Month: June 2012

Breastfeeding After a Reduction (BFAR): Two Stories of Hope and Inspiration

Mothers who have had a breast reduction and want to nurse may be told they are likely to have poor milk production. They might even be discouraged from trying to nurse at all after hearing or reading stories about women who were not able to nurse to their satisfaction. This can be frustrating and confusing. I can only imagine that it might also cause some anguish if one is craving the experience of breastfeeding for either herself or her baby.

In addition to the women’s personal stories, this article will provide you with information, tip and go-to resources based on the experiences of two women who breastfeed after a reduction (BFAR).

I hope their narratives and insights will serve as a source of inspiration and support to women seeking to explore their breastfeeding possibilities.

I had a reduction more than 10 years before getting pregnant, and at that point I had no clue how much I would want to breastfeed. I was told I wouldn’t be able to, but I didn’t think it mattered to me that much at the time.
When I was pregnant with my first child, I decided I wanted to try anyway, so I did a little reading and took the hospital-based breastfeeding preparation class. Right after my son’s birth, I started pumping with a hospital grade pump. I pumped immediately after nursing in order to try to increase my milk supply.

I took all the recommended herbs and teas and I paid attention to my fluid intake and diet. Despite all of this, my supply was very low (about 1/4-1/2 oz per breast at my peak.) My son was frustrated and obviously not getting nearly enough to eat. I wasn’t aware of milk-sharing possibilities (such as donated breast milk) so I wasn’t doing that. We supplemented with formula and I kept at it for about six weeks. I was in tears several times a day, feeling like a failure, and exhausted from the normal new mom stuff, plus so much extra pumping.

I saw a lactation consultant around five weeks postpartum, but in retrospect, it was too little too late. I had already passed the point of my own tolerance. There were also latch issues that should have been addressed much earlier that had led to cracking, bleeding, vasospasms, etc. Though it was quite hard for me to stop breastfeeding, I simply didn’t feel like I could continue. Part of the lesson that I learned was that if you’re not prepared for the work it will take, it could sabotage your efforts. 

When I got pregnant again, I was determined to have a better experience the second time around. First and foremost, I realized that I needed to change my expectations about the quantity of milk I was producing and to focus more on the quality of the breastfeeding. I also knew I needed to be better prepared.

As part of my preparation I read two books by Diana West that were extremely helpful: Defining Your Own Success: Breastfeeding after Reduction and The Breastfeeding Mother’s Guide to Making More Milk.

I highly recommend reading these books before giving birth because they can help you plan mentally and emotionally for the breastfeeding experience. They can also help you practically by allowing you to explore your options for herbal supplements and medications prior to the birth. In this way you can get what you need in advance and have it on hand. Preparing for the breastfeeding experience in advance also allows you to have support in support in place (websites, lactation consultants) before you give birth.

Reading the books prior to birth also gives you enough familiarity that you can easily flip to relevant sections while in the midst of working through whatever nursing challenges you and your baby are facing.  It can be hard to thoroughly read and absorb new and detailed information when you’re sleep deprived and have raging hormones postpartum!

There’s a web forum called BFAR that can serve as a resource for moms. You can sign up while you are pregnant and get advice from women who are currently breastfeeding after reduction.

I planned to see a lactation consultant pretty much immediately after the birth of my child so that I could work on everything I possibly could. I also had to “define my own success,” which for my particular medical circumstances still meant a pretty small supply. This time, however, I was able to work on latch issues right away, which helped with the comfort issues.

I would highly recommend a prenatal consultation with a lactation consultant who has experience working with women who have had breast reductions. It might even be worth interviewing a few lactation consultants before the birth of the child so you can find one with whom you will be comfortable working and who is familiar with BFAR.

In order to supplement a baby’s milk intake during breastfeeding while allowing the baby to latch on to the breast, a SNS is often recommended or desired by women who want to breastfeed but are not producing as much milk as the baby need. The SNS involves a small plastic bottle with tubes attached to it. The tubes are taped to the mother’s chest and the infant receives milk from this system while latching onto the breast. Through the SNS system you can supplement your own breast milk with donated milk or formula.

During my second pregnancy, the lactation consultant and I worked together to use the SNS which was a good way to get my daughter the quantity of milke she needed while nursing. Using the SNS system also provided the nipple stimulation needed for milk production which actual nursing provides so much better than a pump. I still needed to pump several times a day as well, but not quite as constantly as the first time.

