Thursday, June 19, 2008

One Month Doctor Visit & 1st Fathers Day

Technically, Vi and I didn't make it in at 1 month; it was actually 5 weeks, not 4, when we sauntered in to the doctor to check on the babe's progress. Due to the stress and panic over Baby Violet's weight loss after her birth, I was eager to get an accurate measure of where she stands now.

Instead of taking the dear to a pediatrician, I opted to take her to my doctor, a family physician, since I already knew and liked her. I began to have reservations about the Doc when she told me that Violet's weight loss immediately following her birth (she dropped from 7 lbs 13 oz to 6 lbs 12 oz), while normal, was a little on the high side and warranted me supplementing Violet's diet of breast milk with a bottle or two of formula. Anyone who has read anything about breastfeeding or done it themselves would recognize this advice as being suspect. Especially in the early days of nursing, supplementing with formula is a quick way to jeopardize developing a healthy nursing relationship. Not only could giving a bottle cause the dreaded nipple confusion, but since breastfeeding is a supply and demand proposition, if the baby's demand for nourishment is being met at the bottle via formula instead of at the breast via human milk, Mom's not being stimulated to meet Baby's needs, and, "just that one bottle," will potentially turn into 2, 3, 4, and so on as Mom's body fails to be alerted that Baby's hungry!

I know it can be done (my friend Melanie nursed 3 of her 4 kids and started the early days with her son taking bottles as she had a horrific post-birth headache that lasted for days). I also know that nursing is not second nature as many of us believe it will be--it is natural, right?--and it takes the support of everyone around Mom and Baby, especially the Doctor. Duh. If the person you are trusting for medical advice is not encouraging you and is making you doubt yourself in those critical, frightening, first days, it is hard to tune that out. Fortunately for me, I had my own Mom, a former La Leche League leader (or the Big Boob, as we like to call her), my trusting husband, and my friend Amy's mom Terri, a lactation consultant, to teach me, encourage me, calm my fears and help little Violet become the all-star nurser she is today!

So when we got to Doc's office yesterday, I was thrilled to see VBP weighing in at 8 lbs, 12 oz, a gain of a full 2 lbs since her low at 5 days old. She was 21.5 inches, too, adding a full inch and a half to her height in just 28 days! Hooray! My totally breastfed baby is thriving-imagine that!

Then the raining began on the parade. Doc asks how feeding is going-"Great!" Am I pumping-"Everyday to build a supply for when I return to work." And then she suggests that I might want to start introducing formula "just once a week to get Violet used to it" in case my supply dwindles when I return to work in 7 weeks. HELLO??? Remember the little supply and demand relationship I talked about earlier? Yeah, that still applies. I told her we'll cross that bridge IF we come to it and left it at that. There are just so many things wrong with that suggestion, I hardly know where to start. First and foremost, it shows total disregard for my values. The doctor knows from our previous visits with Violet that nursing her is one of my priorities as her Mom. Second, the American Academy of Pediatrics recommends breastfeeding for the first year of life and the U.S. Department of Health and Human Services states that "Babies are born to be breastfed." Instead of easing my transition into bottle feeding, my doctor should be giving me strategies to ensure that I continue to breastfeed for as long as possible. Like warning patients about the dangers of smoking or encouraging them to lose weight for optimal health, a doc needs to make sure patients understand not only the benefits of breastfeeding but make certain that they have the tools to actually do it! Now, I am more determined than ever to make it to 1 year nursing Violet!

I also wanted to talk about immunizations with the doctor as Vi would be on track to get a slew of them at her 2 month visit. You'd have to be living under a rock to have missed all the publicity about the possible link between childhood vaccines and autism. I have done some reading (not as much as I should have) about the topic and I fully expected the doctor to tell me that there is no proven link between the two, that vaccines save lives (they do), and that I should go along with the schedule proposed by the Center for Disease Control. So I wasn't surprised when she did (and cited numerous sources to back her including the American Academy of Pediatrics...where was their input during our breastfeeding conversation...?)What I didn't expect was the interesting logic she used to support her recommendations. When I asked about separating Vi's vaccines so that she could receive them over the course of several visits rather than 5 (FIVE!) in one day, the Doc told me they don't really like to do this. Not because it would leave a longer window for Violet to be exposed to one of these potentially deadly diseases like measles, but because the more often she comes in, the more we break from what is, in her words, the office "routine" for giving immunizations, the more likely it is that someone would screw up and give my baby the wrong thing. Inspires confidence, doesn't it?

I can feel it coming. I am becoming one of those moms I rolled my eyes at before I had Violet. I never questioned the one-size fits all approach to health care when it was just me, just my body being practiced on. But that just isn't good enough for her. I want beyond the best for Violet, like all mothers want for their kids. And apparently, in our case anyway, that may take being a little pushy and not worrying what everybody else thinks. Maybe even going against the medical establishment. And certainly, by nursing, going against the societal norm. So don't be surprised when you see Katie Couric talking to me on CBS Evening news at a "Nurse-In" at some airport to protest or marching on Washington with Jenny McCarthy. It can't be far off...

In the meantime, we enjoyed an extremely traditional, non-radical 1st Father's Day celebration for Shawn at Hollyhock Hill which is where the above pic was snapped.


martha said...

Jill~~You have really hit home with this blog! I started doing some reading about the pertussis immunization when Stephanie had a severe reaction at 6wks old. She had a 102.3 fever within hours of the injection and stayed asleep for nearly 24 hours and upon waking was listless and was crying in a very high pitched cry. Come to find out this was an indication of a severe sensitivity to the "live cell" vaccine they were giving at the time. (They no longer give live cell in the U.S.)I thank the Lord she didn't continue into convulsions and brain damage or death as some babies had done at that time. When the Dr. was informed of this reaction she reccomended that neither Stephanie or any of my children receive another Pertussis vaccine ever! I had to get vaccines in order to send my kids to school so some of them came in the form of what the D.O. gave them (which were much less potent) and I had them give each one independently! By the time they went to school they didn't need some of them because they had already passed the age for them to be necessary. They seem to be doing just fine to this day. All I can say is follow your motherly instincts and your heart where your children are concerned. And I think I'd be shopping for another doctor for Violet. Sounds like you are doing a GREAT job as a mother~~and YOU look good too!

Aly said...

I'd be questioning that doctor too! Telling a mom who has now successfully breastfed her daughter for 5 weeks that formula might be necessary? Really? Where's the encouragement? Where's the gold star sticker you've so obviously earned?

It's frustrating b/c what you've accomplished is something difficult that not everyone ends up doing well. Yet you've stuck it out and really made strides w/ your supply, routine & Vi's weight. I have so much respect for you, for many reasons, but particularly for how hard you've worked to achieve this. As someone who had a bad first experience with breastfeeding, I hope to learn from your success this second time around.

As for vaccines, go with your mommy instinct. Our pediatrician in Evansville spaces them out a bit more than other docs, which is why I chose him before Jack was born. He's not big on skipping major vaccinations, but he is open to your thoughts and concerns as a parent. As they grow, and as various things come up, it really helps to have a doctor who listens to you rather than one who worries about breaking "office routine".

You're doing a great job! Motherhood fits you like a glove and I say keep doing what you're doing.