Can BF really interfere with food consumption?

[@llli*smileyface]

My 2.4 yo daughter has always been at the bottom end of the weight chart. Now, though, she's started climbing the height chart, too, so basically she's getting taller and skinnier, which concerns the pediatrician. Her BMI at this latest visit was 0.03%! 5% to 85% is normal.

The pediatrician recommended I start feeding my daughter more foods with higher fat content and higher calories. Fine.

But then she asked how often I BF my daughter. When I said five or six times, she thought that I should cut back, because non-BF toddlers don't have more than three servings of milk a day and so the additional two or three feedings are likely filling her up and potentially making her eat less regular food, which she believes contain more calories per ounce than breast milk.

A reply to an earlier thread appears to suggest that's a false assumption. But the foods in the link provided (to Kelly's Mom) were focused on mostly pureed foods. I don't know what the calorie comparison is between breastmilk and regular food/entrees that we all consume, which is what my daughter eats at this point.

Regardless, it doesn't seem right to me that breastfeeding can interfere with regular food consumption. I nursed my son for five years, and I can remember with him being amazed how he could consume more food imaginable even after nursing for twenty minutes. The amount of breast milk intake never seemed to correlate to his appetite for food right afterwards.

I also have no idea how to cut back on the feedings. She nurses on demand, not at my suggestion, so what am I supposed to do, simply tell her no? Randomly? I'm nursing this long because I want her to decide when to slow down and eventually stop, so by taking it upon myself to cut back on the feedings kind of goes against that whole chosen path.

The whole thing doesn't make any sense to me. I'd love others' thoughts on this. Am I right to question (read: ignore) the pediatrician's suggestion to reduce how often my daughter nurses, or am I letting my continued annoyance at how extended breastfeeding seems the favored scapegoat for absolutely everything (even my son's late talking, which turned out to be nothing) cloud my thinking?

Any thoughts? Helpful resources?

Thank you!

[@llli*mommal]

My first thought is, since when is "normal" defined as being between the 5th percentile and the 85th? AFAIK, anything from 0-100 is normal, though the number of subjects (in this case, babies) who fall at the uppermost and lower most ends of the distribution will be small. But it's no less "normal" to be in the 3% than the 97%, statistically speaking.

I think it's amusing (sort of) that breastfeeding is so often blamed when a toddler is small, and also when a toddler is large! There are plenty of moms with big toddlers who are told to cut back on breastfeeding, because clearly the toddler is gorging on calorie-rich breastmilk and that is causing him/her to pack on the pounds. So, doctors of the world, which is it? Is breastmilk super rich in calories, or super poor?

I personally would ignore the doc when it comes to breastfeeding. There's no evidence, to my knowledge, that breastfeeding causes issues with weight at either end of the weight spectrum! Just enjoy your toddler, and anticipate the day- not too long from now- when you are being congratulated on having a slender child, and for not allowing her to fall victim to the epidemic of childhood obesity.

[@llli*lllmeg]

Since we know generally what breastmilk contains calorie wise, I imagine a regular ‘diet’ or nutrition calculator or list will give you an reasonable idea of calorie& fat content of 'regular" foods, just for comparison.

I would never assume a child will eat more if they nurse less. Or that it would be beneficial if they DID eat more due to nursing less. If your doctor can refer you to a study that shows this, I would be extremely interested.

What if you stop nursing or cut way back, and your child eats no more? Or eats less? Or eats more but gains less? Or gets viral diarrhea or the stomach flu and ends up in the hospital from dehydration and electrolyte imbalance because you were no longer nursing when you otherwise would have been? Is anyone going to apologize for making you cut back on nursing and leading to a more severe health problem? I doubt it.

Are you concerned about your daughter? There ARE medical or nutritional reasons a child would lack appetite. Iron deficiency or B12 deficiency are two I am aware of. Maybe your child should be tested for these or other issues, maybe not. But as long as breastfeeding is used as the convenient fall guy for below average weight gain no one looks any further.

I strongly suggest the book My Child Won't Eat by Carlos Gonzalez. If you read the reviws on amazon you will see why I suggest it. He covers this type of advice and has some eloquent arguments against it.

[@llli*smileyface]

Thank you, both! So eloquently put. Such voices of reason. And so exactly what I needed to hear. Thank you! Thank you! Thank you!

[@llli*debbers]

I bet a child in the high bmi and high weight percentiles due to an "acceptable" American diet for kids of processed lunch meat, Cheerios, goldfish, juice pasteurized and made from sugar and mass manufactured cow's milk is never challenged by most Peds.

i sure would take no pride or comfort in that. Fingers crossed that my 13.5 month old, who is still breastfed, keeps eating salmon, grass fed beef, avocado and every fruit and vegetable we put in a smoothie because I don't want to be the Cheerios and chicken nugget mom, ever.

[@llli*froggylogic]

Just because you reduce nursing doesn't mean those calories will be made up elsewhere. When I was pregnant with my second and my milk dried up, my then 20 month old did NOT make up the lack of breastmilk with food. His weight gain dropped drastically.

debbers, I didn't want to be that mom either, but there was a period where Goldfish was the main source of calories for DS1. When faced with a child who is extremely picky, every calorie counts! And that "children won't starve themselves" bit? Totally false.

[@llli*mommal]

I bet a child in the high bmi and high weight percentiles due to an "acceptable" American diet for kids of processed lunch meat, Cheerios, goldfish, juice pasteurized and made from sugar and mass manufactured cow's milk is never challenged by most Peds.

I think that the above would be true if you replaced "high BMI" with "average BMI". Kids who have average weight- I don't think docs challenge their parents about what they are feeding those kids, even if it's nothing but string cheese, Doritos, and ketchup. But the high BMI kids- their parents get all sort of flack, even if they are feeding their kids terrific diets and making sure they get plenty of activity!

My first LO was born small (20th %ile for height and weight) but rapidly grew, and has been in 80-100% range for weight and the 90-100% for height since around 2 months. When she was a baby, it was all "Good job, mom!" when I took her in to the pediatrician and her height and weight were skyrocketing. Now that she's seven, and still maintaining the exact. same. curve. she's been on since 2 months, it's all coded talk about "making sure she eats vegetables" and "making sure she gets exercise." The fixation of BMI is often counterproductive at both ends of the growth spectrum!