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Pediatrician recommends supplementing - should I?
Hello all!
I'm sure this has been brought up many times before, but I was hoping for some advice. First some background: my baby girl is 5 weeks old and was 5lb 11oz at birth (not preemie -- 39 weeks gestation, just small, but perfectly healthy). We had a HORRIBLE time breastfeeding the first couple of weeks, and she dropped down to 5 lbs. Since then, she has gained consistently at the rate of 1/2 oz per day (which is on the very bottom of the "acceptable" range according to the pediatrician). He wants me to try supplementing with formula. I want to avoid that at all costs. What would you all do? Thanks for any advice! |
#2
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Pediatrician recommends supplementing - should I?
LubsyB wrote: Hello all! I'm sure this has been brought up many times before, but I was hoping for some advice. First some background: my baby girl is 5 weeks old and was 5lb 11oz at birth (not preemie -- 39 weeks gestation, just small, but perfectly healthy). We had a HORRIBLE time breastfeeding the first couple of weeks, and she dropped down to 5 lbs. Since then, she has gained consistently at the rate of 1/2 oz per day (which is on the very bottom of the "acceptable" range according to the pediatrician). He wants me to try supplementing with formula. I want to avoid that at all costs. What would you all do? Thanks for any advice! Usually, supplementing is shooting yourself in the foot. The more you supplement, the less she'll nurse,the less you produce, the more you have to supplement. I'd think - and I'm not a pedi - as long as she is gaining weight she's ok. btw, dropping weight in the first weeks is normal. We were a special situation (DD was IV fed for a week, tube fed for the second week), but she didn't regain her birthweight until 3 wks old, and gained very slowly once I started Breastfeeding directly (the tube feeds were EBM). The nurses at the NICU were harassing me a bit about the slow weight gain and insisting they at least tube-feed (ie force feed) to make up the difference. Fortunately the neonatalogist sided with the LC and me and insisted we keep on BF. Now, by 3 weeks she *was* gaining reasonable amounts and doing well, your situation does sound a bit different. I gather BF is going well now? How long does she feed on each side? DO you let her nurse until she's done on each side or do you switch sides after a certain number of minutes? Could it be she's not nursing long enough and only getting foremilk rather than hindmilk? DD only nursed on one side per session, and in that first week I'd have to encourage her to nurse more, even though the nurses also said I should switch sides after X# minutes. Have you pumped? You can consider pumping after each feed, then give her that via syringe or bottle (if BF is well established now). That way your supply isn't adversely affected, but you're topping her off for awhile and see if that makes a difference (I also did that with DD for the first week or so). |
#3
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Pediatrician recommends supplementing - should I?
LubsyB wrote: Hello all! I'm sure this has been brought up many times before, but I was hoping for some advice. First some background: my baby girl is 5 weeks old and was 5lb 11oz at birth (not preemie -- 39 weeks gestation, just small, but perfectly healthy). We had a HORRIBLE time breastfeeding the first couple of weeks, and she dropped down to 5 lbs. Since then, she has gained consistently at the rate of 1/2 oz per day (which is on the very bottom of the "acceptable" range according to the pediatrician). He wants me to try supplementing with formula. I want to avoid that at all costs. What would you all do? Thanks for any advice! I had a baby who consistently gained at the very bottom of the acceptable range and chose not supplement. He is now a normal 5 year old. Since your baby is gaining within the normal range, you don't have an immediate emergency and don't "have" to supplement right now. However, you probably would be happier to have her gaining faster. Since she is within the normal range you have time to try various methods to increase her weight gain without supplementing. If her weight gain drops and you do need to supplement, you may be able to pump and use you own milk, avoiding bottles and formula. What is her nursing pattern like? Is she getting at least 10-12 nursings in 24 hours? Is she a fast feeder, slow feeder, sleepy feeder etc? Do you feel like she is running out of milk and would take more if it were available? She could still need work on her latch. You may want to get that checked. If her latch is OK, switch nursing, back and forth from side to side each time she slows down can help her get more milk and increase your supply. Breast compression (squeezing your breast) when she slows down can help too. You may want to try herbs or Mother's Milk tea. Kellymom has good information on herbs. http://kellymom.com/herbal/milksupply/index.html Does she seem to fill up quickly and not want more? Does she have lots of gas? She could be filling up with air. More frequent burping and/or symethicone drops might help? --Betsy |
#4
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Pediatrician recommends supplementing - should I?