A picture of the SNS from Medela website.

“The term “galactagogue” means any substance that is known to increase milk production or milk ejections.” This can include herbal teas, prescription medications, and herbal supplements, many of which have traditionally been used in other cultures for years.

Some herbs that can be used to increase milk supply include marshmallow root, nettle, fenugreek, blessed thistle, and goat’s rue.  

Domperidone (DPD) is a prescription medication which is not available in the US; however, it is widely used in Europe and Australiafor low supply. With DPD, technically you can get it in the US, but only from compounding pharmacies (pharmacies that uniquely create drugs to individuals’ specific needs); however, it can be difficult or impossible to do it this way, and many doctors in the U.S. won’t write the prescription.  Medications can also be obtained via on-line only pharmacies or through Canadian pharmacies with a physical location in Canada (in which case the pharmacy is regulated in Canada) which also offer sales on-line. Some companies will require a prescription which, again, your physician or OB may or may not choose to provide.

One option is to obtain the medication from the cheapest online pharmacy one can find. However, there is no assurance regarding the quality or safety of their products. A commonly used on-line pharmacy for obtaining DPD is

(Disclaimer: this blog is not endorsing or recommending any specific pharmacy for obtaining DPD. This is a discussion I would have with my physician.)

Remember, however, that each woman is different in her causes for low milk supply and the solution. Work with a doctor, lactation consultant, or herbalist to determine what is right for you!

According to

“There is no definitive recipe for making more milk.  There are different causes of low milk production, so the techniques that work for one mother are not necessarily the best methods for another….the effectiveness of the techniques used to increase milk production depends on the actual cause, such breastfeeding management…or damage to your ducts and nerves, such as from breast surgery…Techniques to increase milk production are most effective when they specifically target the causes, which are not always a single factor.”

Be sure to determine what treatment is right for YOU.

A healthy diet and adequate (but not excessive) water intake is important for lactating mothers. Foods which have been associated with higher levels of milk production include oatmeal, carrots, beets and leafy green vegetables. For more information on diet and lactation, here is an article on Foods That Increase Milk Production.

In addition, certain substances have been shown to decrease milk supply and should therefore be avoided. They include sage, caffeine, estrogen (birth control pills) and decongestants.

With this system of SNS, pumping, herbs, prescription medication, skin-to-skin contact and diet, we eventually got to a point where she would just nurse for awhile without using the SNS anymore, and then if she was still hungry, I’d supplement. My body generally was able to provide about a quarter to a half of her nutritional needs which was a big success.

But more than that, it was the nursing relationship that I feel the best about. It was good! After a lot of “blood, sweat and tears” I actually enjoyed it! She obviously did too. I will always cherish that experience with her. I loved it that we were co-sleeping and because I had persevered. There were times I could nurse her back to sleep at night without needing to supplement because she didn’t need much milk. I loved dozing in the wee hours of the morning with her nursing and both of us falling back asleep several times. It felt so right.
So I guess the wisdom I have to share is that breastfeeding after reduction can be truly beautiful and “successful” but one of the keys is preparation. You will need to work hard to educate yourself and to prepare for “success” in whatever way you end up defining it. You will also need to get some support in place ahead of time. It will likely take a lot of work and perseverance – and possibly some altered expectations – but with the right amount of knowledge and support, you will likely find your own route to “success” and it can become one of your most treasured experiences.

Many thanks to Kimberly (kimberlyinmpls at and Jeanine (jeaninedorfman at for their contributions to this blog post and for sharing their stories, wisdom, experience, and advice for other moms!




Scary Mommy Book Review

Book Review of Scary Mommy by Jill Smokler

By Brenda Robert, Ph.D.

Among the most cherished and iconic of our cultural mythologies is that of motherhood. Linked arm in arm with such other icons as baseball and apple pie, motherhood has been painted as a blissful, self-sacrificing state and those who occupy the pedestal are somewhere between the Madonna and sainthood.  Depicted in art and literature as everything from soulful to stalwart, “mothers” of the world have an impossible standard to live up to.  After all, who can possibly match the good deeds of “Mother” Teresa or the ferocious force of “Mother” Jones?

