Update: How do you supplement a baby who refuses all forms of supplementation?

[Blessed_Mom]

Hi,

My DD is 5 mo old. During the first 2 months she used to take a bottle (Avent, Playtex) just fine. Around the 3 month mark she started refusing the bottle and lately she just screams if we try supplementing with a bottle.

I then bought her the lact-aid and tried that. For a couple of days she was fine and used to suck even though she noticed the tube. After about a week's worth of use - she has started spitting out the tube too.
Weird thing about lact-aid is I have to adjust the tube on my nipple at the start of a session (when my nipple is harder ) else the tube won't sit well in her mouth and she empty-sucks. BUT - the start of the session is when I have a great letdown and she gets overwhelmed I think (with the lact-aid in , I mean). Pumping before a session(for a gentler letdown) is not an option because I feed on demand and she gets impatient if her hunger cues are not met promptly.

I pump twice to 3 times a day and get about 3-5 ounces of EBM - which I would like to feed her. She is healthy, gaining well enough but she was born a preemie and thus her weight is in the lower 25% (non adjusted). In a way the supplementation is more for my benefit than hers' - I will readily admit. BUT - there are weeks when she would accept supplementation and gain about 7 ounces a week and now she gains about 4 and 1/2 to 5 and 1/2 ounces a week - so I know I am not off in wanting her to take the 2-3 ounces of supplementation a day (which seems to make all the difference). Problem is - I don't know how to make her take it.

Any idea? I bought her a sippy cup yesterday on reading some suggestions here. The sippy cup clearly states to not give to an infant less than 6 months old....so that makes me leery.

How does one give a 5 month old a sippy cup? Do I just fill it with BM and pool it in her mouth and let her swallow? How is that different from a syringe though? I do not imagine giving her the sippy cup and expecting that she would gladly drink/sip from there herself I have never even given her water...she doesn't know how to hold a cup yet (or drink anything but BM)

Any suggestions? TIA

[Eligracey]

A weight gain of 4-5 oz a week for a 5 month old is perfectly healthy. A newborn should gain 6-7 oz a week but after that their growth tapers off. Look at growth charts online, you'll see that. You don't WANT her to gain 7oz a week for the rest of her infancy and toddlerhood.

As long as she's not falling off her growth curve she's doing fine. Some babies are just petite--my son's always been in the 25% for weight and 50% for height and is perfectly healthy, developing well (walking at 10 months!), and his pediatrician is very happy with his weight and growth.

[Blessed_Mom]

I agree with you. As I confessed - since she was born 5 weeks early (a petite li'l 5 pounder) I have been obssessed with her weight.

At the same time - it is a very heavy responsibility (full of pressure) to know that I am the only source of her nutrition (or means rather). She is attached to my boob and I would like to atleast know that when my supply dips (which it does once in a while) - that I can supplement her.

As it stands today - I have not slept very well since the almost 5 months that she has been born and it has been a never-ending saga of pumping, drinking herbal infusions, eating tons of fenugreek and fish and worrying

[PatioGardener]

Originally Posted by Eligracey

A weight gain of 4-5 oz a week for a 5 month old is perfectly healthy. A newborn should gain 6-7 oz a week but after that their growth tapers off. Look at growth charts online, you'll see that. You don't WANT her to gain 7oz a week for the rest of her infancy and toddlerhood.

:

She'll take what she needs, Mama.

If you want to plot her (adjusted age) on the WHO gowth charts you'll get an idea of how growth happens in an exclusively BF baby. They are made for term infants, but if you plot her weight on her due date as day 0, rather than using her birth weight, and just adjust the rest of the weights accordingly, it will at least give you an idea.

http://www.who.int/childgrowth/stand...irls_p_0_6.pdf

[Blessed_Mom]

So - can no one help me with the sippy cup question? Has no one supplemented a 4 or 5 month old with a sippy cup? How do you do it? Is she sitting when you do? Does your LO suck on their own? Do you pool the milk in her mouth (sounds dangerous) ...

What do you do?

EDIT: Thank you Patiogardener - also we posted simultaneously

[noobmom]

Originally Posted by Blessed_Mom

So - can no one help me with the sippy cup question? Has no one supplemented a 4 or 5 month old with a sippy cup? How do you do it? Is she sitting when you do? Does your LO suck on their own? Do you pool the milk in her mouth (sounds dangerous) ...

What do you do?

