than supporting me as a nursing mom.
Which is fiiiine.
Except that there is so much value placed on nursing by the pediatric medical community that it makes them look like a bunch of hypocrites. You read all their stupid literature and it’s nursing this, nursing that… but you go into the office, and they don’t seem to care either way. If it’s not a big deal to nurse your kids, then they should stop publishing material that suggests that it is. A little consistency would be nice. I read one article the other day that suggested that premature weaning is deleterious to children.
Deleterious means bad, right?
So, you know, in order to be healthy I have to do something “deleterious” to my child. This is not right. They should not write stuff like that if they’re not going to commit to helping me avoid it.
It reminds me of something my friend Errin said to me a few weeks ago when we were talking about being stay at home moms. She said something to the effect of, “It’s nice how society creates these values and expectations about motherhood and then decides to beat mothers over the head with them by denying them support systems needed to meet those expectations.”
Be a nursing mom. Your kids will be better for it… breast is best… but, you know, if anything happens that requires us to do a little research, we don’t have time for that, so you’ll have to wean.
When I called Y.’s pediatrician’s office, I asked them about the medicine. They told me that this medicine was not recommended.
I’m a big believer in language, you know.
“Not recommended” is not the same thing as “absolutely not.”
Not recommended implies that there are specific situations in which it might be okay to take it. It implies that there are risks and benefits that need to be weighed against one another. It implies that there should be some sort of freaking discussion before a big, thick black line is drawn between choosing my health and choosing to nurture my child in the way I beleive is concurrent with my personal values as a mom.
And, trust me, as liability conscious as I know the medical profession is, they are extremely aware of the distinction.
And, yet, I can’t seem to get anyone at that office to elaborate on this distinction with even a remote sense of credibility.
“What do you mean not recommended? Why isn’t it recommended?”
“Well, because it might cause liver damage.” That’s an interesting response, especially since I researched this drug on the Internet for two hours last night and saw no mention of that as a potential side effect in children or adults.
And don’t diminish my Internet research skills, seven years of working on a Master’s thesis has, at least, afforded me the laser like skill of differentiating good resources from bad ones.
“Uh-huh… so how much of the medicine would I have to consume in order for that to happen?”
“Well, it doesn’t say that.” I assume here that she’s talking about a PDR.
“Also, my child isn’t an infant, you know, so doesn’t that make a difference? He’s only consuming about 6-8oz of my milk daily. How much of the medicine passes into that milk? Is the amount that passes into the milk even enough to make a difference?”
Silence.
“Hello?”
“Can you hold on?”
“Sure.”
“Hello, hi, I just ran into the doctor and she also said that the medication is not recommended. She suggested that you go back to your physician and ask for another drug and then we can tell you if that one is okay.”
::Excuse me while I point that this is a stupid idea. Why don’t YOU give me a list that I can give my doctor, since YOU’RE supposed to be the subject matter expert on children and MY doctor treats adults?::
“Okay, sure. And what if this is the only thing I can take?”
“Well, then we’ll have to address the possibility of weaning your son.”
Ah, thank you for beating me over the head with those societal values… I needed a good beating today.
I did more research after that phone call and found some great resources on medications and breastfeeding.
I learned from that research that taking this medication intermittently does not necessitate weaning my son. I also consulted a few physicians that I know personally that supported the research I’d come across. My conclusions, of course, are not based on forums or hearsay, but on articles and association publications that my son’s physician should absolutely be familiar with.
And, yet, obviously is not.
This is incredibly frustrating to me because what if there’s a mother who doesn’t have time to research this stuff or doesn’t know doctors personally?
It just doesn’t seem right, you know?
26 Responses to About Breastfeeding and Hypocritical Doctors… And, Yes, I’m Finally A MommyBlogger
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You’ve stated everything going on in this situation. There’s nothing left for me to say except: If I really needed to take the medication I would discuss with my baby co-creator the intention to do so and discuss if we dared to continue breastfeeding during that time. Like, if I take the medication one day would I then breastfeed for 24-48 hours after or not. I know it’s my body, but it’s our child and somehow I would worry about not consulting the father.
Does this make your blood boil or does this make sense to you?
