Pediatrician's feeding advice @ 12 months — The Bump
Breastfeeding

Pediatrician's feeding advice @ 12 months

I just read the "feeding advice" sheet from my daughter's 12-month appointment and it states: "Switch from breastmilk or formula to whole milk in a cup and offer at each meal."  Now, I know most transition to whole milk at 1, but I can't believe my pediatrician's office is actually "dictating" the switch, vs just putting it out there as a suggestion.  To clarify (so as not to appear so opinionated), I think it could read something more like "You can switch from breastmilk..."  Just my thoughts since I'm still BF'ing DD and plan to go another 6 months (or until she weans, whichever is earlier). 

Furthermore, the AAP recommends "Exclusive breastfeeding for approximately the first six months and support for breastfeeding for the first year and beyond as long as mutually desired by mother and child." http://www.aap.org/advocacy/releases/feb05breastfeeding.htm

What are your thoughts??  Am I reading too much into the feeding advice?  Obviously, I will do what's best for my DD and not necessarily worry about my pediatrician's advice, but it still irritates me. 

Re: Pediatrician's feeding advice @ 12 months

  • I would be annoyed too.  I agree it should be phrased as an option not a "this is what is normal to do at this point."

    I have no plans to switch to whole milk at a year as kiddo is still nursing quite a bit and I don't imagine that changing in the next two months.

  • We introduced whole milk @ 1 yr, but didn't stop Bf'ing (she is still nursing 1-2 times a day.)   I introduced milk so I didn't have to pump if we were going to go out for the night, or if I was going to leave DD w/ DH for a few hours.  I think your pedi's info is probably aimed @ the typical parent/mother who is looking forward to weaning/counting down the days until it's over, etc.  Statistically moms who are still BF'ing @ 12 months are a small minority- so good for you!

    When DD was 13 or 14 months old and had an ear infection I mentioned that I was still bfing and the pedi said that was awesome because she's a bit of a peanut and BM has more calories in it than whole milk.  I got a similar positive response @ her 15 and 18/9 month visits.

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  • image daisyterp:

    We introduced whole milk @ 1 yr, but didn't stop Bf'ing (she is still nursing 1-2 times a day.)   I introduced milk so I didn't have to pump if we were going to go out for the night, or if I was going to leave DD w/ DH for a few hours.  I think your pedi's info is probably aimed @ the typical parent/mother who is looking forward to weaning/counting down the days until it's over, etc.  Statistically moms who are still BF'ing @ 12 months are a small minority- so good for you!

    When DD was 13 or 14 months old and had an ear infection I mentioned that I was still bfing and the pedi said that was awesome because she's a bit of a peanut and BM has more calories in it than whole milk.  I got a similar positive response @ her 15 and 18/9 month visits.

    Maybe I'm a little extra sensitive b/c I can't transition DD to whole milk; she's allergic to dairy.  And that didn't go over well with my pedi either since she's never been tested for allergies.  It runs in my family and she has a variety of symptoms when exposed to it, so I avoid it and keep it out of her diet.  This is probably just another reason I should look for a new pedi; she's so by the book and I don't necessarily think all kids are textbook.  

  • I understand where you're coming from (and I totally agree with you), but I doubt the doctor's office even realizes the significance of what that sheet says.  I'd mention it at the next appointment.  Really--I bet they don't even know. 

    The part that I don't quite get is switching from BF to formula.  I get cow's milk, but if you were going to continue to give fortified milk, why wouldn't you just keep BF?

  • image ljlkm:

    I understand where you're coming from (and I totally agree with you), but I doubt the doctor's office even realizes the significance of what that sheet says.  I'd mention it at the next appointment.  Really--I bet they don't even know. 

    The part that I don't quite get is switching from BF to formula.  I get cow's milk, but if you were going to continue to give fortified milk, why wouldn't you just keep BF?

    I may just mention it; I don't even know if those sheets are owned by the pedi's office or provided by a separate entity altogether.  