The welcome news is that someone has made it OK not to live up to those impossible standards.  That person is Jill Smokler who has written a delightful and truth telling book called Confessions of a Scary Mommy (Gallery Books, 2012). Smokler’s book shines a light into the hidden corners of motherhood….you know those corners, the ones where the dust balls, animal cracker crumbs, and missing pacifiers congregate. It’s also the place where mothers hide their secrets, the dizzying and occasionally distressing aspects of being a mother which aren’t voiced to a judgmental society. Each of Mommy’s chapters is an essay prefaced by a list of Mommy confessions by other mothers on that particular subject.  For example, in the chapter on husbands: “I tell my husband we are out of milk so I can run to the store for ten minutes of quiet time.  I don’t tell him I drank the last of the milk.” On eating: “I eat sweets while hiding in the bathroom so I don’t need to share with my children.”

Scary Mommy is more than hilarious; it’s also addictive, especially so for someone who has been there.  For those who haven’t, it’s a peek behind the curtain of that sanctified state known as motherhood.

Brenda Robert is an author, poet, and mother of three, grandmother of three, and greatgrandmother of one. She earned the badge of MOM long ago and wears it well. She is retired from a career of teaching English and then keeping those teachers in line as an administrator. She is also my mom!

Keep it Real: Day One! Tweet It!

Day 1 ( June 27th ): Tweet It

Tell the Magazines to Keep It Real:
In 140 characters or less, challenge them to change their ways. Use #KeepItReal throughout the day to share your thoughts on how they could improve. Attached is a list of the Twitter handles of some of the biggest fashion magazines and their editors – tell them you’re not buying digitally-altered beauty standards anymore.

Sample #KeepItReal Tweets:

  • “Hey @seventeenmag will you pledge to #KeepItReal and print one unphotoshopped pic of a model per issue?”
  • “Hey @Vogue, we’d love you to #KeepItReal by celebrating women’s natural beauty – including pores and freckles!”

Keep it Real: Day Two! Blog It!

Well, I accidentally published day two a day early. Whoops!

If these statistics aren’t enough to encourage magazines to stop photoshopping their already stick thin models then I don’t know what is. Perhaps a little cellulite in the magazine and media would bring the whole body image thing back down to earth. Personally I remember my 13 year old self thinking I was fat because I could pink skin on my thigh. Where I got that from I’ll never know. We need to do something to help young girls feel good about themselves and their bodies without looking to the media for unhealthy models (and role models) of people that don’t exist in real life, or if they do exist, are so thin that it’s unhealthy. The beauty industry has extremely unrealistic expectations of the employees. I recently read that Jennifer Aniston was asked to lose 30 lbs in order to be employed by the television show “Friends.” Unbelievable. Keep it Real asks magazines to stop the photoshopping and start redesigning beauty to involve a dose of reality – because even reality can be beautiful, believe it or not….

(Did you know that in some African countries, the bigger you are the better because that shows that you family has the means to feed you well.) The definition of beauty is constructed or created by our society and by the media that we consume. We get our ideas about beauty from the magazines we look at and the actors and actresses we see on t.v. How many slightly plump actresses are walking the red carpet. Ummmm….almost none…! And to make matters worse, how many pregnant actresses are shown three weeks after the baby is born with their pre-birth body all back in shape!? What kind of ideal are we striving for as pregnant women? It puts undue and unnecessary pressure on women, on children, on young girls and it’s not healthy!

American teenagers spend 31 hours a week watching TV, 17 hours a week listening to music, 3 hours a week watching movies, 4 hours a week reading magazines, 10 hours a week online. That’s 10 hours and 45 minutes of media consumption a day.

Source: The Henry J. Kaiser Family Foundation “Daily Media Use Among Children and Teens Up Dramatically From Five Years Ago”

53% of 13 year old girls are unhappy with their bodies. That number increases to 78% by age 17.

Source: National Institute on Media and the Family

3 out of 4 teenage girls feel depressed, guilty and shameful after spending 3 minutes leafing through a fashion magazine.


Twenty years ago, the average fashion model weighed 8% less than the average woman. Today that number is 23% less.


48% of teenage girls wish they were as skinny as models.


65% of American women and girls report disordered eating behaviors.

Source: SELF magazine and the University of North Carolina at Chapel Hill

Forty-two percent of first to third-grade girls want to be thinner, while 81 percent of ten-year-olds are afraid of getting fat.

Source: Dove Real Beauty Campaign, 2004

Eighty percent of 10-year-old American girls say they have been on a diet. The number one magic wish for young girls age 11-17 is to be thinner.


