FFF Friday: “I don’t think I have ever felt quite so judged about any other parenting choice.”

So much of the conversation on infant feeding focuses on first-time mothers and their breastfeeding experiences, for understandable reasons. But that also makes it easy for some to dismiss these experiences as simply “misconceptions”, “nervousness” or “inexperience with breastfeeding”.

But what happens when a third-time mom has twins, and despite the fact that she breastfed successfully twice before, she finds herself dealing with unexpected complications? Turns out, in Michelle’s case, that mother ends up dealing with the same emotional turmoil, conflict, and confusion as the first-timers. Because breastfeeding problems are not the sole property of any “type” of mother, of any age, socioeconomic group or ethnicity, or parity. These problems can strike any mother – and when they do, each and every one of us deserves support, respect, and the opportunity to make the best decision for our families. 

Happy Friday, fearless ones,

The FFF

***

Michelle’s Story

When I found out that baby #3 was going to be baby #3 and #4 I was understandably excited and nervous. One one the first things people commented/questioned me about was whether i was going to try to breastfeed them. My answer was always that I would play it by ear and see how it went.

The twins developed something called TTTS (twin to twin transfusion syndrome, which can happen when identical twins share a placenta) and I was hospitalized for 6weeks with daily ultrasounds and monitoring, to make sure the babies were still okay. Every day I worried that one or both babies had died. It was not a relaxing pregnancy.

My babies were born at 31 weeks….tiny but perfect. They spent 6weeks in the NICU and I spent those six weeks pumping every 3-4 hours and making trips back and forth to the hospital while also trying to care for my other two kids who were not quite 2 and 6. I was generally NOT at the hospital for feedings, but the girls were getting my milk, first through an NG tube and then when they got better at suck/swallow/breathe, through a bottle. When they were getting close to discharge, the nurses told me to buy bottles and I was clueless and overwhelmed because I had always breastfed my others and had never used a bottle. I had requested a lactation consultant to help me transition them from bottle to breast, but she told me to nurse them and give them bottles afterward if they still seemed hungry. Prior to their discharge, I had attempted putting them on the breast exactly one time and it was not what in would call a rousing success.

They were discharged at 37 weeks and they were still incredibly sleepy and not interested in working for their food. I continued with nursing, bottle feeding, pumping every 3-4 hours. I was attached to the pump. I was miserable . I got in touch with a different LC who was more helpful and over the course of a week or so, I got the girls to latch and eat and finally I could be rid of the infernal pump.

Around 40 weeks the girls woke up. And they screamed. They screamed and they screamed and they screamed. They were miserable. I contacted the same LC again and she thought maybe I had oversupply. I worked on that. The babies continued to be miserable. I took them to the pediatrician who said some babies are just miserable and despite the fact that I had experience with two other babies, I had not had experience with twins. The girls still screamed. Finally when they were around three months old I read about milk protein intolerance and decided to eliminate dairy from my diet. There was much less screaming. There was still some though, and their stools were still showing signs of further intolerance, so I stopped eating soy also. That seemed to be the magic thing. Finally, I had happy babies (their bowel movements still seemed weird, but they were happy, I was happy…everything was finally good in our world). They were five months old at that point and I was finally enjoying them.

Fast forward to their weight checks. The older they got, the less they were gaining. They started out at three pounds, were almost five pounds when they came home at 6weeks old, and at five months were eight pounds. At six months they were up a couple more ounces each. We were going to the pediatrician for weight checks weekly and they were gaining, but slowly. Nobody suggested formula (I had on occasion used nutramigen when I got too touched out and needed a break. They also suffered from pretty severe reflux and wanted to nurse ALL THE TIME. I had tried a “gentle” formula once and it had resulted in immediate screaming that lasted two days, so that solidified my belief that these babies could not tolerate any dairy).

