Breastfeeding

Weird pedi advice?

We had our one month appt today and I was really thrown by my pedi's answers to some of my questions.

In conversation I mentioned I wasn't sure how many times I should pump when I go back to work. She told me one pump would be plenty and that he would eat before and after work. I had already told her he would miss 3 to 4 feedings during my day and one pump seems like terrible advice?

Then I asked how I would know how many ounces to send and when to increase. She said the rule is "age in months plus 3" so since he is one month he needs 4 oz. That just seems like a ridiculous amount at say, 5 months. Every BF baby I know always had smaller bottles.

Then she went on to say if I don't end up pumping enough I can always supplement with an ounce of formula in the breastmilk bottle.

Is all of that weird BF advice? It just doesn't sound right to me and I feel really hesitant. But DH says she has more experience so she would know...
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Re: Weird pedi advice?

  • Wow, that's the worst advice I've ever heard. 2-3 pumps is normal.

     There is no "rule" about ounces of BM. Most BF babies don't increase their ounces much past 4-5 oz bottles as your milk changes composition to meet their needs. I'd start with 4-3oz bottles and see how LO does, with the caveat that the 4th bottle will probably carry over to the next day. Some babies don't eat a lot away from Mom but I wouldn't send a ton of milk in case DCP overfeeds.

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  • Honestly, it sounds like your pedi recieved the standard med school education... WEEKS upon weeks of teaching about formula feeding, and less than a day of education about breastfeeding. 

    I would ignore her advice...and perhaps write a letter or refer her to kellymom to learn about BFing. 

    You should pump every 2-3 hours when you are back at work. Some moms get by with every 4. As often as necessary to feed your LO while you are gone.  

    The "rule" is to divide 24 by the number of times your LO eats in a day - so if LO eats 8 times a day, each bottle should be ~4 ounces. Of course, that's just a guideline.  My LO ate 3 ounces every 2 hours from 3mo-4mo, then 4 ounces every 3 hours until 5.5 mo, and 5 ounces every 3 hours since then (with slow addition of solids after 6M).

    Either ignore your pedi and take BF advice from the internet or a lactation consultant, or find a more BF-friendly pedi...

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  • Kellymom.com is my BFing bible. Seriously check it she has a really good way of calculating how much you should send. Also remember that pedi's are not trained in BFing. Most of them excessively push formula because its what they are used to dealing with. Its sad and should be fixed but it is what it is
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  • Yeah, that's dumb. I pump 3 times while away and once in the morning. I can normally make enough for 3 or 4, 4 ounce bottles; one does usually carry over to the next day.
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  • Okay thanks! I am glad my instincts were right at least. She is much older and has bf her kids which is why I wasn't sure.

    Anyway I'll check out Kelly mom and see if I can get some better facts to show my husband. Thank you!
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  • Just so you ladies know, doctors do not get education on formula feeding either. During medical school, we really didn't get much education on feeding babies or kids at all. We touched on allergy stuff (which has all changed now) and other safety prevention stuff. Recommendations and guidelines change so much, it really is on the individual doctor to read and educate themselves on those kinds of topics. I would never rely on a physician for help with feeding you kids at any age!
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  • This pediatrician doesn't know anything about breastfeeding, and I would either not listen to a word she says about breastfeeding, or I would find a new doctor.

    Pump every 3ish hours in the beginning at work.  My BF baby never took more than 4oz at a time even up until he was a year old, so that is horrible advice to give age in months plus three.

    Trust your gut.  Forget everything she said about BFing.

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  • I'm sure she BF her own kids. I bet she did it for a few weeks, even!

    I don't think doctors are educated in FF or BF. I think FF does a better job of leaving them some phamplets. It would be nice if a doctor that was going to dispense advice would base it in some actually educated information. 

  • image Grace0609:

    This pediatrician doesn't know anything about breastfeeding, and I would either not listen to a word she says about breastfeeding, or I would find a new doctor.

    Pump every 3ish hours in the beginning at work.  My BF baby never took more than 4oz at a time even up until he was a year old, so that is horrible advice to give age in months plus three.

    Trust your gut.  Forget everything she said about BFing.

    All this! 

    I started pumping 3 times per day, then switched to 2 times per day with an extra pump before bed time.  At 1 year, I will go down to 1 pump per day.



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  • image heatherjesse:
    Just so you ladies know, doctors do not get education on formula feeding either. During medical school, we really didn't get much education on feeding babies or kids at all. We touched on allergy stuff which has all changed now and other safety prevention stuff. Recommendations and guidelines change so much, it really is on the individual doctor to read and educate themselves on those kinds of topics. I would never rely on a physician for help with feeding you kids at any age!


    This! My residency was not in pediatrics, but I never had any formal training on either FF or BF, or on any of a number of other well infant care issues.
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  • I'm a family medicine doc not a pedi (though I cover the inpatient ped and newborn services) but there were no formal lessons in infant feeding that I recall in med school.  I like to think of some of this stuff as more parenting decisions than medical decisions though that's problematic in our society these days.  On the other hand, I'm now a lactation counselor because this is an interest of mine.  I second Kellymom.com and add workandpump.com, these are sites I send my patients to for extra information and the questions they have in the middle of the night.  
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