32% of teenage girls admit to starving themselves to lose weight.


The number of cosmetic surgical procedures performed in America increased by 457% from 1997 to 2007.


Shopping for and Choosing Infant and Toddler Shoes: Oh, the Places You Can Go!!

Choosing and buying shoes for your child can be an overwhelming and expensive endeavor, especially because each developmental stage and seasonal change brings forth a new selection of shoes, boots and slippers.

I love shoes – as you will find out below – and it’s been fun for me to buy my daughter shoes. Here are a few tips and some pointers from someone who is way too familiar with the infant-toddler shoe scene! 

Infant shoes (also called crib shoes) are the little leather slipper type shoe that the baby wears up until he or she can walk and a little past that point. In my opinion Robeez are probably the best but part of that is because I didn’t buy other brands.

I did have one pair of non-Robeez crib shoes. They were from Target and were given to me as a gift. They were cute and comfortable but they didn’t last very long. The leather on top started peeling off and they wore out VERY quickly. They did not hold up well compared to the Robeez.

A friend of mine swears by the Soft Star shoes. She had her boy in them from the time he was crawling until he started walking and then she bought him another pair. They were the only shoes he wore. According to their website, the company is “passionate about minimal footwear for healthy development of bones, muscles and balance.” They make all of their shoes by hand.

The Soft Star mocassins are described as having “soft suede uppers and our strong, soft suede sole…[with] genuine sheepskin innersoles that keep the foot protected, dry and comfortable. Sheepskin is nature’s heat regulator – and keeps feet dry in the summer, and cozy in the winter. Inner elastic hugs the ankle which makes the shoe easy to slip on, and they stay on.” You can also design your own but that would just leave me feeling completely overwhelmed!

They also have an option for regular or wide so if your child has wide feet this might be the place to go. I think they also will use an outline drawn of your child’s foot if you are custom ordering.

I also just noticed while researching for this post that they have “classroom shoes” and Waldorf or Montessori shoes. That kind of cracked me up—But then I ordered a pair! My girl is starting at Montessori preschool in a couple of months and doesn’t have any soft-soled shoes. The kids don’t wear their street shoes in the classroom so I figured it’d be a good way to go. I got a pair on clearance for twenty-something.

When the babies start walking outside you can still put Robeez on them but realize the soft leather will wear out very quickly on the cement and other hard surfaces. There are some models of Robeez shoes that have a sturdier bottom and they are better for walking outside. We had a pair with sheep on them that my daughter LOVED. She liked them so much that we ended up buying a second pair when she outgrew the first pair.

They held up really well. In part because of the thicker bottom, which was still quite flexible but doesn’t wear out like the soft leather.

We both LOVED the Riley Roos that I bought her, even more than Robeez. They were by far my favorite of all of her shoes. The orange Riley Roos shown below are the exact shoe we had, except we had them in brown.

They are comfortable and soft and have a sturdy bottom. She wore them until her toe was all the way up to the end of the shoe!

Here’s a pair of the Soft Star shoes that look like they have a sturdier sole. Soft Star also makes shoes for adults. I think they also have a sale once a year where the percentage off starts out low (like 10%) and then increases as the end of the sale nears.

We also had these pink Riley Roos boots. She wore them quite a bit. They were very cute and comfortable but they did not hold up very well. They leather pulled away at the seams. They were good for the one winter season but have pretty much come apart to the point that I can’t resell them on Ebay.

We also had these Robeez boots. I loved them. They were soft and supple but had a lot of warm foot coverage. They looked really cozy and if they made them for adults I would totally buy myself a pair. They also come in pink. I’m surprised I didn’t have them in both colors!

Of course, when the snow starts to fall, you will need a pair of snowboots. I don’t recommend spending a lot of money on snowboots but there’s one thing you have to watch for…Access into the boot! If there’s a once inch zipper that goes down and you’re expected to cram a moving child’s food into it, don’t buy them. Look for boots that have zippers on both the left and the right side of the shoe or some way that the tounge goes WAY down. The more you can open up the boot the better, otherwise you’ll be banging and pulling and tugging and pushing trying to get your child’s foot down into the boot and ultimately you won’t know how successful you are because they can’t tell you. You’ll know when they get up and start walking and trip over the boot and land on their face. Then it’s back to the drawing board. It can be quite frustrating, amusing and time-consuming. Oh, and if the kid isn’t into having the boot put on in the first place, good luck. The meltdown will just be prolonged and you’ll end up carrying your child to the car and throwing the boots in the back seat. My advice: Find a boot that opens up!!!!