LubsyB wrote:
Hello all! I'm sure this has been brought up many times before, but I was hoping for some advice. First some background: my baby girl is 5 weeks old and was 5lb 11oz at birth (not preemie -- 39 weeks gestation, just small, but perfectly healthy). We had a HORRIBLE time breastfeeding the first couple of weeks, and she dropped down to 5 lbs. Since then, she has gained consistently at the rate of 1/2 oz per day (which is on the very bottom of the "acceptable" range according to the pediatrician). He wants me to try supplementing with formula. I want to avoid that at all costs. What would you all do? Thanks for any advice! Don't supplement. Just nurse until baby is full or asleep. Don't time the session, just nurse. -- Anita -- |
#5
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Pediatrician recommends supplementing - should I?
LubsyB wrote: Hello all! I'm sure this has been brought up many times before, but I was hoping for some advice. First some background: my baby girl is 5 weeks old and was 5lb 11oz at birth (not preemie -- 39 weeks gestation, just small, but perfectly healthy). We had a HORRIBLE time breastfeeding the first couple of weeks, and she dropped down to 5 lbs. Since then, she has gained consistently at the rate of 1/2 oz per day (which is on the very bottom of the "acceptable" range according to the pediatrician). He wants me to try supplementing with formula. I want to avoid that at all costs. What would you all do? Thanks for any advice! Up to a ten percent drop in weight at first is considered normal, so that would be about 9 oz. for a 5 lb. 11 oz. baby. She lost just *two* ounces more than that ... not such a hideous thing. (Two of my three babies lost more than 10% without having any problem, but they were biggish babies to begin with, plus they lost most of the weight almost immediately, and I think their birthweights may have been inflated due to retained water from my being on an IV for a long time before they were born.) Yes, half an ounce a day is at the bottom of the range, but heck, she's not a large person, and she *is* into the normal range despite your rough start. I don't see a reason to panic yet, if she's acting normal, pooping and peeing well, and all that. What's her feeding behavior like -- is she nursing for decent lengths of time, latching well, not going too long between feeds? I wouldn't be surprised if she started gaining a bit faster soon. Some people do breast compression to try to get more hindmilk into the baby. Maybe someone who knows more about it can post. --Helen S. |
#6
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Pediatrician recommends supplementing - should I?
I'm sure this has been brought up many times before, but I was hoping
for some advice. First some background: my baby girl is 5 weeks old and was 5lb 11oz at birth (not preemie -- 39 weeks gestation, just small, but perfectly healthy). We had a HORRIBLE time breastfeeding the first couple of weeks, and she dropped down to 5 lbs. Since then, she has gained consistently at the rate of 1/2 oz per day (which is on the very bottom of the "acceptable" range according to the pediatrician). He wants me to try supplementing with formula. I want to avoid that at all costs. What would you all do? Thanks for any advice! sorry, it's at the bottom of acceptable, not below the acceptable range, so exactly why does he want you to supplement with formula? Even if it was below the acceptable range the first solution would not be to supplement (unless it was an urgent health issue), I'd recommend a visit to a lacation consultant, just to check your latch and everything is ok. Given she was small, that's probably just her constitution so she's not going to be putting on as much, that amount is going to be a similar percentage of her body weight gained than a larger baby that gains an ounce, her stomach is going to be smaller, so in some ways her acceptable range should be adjusted and she's probably middle of that range. Cheers Anne |
#7
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Pediatrician recommends supplementing - should I?
Hello,
Helen S. mentioned trying breast compressions. These can be very effective for "supplementing" baby with your milk as she breastfeeds. Assuming she is nursing well now, and you are not in pain when she sucks; all you do is move your hand back towards your chest (not towards her mouth). You compress the breast while the baby is actively sucking, then relax when she pauses. There is a good description of breast compressions on Jack Newman's section of Breastfeedingonline.com. What you are are doing is simply moving more milk towards the baby than she can get herself with each suck. It's a very simple, efficient way to "supplement." Good luck, Rachel On Jan 3, 8:56 am, "LubsyB" wrote: Hello all! I'm sure this has been brought up many times before, but I was hoping for some advice. First some background: my baby girl is 5 weeks old and was 5lb 11oz at birth (not preemie -- 39 weeks gestation, just small, but perfectly healthy). We had a HORRIBLE time breastfeeding the first couple of weeks, and she dropped down to 5 lbs. Since then, she has gained consistently at the rate of 1/2 oz per day (which is on the very bottom of the "acceptable" range according to the pediatrician). He wants me to try supplementing with formula. I want to avoid that at all costs. What would you all do? Thanks for any advice! |
#8
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Pediatrician recommends supplementing - should I?