At their NICU developmental follow up appointment at almost 8months, the neonatologist was very concerned about their weights. At first they were recommending physical therapy, but he thought that if they started growing that it would not be necessary. They were 8 and 9 pounds and had been within 6 ounces of that same weight for at least 10 weeks. He suggested me doing an elimination diet and also supplementing with puramino formula 2x a day to see if that would help. I was already struggling without dairy/soy and feeding the rest of my family, so I was not thrilled about an elimination diet. I was not thrilled about the prospect of formula either. I thought long and hard about it, and decided to give them the formula and go back to eating what I wanted. I continued to pump just in case, for about three weeks. I watched my supply dwindle. I initially struggled with guilt, despite the fact that in the month they have been on the formula, they have each gained THREE pounds. There are rolls of chub on their legs! They are finally thriving and I love seeing them grow (they are almost 9months old now).

Nobody says “Good for you for feeding your babies!”. People insinuate that I didn’t try hard enough, that if I were a really good mother I would have gone on the elimination diet. One lady told me that I finally gave in to the evil medical establishment and that I should go back to breastfeeding. I don’t think I have ever felt quite so judged about any other parenting choice. I hate that I feel like I have to explain how we got to this point and despite me resolving NOT to explain, I feel oddly compelled to anytime anyone comments (which they all do immediately upon seeing a bottle).

One thing these babies have taught me is empathy. I never really understood empathy like I do now. I am much better able to put myself in someone else’s shoes and not be judgmental (secretly or otherwise).

I am so incredibly grateful that i found FFF when I did. My healthy thriving babies are glad also!

***

Share your story. Email me at formulafeeders@gmail.com.

The FFF Quick-and-Dirty Guide to Formula Feeding: Recognizing Sensitivity, Intolerance or Allergy to Formula

Those of you who haven’t been following this blog since the beginning may not know this, but my son Fearless Child (FC) has a dairy allergy, which went undiagnosed for the first few months of his life. Having his insides assaulted on a daily basis made him grumpy – so grumpy that he screamed bloody murder for about 20 hours a day. And yet it took us over a month of elimination diets, doctor visits, and late-night consultations with Dr. Google to figure out what was going on. This was partly because FC’s symptoms were slightly atypical, but more so because as new parents, we were utterly confused as to what was “normal” newborn behavior and what necessitated medical intervention.

There’s a good deal of information on dairy intolerance in babies on the Web, but not much specifically geared towards bottle-feeding parents. This is unfortunate, as those of us feeding our kids in this manner actually have a really simple way of figuring out if food issues are at play – and yet so many of us struggle for months, feeling increasingly frustrated and hopeless with our inability to comfort or feed our children adequately.

I always hesitate to offer what might be construed as medical advice, since there’s far too many hacks out there doing just that. So before I continue with this post, let me reiterate: I am not a doctor. I haven’t even played one on t.v. (Does anyone still get that reference? Or does it make me sound old?)  The following information is what I have culled from my own research, talking to pediatricians and pediatric GIs, and from my own experience as the mother of two kids with feeding issues.

Oh, and one more note: I am going to use the terms “intolerance”, “sensitivity”, and “allergy” interchangeably here, even though these three things are entirely different. This is because until you see a physician, you won’t know which of the three you are dealing with. My purpose with this post is to help you realize when something is amiss, and to assist you in navigating a medical system which often ignores the power of parental intuition and knowledge of one’s own child. You’ll have to see an actual MD to get a true diagnosis… and I don’t meant Dr. Google.

 

Behavioral Symptoms of Formula Intolerance or Allergy in Young Babies

Newborns are complicated creatures. Some are calm and sweet (this is the kind of baby everyone else seems to get at least once, but apparently my and my husband’s genetics do not morph in a manner conducive to a docile temperament), others are generally chill except for a bout of colic between weeks 2-8, and others are fussy all.the.time. This last group is the one that we need to worry about. Typically, a calm, contented baby is a well-fed and happy one. This is not to say that food allergies will not strike later in life, once solids are introduced, but a newborn who is sensitive to something in formula will usually express discomfort in a pretty vocal way. Watch out for:

– Extreme fussiness. Colic is defined as crying for a period of 1-3 hours, at least 3 days a week, typically in the evening. A baby who is sensitive to formula will cry constantly, throughout the day. They can sometimes be comforted, but only by extreme measures like continuous movement (we had to bounce FC so vigorously that once, while shopping for a new car, a man came up to us in horror and told us we should stop shaking our baby; a friend’s dairy intolerant breastfed baby was only comfortable while being vibrated in his bouncer – all night long), specific holds (the Harvey Karp /Happiest Baby hold is magical for babies with tummy issues). The difference between a “normal” fussy baby and one with potential allergy or intolerance is that they have 2 settings: sleep and screaming. The fussiness is the default, rather than the exception.

