October 23, 2006

On the mend but still annoyed

It is no secret that the American Academy of Pediatrics recommends nursing until your baby is at least 12 months old. An article came out recently in diabetes literature, citing that breast milk is really the best thing for your baby and that cows milk should be avoided until the age of two. Breastfeeding helps reduce the incidence of diabetes in both Mom’s and babies. With the strong history of diabetes in my family, and considering the fact that I had gestational diabetes while pregnant this last time, I felt that it was my duty to nurse this baby as long as I could. Although I started the weaning process at 10 months, I nursed Big I until she was 14.5 months old and when she stopped nursing it was so gradual that she never even missed it. It was the best thing for both of us.

Lil C recently turned a year old and I am still nursing her. I am in the process of weaning her, but weaning to me, is not something you do cold turkey. That is not beneficial for either of us. It’s a very gradual process in this household and I appreciate it greatly when people mind their own business about it. A popular chant for abortion rights activists is "My Mind, My Body, My Choice" and I feel that saying applies even more so to breastfeeding a baby. I never imagined in a million years, that a doctor or physician’s assistant of all people would be so unsupportive of my decision about nursing and how long to continue nursing.

After toughing it out all last week with body aches and a fever on and off, I finally made an appointment with my doctor’s office and of course could only get an appointment with a Physician’s Assistant. I’ve seen her before and it always felt like she was rushing me out the door. Friday was no exception. We ran through the gamut of my symptoms and she determined that I had strep throat. I told her I would need a medication compatible with nursing. She asked how old my baby was, and I told her that she is 12 months old. I saw the reaction, subtle but definitely there and judgmental. She left the room to go consult on what she should prescribe.

She came back a few minutes later with a prescription for Levaquin. Levaquin is what they put my husband on after he had abdominal surgery. It is a strong antibiotic and a bit of an overkill for a strep throat. "Here you go" she said handing me the prescription. "Oh, and you’ll have to pump and dump for seven days." Lil C has not ever taken a bottle. She refuses, and pumping is not exactly easy for me either. It’s not like I have a freezer full of back-ups.

"That’s not going to work," I told her. "I need something safe for nursing. I’m in the process of weaning her and I’m not going to do it like this." She responded with "Well, I nursed my daughter for eight months. I know it’s hard, but there’s nothing else we can give you." "There has to be something," I retorted. "Nope, sorry. Pump and dump for seven days or just wean her now." I told her I would just not take the drug. She said, "Well, then it will go to your heart and kidneys." I was finding it very hard to believe that a mother who also nursed her child wouldn’t be more sympathetic.

I left the doctor’s office and was a mess. What was I going to do? I got home and consulted the internet. I found resources from The Breastfeeding Network that listed at least ten antibiotics safe for nursing. I called the office and left a voice mail saying that I wanted my prescription changed to one of the drugs I found on the list that I had success with before. The nurse called me back and said, "I talked to (the PA) and she said she already discussed this with you. She prescribed the one drug that is safe." "Levaquin is not safe," I said, "and she told me so." "Oh," said the nurse. It was obvious that they were not taking my request seriously. Can you imagine if I had taken the nurse at her word and taken an unsafe drug while nursing?

I repeated my request for the different drug and told them to call it in for me. They said they would call it in but that it was still not compatible with nursing. She threw out a "Well, WE’RE trying to do what’s best for your child". "Really?" I said. "Well if that were the case, then you would know that breast milk is what’s best for my child, and weaning her cold turkey is not."

I called my daughter’s pediatrician and left a message telling them my dilemma. Within a half hour, the nurse from the doctor’s office called me back and left me a message (I was at the pharmacy). The medication I requested, along with the other nine or so I had found, were completely safe with nursing. She told me things to watch for in Lil C in case of a bad reaction, but stressed that the drug I had requested was safe.

While at the pharmacy, I asked the pharmacist his opinion. He told me the drug was safe as well and said it was fine to take it and continue nursing as usual. I am nursing her so infrequently now that I could time the drug so that there would be many hours before I had to nurse Lil C again.

So, my question is this: If I could go on the internet and find reliable information including the package insert for the drug that says it is safe for nursing; if my pediatrician could tell me it was safe; if the pharmacist could tell me it was safe. . . then why couldn’t my doctor’s office?

I have decided to switch primary care physicians because if they are incapable of helping a nursing mother out, then I am incapable of giving them $25 every time I need to see a physician’s assistant who has less schooling than I have. Although she didn’t come right out and say it, there was an obvious judgment being made about my decision to wean my 12-month old daughter gradually, and that is just one of the problems that nursing mothers face every day. Until now, I had never really experienced this, and I hope to never experience it again.