Babies Are Born To Breast-feed

By Sylvia Pager
Interviewed by Guest Writer
Wednesday - November 07, 2007
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Sylvia Pager

Dr. Sylvia Pager
Pediatrician & Breast-feeding Consultant

What is your area of specialty within the pediatric field?

My major interest is breast-feeding and helping mothers succeed and enjoy their young infants.

Babies were born to be breast-fed, but unfortunately, a lot of people seem to be experiencing difficulty with that.

Dr. Sylvia Pager examines 3-week-old Reise Pickett
Dr. Sylvia Pager examines 3-week-old Reise Pickett

What do you notice are the more common reasons why mothers choose not to breast-feed?

In Hawaii we have something like 90 percent or more of mothers who begin to breast-feed, whereas other states don’t have nearly that. But they find that it’s not as easy as they thought it was going to be. They thought that it was going to be easy and natural. Unfortunately, formula is so easily available and mothers can so easily reach for the bottle. This quickly takes the place of breast-feeding for a whole bunch of different reasons, including that the baby is no longer hungry, so that they don’t suck. But if your baby doesn’t suck and empty the breast, you aren’t going to make more milk.


Not having enough milk is a common perception that is not valid in most cases, because babies are designed to not need very much milk in the first few days. And the more they suck, the more the milk comes in, and eventually there is plenty. But once you interfere and give the babies bottles, the whole process gets distorted. And this interferes with the whole immune system because the breast milk is the baby’s first immunization.

What are some tips you often give to mothers who have just started breast-feeding?

Early on, be prepared for reality - that you do need to feed frequently and it’s not an every-four-hours schedule that some people seem to think that mothers are programmed to do. But that bears really no relation to what babies are programmed to do. It could be every hour or so. So be patient and believe that you can do it.

The human race has survived because babies have been breast-fed for thousands of years. But now the availability of an alternative gets in the way. There is a need for formula at times. In such cases, it should be prescribed like a medicine, for a specified time, with a view to definitely discontinue it at some point. And if there is such a need, it should be clear that breast-feeding is in trouble, and a specialist should be brought in to deal with it. Because just giving formula without fixing the problem with the breast-feeding isn’t going to provide an adequate solution. Many such problems turn out to be just be a matter of latch adjustment, which requires experience and skill, and encouraging and empowering the mother to succeed. There may be a variety of other problems, but most can be solved and the babies can return to being breast-fed as they were born to be.

What about mothers who have to return to work?

That is a challenge, but there’s a new United States breast-feeding initiative to promote breast-feeding in the workplace. There are a number of studies that show that employers actually make more money if the mothers are empowered to continue breast-feeding when they’re at work. All it takes is giving the mothers a little flexibility in their work hours and a suitable place to pump. It has been found that mothers are often so appreciative that they stay later, and come in earlier and are more productive. The main plus side is that the babies don’t get sick as often or as seriously if they’re breast-fed, compared with formula-fed. So the mothers don’t have to take time off from work to care for their sick babies. And the employer does-n’t have to go and hire substitute workers and retrain and all that. In addition, the cost of health care for the sick babies is avoided.

What is the longest that you recommend mothers to breast-feed?

I have never told a mother to stop, unless she’s hating it (but she shouldn’t be breast-feeding if she’s hating it). If mother wants to continue until the baby is 5 years old, I see nothing wrong with that. Babies do not get “over-attached” to the mother. In fact, breast-fed babies have been shown to be more outgoing and more independent. I think if a mother is coming to school to breast-feed her kindergartner then it’s a bit odd, but I have heard some stories like that. I would-n’t be too concerned. I would be more concerned with getting everyone to exclusively breast-feed until six months. People often ask me about older kids who are still breast-feeding, but these are so very few. It’s really not a problem.

What is the age range of most of your patients?

My patients tend to be getting older because I’m not seeing as many newborns as I used to. As OBs get older they cut back on deliveries, and the younger OBs send their patients to the peers that they went to school with. But that’s OK. I have a few patients who are now “second generation” - very rewarding. I don’t have as many patients on the young end and I do have more teenagers than I used to. But I love to do the breast-feeding because it’s something that I think I do better than a lot of other people, and it’s so satisfying to help people achieve the best for their babies.


At what age should someone switch from a pediatrician to a family doctor?

That’s an interesting question because about 20 years ago the Academy of Pediatrics came out with a recommendation that we should extend our age range. When I started in medical school, pediatric hospitals stopped at 12 and then it extended to 15 and 20. And then they came out and said that you should be seeing young adults because, in this society where education is extended, there are more kids in this continuing growth and development stage, which is what we pride ourselves that we do well. So given that kids are dependent on their families for schooling for a longer period of time, they fit into our style of practice. We’re happy to see them as long as they are comfortable coming. I have a few 20-something-year-olds who still seek my services, and I love to see them.

This information is provided as educational and is not intended as a substitute for consultation with a physician. For questions, consult your physician or call the Honolulu County Medical Society, of which Dr. Sylvia Pager is a member, at 536-6988.

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