Monday, February 18, 2008

Dentist Appointment Tomorrow

Tomorrow Rose gets her teeth fixed! I'm excited that she'll finally not be in pain every time we brush her teeth. Poor baby. Today I took Dave to the dentist to fix his teeth. They are done! No more fillings or root canals! He has a dentist appointment in a few weeks for a cleaning and they'll make the treatment plan for getting his dentures. I'm a little annoyed because I thought that was part of the current treatment plan. I guess not.

While I was there waiting for Dave (I have to drive him because of his anxiety issues he takes valium before appointments) I met with the new pediatric dentist concerning the appointment tomorrow. I so miss the old pediatric dentist I used to have. I was open with him about Rose's nursing status and he always shrugged and said "Oh, okay," and never said anything about weaning/night weaning/bottles of water instead, and never implied that any decay was caused from nursing. He left in December and I'm really missing him now.

I've been really open with this new dentist that Rose still nurses multiple times at night, as well as during the day, and to go to sleep for naps. She probably nurses 10 times a day still on average. The dentist didn't say anything negative about extended nursing, but she certainly seemed shocked that I'm still nursing her. She suggested nightweaning, trying bottles of water instead of nursing, etc. Well, I've tried nightweaning her, even before her suggestion, but so far.... it ain't happening. And I'm okay with that, for now. The trouble is, the dentist is pretty insistent that the decay is caused by the nursing. While I don't doubt that in the past, nursing at night after a less-than-thorough job of brushing teeth probably contributed to a lot of the decay, especially considering where the decay is located on her teeth, I don't think it is the real reason why she has decay. Especially considering the decay Dave has had to deal with. What I've determined from my own research is that on its own, breastmilk is pretty benign. When her teeth aren't brushed as well as they should be, the milk reacts with the other foods she has eaten and causes the decay. Also, that dental carries are actually contagious-- a portion of the population have an increased amount of a certain bacteria that causes dental decay. This can be passed on through saliva. I'm certain Dave has this type of bacteria and has passed it on to all of us. Notably, my oral health has diminished in the past several years, despite impeccable dental habits.

So at the consult, the dentist was clear that Rose should not have food or milk 6 hours before the appointment, because of a risk of aspiration. While she did not specifically say no breastmilk, I took her words to imply that since she knows I still nurse Rose. What bothered me most, though, is that she said if she was really hungry, she could have some toast. So I don't understand why my milk is such a risk, but toast isn't. My friend Emily pointed out that dry toast will digest very quickly, so it is not as much of a risk as other foods, and it is sound medical advice. I responded that breastmilk is considered a clear liquid (no other milks are classified as such) and digests very quickly as well. I'm just afraid the dentist she considers breastmilk to be the same as cow's milk, which it very clearly is not. And I'm afraid that she doesn't approve of my nursing relationship with my child at all, but hasn't said anything about total weaning, just night weaning/bottles of water instead of nursing, because she is a nice person and wants to have a good relationship with her patients. So based on the information I have read, I plan on treating breastmilk as a clear liquid and will withhold it starting at 6 am tomorrow (for her 8 am appointment) but no earlier than that. If the doctor asks me straight out, I will have to lie. I cannot risk Rose not getting the dental care she needs based on erroneous ideas about breastmilk. While I am honest almost to a fault typically, I feel in this case a little fib is appropriate in order to get my child the treatment she needs.

This is decay that cannot wait for a new dentist, and we only have one choice of pediatric dentists in this particular clinic, which we have to use for insurance purposes. Open enrollment for our insurance plan is next month, and I plan on switching dental providers at that time to another dentist who will be more compassionate toward breastfeeding relationships than my current dentist. I feel like, even though the dentist is really nice and so cheerful about everything, and the kids really like her, that she is really judgmental about our nursing relationship, and it is really bothering me. I just get that vibe from her that the niceness is covering up a distaste for extended breastfeeding, which I thought she would be more open to since she is not from the US. Or maybe (probably) I'm just being overly sensitive, which I tend to be a lot. But for the next few months at least, I have to put up with her, since my children have dental problems that need to be fixed fairly soon. But I'm emotionally drained after today, and I'm bad with confrontation. I'm a people pleaser and I just want her to like me and my kids and not make me feel bad that I don't want to push the nightweaning if my daughter is not ready.