"LubsyB" wrote in message oups.com... Hello all! I'm sure this has been brought up many times before, but I was hoping for some advice. First some background: my baby girl is 5 weeks old and was 5lb 11oz at birth (not preemie -- 39 weeks gestation, just small, but perfectly healthy). We had a HORRIBLE time breastfeeding the first couple of weeks, and she dropped down to 5 lbs. Since then, she has gained consistently at the rate of 1/2 oz per day (which is on the very bottom of the "acceptable" range according to the pediatrician). He wants me to try supplementing with formula. I want to avoid that at all costs. What would you all do? Thanks for any advice! Hmm. Do you feel like she is weak or lazy? One of mine was weak and lazy and while my supply was fine, he wasn't very good at getting full until he was a little stronger. If she is strong, alert, active, healthy looking, plenty of diapers, etc she's probably just small. I could tell my weaker baby wasn't getting as much, but then I had nursed two previously and he is a twin so I had another stronger baby to compare to in real time If you think she may need to get a little stronger she is old enough to introduce a bottle. If you decide to go that route, my advice would be to pump some milk...nurse her until she is full, and then have someone else give her a couple ounces from a bottle. I'd do that maybe twice a day. Pump while someone else gives her the bottle. You aren't likely to get much milk then but don't worry about that, it is just to signal your body. You may need to pump each morning to get those ounces. If she refuses the milk, she is getting full at the breast. If she is drinking it down just continue on like that for a couple weeks and she'll slowly get stronger and better at the breast. Cut out the one bottle, and then cut out the next a few days later. I was able to eliminate all the bottles and he was/is fine. -- Nikki, mama to Hunter 4/99 Luke 4/01 Brock 4/06 Ben 4/06 |
#9
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Pediatrician recommends supplementing - should I?
Hmm. Do you feel like she is weak or lazy? One of mine was weak and lazy and while my supply was fine, he wasn't very good at getting full until he was a little stronger. If she is strong, alert, active, healthy looking, plenty of diapers, etc she's probably just small. I could tell my weaker baby wasn't getting as much, but then I had nursed two previously and he is a twin so I had another stronger baby to compare to in real time If you do feel this is the problem for your baby then the last thing you want to do is introduce a bottle, babies like this are much more suspetible to developing problems with switching between breast and bottle. I've also had a baby with a weak suck, but I didn't notice as he was my first, we didn't really have a problem until I introduced first a pacifier, then a bottle, after that it took weeks of pumping after every single feed and even then we didn't quite make it through without some supplementation, though those were more related to my health issues than the early problems. Breast compression is a very good way to assist a baby with a weaker suck, use your thumb and forefinger, thumb on top of the breast, cupping it an massage down towards the nipple, you can actually apply quite a lot of pressure, the aim is to get to the deep tissues and really make sure that the breast is emptied during a feed. Anne |
#10
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Pediatrician recommends supplementing - should I?
Thanks for all the advice! In answer to some of your questions,
breastfeeding is going much better now (I've had my mom, who successfully bf'd 3 babies, sit with me many times to watch her latch, etc.), and I let Sara feed on each side until she gets too sleepy (10-15 mins per side). If she still acts hungry, I let her go back on the first breast for a few more minues. I also have been pumping some, and offering her that after a couple of feedings a day, and she always takes 1-2 more oz when I offer, so that makes me think she leaves hungry sometimes -- even after 45 minutes. One thing of note is that she doesn't eat 10-12 times a day, maybe more like 8. She typically sleeps for 2-3 hours every time before waking up to eat. Her diapers are definitely good, and she has long alert periods where she's perfectly content, so it's not like she's crying all the time or anything. |
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