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Nutritionist says to limit bf to twice a day

post #1 of 29
Thread Starter 
Hi all,

Just looking for a little reassurance here....

My DD will be one year old next week. She was born very small, 1st percentile, but then gained weight rapidly and had jumped to the 45th percentile (in the WHO breastfeeding charts) by two months old. After that came a slow but seemingly inexorable decline in weight gain, and right now she's around the 20th percentile, still gaining, but much slower than before.

She started solids at 6 months and seemed interested at first but then lost focus. We've been doing BLW and trying to take it at her pace, just offering her lots of different things, although not a whole lot of meat as we don't eat that much ourselves. She does eat a fair amount of fruit puree and plain, organic yoghurt on some days, then nothing at all on other days. She dabbles at other things but really doesn't seem all that into it.

She's very active physically and is particularly into climbing things - she's a champion stair-climber - which, judging from what I've read on other threads, might mean she's burning off a lot of calories.

My mother thinks she isn't eating enough solids and so I decided to get her weighed. The nutritionist who weighed her thinks I should offer her a lot of pureed stuff at noon and four o'clock and not let her breastfeed anymore except in the morning and evening (in order to force her to eat the pureed stuff).

This seems wrong to me - quite apart from the idea of trying to force her to eat, which gives me the creeps, I would have thought that even at her age it still isn't a good idea to deny her breastmilk if she is asking for it. I could understand maybe offering solids first, but it seems a bit extreme to not allow her the breast at all for much of the day.

Any thoughts?
post #2 of 29
Trust your instincts. If you feel she is healthy and just small and you don't have a problem breast feeding her as much as she wants it than change nothing.



Your breastmilk is still the absolute best source of nutrition for her In fact I might consider offering it more often. Pureed food is really supposed to be for practice eating and digesting. There is way more fat and calories in breastmilk than fruit puree.
post #3 of 29
It seems wrong to me, too. I'd continue to nurse her on demand, and offer solid foods often -but let her lead the way.
post #4 of 29
Breastmilk is much more calorie dense than pureed solids. I work in a mother's day out program and checked the calorie count in a jar of sweet potatoes and squash today. For a 6 ounce jar, the sw. potatoes had 110 calories and the squash had 60 (IIRC). Six ounces of breastmilk has, theoretically, 120 calories in it.
post #5 of 29

RE: Nutritionist says to limit bf to twice a day

If your daughter is healthy and active and developing "normally" I wouldn't worry about it.
My daughter has always been "below average" in weight but is well advanced in her developmental skills and is very active. Her specialists complain but she has always progressed at a steady rate and her pediatrician thinks she's just fine.
Some women breastfeed solely without any solids at all until their babies start to wean themselves and show an interest in food.
Do what feels natural for you and your baby. As long as she is active and growing, she should be fine.

Good luck!

Kai's Mamma
post #6 of 29
do the math....there are more calories (and nutrients) in BM than pureed peas (or other simple fruits and veggies). So your being asked to increase her weight by reducing her calories????

if you do offer more solids at least offer those high in calories - avacado, use BM (instead of water) to thin your pureed foods, add powdered formula (if your into that), add flax seed oil, coconut water (from a fresh coconut) etc.

good luck - sounds like your doing a great job!!
post #7 of 29
That sounds like the opposite of what you should be doing. I would offer the breast more, not less. At that age my DS was nursing every 2 hours around the clock, except when I was at work. He had bottles of breastmilk every 2 hours while I was at work. Trust your instincts and nurse your DD as you see fit.
post #8 of 29
I'm echoing everyone else and adding a chart from Kellymom showing the difference, calorie and fat wise, between breast milk and common solids.

If you're looking for weight gain you want more breast milk rather than less.
post #9 of 29
Ditto on the milk being more nutrition than solids thing. Also, for a lot of kids it is perfectly normal to practically stop gaining weight between 6-18 months. My son did that.
post #10 of 29
Ditto on what everyone else is saying.

Up the (good) fat intake for both of you. Up her protein intake if possible.
post #11 of 29
Only 4 "meals" a day in total? That just doesn't seem like enough to me at all. You're doing great.
post #12 of 29
ditto all the previous posters. you are doing an awesome job with her. continue to listen to your gut. adults are not all the same size, neither are babies. she sounds like she is growing well, and has lots of energy. honestly i would discontinue pushing pureed foods, and let her nurse first, then offer her actual solid food. good healthy stuff that she can feed herself, like chunks of boiled sweet potato and avacado
post #13 of 29
Your nutritionist's advice definitely does not sound logical to me, for the same reasons that previous posters have mentioned. I would trust your instincts and continue to nurse on demand. I don't think there is any need to rush the amount of solids she is consuming... just keep offering, but I would not push it.
post #14 of 29
Quote:
Originally Posted by nannymom View Post
Your breastmilk is still the absolute best source of nutrition for her In fact I might consider offering it more often. Pureed food is really supposed to be for practice eating and digesting. There is way more fat and calories in breastmilk than fruit puree.
Exactly!

Purees do not have the nutritional quality of BM. My dd id over 26lbs at 13 1/2 months and she still drinks PLENTY of breastmilk and not tons of solids. The breastmilk fills in the gaps nutritionally.
post #15 of 29
I don't really get the idea that weight gain will be achieved through limiting her best source of calories and nutrition? Nursing twice a day and force-feeding purees twice a day is supposed to make her gain? Uh huh.

Nurse her as often as she wants. Keep offering a variety of foods. Maybe increase foods that are dense in calories - avocado, oils, etc. One thing that comes to mind is bread dunked in olive oil - my DS loves that, and it's nice and caloric!