Honestly, I have not found a pair of slippers that I have liked for my child, either as an infant or a toddler. For infants, I have found that socks with good ribbing around the ankle are the best. As for toddler slippers, 90% of them have either fallen off or ended up around her ankles as she was running around. Maybe that’s because she has skinny feet. Not sure. She does have a pair of Elmo slippers from Target that have worked out well. They stay on and they are cute. They have an enormous amount of ribbing around the top which might be why they stay on. The Minnetonka Moccasins did not work for us either. I had one pair that I couldn’t get on her feet – they were too tight in the toes. Another pair wouldn’t stay on her, even with socks.

I prefer close-toes sandals to open-toed just because the open toe can get hung up on surfaces causing them to trip and fall especially on the playground.

I bought my daughter these Nike sandals this summer because they were so darn cute. She loves them. They are even a little bit long for her yet they stay on. They’re made from a neoprene type of material so they are quite good in the pool or the lake. They are close-toed so she can go on the playground in them. Plus they look good even when she’s wearing a little dress or a shorts outfit.

I’m not a fan of Crocs even if they are super cute; they don’t really seem to stay on or to be that practical. On playground equipment they seem to be too loose and unsafe.

Keen makes great sandals and shoes but they tend to be too wide for my girl’s skinny little feet. They are great for our roommate’s two and half year old chubby little feet. I bought the blue tennis shoes below from Sierra Trading Post and they were too wide so my roommate’s little boy acquired them and they fit just right.

Hello, cute girl Keen shoes which I can’t buy because they will be too wide! (Click on the shoe pictures and it will take you to Sierra Trading Post.)

My girl loves the Mary Jane style of shoes that allow her to pull the strap over and velcro them herself. The Robeez sheep shoes and the Nike summer sandals are both like that and have been her favorite shoes. I can go tell her to put on her shoes and she does it all by herself.

Babies-R-Us has a very cute selection of shoes and you can usually find them at a good price on sale especially at the end of a season. I bought a couple of cute pairs of velcro tennis shoes when they were having a good sale once. I just bought a pair of pink converse for my baby girl at Target for $12.99.

We have a lovely pair of Ecco brand lace up shoes that are great for walking, especially if you’re going to be outside or in colder weather. She does wear them quite a bit but on several occasions when I went to get her out of her carseat I found she had removed the laces and had thrown them on the floor.

Here are the Ecco first walk shoes. New they are quite expensive. The walkers below are $58.00 but I’ll tell you, they are really good shoes! The leather is both sturdy yet flexible and they seem to fit the foot really well.

Riley Roos
Softstar Shoes

WHERE TO BUY SHOES (my personal favorite)
Once Upon a Child (also a favorite – great prices!)
Little Feet
Consignment stores

The place I have gone to most for shoes has been Ebay. I also resell her nice shoes on Ebay. I think I got her Riley Roos on sale from a store on Zulily. Zulily is a shopping website that you have to register on. Once you get registered you can go into the site and look at the different stores and the items they have on clearnace. They stores have amazing sales but the stuff goes fast! I have also bought a few pairs at the Pacifier store, which is local, because I had Groupons for their store. I haven’t shopped outright there for shoes, but they do have a good selection of Robeez. I also bought Robeez at the hospital gift store where I had my baby! The Ecco walkers I got a consignment shop for around $20.00. I also recently found a pair of Ecco Mary Jane’s at Goodwill for $2.99. I was psyched! I bought a pair of Columbia sandals for her on Sierra Trading Post last summer. They have reduced prices on their merchandise. The brown Robeez boots I got on Ebay for a decent price.

Well, anyway, happy shoe shopping with whatever brand you decide to go with. Let us know what you purchase and what has worked well for you and your child. I’ll be interested to hear from any other shoe lovers out there!

Update: Just got these shoes for my three year old daughter and she LOVES them! She’s been wearing them everywhere and she can take them off and put them on herself without any help. They are made by Minnetonka Moccasin.


Minnetonka Moccasin Kids' Girls Britta Trapper Shoe

“The Keep it Real Challenge”: A Plea to Magazines for Real Images of Women

These statistics are mind boggling and frightening.
42% of six, seven and eight year olds want to be thinner!? 81% of 10 years olds are afraid of getting fat!? What kind of world are we living in?

