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Finding a Breastfeeding Friendly Pediatrician

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Melissa Portunato MPH, IBCLC, RLC

Breastmilk is a living substance loaded with nutrients, antibodies, and vitamins, providing the perfect nutrition composition for your growing baby. Experts recommend breastfeeding exclusively for the first 6 months and continued breastfeeding for 2 years or as long as the mother and baby desire. Some mothers exclusively express breastmilk for their babies, while others prefer to nurse directly at the breast. No matter how you decide to provide breastmilk for your baby, you will give them the very best start by feeding them your precious breastmilk. 

The pediatrician you choose for your baby will significantly impact your breastfeeding journey. Some pediatricians are more knowledgeable about breastfeeding than others, and it’s recommended for expectant parents to interview candidates for their baby’s doctor during pregnancy. Read on for questions you can ask and the answers you should look to receive. 

What percentage of babies are breastfed in your office?

The national breastfeeding rates published by the CDC depict that 45% of infants are exclusively breastfed at 3 months, and about 25% are fed only breastmilk at 6 months. Your pediatrician’s practice should have a high breastfeeding rate, but don’t be discouraged if they don’t know the current national breastfeeding statistics. However, they should know the average of breastfed infants in their office and be willing to listen and support you on your breastfeeding goals. 

Do you work with an International Board Certified Lactation Consultant (IBCLC) should any problems arise?

The IBCLC credential is the gold standard in lactation care, providing skilled, evidence-based breastfeeding support. Access to an IBCLC at your pediatrician’s office will make a big difference. It tells the pediatrician understands your concerns and values specialized lactation care for their patients. 

How much breastmilk should my newborn consume daily?

Breastfed babies consume between 25-30 ounces per day. The amount your baby will consume stays consistent for the first 6 months. If you are exclusively pumping, aim for that total, and if you are nursing and pumping about half (12-15 ounces). 

What growth charts do you use in your practice? 

Breastfed babies should not be compared to formula-fed babies. Research shows breastfed babies are leaner over time and grow in different patterns than their formula counterparts. Breastfed babies should be measured on the WHO growth charts, NOT the CDC growth charts. You can download a free WHO growth chart here. Remember, percentiles are just a comparison with your baby among 100 other babies. If your baby is not growing as quickly as their peers, it doesn’t necessarily mean feeding is an issue. Genetics should be considered, and seeking advice from an IBCLC. 

When is supplementation medically necessary, and how should it be given?

On average, your baby should not lose over 10% of their birth weight and be back at their birth weight at 2 weeks. If your baby requires supplementation, your pediatrician’s first advice should be to breast pump and provide breastmilk as a supplementation in addition to nursing directly at the breast. Alternative feeding techniques like a cup, spoon, or syringe should be suggested instead of bottle feeding. If bottle feeding is preferred, the paced bottle technique is the best way to feed your newborn with a bottle. 

When do you recommend introducing solids?

AAP recommends exclusive breastfeeding for the first 6 months, introducing solids at 6 months, and continued breastfeeding for 2 years or as long as mother and baby desire. Your baby does not need any other food, water, or juice – only breastmilk for the first 6 months. 

When do you recommend weaning from breastfeeding?

The answer here should be until mother and baby desire. There is no specific timeline for weaning, and every family should make a personal decision on when to discontinue breastfeeding. Studies show there are benefits to breastfeeding at one year and beyond. Breastmilk continues to be a source of nutrients, antibodies, and vitamins through toddlerhood and early childhood. 

Be prepared and educate yourself before you begin breastfeeding. Finding a pediatrician that supports your decision to breastfeed is important and can influence the achievement of your breastfeeding goals. If your pediatrician is not supportive of breastfeeding, you can always opt for a second opinion. You are your baby’s advocate. 

Need help getting started with breastfeeding? Schedule a complimentary consultation with a Spectra Baby USA IBCLC here. 

We’re here for you, and we support YOU! 

Source:

Kellams, A., Harrel, C., Omage, S., Gregory, C., & Rosen-Carole, C. (2017). ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeeding Medicine, 12(4), 188–198. https://doi.org/10.1089/bfm.2017.29038.ajk

Is My Baby Getting Enough Milk?

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“Is my baby getting enough?” This question is one of the most common among nursing moms. Whether you’re a first-time mom or this is familiar territory for you—no breastfeeding journey is identical, and questions will likely arise. Breast milk digests quickly and easily. At times you may notice your baby demanding back-to-back feedings, so much so that you’ll probably even start questioning if you’re producing enough milk to keep your baby healthy and satisfied. As stressful as this may seem, know that this is a common concern, and there are several ways to check whether your baby is getting enough liquid gold.

Hello Breastmilk 

Drops of clear or yellowish colostrum are the baby’s first milk and are the perfect nourishment for your newborn’s first few days of life. By day four, you should notice milk increasing in volume. Every mother is unique. This time frame could vary based on previous breastfeeding journeys, labor duration, and even if you had a c-section or vaginal delivery. Your breasts will likely feel engorged, and you may leak in between feedings. If you notice little to no sign of milk coming in, you should contact your doctor or lactation consultant to discuss the reasons why your milk supply might be delayed.

Momma the Diaper Slayer 

You may find yourself going through diapers more than your wallet would like to admit. Luckily, this is a strong sign of a well-fed baby! Expect to go through 6-10 diapers a day. Several of those should be yellow or mustard-colored poop. While diapers with only pee are a sure sign that your baby’s staying hydrated, make sure to be on the lookout for those poopy diapers, ensuring your baby is getting what they need. At least 3-4 stools per day, the size of a quarter or more. 

Gulp-up, Buttercup!

Try to listen to swallowing sounds. You’ll notice your baby’s jaw movements, and once milk letdown kicks in, you should hear swallowing or gulp-like sounds. If it seems as though your baby is dozing off on your breast, try to fit in some breast compressions, a gentle massage used to help express milk. 

Fill up that onesie!

It’s entirely normal for your baby to lose 5-7% of their weight within a week of birth. After the first seven days, your baby should be gaining an average of 7-10 ounces per week for the first three months. That amount will slightly decrease somewhere in between 3-6 months. If your baby is not nursing well, pump with your spectra between feedings to provide expressed breastmilk and create a healthy milk supply. Bottom line, stay on track with your wellness visits and check-ups to ensure your little one’s chart is where it’s supposed to be.

Off to Dreamland 

You may notice your baby naturally falling asleep or letting go of the breast within 10 to 30 minutes of each nursing session. This is another strong sign of a full belly. On the other hand, a baby who looks distressed during feedings and sleeps all the time may not be getting enough milk. Starting every feeding skin to skin can help wake up a sleepy baby and encourage nursing. Also, try every feeding undressed from the waist up and baby only in a diaper. 

Work on establishing your milk supply by staying close to your baby and allowing for unlimited access to the breast. The best time to introduce pumping is about 3-4 weeks after delivery. However, many mothers find that pumping is a great way to fit in breaks when needed (hello, date night)! Additionally, moms who are returning to work might want to get on a schedule and build a small milk stash for the transition.

On average, a baby from 1-6 months old will intake an average of 25-30 ounces per day. Moms pumping for a missed feed at this stage will see 2-4 ounces combined. If pumping is in addition to nursing at the breast, you’ll notice about half of that. Pumping is never a good indicator of your milk supply; it simply tells us how much milk you can pump. You are doing the best you can, mamas, and that’s enough!

Spectra makes all of this possible. Read our top tips HERE on best practices for pumping and storing!