It’s one thing for me to do something questionable for my health, it’s another for me to do it to my child, even if no healthcare provider chooses to be educated enough to articulate or cite examples of the possible risks.
@Poppy, I most definitely agree that my husband should be involved in the process. He’s been very supportive.
Ahhhh the joys of our overly litigeous and incredibly frightened society.
I know what I would do in this situation. But I’m not going to share that with you because what works for me may not work for you. Good luck making that (informed) decision though.
@Karen Sugarpants, Aww, come on, I’d love to know WW-KSP-D.
What I love is the huge double standards society has. People (myself included) put a lot of blame for the state of many of our country’s young people on their parents not being involved enough in their lives in meaningful ways. On the other hand, stay at home mommies are often treated as lazy, not wanting to work and not worth as much as their working female counterparts. I’m not even going to start on how ridiculous a six week postpartum period is!
At least your doctors are discussing the issue. While Cash was only about 7 months old, I stuck a toothpick into my foot. I didn’t step down onto it. It slid into my foot parallel to the bottom of my foot a good inch and a half. Luckily, it came out whole, but I had to have a tetanus shot and antibiotic. I told EVERYONE I came in contact with at the ER that I was a nursing mom and they still gave me an antibiotic that is contraindicated in nursing moms. What does that mean? It means my baby had the raging poops for two days after only one shot of that medicine! I should have taken him up to the ER every time he cried because his tummy hurt or his little behind filled his diaper with what smelled like radioactive toxic waste and made them put on protective gear and clean it up, but I have this thing against wasting resources and the ER is a good 10 or 15 miles away. The point is, what if that had been a medicine that would have damaged his liver?
Another thing that really irritates me is how everyone thinks that, just because you’re a stay at home mom, you must not have the intelligence or ability to do anything else, like no one with any other options would choose to stay at home and raise their own kids.
@Windy, I think “society” (and by society, I mean, patriarchy) figures out how to make women feel bad about what they do regardless of whether stay at home or work… If you work, you’re a bad mom, if you stay at home, you’re lazy… these are fallacies and they have very little to do with the truth.
Hmmm, I don’t know that I agree with you on this. Medicine isn’t an exact science, after all, and the best they can do is make a recommendation to you. Over the phone, it’s entirely possible that a doctor doesn’t have a chance to tell you about all of the research they have or have not done or read about and so they are giving you their recommendation.
It’s up to you, as the patient, to decide what to do with that recommendation. Do you take them at their word, get another recommendation, or research further?
Would you have felt better if the doctor had said that their general recommendation was that it probably wouldn’t matter, but there’s always a possibility that it does?
@Miss Britt, Um, I would have felt better if I had gotten to speak with the doctor in the first place… AND if they had given me a rationale for the recommendation!! I should have mentioned that I called the office to ask for an appointment to discuss this with the doctor. I was transferred to a nurse instead.
I asked the nurse for an appointment, and she indicated that she could answer my question on the phone. I assure you, I wouldn’t be irate simply because she didn’t stay on the phone with me for half an hour explaining why I shouldn’t take the medicine. I get that they’re too busy for that, that’s why I asked for an *appointment*… with the *doctor*.
That said, yes, we seem to disagree on how much responsibility a physician has in terms of their patients.
It is my opinion that physicians are more than just people who give you medicine when you’re sick. They are also educators. It is their responsibility to educate us regarding the best options concerning our health, and their roles as subject matter experts require that they actively communicate their rationale for their “recommendations” if they are prompted to do so.
This point is the unequivocal difference between a merely passable physician and an excellent one.
So, I demand excellence from my physicians for myself and my family, as should everyone else. Maybe that’s a high standard, but it is the standard to which I am accustomed and I feel we all deserve. They have absolutely no reason not to answer my questions in detail, that is their JOB, as I see it. And, they are paid VERY well to do it.
To complicate my specific circumstance, I ran into Y.’s physician this afternoon and asked her about it in person. She said taking the medication in my specific situation was fine. Apparently, the nurse I spoke with spoke with another doctor at the practice who was not my son’s physician, and THAT physician gave the recommendation. That is incredibly shady. And it’s really more at the heart of the matter regarding this post… I was given the options to either not take the med, go back to my doctor and get another one, or wean my son by a nurse who did not even ask me how much my son weighs, and double checked with a doctor who has never even SEEN my son.
