Monday, August 3, 2009

Weaning Worries

I owe you all an apology for being so behind on my posting. Actually, my ISP should apologize since we've had some Internet connection issues but they appear to be resolved now. Back in business.

Nate had his 1-year appointment with his new pediatrician on Friday. He now weighs 21 lbs, 4 oz. and is 30.5 inches long. 25th and 75th percentiles respectively. Tall and thin. Male model-to-be, perhaps?

She examined him and issued him a clean bill of health. She asked about his verbal and physical capabilities and seemed satisfied with my answers. Everything was going perfectly.

Until I innocently inquired about weaning.

I explained to the doctor that Nate was still breastfeeding around 5x/day (every 2-3 hours) and I would like to begin the weaning process soon but I wasn't sure how to go about it. I described his picky choosy eating habits and illustrated my concern over eliminating this nourishment when it is currently filling the nutritional and caloric gaps. Also, since he hasn't fully adopted the sippy cup, how could I successfully replace breastmilk with whole milk? I explained that he is not consistently STTN and usually wakes to nurse once or twice a night – could this mean that he is not getting enough calories during the day? I wanted to nip all of these issues in the bud but didn't have a clue where to start. I was beyond overwhelmed.

Her advice: cut out breastfeeding entirely. Give him no other option and he'll have no choice but to eat solids and drink from a sippy. And whatever I do, don't give in. Children at this age have the “power to manipulate” and if I breastfeed him after a meal, he is just going to fight me at the next feed until he gets the breast. She told me I could start weaning as soon as I felt ready but the longer I waited, the harder it would be. Soon, breastmilk won't be enough nutritionally so she suggested I think about that when making my decision. Regarding night weaning, she said he is not STTN because I am instilling poor sleep habits. Not because he is not eating enough during the day. A 1-year old is fully capable of STTN for 10 hours or more without food. I should use the CIO method so that he learns to self-soothe and can put himself back to sleep when he wakes. I also shouldn't nurse and rock him to sleep initially or else I'll be doing it to a preschooler. I should put him down fully awake and let him cry if necessary.

I was aghast. Was she serious? I was hoping to wean gradually. Over time. Not change everything all at once without warning. That hardly seems like a healthy approach for Nate or for myself. More physically and emotionally traumatic than anything. Not to mention the backhanded irony of "do it when you're ready but it better be soon or else".

Does she think my son is a robot – a machine that should fall into place on the assembly line of social acceptability? It couldn't possibly be in his best interest to starve him until he succumbs to self-feeding. Okay, maybe he wouldn't starve per se, but it still seemed like cruel and unusual punishment to me. I wouldn't want to be treated in such a way. How could I do something like that to my own flesh and blood?

I nodded in disbelief as she made her way out the door. Nate shed pools of tears from his three vaccinations and I wanted to cry right alongside him. It seemed like I was doomed to fail before I even began. Why does everything have to be so black and white? Is there no gray area here? When it comes to breastfeeding, is it truly all or nothing?

I should have left the office thrilled to have a healthy toddler but instead, I left confused, angry and defeated. I felt strangely guilty – for what I'm not sure. For not starting to research this sooner? For not being more insistent with solid feeding? For allowing myself to become a human pacifier for my son when he needed comfort at night? I just felt ashamed, as if I was solely responsible for the sleep and feeding issues we are having.

Making the decision to wean is inevitable (either baby-led or mommy-led) but it is also an extremely emotional one. I was feeling guilty enough knowing that I would be the one to break the tie that has bonded us so tightly over this past year. I didn't need to be shot down with derision.

I never would have thought I'd say this a year ago but I see nothing wrong with extended breastfeeding. My plan was always to breastfeed for 6 months, possibly a year. But the best laid plans don't always come to fruition. Now that I have bonded with my son and we are in a routine, my plans have changed. My feelings have changed. I want to nurse Nate as long as it remains a positive experience for the both of us. I cherish that time together, especially at night before bed and first thing in the morning. When he looks up and smiles at me with milk running out of the sides of his teeny mouth. But I also want my body back. Is that too selfish? It's been over a year and I have yet to get PPAF. DH and I would like to begin TTC #2 later this year, but without AF, it will be unlikely. We have some time but I wanted to start now because, with Nate being so adverse to change, I know that it will probably take months for us to see progress.

I came home and put Nate down for his morning nap while I did some research online, looking for any tips I could find about weaning. Out of the roughly twenty sites I viewed, NOT ONE suggested a sudden, voluntary cold-turkey approach. Each site recommended a gradual, patient, gentle approach so as to avoid physical and emotional repercussions in the mother (such as plugged ducts, mastitis, depression from hormone fluctuations) as well as the obvious stress for the baby.

