I was invited to speak to my local group of Plunket nurses a few years back. I didn’t prepare anything specially for them, I simply rocked up and held a question-and-answer session. They were a fun bunch of ladies and I had a great time. But I left the session chewing my lip, worried about the state of the system they were educated in.
I had invited them to ask me all of their non-PC questions, to take this opportunity to find out what they really wanted to know about nutrition in babies and young children. As predicted, the topic of obesity inevitably came up.
One nurse leaned forward and earnestly asked, “What do you do about exclusively breastfed babies who are already fat?”
A jolt of shock pierced through me at this question. This nurse was completely sincere and some of her colleagues were nodding alongside her, eager to here how they should deal with this siutation.
Exclusively breastfed babies are just that – exclusively breastfed. They are too young for solid foods and they don’t have any formula or water or, you know, anything but breastmilk. Breastmilk. I.e. one of the healthiest substances known to man.
I was so thrown that I gave a rather blunt answer initially. “Well… Nothing. You don’t do anything.”
I could immediately sense the confusion in the room. I needed to elaborate. “I mean, you would congratulate the mother on the great job she’s doing breastfeeding and that’s it. Breastfed babies can be fat. My own baby was a whopper. But that doesn’t mean they’re not healthy. This is the time in their lives where it’s perfectly fine to be fat, and breastfeeding in the long-run will only reduce their risk of obesity. You can’t overfeed an exclusively breastfed baby who is being fed on demand.”
That was enough of an explanation for that group of nurses but since then, I’ve only seen things get worse. I’ve received referrals for babies under 2 years old because they have a “high BMI”. Babies. I actually just watched the recording of a webinar in which academics who are supposed to be our experts in this area seemed to be advocating to calculate BMI in babies under 2 – despite the World Health Organisation specifically stating that BMI should not be used in under 2s. I don’t always agree with the WHO (they can be behind the times and can be lobbied, etc.) but in this regard, they are spot on.
I told my partner about the webinar suggesting we measure BMI in babies and his exact words were, “That’s the stupidest thing I’ve ever heard.”
I’ve even seen a role play where a large baby was crying and the mother fed it. Then it was a big thing about how could the nurse best educate this mother to not jump to feeding the baby – the baby may be crying for reasons other than hunger. That’s fair enough… Kind of. The thing is, nowhere in this role play did they say how the baby was fed. Babies cry for all sorts of reasons and I don’t think we should be shoving a bottle at them if they’re not hungry and they’re just after a cuddle… But the breast is different. Breastfeeding is so much more than breastmilk (see my blog post about it here). It is comfort, it is security, it is connection. Nature has given mothers the instinct to put their baby to the breast when the baby is crying for a reason. If they’re not hungry, they’ll usually refuse the breast or just have a wee suckle and leave it at that. Babies know when they are hungry and when they are full.
And while breastfed babies can be chubby as they come, there is absolutely no research to suggest they then become overweight adults. In fact, it’s the opposite. Breastfeeding protects against obesity and the longer you breastfeed for, the better.
We have to stop this ridiculous rhetoric that thousands of years of instinct honed by nature is somehow wrong. The whole medical profession seems to have been hijacked by this notion that they know better than mother nature does. Well, f off. If my baby is crying and reaching for my breast, I’m going to breastfeed him.
What gets me the most about suggestions that we should be tracking BMI in babies is this: the ‘intervention’ for fat babies is no different than it is for skinny babies (and indeed for older children and adults – see my post about BMI here). We want parents to be looking after their own health. We want families to cook food at home as much as they can. We want kai to be shared with loved ones around the table. Those simple things are what our health professionals should be talking about with the patients they see, instead of calculating BMI in babies and scaring mothers into not breastfeeding their crying child.