Is Your Pediatrician Actually Breastfeeding Friendly? (5 Ways You Can Tell)

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Are you confident your baby’s pediatrician is actually breastfeeding friendly? Or are you getting feeding advice that is actually making breastfeeding more difficult? If you don’t know what to look for, it’s not always easy to tell. Here’s what you should know.

Unfortunately, not all pediatricians are “breastfeeding-friendly.”

What they don't tell you about breastfeeding

 This is what they don’t tell you in the hospital. Our FREE guide will give you 12 breastfeeding secrets that will help you avoid common problems down the road.  

Most encourage it, at least initially. But when difficulties arise, research has shown that pediatricians today are less likely to believe mothers can be successful breastfeeding and less likely to feel that breastfeeding difficulties are worth overcoming (source). Thankfully this is not true of all pediatricians, but it is true of some.

And if your goal is to breastfeed, this is a problem.

Do you have a breastfeeding friendly pediatrician? Here's 5 ways you can tell.

Supporting a nursing parent is more than simply believing or expressing that breastfeeding is a good idea. It’s helping you find lactation help when the practice can’t provide it. And it’s supporting baby’s health in ways that don’t undermine your breastfeeding goals whenever possible.

As a lactation consultant and co-admin of a private Facebook support group of over 13,000 parents, I too often hear stories of pediatricians giving out breastfeeding advice that inadvertently undermines milk supply and breaks down breastfeeding relationships.

That said, I’m confident that all of these pediatricians are well-intentioned! Their goal is a happy, healthy baby. But since a baby can be both happy and healthy without breastfeeding, preserving the breastfeeding relationship is not always a valued goal.

As a result, there are breastfeeding secrets you might not be hearing from your pediatrician. Here are 5 you should know about:

Medical Disclaimer: The content of this blog post is not medical advice nor is it a substitute for medical advice, diagnosis, treatment, or professional lactation care. This post is for educational and informational purposes only. It is the reader’s responsibility to review all information regarding any medical condition or treatment with a healthcare provider. See full medical disclaimer here.

1) A BREASTFEEDING FRIENDLY PEDIATRICIAN KNOWS THAT BOTTLES DON’T FIX BREASTFEEDING

A bottle can be a useful tool to get baby fed while you get breastfeeding difficulties handled. It can be a useful tool for caregivers who need to feed baby when you cannot be there. It can be a useful tool if you would simply prefer to bottle-feed pumped milk or formula! 

There isn’t anything inherently wrong with bottles.

But if there is something amiss with baby’s latch or with your supply, and if your goal is to nurse off the breast, a bottle by itself is unlikely to be the answer to your troubles. In fact, it can actually make some issues worse!

If your pediatrician stops at suggesting a bottle, you will need to go elsewhere for help.

A qualified and experienced IBCLC (International Board Certified Lactation Consultant) will likely be better equipped to help you get to the root of your breastfeeding difficulties. Not only can they typically meet with you for a much longer period of time–an appointment usually lasts from 1 to 2 hours, often in the comfort of your own home–but their lactation training will also be more extensive.

The truth is, most pediatricians have limited–if any–lactation training and limited experience with clinical breastfeeding management (sourcesource).

A breastfeeding-friendly pediatrician will give you guidance on supplementing if needed while also encouraging you to see a lactation consultant. And a great breastfeeding-friendly pediatrician will have a list of referrals ready to go for you.

RELATED POST: Worried about low supply? Here are Is My Milk Drying Up? 10 Supply Myths You Need to Know.

2) A BREASTFEEDING FRIENDLY PEDIATRICIAN HELPS YOU PROTECT YOUR MILK SUPPLY

Sometimes we need to supplement with pumped milk or formula per doctors orders, or we feel compelled to because we are afraid we aren’t making enough milk.

There’s nothing wrong with this. The first rule of breastfeeding is feed the baby!

If your goal is to breastfeed, supplementing just needs to be done carefully, because it adds variables that can affect milk supply. In some situations, it can even create supply issues that were never there to begin with!

The key to avoid accidentally causing a supply issue by supplementing is to make sure you pump every time baby receives a bottle.