In all of my venting and my desperate search for solutions, a friend of mine referred me to a La Leche League coordinator. She lended me her supportive ears and shoulders and sent me some valuable links to help ease the transition. We came to the same conclusion.

This doctor is a QUACK with a capital Q. She certainly has never breastfed and has no business giving advice about such sensitive subject matter. I will possibly be choosing yet another pediatrician due to this experience. That, or I will request that I NEVER see that particular doctor again and will go out of my way to ensure Nate's well visits will be conducted by other pediatricians in the practice. The final verdict has yet to be made.

DH and I had a long talk about how we wanted to implement this change and came up with our own plan of action. We are working on eliminating night feeds as top priority. When Nate wakes during the night, DH is going in to comfort him. We will continue to Ferberize if need be, but so far (knock on wood) we haven't needed to go in more than twice in 20 minutes for him to soothe himself back to sleep. The past four nights, he has only been waking once during the night and goes back down fairly easily, sleeping in his crib until our usual wakeup time of 7am. That's 11-12 hours total. Not too shabby.

I am now offering 3-4 solid meals a day (plus snacks) and am offering a sippy with milk, juice or water with each meal. If he wants to nurse, I offer solids first. Sometimes he is satisfied with the solids and other times he wants to breastfeed afterward. Either way is okay with me. I am just letting him lead the way, as I encourage him to try different flavors and textures. I am confident that with consistency, he will eventually come around and accept these new noshes. I did hit up BRU and practically bought out their sippy cup department so hopefully, soon, we will find one that is up to Mr. Picky's standards.

As he becomes more accustomed to our new routine, I will attempt to remove midday nursing sessions. Last to go will be the first AM and last PM feeds. We'll take it a day at a time until we get there.

He has really surpassed my expectations these past several days. He is eating many more finger foods in addition to his purees. He still fights me sometimes - maybe I time it wrong and he's not really hungry or maybe he's just being obstinate - but as I offer more variety, I can see his interest is peaked. You should have seen his facial expression upon discovering kiwi for the first time. Whoa.

I think I'm still in a bit of denial that our breastfeeding relationship will soon come to an end. I can't imagine not sharing that with him anymore. The thought saddens me deeply. Being able to breastfeed for a year and counting is one of my biggest achievements to date. I am so proud to have been able to give my son this precious gift. But I know all good things must come to an end.

It's just too ironic that all of this happened just in time for World Breastfeeding Week, eh?


Emily said...

My son has had sippy cup issues, too, and I've been going broke trying to find one he likes. The only one I've found so far is the learner cup by Nuk. BRU doesn't carry it, but Target and Wal-Mart do (in my area, it's $.60 cheaper at Target than at Wal-Mart). It's awfully bottle-like, which is why I think he likes it. I figure this will work until he decides he's ready for a real sippy. The downside? It's a $6 sippy cup.

You might also want to try straws or just regular cups instead of a sippy. My son seems to prefer both of those options over the sippy cups. The regular cup is horribly messy, but the straws aren't too. bad.

Good luck with everything!

Rachel said...

I would definitely avoid that pediatrician. One of my friend's daughters was slightly underweight and she wanted to night wean her daughter and our pediatrician (we go to the same one) told her not to cut out any calories until her daughter had gained some weight. I know that all sorts of people say "a baby will never starve himself" but that won't make it easier to feed a picky eater on a day to day basis.

I know many women who have happily breastfed well past a year and all of them have said that weaning was -easier- later - thanks in large part to being able to talk to their babies and explain that they weren't going to breastfeed at the moment and then allow them to chose from a range of alternatives (we actually haven't bought a sippy cup yet because my daughter is a bit younger, but she really enjoys sipping water out of my glass - don't know if that would work?) I am definitely hoping to continue breastfeeding until we can afford fertility treatments again, but I can't tell you how many negative comments I get about that - especially when people see my breastpump. Apparently where I am currently living it is considered absurd to pump past 3 months - and people love to share their wisdom with me. Makes me so mad.

Emily said...

First of all, congrats on a HEALTHY and HAPPY one year old.. he's healthy and happy mostly because of his wonderful mama...

Secondly.. Woah. That pedi is ... um, yeah, crazy. It sounds like you've resolved this and I totally agree that it should be more gradual than what she suggested.

In the end, Will was only nursing once a day and it was still a very bittersweet time for me. I couldn't talk about it for a long time without crying.