The Keep It Real Challenge, which runs from June 27th – 29th, 2012, is designed to start a media revolution and help girls, women and their allies realize the power of their individual and collective voices to create positive change. SPARK Movement,, I Am That Girl and LoveSocial have joined forces to host this three-day social media campaign to urge print magazines to pledge to use at least one non-photoshopped image per issue.

Tell magazines to drop photoshop! Inspired by 14 year-old Julie Bluhm’s petition of Seventeen Magazine, we’re promoting a 3-day social media campaign to challenge photoshopped beauty standards and empower women and girls to use their voices to create change. We’re making a simple request of magazines:

Pledge to print at least one unphotoshopped picture of a model.

Day 1: Wednesday, June 27: Tweet it. Twitter users will use hashtag #KeepItReal, directly asking magazines to pledge to change their practices around photoshopping bodies.

Day 2: Thursday, June 28: Participants will create a blogging firestorm – personally reflecting on how unrealistic images of beauty have impacted them.

Day 3:  Friday, June 19: On the final day, via Instagram, users will post their own photos of “real beauty” to be entered in the #KeepitRealChallenge – with selected photos to be featured on a billboard in New York City later this year.

SPARK is a girl-fueled activist movement working collaboratively with girls, activists, scholars, parents and educators to challenge and end the sexualization of girls. The SPARK network is creating a cultural “tipping point” where the sexualization of girls is unacceptable, intolerable, unthinkable and unprofitable, while simultaneously building support for girls’ healthy sexuality. is a cross generational movement organizing millions of small actions to awaken people’s consciousness to recognize the true value of women; change the way women and girls are represented in the media; interrupt and stop patterns of sexism; level the playing field; and ensure a tipping point that will lead to gender parity in leadership throughout the United States and the world. Learn more about the campaign at

Lovesocial was founded in 2009 with a vision of creating authentic and creative communication strategies through the channels of social media. With a motto of, “keep it simple, find the value and communicate it well,” Lovesocial quickly became what is now dubbed an “anti-agency”. With a commitment of not further cluttering or saturating an already crowded online space, Lovesocial works to create clarity and value for their clients to help accomplish their

I AM THAT GIRL aims to be the definitive voice on the intellectual, emotional, and social needs of millennial girls by building an online and offline community devoted to inspiring and empowering girls to discover their innate worth and purpose. This community provides girls with a safe space to have honest conversations, consume healthy content, and collaborate with other girls seeking to be confident in their own skin.

High Needs Babies: Read Dr. Sears

My baby was most definitely a High Needs Baby. I think it would have been helpful if I had known about these types of babies before I had here! The only way to soothe her was to hold her and to swaddle her. The sling is still the best way to get her to settle down because she simply gets too overstimulated. The sling is our miracle worker and she is three!

Famous People Breastfeed Too!

“Singer Pink took a break on a photo shoot set to nurse her 1-year-old daughter Willow.”
“The singer took to Twitter to share that she and her husband Carey Hart subscribe to the AP philosophy”:

“I felt that the article in TIME on attachment parenting was unfortunately a tad extreme. I support attachment parenting 100%… And have a very happy and healthy little girl to show for it. It’s time we support what’s healthy (breast feeding) instead of judge it.”

I think this picture of Maggie Gyllenhall is my favorite of the celebrity breastfeeding pictures because this what the reality should and could be. It’s normal to breastfeed in public and we shouldn’t have to work hard to cover it up to protect those who are uncomfortable. Plus it casts a light of normalcy on a famed figure.


Scary Mommy Post: It’s Not Easy Being Green (A story about single motherhood)

My guess post called:

It’s Not Easy Being Green: The Life of a NMSM was published today on the Scary Mommy Webstie. Check it out!


Choosing a Pediatrician: It’s Like Going on a Date!

When my baby was about six weeks old my pediatrician told me that my baby shouldn’t be nursing for more than twenty minutes per breast. More than twenty minutes, she informed me, and “She is using you as a pacifier.” What? She’s using me as a pacifier? Is that bad? Hello, parenting decision. And here I thought she was eating. “But maybe she’s just hungry…,” I mumbled. 

“No. She’s using you as a pacifier.”  There was no hesitation; no ands, ifs, or buts about it. It was definitive. My child was using me. I was being used.