To me, that is an incredibly unsupportive circumstance to place a nursing mother in… I was essentially denied an appointment and then given bad advice. And this? Is typical of many of the experiences that nursing mothers I know have had with pediatrician’s offices.
Furthermore, what is a patient who does not have access to the Internet supposed to do in order to research treatment rationale? Go to the library? What books would they look for? Should they ask their family and friends? That is a *terrible* idea unless the majority of their friends are medical professionals and are completely aware of their health status. On top of all the other responsibilities we have, we now must assume the responsibility of double checking the advice of a licensed professional? That doesn’t seem right or efficient to me. I’m all for getting a second and third opinion, but, at some point, somebody’s answer should mean something to you as a patient. Otherwise, why don’t we all just buy some medical books and treat ourselves?
So, no, I don’t think it’s the patient’s responsibility to research treatment rationale, it’s their responsibility to ask as many questions as they need to until they are answered adequately by the doctor who went to school for eight plus years studying the human body.
Look. I wrote a whole blog post in my comments… just.for.YOU. XO
@Faiqa, lol… welcome to my situation here… rolls eyes… seriously. One would expect doctors to take the time to educate you but it doesnt happen that way sadly… sigh
I am the research queen myself, so I’d probably have done exactly what you did.
So frustrating – in every way possible.
@Sybil Law, The thing that bugs me is what if I weren’t a research queen? Ugh.
What about contacting the drug manufacturer themselves? I would assume they have more specific answers to your questions since they invented the stuff. I don’t think the doctors office will research anything beyond a red flag in their computer systems to make a warning statement.
It’s sad though that our society, via fear of lawsuits, has come to this. The flip side is someone is doing far more research to come up with these red flags but it doesn’t always seem to get passed along or read in its entirety.
I would call the drug manufacturer, they usually have an information line to answer questions why they would not recommend nursing moms use their product.
@Hockeymandad, Calling the drug manufacturer is a good idea.
I totally agree with you. I have run across this in the past and it is very frustrating. Good luck with all your decisions!!
@Becca, Thanks… I think I have it figured out, at this point.
Wow. Unlike your 30 days of truth meme, I have Nothing to say! I do, however know a thing or three about the medical profession & No one wants to make the call, in case they are Wrong. At least 2 women I am close with have asked me about if they should Marry their Significant other. In both cases, I said No, for (what I thought were)Good Reasons. Both invited me to their weddings. Yeah. Like that.
@yknot, Yep, I know the not wanting to be called out on being wrong is an issue. Also, that’s so funy about the marriage/wedding thing. I’m always VERY careful in those situations about what I say because you never know. At the same time, it’s important to speak up when you see something really wrong.
@Faiqa, “Some people marry for Better, Some for Worse but almost no one for Good!”
Not recommended… like, you probably shouldn’t have a glass or two of wine while breastfeeding? (And I don’t know about you, but I consumed wine while I breastfed!)
Like you said, if you’re not taking this medicine every single day, but as needed, and if your child is only consuming 6 to 8 ounces a day of breastmilk a day… well, I’m no doctor, but I think you’re totally safe. (I also hate discussions over the phone with health care professionals.)
On the other hand, I didn’t eat feta – even pasturized – while I was pregnant because I worry ALL the time.
And having a child who has been in the hospital a few times, I learned to be a research queen myself. To the point where I would argue with the doctors because I knew I was right. Like, rather than stick an IV in my 12 week’s old HEAD, how about a shot in his thigh since it’s his last dose of antibiotics? “Oh, yeah. We could do that.” Sigh.
Sorry, I’m rambling. How about talking to a pharmacist? Good Luck – I know you’ll make the right decision.
I completely agree with you. This is not right. I have found that unfortunately, many doctors that both my husband and I have been treated by are lazy. When it comes to medications, the majority of the time we’ve done our own research then asked if they could prescribe what looked like the best option. I also agree that the values we tell women are important and the support they get in maintaining those values are inconsistent. I’m glad that you WERE able to do your own research, but I know there are a lot of women who wouldn’t be able to, and that stinks.