– Trouble sleeping. While many young babies sleep erratically, they usually sleep a lot cumulatively.  A newborn with a formula intolerance will often be too uncomfortable to sleep.

– Trouble eating. This one gets tricky, because other issues can cause trouble with feedings – sensory issues, reflux, dislike of the type of bottle or nipple you are using… but one common symptom in babies experiencing formula intolerance is fussiness around eating. They may pull away from the bottle and scream; or eat only small amounts at a time. Reflux can also be associated with formula intolerance, so spitting up an excessive amount after every feeding (especially if there is curdled formula or blood in the spit up) might signal a problem. Some babies might develop an aversion to eating, associating the formula with pain, and refuse the bottle altogether. Others may “comfort feed” and want to eat constantly (more on this later).

– Inability to connect or bond. Again, this can signal a far more serious issue, but it should be noted that babies who are in constant pain have a rough time chillaxing enough to focus on their parents or begin engaging in social interactions. I’ve had numerous parents tell me that they had secretly worried their baby “had no soul” or “wasn’t all there” prior to diagnosing and solving a severe allergy or intolerance. If your baby is screaming constantly or is noticeably stiff, writhing, or doesn’t seem to be comforted by touch, see your doctor.

 

Physical Symptoms of Formula-Related Food Intolerance or Allergy

The physical manifestations of a formula intolerance are more straightforward, but they also tend to suggest a more serious problem (i.e., clinical allergy versus sensitivity). In terms of getting a diagnosis, they do make life easier, but they can also be scary when first encountered. These include:

– Weight loss, or extreme weight gain, from comfort feeding.  I’ve heard of more than a few cases where babies who are overeating are misdiagnosed with the excuse that “milk protein intolerance causes failure to thrive”. This is true; many kids will have aversions to formula or breastmilk caused by associations with pain, and refuse to eat; these conditions can also cause malabsorption, so the baby isn’t getting the necessary nutrients to grow. But some babies find the liquid comforting as it goes down (especially those who have reflux associated with the intolerance or allergy), or like the sucking action, and want to eat constantly. The offending food causes more distress, which then creates a need to comfort feed more… and suddenly you’ve got Jabba the Hut, Jr. on your hands. Their girth may cause doctors to dismiss discomfort and symptoms as “overeating”(which can certainly cause a whole list of problems, but my point is that sometimes, the overeating is a symptom, not a cause).

– Blood in the stool – this can appear looking like strawberry jelly (red) or like coffee grinds (black). If you see blood, drop everything and call your pediatrician.

– Mucous in the stool – this is a biggie, because often the blood will be invisible to the naked eye, but mucous is easy to spot. Mucous looks like stringy, gelatinous strands, usually white or clear in color.

– Rashes – these can appear in a variety of forms, and may be hard to differentiate from normal newborn skin issues like diaper rash or infant acne. Sometimes the rashes might look like hives, but they can be atypical. FC would get petechia-type red dots on his cheek, right next to his eye, and down his cheek. (This same reaction continued as he grew into toddlerhood, and was a great way for us to know we’d screwed up and allowed for accidental exposure). Other parents have told me that the rashes congregate near the joints, or as a red ring around the anus. All lovely and comforting things to see on your precious newborn, right?

– Vomiting up blood. Again, this merits a panicked call to the doctor. Stat.