If you ever need anyone to bounce all this off of, PLEASE let me know! I'm happy to chat about it anytime!

You are doing such a great thing for your little man!

Roadblocks and Roller Coasters said...

Wow. I cannot believe that doctor. Even my ped who I'm convinced is the most insensitive doctor in the world said to wean gradually. Wow.

It sounds like you've got a good plan. Keep us posted on your progress as I'm in the same boat and Lemy us very reluctant to stop nursing.

Good luck!!! ((hugs))

Natalie said...

Holy hell. I have not ever breastfed, and even I know that advice is messed up! I would change pedis, then write a letter to the pedi office explaining why I switched and will not be coming back... also saying that I am telling everyone to avoid this pedi because of her potentially dangerous advice. Cite all those references you found, LLL, all of it. It is TOTALLY unacceptable, and how many people do NOT know better and actually follow that quack's advice?! OMG. How freaking traumatic!!

E. Phantzi said...

Kristen, thank you so much for sharing this whole story - I relate to so much of what you write about here. I love how you put it: "I am just letting him lead the way, as I encourage him to try" different things. Gentle, patient encouragement - I feel like that's what I would want myself!!!

sacredandscarred said...

Wow that dr sounds like a complete ass.

Nate's BFing sounds pretty darn normal to me. It's normal for babies, even at 1yr to wake to BF overnight. TTG turned 1 a couple of days ago and his BFing sounds a lot like Nate's.

Breastmilk is the ideal food for Nate.

You have done NOTHING wrong!!!! It is wonderful that your body has been, and continues to nourish your son perfectly.

Remember the recommendations are to breastfeed for at least 2 years, you are only half way there.

I'm on my 4th PPAF and will quite happily send it your way ;)

I am really sorry you had to deal with such an asshole of an uneducated dr. But I'm proud of you for educating yourself and doing what you feel is best.

sara said...

Since I'm just pumping I don't have any great advice, but I have to agree with all the points you bring up. At the end of the day, you know your kiddo the best and it sounds like you are going to do a great job!

adellmcc said...

Um, yes. Weaning that suddenly would be really traumatic for Nate.

And nobody has mentioned YOUR BEWBS and how they would HURT OMG HURTY-HURT-HURT. I don't know anyone who could possibly think that weaning cold turkey is a smart plan.

Besides going your own way, you may want to call up the doc and tell her that you disagree and why - especially if you leave her practice. If Doctors don't get feedback from us patients, they'll never change their ways.

And in the end, it's a business relationship. She just lost a paying customer because she didn't give you options and outline choices. She just dictated her version of right - that's not what good doctors do.

But seriously, think of your boobs. Is she fucking CRAZY?

christina(apronstrings) said...

I am so glad that you realized how insane your doctor is. What the? How the? Who the? That would be so traumatic--for you both. Breastfeeding is hard and you stuck to it!

I've heard that bfeeding babies do good with sippy cups with straws. For Cate we use her old born free bottles with sippy cup lids.

Weaning is sad--but the freedom you'll feel afterwards is priceless.

Katie said...

I am having almost the exact opposite experience with Will. HE is weaning before I am ready. Gah! Kids!

That being said, I think it's emotional no matter how the breastfeeding relationship ends. I can't imagine going from every 2 - 3 hour nurses to nothing at all, though. That would kill your boobs! I would try eliminating one feed at a time, which is pretty much what you are doing now. Get the night feeds out of his system, then an afternoon feed, then a morning feed, etc. Leave the last feed of the night and first feed of the day for the end. And keep those if you want to, for pete's sake! How ridiculous to have to give those up altogether!!!!! My view of nursing also changed once a real live baby was on the other end of The Boob, so to speak, and I know MANY people who nurse far past infancy and have perfectly normal kids who regularly STTN. He will do that when he is ready to.

The sippy cup that we (well, Will) likes best is the Nuby and it is most similar to a bottle, but it still is an official sippy cup.

Orange Juice said...

WOW! All I can say is WOW! Maybe it's because I hang out with a granola crowd but that sounds WAY normal to me and I know LOTS of ladies BFing at 3 years!
Weaning on breast of bottle is just plain hard.
Good luck!

KP said...

so sorry that this is so late--got interrupted when I was about to type a response last week. This pediatrician really makes me angry! I'm a family physician and would never tell a patient what she told you at that visit. I totally support your approach, and am happy to hear that it's going well in the follow-up post! I'm still nursing my almost 1yr old daughter (am off work for a few months and am enjoying the easy part of nursing at this point--4-5 times daily, much better than my pump!) Good luck, and I look forward to continuing to follow you on this journey!