Breast Feeding 101

Many nursing mom's switch to this.





Without judgement, I completely understand why.


Although I am a pediatrician, I did not want to breast feed my baby. I know, having learned over and over again in medical school and then again in residency all of the reasons why women should breast feed.
I had heard the mantra "breast is best" over and over. Many of you know that breastfed babies have better immunity, tend to "bond" with their mothers and the books say, it is easier than formula feeding!

Regardless of all of this information, I had decided in my mind, at some point in medical school that I hated the thought of "me" breast feeding. I wanted everyone else to do it, all my patients and my friends. But, me, breast feed-- No Way! I mean no thanks. But, before my baby was born, I promised my baby's daddy (also a pediatrician) that I would at least try to breast feed.

The day arrived unexpectedly, and so did my first true test.

Day 0, hour 1 of my daughter's first day. I lay awake and asleep in my hospital bed to find my precious little daughter in my arms. It was time for her to eat.

She latched. She sucked, She drank. We did it! To be honest, the first time around, I was so dough eyed in love that I didn't really know what was going on.

And then, we got home and it started to sink in. She cried with hunger, she cried with exhaustion, I breast fed. But, I was exhausted and in pain from surgery. I was also overwhelmed by the new person in our home, yet for some reason I continued to breast feed. My little daughter lost weight the first week and was jaundiced. I worried she was not getting enough to eat, and despite that I continued to exclusively breast feed.

There it was. I had not given her any formula. Hip Hip Hooray!

But I still felt, well, not comfortable with breast feeding.

Despite that,I marched on. I continued to love, love and love my little daughter. But the breast feeding all I could express to others was, "they say, "breast is best."

so, at 3 months post partum I felt like this:

What job can only one person perform every 2hours, for 20-30 minutes at a time, 24 hours/day, 7 days a week for months and months at a time.
Breastfeeding. Only a mommy can do that.

This is what no one talks about. The challenges of breastfeeding. No coffee breaks, no bathroom breaks and certainly no meal breaks. How does anyone manage to take a shower, answer a phone call, or have a coherent thought in the middle of all of this. And I did not even mention the middle of the night feedings, diaper breaks, dirty laundry, oh yes, and grabbing a bite to eat yourself.
With all of this, it is no big surprise that most woman in the US don't do breast feed for long. Most women give up or wean before or around 6 months post partum.

All the while, that powdered white formula is sitting there, like a tiny while bottle of evil, calling my name, enticing me to pick it up and use it.

Some of my colleagues, wondered why I didn't give my daughter the occasional bottle of formula. But they just didn't know me in that special way. My obsessive compulsive tendencies weigh in and prevented me from going for the formula. If I was going to do something, I always do my best. And then was the other simple truth about me, if I tried the bottle of evil, a quick and easy shortcut, would I even be able to go back to breastfeeding?

So, I trudged on. Exhausted, and waking up every 2-3 hours to feed her all day and night.

As a mommy who has been exclusively breast feeding her baby for 10 months (no formula yet). I can say it ain't easy.

So why did I keep going? Because my daughter was thriving, and she was thriving so beautifully I did not want to give her any less than my personal best. I'd be lying if I didn't tell you there were many moments where I loved being the one person who she needed the most, for love, attention and her meals, but it went beyond just that. Something I just can't explain. With the combination of sleep deprivation and breast feeding, somehow, perhaps with the help of all of the maternal hormones still surging thru me, I was able to manage to wake up every day and be excited about seeing her and breastfeeding her.

In the end, I think that if someone had told me how much work the breastfeeding was, I might have been better prepared. Now, I hope you might be. But realistically, I don't think anyone can know, until it really happens.

As far as I can tell, I just passed my first test of motherhood, with patience, dedication, hard work and lot of love. Now, only many many more years to go.

A Doctors Guide to Choosing Your Child's Doctor

How to pick a pediatrician?

Stressed out. Sleep deprived. Tired. Excited. Getting the nursery ready, checking off your "before baby arrives" to do list. Seeing old friends and relatives and working overtime to get extra time at home with baby once she arrives. Sound familiar? If so,you'll find this guide to the "Pre-Baby Basics" helpful.

I was so excited before my baby was born, but it felt like life was chaotically in limbo. And I still had not picked the pediatrician.

Take it from a pediatrician, choosing your pediatrician can be a daunting task.

So here I am, a pregnant pediatrician, ready to become a mommy, but not ready to become a mommy either. It just happens to be that my baby's daddy is a pediatrician also. So the task of finding our pediatrician seemed even more challenging.

All of my friends, and family assumed with my unique situation that I, or my husband would be our baby's pediatrician.

No way, I thought!

Here's why: You want your baby's doctor to remain objective. Anytime I give advice to family members about their kids, I find myself wanting to tell them what they want to hear. I find myself wanting to give them advice I would never give to my patients. The best doctors remain objective about the situation. It is difficult to remain objective about a child who is part of your friends and family network.

For example, my baby had terrible reflux in her first few months of life. On many occasions, my husband and I wanted to treat her condition, but I knew that I would advise my patients not to do anything in this situation. Yet, I could not watch my daughter suffer with it. I could not be objective. Thankfully, we found a doctor who was objective.

That said, how did we find our pediatrician?

Take it from a mommy who loves to shop. The first rule for shopping, buy something only if you LOVE it! Finding the right pediatrician can be similar to finding a pair of shoes you could live in forever. So, in order to get it right, you may have to meet a number of different doctors until one "feels" right. What do I mean by, "feels right?" There are many issues that go into that "feeling".

For me, it meant finding a doctor who really listened to me. Someone who not only listened to what I said, but actually heard me. When my daughters reflux worsened I called my pediatrician. He was out of town. So, I decided to speak to the on call physician. The on-call pediatrician knew I was a pediatrician, yet,he talked down to me, and further went on to tell me- "you already know your options." In reality, he was right, I did know my options for my daughter's condition. And I also knew how I would approach a patient with a similar issue. But, what I needed at that moment, was a doctor who could realize my fears as a mom. A doctor who could say, "Wow, that situation sounds scary know, but here is what I think, here is what you should do and this is why everything is okay."

As a pediatrician, some doctors may assume that I already know everything. But, my daughter has taught me that being a parent means. It means on occasion all rational thoughts vanish. So, find someone who you can ask the silliest and most embarrassing questions. You will be surprised what questions you may have for your doctor in the future.

Some other important tips to find the pediatrician that is right for your family.

1.) Is he/she board certified in pediatrics?

2.) Find out who takes calls after hours and on weekends.

3.) Find out what their weekday schedules are. Many pediatricians work part time, so find out if their schedules fit your families needs.

4.) Meet the other doctors who work in their office, chances are, you may see one of them on occasion.

5.) Ask where you go for labs, x-rays and in emergencies, much of this is dependent on your insurance, but it is still important to know.

6.) Oh yes, this may seem basic, but find out how far they are form your home? When your child is ill, you want to be close by. I ended up picking someone 20 minutes away, but when your baby is ill, that feels like a long drive.

7.)Ask the pediatrician questions about what is important to you. Examples may include their philosophy on child rearing, vaccines, co-sleeping,antibiotics and anything else that may be important to you.

8.)Ask how they keep up with medical advances.

9.) Word of mouth is important. Talk to other mothers locally and get their feedback.

10.) If you don't know any moms, you can always check the local mom's groups for opinions.

Most importantly,if you choose someone and later on it doesn't "feel right", its not too late. You can pick someone else and you won't hurt any-one's feelings. You are your child's advocate so follow your instinct. And remember, before your baby arrives, go meet the different pediatricians. Comparison shopping is best to do before your baby arrives.