Something you should also know is that milk protein allergies come in two forms: rapid onset (immediate reaction) or delayed onset (reaction within 7-10 days of ingesting milk). This may explain why some babies don’t start reacting to formula until a week or so after birth/switching over from breastfeeding. Rapid onset looks more like a “classic” food allergy – hives, wheezing, bloody diarrhea. The rapid onset form is far more dangerous, as allergies can worsen with every exposure, eventually leading to anaphylaxis, so if you see these sort of symptoms, do not pass go, do not collect $200, just dial your pediatrician.

Which brings me to….

Seeing Your Doctor

There are a lot of fabulous pediatricians out there. There are also some really crappy ones. And in the middle, there are doctors who have seen thousands of neurotic new parents who freak out at the first sign of slight fussiness in their babies, and also a slew of legitimately concerned parents dealing with the untreatable hell that is infant colic. Considering that in the majority of cases the babies they see are either healthy and just waking up to the world (it’s normal for a baby to be impossibly easy and sweet for the first few weeks and then wake up one day with an attitude. Think of it as good practice for the teen years), or are unfortunate victims of colic and just have to wait it out (excuse my tangent for a moment but I cannot for the life of me understand why no one has figured out this colic thing. Seriously? We can clone sheep and we can’t figure out why some babies cry inconsolably for exactly 3 hours at the same time every night??!), it is understandable that some pediatricians have dismissive or patronizing attitudes towards those complaining about fussy babies.

I have seen parents who do overreact to sudden onset of mild spitting up, fussiness, or constipation- it’s hard not to, considering the lack of sleep, the hormones, and the lure of the Internet (Dr. Google is an alarmist). But for the most part, every parent who has emailed me with a laundry list of weird symptoms and a general, foreboding sense that something is “not right” with their newborn, has later followed up to confirm diagnosis of an allergy or intolerance. I’m a big believer in mommy/daddy “gut” when it comes to your baby’s gut.

So, here’s what I would suggest: before you go in for your child’s appointment, write down a list of every symptom you have observed. If you’ve been noticing mucous or blood, collect a stool sample, and show your doctor the craziness that is coming out of your kid’s tush. If your doctor starts talking about colic, explain to him/her that you are well aware of what colic is, and colic does not explain the other symptoms you are noticing (you might also want to mention if your child’s crying doesn’t follow a colic-like pattern – meaning that it is not sustained crying for a specific period of time, but rather constant fussiness throughout the day).

It is also well within your rights to request allergy testing, but here’s the thing: with this sort of testing, only a clinical allergy will show up. If your baby has an intolerance or sensitivity, the testing will probably come back as inconclusive or “normal”. Additionally, there is some controversy on whether allergy testing in young infants is even accurate.

Luckily, there is another, non-invasive way to see if the formula you are using is the problem, which is what I like to call…

The Miracle Cure

I could write a Shakespearean sonnet for hypoallergenic formulas, and I’m sure the folks who like to think I’m paid off by formula companies will find fodder for this conspiracy theory in how often I hawk Alimentum on here. But I just love the stuff. And not just Alimentum. Nutramigen, and Neocate, and whatever comparable product is on the European/Asian markets. The stuff is stinky, expensive….and utterly lifesaving.

If you suspect that your baby has a milk protein sensitivity, and the symptoms are not severe enough to necessitate medical intervention, you might want to consider doing a 48-hour hypoallergenic challenge. This is a 4-step process:

1. Get thee to thy nearest drugstore/grocery store

2. Purchase a commercial hypoallergenic formula (please read my post on types of hypoallergenic formula to ensure that you are choosing a true hypoallergenic and not simply a “sensitive” brand)

3. Serve said formula to thy infant, and observe for the next day or two

4. Thou shalt be singing high praises to the heavens by yonder morning, otherwise the formula probably wasn’t the problem in the first place.

While milk and soy protein allergies are the most prevalent in young infants, there are some kids who are sensitive to corn or other ingredients in formula. And for children with severe milk protein allergy, a commercial hypoallergenic isn’t going to cut it – they will need an amino acid-based formula, which is available by prescription only. But for most babies suffering from mild to moderate sensitivities/intolerances, a hypoallergenic formula is truly a godsend. You should see a marked improvement within 2 days if the problem is food related and not due to some other underlying medical condition (cough*call doctor*cough) or- and I seriously hate to say this – if it’s just colic or fussiness, in which case you really do just need to give it time, and start drinking heavily to get through the next few months. Kidding. (Maybe…)

If you are dealing with colic or normal infant fussiness, the good news is that you can skip the following section, and not have to worry about a childhood without ice cream and birthday cake. But if the formula does make a dramatic difference, you may want to consider….