Also, since when is 20th % a bad thing? As long as she's gaining over time, it's totally okay to be on the smaller side! Everyone is different.
post #16 of 29
I don't know whether this applies to you, but as a little anecdote...

I used to babysit a little 2 year old boy. He constantly came up in the lowest percentiles at the doctor's office. His mother was always concerned about this. Concerned, concerned, concerned. One day I told her what was what. She's five foot six and must weigh 110. Her husband must be 5' 8" and once talked of going on a diet because he'd weighed in at 175. THE KID JUST HAS LESS OF A SIZE TO ASPIRE TO, I proclaimed.

Well that might not be the case with your kid but the point remains. Every kid is different. Is the kid happy, bouncy, developing, hitting milestones? If so, who cares if she is small? A kid who is failing to thrive will be listless, falling behind.

In my opinion you should continue to breastfeed, not exclusively of course at one year, but still... consider your milk the ultimate multi-vitamin for her. If anything, I'd suggest trying to make sure that your milk is in addition to everything else she eats, instead of instead. Let her eat vegetables and whole grains on top of lots and lots and lots of mommy's milk. She's only one, for crying out loud, and even the WHO says babies should breastfeed 'til 2, don't they?

- Amanda, new-ish mommy, long-time child-care-giver, self-described sensible person
post #17 of 29
Thread Starter 
Thanks so much for all the support! I'd been feeling as though I'd been neglecting dd, and now I feel cheerier. We have a checkup at the doctor's next week which I had been dreading because the doctor isn't very bf-friendly either (he told us to start dd on solids at 5 mo because of her slow weight gain, and has been continually astonished that we're still breastfeeding) but now I'll keep in mind all the useful info you've given me, particularly the chart from kellymom.

Just to clarify - it wasn't so much the fact that she's small which was bothering me, as the way she keeps slipping down the percentiles. But of course, she started out on such a low percentile that it's hard to know which percentile she really 'belongs' on. And plus, as a lot of you pointed out, some babies just don't gain much weight at this stage in their lives.

She's always been a frequent feeder, at least every two hours around the clock, and I've never stopped her from feeding when she wants it (or not consciously anyway!). So there probably isn't a supply problem, but just in case I'll make sure to eat lots of good stuff and offer her the boob often.

I offered her some protein-rich food for lunch today and she insisted on feeding it to me instead!
post #18 of 29
Quote:
Originally Posted by winter singer View Post
Thanks so much for all the support! I'd been feeling as though I'd been neglecting dd, and now I feel cheerier. We have a checkup at the doctor's next week which I had been dreading because the doctor isn't very bf-friendly either (he told us to start dd on solids at 5 mo because of her slow weight gain, and has been continually astonished that we're still breastfeeding) but now I'll keep in mind all the useful info you've given me, particularly the chart from kellymom.

Just to clarify - it wasn't so much the fact that she's small which was bothering me, as the way she keeps slipping down the percentiles. But of course, she started out on such a low percentile that it's hard to know which percentile she really 'belongs' on. And plus, as a lot of you pointed out, some babies just don't gain much weight at this stage in their lives.

She's always been a frequent feeder, at least every two hours around the clock, and I've never stopped her from feeding when she wants it (or not consciously anyway!). So there probably isn't a supply problem, but just in case I'll make sure to eat lots of good stuff and offer her the boob often.

I offered her some protein-rich food for lunch today and she insisted on feeding it to me instead!
Best wishes at the doc. I suspect that the dr's main concern will be "slipping down the charts," too. Make sure they are using a chart of breastfeeding children. (Is that the kellymom chart suggested to you?) And remember that, compared with formula- or part-formula-fed infants, breastfed infants DO look like they are falling down the chart after 6 mos. They start out chunky and then slim out. If yours started slim, she's gonna get slimmer!

(but keep up the good work!)
post #19 of 29
Quote:
Originally Posted by winter singer View Post

I offered her some protein-rich food for lunch today and she insisted on feeding it to me instead!
We're into feeding mom here, too. Sometimes Dad.

Just wanted to add that DS slipped down the charts. He started at 80+%tile, and is now about 60. But his height has remained above the 90th, and is now above the 97th. I entered his height and weight into a BMI calculator for children, and he came up malnourished!! He's perfectly fine, I assure you. Children come in all shapes and sizes, and the averages and charts simply cannot capture the physical diversity of all human children.
post #20 of 29
Thread Starter 
Quote:
Originally Posted by ASusan View Post
Best wishes at the doc. I suspect that the dr's main concern will be "slipping down the charts," too. Make sure they are using a chart of breastfeeding children. (Is that the kellymom chart suggested to you?) And remember that, compared with formula- or part-formula-fed infants, breastfed infants DO look like they are falling down the chart after 6 mos. They start out chunky and then slim out. If yours started slim, she's gonna get slimmer!

(but keep up the good work!)
Oh boy - she's slim alright, always has been! I'd better just brace myself for many more difficult health care apts in the future.....

We've been using the breastfeeding children's chart ever since the doctor told me at 5 mo that DD's weight gain was too slow. I posted about that to MDC back then and someone gave me the link to the chart (on the WHO site). I printed it out and have brought it to all the doctor apts since. The doctor was a bit bemused to see it at first but he seemed to accept it alright.

In fact on the last visit at 9 mo, there was a student doctor there too and he made some remark to her (the student) about how it was interesting the way the charts differed. I'm hoping it sank in with her and that the next generation won't have to deal with all this grief!
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