So today, after the appointment, I was really grumpy and unhappy, and I couldn't put my finger on why. I was especially annoyed with Dave, who was getting over the valium he needed to take this morning. He unfortunately threw up his first pill and had to take a second before we left, and I think the first one had at least partially absorbed so he got a larger dose than usual, which made him extra tired. I don't like naps for adults, so I was quite annoyed that he was napping while I was working. I know I was being unreasonable, but at the time, it was completely reasonable to me that he should help me despite the fact that he was still drugged. I had to leave after Dave had recovered sufficiently and go to the fabric store with my sister. Dave stayed with the kids. I really needed a break from them, and to do something fun that I enjoy doing. I'm glad I was able to do that. After I got back, Dave went fishing, and I was annoyed with the girls all afternoon. I couldn't figure out why. I talked to Emily on the phone, and she straight up told me that I was being unreasonable and that I needed to look at it from a different perspective. After our phone call, I realized that I was acting this way because of my children's dentist.

I put so much effort into making sure that breastfeeding would work for me. I got the support I needed, read book after book during pregnancy, planned for an intervention-free birth so my baby would come out more likely to be able to nurse right away, didn't give them pacifiers or bottles until after nursing was established, etc. I did it because the health reasons are so compelling. I married a man with asthma and allergies, poor dental health, digestive tract problems, chronic ear infections as a child, and migraines as an adult. I read everything I could about keeping those aliments at bay as long as I could. While I realized that breastmilk is not a miracle elixir, I know that on average breastfed babies fare better than their formula fed counterparts, all other things being equal. I am thankful every day that Dave was breastfed into toddlerhood. I can't imagine how much worse his health problems would be had his mother given up. Thank goodness she was the kind of woman she was, and was able to nurse all of her boys. I also did other things to decrease the chances my children would have health problems-- I delayed solids until at least 6 months for both the girls (infant guts close around the 6-7 month mark, so earlier solids can cause digestive tract issues), I avoided antibiotics during infancy and treated ear infections with homeopathics and herbal remedies (antibiotic use during infancy is correlated with higher instances of asthma as adults), and delayed the introduction of cow's milk in both my children. I also made a goal to nurse my children for 2 years minimum, and weaned Lacy at 3 years 3 months of age. I plan to nurse Rose for at least 2 year and possibly as long as her sister, though it is still up in the air (I kind of want my body back for a while... I've been nursing almost 4 years straight now). I know that my decision to nurse Lacy as long as she nursed was a wise decision. Within weeks of weaning, Lacy broke out with eczema. She had it mildly before, but never to the extreme she now has it. I don't think it is coincidental that the eczema hit as soon as she was weaned. I believe that it was a protection to her. I also believe that had she not been nursed at all, her eczema would be much, much worse.

Anyway, my point is that my decision to breastfeed did not come lightly. I took this decision very seriously, since my children's health is my highest priority. And I now realize why this meeting we had today is so upsetting to me. This decision to breastfeed was a conceived very carefully. It was done for health reasons. I feel like she is only seeing the very narrow picture of poor dental health, and thinks I am foolish for allowing my children to nurse to older than typical (in the US) ages. And I'm the type that just wants everyone to like me and not judge something I'm doing as wrong or foolish, especially when it is something so important to me. It really hurts.

I've learned a lot today. I realized karma is a very powerful thing. I am not always tolerant and compassionate, and I need to be more so. How can I expect tolerance and compassion for myself when I don't exhibit it more for others? I think I need to spend a lot of time on my knees figuring out how to achieve this for myself.

1 comment:

Eve said...

I admire your desire and determination to breastfeed your daughters for as long as they seem to need it.

Perhaps the dentist thought you were asking for tips on how to wean? Not what you intended, I know. Since full-term nursing is unfamiliar to most medical professionals, oftentimes they assume the child is "still" nursing b/c mom hasn't figured out how to "break the bad habit" and they willingly offer their advice for weaning.

Maybe that helps to see where the dentist may be coming from? Then, you can state your position, with firm respect: "Thank you for your ideas. I am not interested in weaning my daughter. What other options are open to us for helping with her decay?"

Consider bringing along your documentation about the benefits of breastfeeding as it applies to dental health for your dentist to become more educated about. La Leche League is a good place to start as they have been sharing up-to-date information on many topics relating to breastfeeding for over 50 years and are well-respected.

Here are some more links, in case you want to check them out:

Good luck and good for you for sticking to what works for you and your daughter!