What the Future Holds

If the hypoallergenic works wonders, you can continue to use the formula and try re-introducing a normal or sensitive formula at about 6 months, once your baby’s system has developed a little more. If symptoms return, then you simply return to the hypoallergenic.

That said, hypos are quite costly, and if your child does have a true milk protein allergy, you might be able to get the formula covered by your insurance. You’ll need to see your pediatrician to get the right paperwork filled out in order to do this.

I’d also suggest that you do ask for a referral to an allergist and/or pediatric GI, just so you will have someone in your corner when you start solids. While most children outgrow a milk protein allergy or intolerance as they become toddlers, some take longer than others. It gets really difficult to figure out a delayed-reaction allergy once they start solids, because the exposure could have been anytime in the week or so prior to the reaction. Also, weaning off formula looks a bit different in a dairy intolerant/allergic child. Sometimes, pediatricians will want you to stay on formula a little longer since it’s harder for kids to get the nutrition they need when they can’t eat or drink dairy products. In other cases, using a milk substitute like soy (unless your child is sensitive to soy as well, which many milk protein intolerant kids are), rice, almond (as long as you’ve seen an allergist and been tested for nut allergies), oat. or hemp, can be a perfectly acceptable option. My kids have both thrived on unsweetened almond milk, which is fortified with so much stuff nowadays that the only thing milk trumps it on is protein content and fat (and we incorporate other foods into their diets that compensates for this).

You’ll get very good at reading labels, and creative with recipes, and become a master at surreptitiously pulling vegan cupcakes out of your diaper bag at birthday parties so your kid won’t feel left out. You’ll probably do “challenges” with your kid every so often to see if his or her body has decided to make friends (or at least frenemies) with dairy, and when that day comes, you may even get to see a face like this:

Fearless Child’s first time eating cake & ice cream at a friend’s birthday. And yes, I cried.
Until then, remember- you are the expert on your child. You are also your child’s best advocate. Formula can be changed at any time, so there is no reason to suffer stoically if you suspect an intolerance or allergy to the one you are using now.
Great Links/Sources
http://kidshealth.org/parent/medical/allergies/milk_allergy.html
http://www.allergy.org.au/patients/food-allergy/cows-milk-dairy-allergy
http://foodallergies.about.com/od/dairy/a/babymilkallergy.htm
http://adc.bmj.com/content/92/10/902.full.pdf
http://www.kidswithfoodallergies.org/resourcespre.php?id=140&
http://www.medscape.org/viewarticle/563463