You’re absolutely right to be angry, Faiqa. And I think it’s a symptom of a larger problem- the infantilization of women (primarily, but not exclusively) by the medical industry. Rather than the best answer- which in your case seems to be “in your current situation the risk to Y. is minimal, but if he starts to nurse more frequently that could change and we’ll need to reassess”- you were given the easiest answer. I’m sure no one in the pediatrician’s office consciously thought “oh no, her delicate ladybrain cannot handle serious science-talk, better tell her something simple!!!”. But it’s disturbing that your medical professionals didn’t see the benefit of educating themselves appropriately to address your concerns. Because it IS their job. It’s not your responsibility to take a crash course in medicine every time you get sick. And all patients cannot be expected to know hiw to evaluate medical information appropriately- that’s assuming they would even know how to find reliable info in the first place. Patients deserve accurate, up-to-date information about their health. They shouldn’t have to be ace researchers, they should be able to trust their doctor to provide it. And doctors should be able to communicate information accurately and clearly. Patients deserve to understand their options and to be trusted to make decisions about their own health.
And also. SQUEEE!!!!! You quoted me! And I sound so much more articulate in your blog than I do in real life. Thanks for translating all the aaarghing and gnashing if teeth into a credible argument for social change. You rock my socks!
You keep saying “medication” when we know you mean “heroin”. I mean, c’mon, let’s have an open forum here.
I think in this situation, your physician is one voice – an educated voice, yes, but one voice. You have done research and seen information that your physician may not have seen, and you are a responsible adult, so make your own informed decision, knowing the risks and the rewards.
I recommend contacting your local LLL Leader and asking to see a copy of Medications and Mother’s Milk. This book will have all the information you need, which you can present to your doctor. I have a copy of it myself, as I’ve been forced to fight for sane medical care on more than one occasion. Relying on the drug manufacturer’s recommendations is usually not helpful either, as they are also more concerned about lawsuits than evidence.
I understand your frustration, and I get that your situation is not the norm when discussing breastfeeding (in that the volume of milk being consumed is reduced AND the size/development of the child consuming the milk is beyond the norm), but I’ve always been of the opinion that when it comes to health (anyone’s health), it is better to err on the side of caution.
Is there nutritional value in breastmilk to your son? Undoubtedly. Is it essential? I’d hazard a guess at no, just given his age and the amount he’s consuming, not to mention the fact that many mothers aren’t dedicated to breastfeeding past one year.
That being said, you should be able to rely on the medical community for support and information. (Although I must say I personally wouldn’t expect my GP to know what meds are bad for breastfeeding… I don’t even know if I’d expect a pediatrician to know that. I’d look at a breastfeeding clinic or the like as they specialize in the area.)
I had PPD after I had Little Miss. When she was three months old or so, I finally called my OB. They put me on Wellbutrin but he said that I would have to quit nursing.
Considering the emotional and hormonal train wreck that I was, I didn’t even question him. I stopped nursing and took the meds. Luckily (I suppose), at that point I’d already been back to work for two months and we had already settled into the routine of pumping, having bottles during the day, nursing in the mornings and nights, supplementing with formula when needed.
It wasn’t until all that foggy stuff cleared that I even thought about different meds I could’ve taken. Turns out there are a whole slew of antidepressants that are safe to take while nursing. Ironically enough, it was perfectly safe for me to be on morphine and hydrocodone for two weeks post-c-section while nursing.
Anyway, I’m rambling now so I’ll just say that I am proud of you for questioning and researching before making the decision that works best for your family. I wish I’d been able to do that.
Oh, I can totally empathize with you 100% on this.
I went through almost this exact situation! It’s not fun and it’s a very difficult decision that you have to make.
Can you find out how long the medication remains in your system and then not nurse for that long (kind of like the pump/dump scenario?)? Just a thought. I don’t know the specifics of how often you have to take the medication.
I breastfed both of my babes for quite a while as well and I know how important it can be when you want them to wean themselves.
I’m here if you want to discuss this further/hash out your ideas etc. I’m a good listener and I’ve been through this.
I’m sorry you have to go through this
AND it bugs me that people feel the need to state opinions about breastfeeding past infancy. Grrr…..