Why? Because breastfeeding and pumping are what tell your body to make milk. Your body has no way of knowing it needs to make more milk if it doesn’t receive this signal, and it doesn’t get this signal when baby receives a bottle.

A breastfeeding friendly pediatrician shares this important, milk-supply-protecting information with you.

A breastfeeding friendly pediatrician will help you avoid the top-up trap. This happens when you top up baby with a bottle of formula, baby drinks less from the breast, and the body slows down milk production as a result.

When pumping for a missed feed, be sure to pump both breasts for at least 15 minutes–ideally closer to 20-25.

In most cases, if you need to supplement, you can supplement with your own pumped milk first and make up any difference with formula if needed.

If your goal is to breastfeed and your pediatriciansuggests supplementing with formula without mentioning the option of using your own pumped milk–either partially or in full–consider asking why. Supplementing with formula in lieu of available pumped milk is rarely medically necessary.

3) A BREASTFEEDING FRIENDLY PEDIATRICIAN ENCOURAGES PACED BOTTLE FEEDING

Bottles and breasts are different.

Unlike a bottle, the breast does not allow milk to continuously drip from the nipple. Only small amounts of milk are released until the “letdown” occurs and milk flows faster for a few minutes before slowing down again (if you don’t feel your letdown, don’t worry–many parents don’t feel it!). If baby wants more milk, he or she has to actively, intentionally suck for a while before milk is released again (source).

In other words, the breastfed infant controls the feed and self-regulates milk intake, easily stopping when he or she is finished (source).

In contrast, milk flows relatively easily, quickly and freely from bottles. As a result, bottle-fed infants can’t as easily control how quickly or how much they eat, and they are more likely to be encouraged to finish bottles by a caregiver (sourcesource). This is part of why bottle-fed infants are at increased risk for obesity later in life, even if they’re getting breastmilk from a bottle (source).

Bottle leaking milk on a pink background
Compared to the breast, milk flows easily and freely from bottles–even bottles with “slow flow” nipples!

It’s particularly problematic when breastfed babies receive bottles that aren’t pace fed.

Since milk flows so easily from a bottle, breastfed babies can begin to develop bottle preference (a.k.a. “nipple confusion“). Some babies become so frustrated at how much more effort they have to put in at the breast that they refuse to breastfeed entirely.

Other babies are willing to breastfeed but are used to quickly drinking large volumes (5-8+ oz.) of milk from a bottle. These babies get frustrated that the breast doesn’t release as much milk the same way. As a result, they act like they need more milk. This puts a lot of unnecessarily pressure on you to produce or pump more milk than baby actually needs, and it can make you believe you have “low” supply when you don’t.

So what can be done about this? A little something called paced feeding.

Paced feeding helps bottle-fed babies self-regulate their milk intake by slowing down feeds. This is important regardless of the type of milk–breastmilk or formula–baby is drinking from the bottle.

Unfortunately, many pediatricians either do not know the benefits of pace-feeding or don’t explain to parents how to do it. As a result, many babies are fed until they have to push the bottle away or until right before they would otherwise vomit.

A breastfeeding-friendly pediatrician will share how to appropriately bottle-feed your breastfed baby. If yours didn’t (and it may have been an honest oversight!) you can get an explanation here.

4) A BREASTFEEDING FRIENDLY PEDIATRICIAN WON’T ENCOURAGE PARENT-LED FEEDING SCHEDULES.

Babies are not born with watches.

They don’t pay attention to how long it’s been since they were last at the breast.

The idea that a baby “should” go a certain amount of time before nursing again is a cultural myth based on bottle- and formula-feeding norms of the last century.

In our culture, as bottle-fed babies age, they are given larger and larger bottles so that they can go longer between feeds. This is for convenience, not because there is a biological reason a certain amount of time needs to pass.

Feeding schedules are convenient for parents, but they are NOT the way babies–especially breastfed babies–are wired to eat. Breast milk digests easily and quickly, and breastfed babies seek the breast for more reasons than just hunger!

Adults drink when we’re thirsty. We don’t abide by rigid schedules, and neither should a baby!

In fact, there are MANY reasons a breastfed baby will desire the breast that have nothing to do with low supply or milk that “isn’t fatty enough.” Growth spurts, developmental leaps, relief from overstimulation and stress, and differences in milk storage capacity between mothers are just a few reasons why a baby might wish to nurse again before an arbitrarily amount of time has passed. (Not to mention comfort, which is a valid human need).