The tale of the asshat pediatric GI

Recently, the Academy of Breastfeeding Medicine held their annual conference. I followed the Twitter stream from the conference, and some of the soundbytes coming out of there were frightening, even more so because they were coming from the mouths of medical professionals. One speaker was quoted in numerous tweets for spouting this lovely tidbit: “I don’t say, ‘breastfeeding is so protective for mothers.’ I say, ‘Formula feeding is so dangerous.’” This came from a woman whose CV mentions an interest in the “responses of women to life stressors such as trauma.” Sounds about right; she can traumatize them with comments like that, and then study them to see the effect.
My main problem with this conference is that I think calling it the Academy of Breastfeeding MEDICINE is misleading. If it’s the Academy of Breastfeeding Medicine, let’s talk medicine. Presentations like “The Dermatology of the Breast” and “ Exclusively Human DIET (EHD) for Infants <1250 grams to Prevent Nectrotizing Enterocolitis (NEC)" sound perfectly suited to this event; "Effect of Delaying the Bath on Exclusive Breastfeeding Rates” and “ A Report from Japan: What We Learned from the 3.11 Disaster”? Not so much. 
Okay, quick irrelevant aside, because I just can’t let it go. According to the abstract, the “findings” of the latter report were:
The myth that the artificial milk was safe collapsed in the developed country such as Japan. Though the information that indicated the safety of breastfeeding at the time of a disaster was easily accepted, the assertion to be said not to receive liquid milk donated from foreign countries was hard to be understood not only by general public but journalists. The problem about nuclear accidents is now going on.
Maybe it’s a language barrier, but isn’t this stating that that the public and journalists were pissed off that UNICEF was discouraging formula donations – ready-to-feed formula donations, to be specific? Did they not see why people would be pissed? (And yes, I know the reasons why UNICEF has it’s protocol for infant feeding in disasters; I’m on the fence about it, actually. But it isn’t a totally black and white issue, either.) Am I reading too much into this abstract and the tweets coming from its presentation if I say these folks sounded mighty gleeful that the disaster “collapsed the myth” that formula was safe?
Anyway. Back to the reason this makes me so uppity…  I worry that by morphing together breastfeeding advocacy and breastfeeding science, we are coloring the judgment of those who should be treating us on a case-by-case, individual basis.
And speaking of case-by-case, here’s a case in point. A little story about the FFF in my  Fear-ful days, when I was a brand new mom; a floundering mess with a child who wouldn’t stop crying and a pump which wouldn’t stop screaming “YOUSUCKYOUSUCKYOUSUCK” every time I turned the blasted thing on.
Fearless Child had been miserable pretty much since the 4th hour of his life. First, he’d been starving; once we realized he’d never latch and resorted to exclusive pumping, he gained weight fast, but he never seemed healthy. He had a weird rash all over, never slept, screamed before, during and after feedings, and had mucous-filled diarrhea about 15 times a day. My doctor suggested cutting out milk, soy and nuts; I did so for two weeks, to no avail (actually, I’m about 90% vegan to start with, so there was little dairy in my diet to begin with. Soy was a lot harder for me to cut out.). The third or fourth time I visited our pediatrician about FC’s stomach issues, she looked at the poor little guy, still screaming his rashy head off; felt his tight, gurgly abdomen; and suggested that we see a pediatric gastroenterologist. As she wrote down the contact info for the referral, she told me she’d also give me a sample of a special, hypoallergenic formula, to try in the interim. “The guy we refer to will probably have you try this for 48 hours to see if there’s a difference, rather than putting FC through a lot of invasive testing. You might as well try it out while you’re waiting for an appointment – no need for him to suffer any more than he already has, and it’s worth a shot.”
Within twenty-four hours, we pretty much already had our diagnosis. The hypoallergenic formula stunk to high heaven, but FC lapped it up like it was chocolate milk. And after he finished the first bottle of the special formula, he slept for a record four hours. That night, although he still fussed a bit, like normal babies do, Fearless Husband and I were able to sit down and eat dinner for the first time in weeks. FC let us put him in his swing – practically unused, up until this point – and he stared up at the attached mobile, eyes clear and wide. We knew better than to declare victory. Instead, we held our breath and hoped, hoped, hoped.

 