    Also, it doesn't say switch from BM to formula or cow's milk; it says to switch from BM or formula to cow's milk. 

  • image LyndsayQ:

    Maybe I'm a little extra sensitive b/c I can't transition DD to whole milk; she's allergic to dairy.  And that didn't go over well with my pedi either since she's never been tested for allergies.  It runs in my family and she has a variety of symptoms when exposed to it, so I avoid it and keep it out of her diet.  This is probably just another reason I should look for a new pedi; she's so by the book and I don't necessarily think all kids are textbook.  


    Are you allergic to dairy or have you had to adjust your diet so you could bf your DD this whole time?  Either way a HUGE congrats to you!  That is very impressive!

    I would probably look for a different pedi if you aren't comfortable w/ the current one's approach.  I tend to ignore a lot of the written stuff they give me @ mine, it's photo-copied & some of it is old.  My dad is a family physician, so I have a 2nd opinion v. close @ hand.  Also from my original reply it might have seemed like I went to bf'ing only 1-2 times a day @ 12 months- she was still nursing a lot until about 16-17 mos.

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  • I agree! I was pleasantly surprised that DS's pediatrician told me to "Keep it up!". I did not expect that from him at all.

  • Those are probably some general guidance sheets that they give everybody.

     

    At my office, we don't really have any handouts that are given, but when they are there for the visits they fill out this little paper with what they are eating, bowel habits, if they have questions, ect. SO then I can address any specific concerns. Obviously if they are on formula I go ahead and tell them to change to whole milk, but if they are happy nursing, I'm very supportive. I was pleasantly surprised when a mom asked me if she needed to stop bf'ing her her 12 month old, and I told her not unless she wanted to, so she said that she was planning on continuing!

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  • image daisyterp:

    Are you allergic to dairy or have you had to adjust your diet so you could bf your DD this whole time?  Either way a HUGE congrats to you!  That is very impressive!

    I'm not allergic, but my sister, niece, and Mom are allergic.  I was on soy formula as a baby, but a milk allergy was never technically diagnosed.  I've been avoiding it for about 7 months now b/c it took me 5 months to come to terms she was allergic and I had to alter my diet.  Its not that bad; thankfully my sister is a dietitian and she's been avoiding it a lot longer than I so she's a great resource for alternatives.  :)

  • image makclair:

    Those are probably some general guidance sheets that they give everybody.

    I agree; however, I would think they might have them changed so as to reflect the AAP's recommendations.  Just my thoughts tho and I am not going to change what I do.  I appreciate everyone's comments. 

  • I would be annoyed too- just like I was annoyed when the NP @ our pedi's office told me I should start rice cereal @ 4 months.  I was like "uh, did you look @ her chart, her dad has asthma and allergies, we will be EBF'ing for 6 months."

    I wanted to slap her upside the head and tell her to get w/ the new program. 

     

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  • image ljlkm:


    The part that I don't quite get is switching from BF to formula.  I get cow's milk, but if you were going to continue to give fortified milk, why wouldn't you just keep BF?

    Didn't you know that breastmilk turns to cherry Kool-aid at midnight on the first birthday?

  • I got one of those feeding sheets at DD's 4 month appointment when we saw a different (older) pedi in the practice. Ours was out on maternity leave. I think it said something crazy like 3 meals of solids by 6 months. It ended up in a pile of papers on the desk and probably got thrown out soon after. Our pedi had very different guidelines. She said most babies were on 2 meals/day by 9 months and 3 meals/day by 12 months. She never gave us a sheet of advice.

    I think the most annoying part is that it doesn't leave any room for parental judgment. There are people who will follow a doctor's advice to the T, and they wouldn't even think to question. That's what's most irritating.

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  • image Angela814:

    I think the most annoying part is that it doesn't leave any room for parental judgment. There are people who will follow a doctor's advice to the T, and they wouldn't even think to question. That's what's most irritating.

    This exactly!  I feel like people should do more research to form their own opinions based on what's best for their family.  

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