While the convenience of spacing out feeds is tempting, parents should be informed that feeding schedules and taking steps to space out feeds can actually result in low milk supply for many breastfeeding parents (learn more here). Babies may naturally nurse less often as they age, and this baby-led regulation does not come with the same risk of low supply.

A breastfeeding-friendly pediatrician will not set limits on the number of times or length of time an otherwise healthy baby is allowed to nurse. He or she understands that it is normal for babies–especially young babies–to nurse 8-12+ times in 24 hours (source), and that babies should be fed according to hunger cues (and from a pace-fed bottle when a bottle is needed).

If your pediatrician suggests that your otherwise healthy and growing baby should be going longer between feeds, or that your milk “isn’t fatty enough” or even “stops being nutritious” after a certain (arbitary) age, you may want to seek a second opinion from a pediatrician more familiar with breastfeeding.

IMPORTANT DISCLAIMER: If you are concerned that your baby is feeding excessively frequently, take your concerns to your healthcare provider and an IBCLC immediately. When a problem exists, it is usually accompanied by other symptoms that these providers can help you identify. If baby is not having an appropriate amount of wet and dirty diapers or shows signs of dehydration, inform your healthcare provider immediately.

5) YOU ARE NOT A PACIFIER

Perhaps this is merely a personal pet peeve, but I hear it so often from providers I feel compelled to address it:

Your baby is not “using” you as a pacifier.

On the contrary! Your baby “uses” a pacifier as a you! Pacifiers are a substitute for the breast, not the other way a round. They aren’t nipple shaped by accident!

There is nothing inherently problematic about a healthy, full-term baby suckling on the breast for comfort. It’s not any more inappropriate or problematic than suckling for comfort on a pacifier.

If your pediatrician suggests that baby is using you as a pacifier, you may not have a breastfeeding friendly pediatrician. Mother breastfeeding her young baby on a nursing pillow.

The only real difference? Cultural belief. Western cultures have a history of discouraging this natural way of soothing infants for reasons that have nothing to do with a baby’s biological well-being. We worry about creating “bad habits” to the point where we lose sight of the fact that comfort is a valid need.

You will not “spoil” your baby with too much affectionate access to the breast. You will not “create a problem” in the future, either–the “problem” of your baby desiring your close presence already exists! Likewise, you are unlikely to “break” breastfeeding by using a pacifier (source), and there is nothing wrong with feeling touched out or needing a break.

The truth is, the choice to comfort nurse or use a pacifier is yours to make. A breastfeeding friendly pediatrician will encourage you to make that choice as you see fit rather than push a culturally-biased, personal preference about the “type” of nursing you should or should not allow.

TRULY BREASTFEEDING FRIENDLY PEDIATRICIANS WILL DO MORE THAN SIMPLY ACKNOWLEDGE THAT BREASTFEEDING IS VALUABLE.

A breastfeeding friendly pediatrician will help you breastfeed, rather than simply suggest a bottle. They’ll teach you how you protect your milk supply when bottles and supplementing are necessary. They’ll encourage you to feed on demand, and they won’t discourage you from comforting your baby with your breast.

They’ll know when you need more breastfeeding help than they can provide. And most importantly, they’ll help you get it.

What they don't tell you about breastfeeding

 This is what they don’t tell you in the hospital. Our FREE guide will give you 12 breastfeeding secrets that will help you avoid common problems down the road.  

If you enjoyed this post, be sure to check out our digital library of helpful resources that quickly teach how to avoid common breastfeeding problems and give you the peace of mind and confidence you need to meet your breastfeeding goals.

ADDITIONAL REFERENCES

  • Campbell, S. H. (2019). Core curriculum for interdisciplinary lactation care. Burlington, MA: Jones & Bartlett Learning.
  • Lauwers, J. (2016). Counseling The Nursing Mother: a lactation consultants guide. Burlington, MA: Jones & Bartlett Learning.
  • Wilson-Clay, B., & Hoover, K. (2017). The breastfeeding atlas. Manchaca, TX: LactNews Press.