We came close to cancelling our appointment with the specialist many times in the following week. FC was an entirely different baby, a smelly-and-expensive-formula-induced changeling. I began realizing why people would actually choose to be parents. It was kind of fun when the kid wasn’t miserable and wailing twenty-four hours a day. His rash cleared up and his diapers no longer scared us. It seemed that we had our answer, and it came in a purple can with a $30 per week price tag.
Still, we figured it couldn’t hurt to get a definitive diagnosis so we would know what the future held. What happened to dairy and soy intolerant kids when they were weaned off formula – were they sentenced to a life of rice milk and birthday cake deprivation?
After a two-hour wait, we were taken into a small room where FC was weighed and measured. It appeared that in the week since we’d seen the pediatrician, he had apparently shrunk an inch. When we asked the nurse about this, she just shrugged her shoulders and said that measurements could be off between offices.
A few moments later, a young woman entered the room and introduced herself as the doctor’s resident. She spent a half-an-hour obtaining a ridiculously detailed history of our son and his feeding issues, stopping several times to excitedly tell us that this was “classic” milk/soy protein intolerance behavior.  FC even added his two cents to the discussion in the form of a dirty diaper, which the resident encouraged us to hold onto for testing. Considering we’d been on the hypoallergenic formula for a week, and his system was free and clear of all offending foods, she wasn’t sure this would be an accurate diagnostic tool, but she wanted to doctor to have the option.
By the end of this warm-up act, we were even more geared up and anxious to hear from the illustrious doctor himself. The resident seemed pretty enthusiastic, too – she told us that it was clear our pediatrician had diagnosed this correctly, but she wanted the doctor to confirm and explain the condition to us in detail. She left the room to go over her notes with him, and promised to return, doctor in tow, in a few minutes.
My memory of what happened next is fuzzy. I know the doctor came into the room, and proceeded to school us on Baby Basics 101. He referred to what FC had as “colic”, suggesting that I “call my mom to come help me out if it’s too much for me”; when we explained we had no family in the area, he blithely quipped that we should “just hire someone.” (We could barely afford FC’s formula at this point, let alone a caregiver for a newborn.)  He refused to even look at the detailed history the resident had taken (she stood behind him, mouth agape, and sending apologetic glances in our direction); he threw out the diaper we’d kept for his inspection without even looking at its contents. I remember pleading our case, trying to get a logical answer as to why FC had rashes and mucousy diapers for so long, and recovered so remarkably once he was switched to hypoallergenic formula. “The peak of colic is about 6 weeks,” he responded, a condescending smile never budging from his lips. “It was probably just good timing.”
“So you’re saying that he went from a screaming, rashy mess to a calm, happy baby in one day by chance? And it had nothing to do with switching him to hypoallergenic formula?” I asked, the anger churning in my belly so powerfully that I probably needed my own visit with a gastroenterologist.
“Yes, that’s what I’m saying,” Everything out of his mouth sounded syrupy sweet, between his velvety accented English, and the icy smile that capped every sentence.
“You don’t even want to look at the history we just spent 30 minutes rehashing?” Fearless Husband piped in. The doctor shrugged his shoulders and opened the folder containing the resident’s careful, thorough notes. He scanned the first page – simply detailing FC’s height and weight stats – and conceded that there could indeed be a problem, although not the one we suspected.
“You’re overfeeding him,” he proclaimed. “He’s overweight. He’s in the seventy-fifth percentile for weight, but his height-to-weight percentile is closer to the ninety-fifth.  Do you know what that means? Only 5% of babies his height are fatter than him.”
“I think your nurse may have mismeasured him, actually,” my husband muttered. We both knew this was a lost cause. It was no use suggesting that FC may have been comfort eating for the entire time he was on pumped milk – a pattern that had ceased as soon as we’d switched to the hypoallergenic. Or that the poor kid had been growth restricted in the womb, and probably had been making up for lost time (or food, in this case) now that he was able.
Then came the kicker. “It’s a real shame you gave up on breastfeeding,” the doctor sighed. “It’s best for the baby, and so much easier on their stomachs.”
Next to me, I could feel my husband’s entire body tensing up. “That’s funny,” my husband retorted, coldly. “He was the most miserable on her breastmilk. And as we’ve tried to tell you about five different times, now that he’s on hypoallergenic formula, he’s doing great. I’m not sure what you don’t understand about that.”
“Well, I can only tell you what I think,” said the doctor, snapping the file closed.
 
Three years later, I can only tell you what I think. I think that guy was an asshat. But beyond that, I think this experience was what provoked me to start this blog, more than any mommy-war drama, more than any study I’ve seen misrepresented in the news. It was seeing how a doctor could immediately dismiss you, immediately judge you, simply because they were married to the party line regarding breastfeeding. 
And unfortunately, if the tweets from the ABM conference are any indication, there is an awful lot of dismissive judgment going on in the medical field. Unless you’re an exclusively breastfeeding, educated, white, middle-to-upper-class mother; then you’ll be given a gold star. 

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