Later, when my child was about six months old, this same pediatrician informed me that my baby no longer needed to be nursing at night. “A baby this old has no need to be nursing at night any more. She can sleep through the night just fine. If you continue to nurse her at night like you are now, she’ll be yours for life.”

What did that mean, she’ll be mine for life? Isn’t she already mine for life? Did she mean that my baby will still be wanting to nurse as a teenager? I didn’t get it. The only think I could figure is that she wasn’t in favor of long-term nursing. That then raised  more questions for me. How long did I want to nurse at night? Isn’t that for the baby to decide? I was confused and my baby’s doctor wasn’t making it very easy for me to wrestle with these tough parenting issues. She was giving flat out advice and that style just wasn’t working for me.

It was at this point that I realized my doctor and I needed to break up. I would do it gently. “It’s all about me. It has nothing to with you. Really!” The fact that we probably didn’t really see eye-to-eye on some pretty important parenting practices was a big part of the problem, but even bigger was the fact that I didn’t feel there was space in the examining room for my opinions. And what did I know? This was my first baby. I didn’t feel very confident in disagreeing with her and there was no room for conversation or objection or even curiosity. I simply didn’t feel comfortable in our relationship anymore. And counseling clearly wasn’t an option.

The pediatrician-parent relationship is a complex and important relationship, especially for the first-time parent. During those really early months of your baby’s life a zillion questions come up about caring for this new little being. And the books just don’t have the answers. (Either that or you’re too sleep deprived or petrified to read them.) So who do you turn to? Your pediatrician. Your pediatrician and the clinic where you have those appointments every week. And don’t kid yourself—in between those appointments, you’ll end up calling about anything from a pimply butt to a red face. Maybe she has the measles! Maybe it’s a life threatening rash! I’d better call the doctor.

Choosing a doctor before the baby comes is one of the most important things you will do prior to giving birth. As soon as that baby is out of the womb she already has about ten doctor’s appointments lined up that she’ll need to go to over the course of the next couple of months. During those first visits the doctor will be direclty and indirectly evaluating you as a parent and whether that baby is thriving in your care: Where does the baby sleep? How long does she sleep? What is she eating? How much is she eating? How much does the baby weigh? How much has she gained since I saw her a week ago? Is she breastfeeding or bottlefeeding? How much and for how long?

And then the big question: “Your baby is scheduled for three vaccinations this visit. Do you want to give them all?”

Because of all the decision-making that goes into parenting and caring for your baby, you need to find a doctor that fits your personality, your parenting style and your expectations of a physician. You and your doctor might not agree on every issue but hopefully you will enter into a relationship with someone who will  listen and honor your decisions as a parent while giving you the information you need to make informed choices. Most importantly, you will want to find someone you like as a person and whose opinion you respect.

I initially chose the doctor that I did because she seemed to be a pretty liberal doctor and was open to a delayed vaccination schedule. However, six months after the baby was born we split up because of irreconcible differences. The marriage was annuled. Our views on breastfeeding seemed to differ pretty radically and our communication didn’t feel like a two way street.

If you and your doctor have radically different ideas about how to care for a baby, it might not be a good fit. It’s kind of like going on a first date. You may think you’re in it for the long haul but as you find out more about the potential partner, your opinion may change over time. If you can get it right the first time, it can make things a little bit easier.

Part of the reason this relationship with your doctor is so important is because parenting requires loads of on-the-fly decisions regarding your baby’s health and well-being. In addition to the “What do I do right this second?” decisions, it also involves the questions about “How do I want to parent my child over the next year or two years?” Some of these decisions will be about issues that you will want to run by your doctor. When do I introduce solids? When do I stop breastfeeding? Is it safe to co-sleep with an infant? How long should a breastfeeding session last? These are topics that you’re going to want to discuss openly and honestly with your pediatrician, and the more comfortable you feel with your doctor, the better. Every doctor has their views on raising children and if your doctor’s methods are drastically different from what you want and care about, you won’t be getting the most out of the relationship.

Looking back on the process of choosing a pediatrician, I realize that I grossly underestimated the importance of finding a doctor that I liked as a person and whom I would respect.

When you pick a pediatrician you want to pick someone to whom you really want to go for advice; someone who will be open to hearing your opinions and point of view; and someone whose opinion you will trust. You want someone you can stay with for years to come. Find a pediatrician to walk down the aisle with and one with whom you can work, both in sickness and in health!