EDIT: Thank you Patiogardener - also we posted simultaneously

At that age we spoon-fed for supplementation or used a syringe. You could also try using a regular cup (something the size of a shot glass--or, in our case, an actual shot glass). Personally, I dislike sippy cups at any age because they require really hard sucking and that can hurt their ears, so I never really used them with DS. When he was older, we moved onto regular straw cups.

BTW, we spoon-fed milk. Just to clear that up.

[zensven42]

I would agree with most posters here in that she seems to be gaining plenty of weight without the supplementation. but, if you really want to anyway, sippy cups require hard sucking and are hard for younger children to use. they are more for toddlers. However, a regular cup, or a straw are easier. They can suck on a straw much like the breast.

[Blessed_Mom]

Thank you so much....DD has no clue what to do with the sippy cup either. she thinks it is another teething toy we are plonking in her mouth for her gums (which also is another thread material but she refuses all forms of teethers) and she tongues it a bit and loses interest.

This last week has been especially bad. Because of her teething she is unable to suck for long and is worsening my already on-the-border supply even more. I can easily tell that my supply is tanking and am getting desperate

To the point of considering Dom (which I am so dead against).

I wonder what the full-supply mamas do when their LOs teethe? Shouldn't their supply fall down too ? Can you guys afford it - for 2 or more months? Does it ever get better or is this the point most mamas lose their supply forever?

[zensven42]

If breastfeeding normally, without pumping, women do not lose their supply until the baby weans, which can be many years. It is a myth that women will ever not make enough milk to feed their baby, and will ever need to supplement with formula. In reality it is only 1% of women who will ever have a true medical condition which affects normal breastfeeding permanently. The best way to deal with supply problems is to nurse more without using a pump. Babies are much better at stimulating milk production than pumps, and pumps can interfere with the process. What I would suggest is that you spend some long quality time with the little one, hang out with your shirt off and just nurse, nurse, nurse. Drink loads of water and eat some oatmeal cookies and relax. Be sure to nurse a lot at night as well, as often as the baby wants it. (Babies sleeping "through the night" at an early age is also a myth. Babies need nighttime nutrition for a long time) Your supply should adjust so you have just enough milk for baby. Yes, it is a responsibility to be the sole provider of your child's nutrition, but this will be the case for many years, even when solids are involved. Children are a responsibility, that is just life. If you are feeling overwhelmed, I would suggest finding some support in your community, whether it be a local LLL or other breastfeeding group, or just some friends who can offer some hugs. With your child's current weight gain w/o supplementation, it sounds as if they were gaining just fine, so switching to just nursing should go pretty smoothly for you. Good luck and lots of hugs, you can do it!

Added: seeing how much you can pump is not an indication of your milk supply, as pumps do not work as well as a baby. When I pumped and worked outside the hom, I could often not pump as well on days I was more tense and stressed, which has nothing to do with supply. As far as teething goes, baby may nurse more or less during that time. Babies will often eat more or less depending on so many factors such as how active they were that day, growth spurts, teething, illness, amount of sleep, and just wanting more comfort. It will constantly change. This is normal, and the breast will adjust accordingly. It sounds as if you are micromanaging and obsessing a bit too much, and the stress alone can make it hard for milk to letdown. This may possibly be the true reason for you child fussing at the breast. Relaxation and confidence can do a lot to help your milk letdown.

[Blessed_Mom]

Originally Posted by zensven42

If breastfeeding normally, without pumping, women do not lose their supply until the baby weans, which can be many years. It is a myth that women will ever not make enough milk to feed their baby, and will ever need to supplement with formula. In reality it is only 1% of women who will ever have a true medical condition which affects normal breastfeeding permanently. The best way to deal with supply problems is to nurse more without using a pump. Babies are much better at stimulating milk production than pumps, and pumps can interfere with the process. What I would suggest is that you spend some long quality time with the little one, hang out with your shirt off and just nurse, nurse, nurse. Drink loads of water and eat some oatmeal cookies and relax. Be sure to nurse a lot at night as well, as often as the baby wants it. (Babies sleeping "through the night" at an early age is also a myth. Babies need nighttime nutrition for a long time) Your supply should adjust so you have just enough milk for baby. Yes, it is a responsibility to be the sole provider of your child's nutrition, but this will be the case for many years, even when solids are involved. Children are a responsibility, that is just life. If you are feeling overwhelmed, I would suggest finding some support in your community, whether it be a local LLL or other breastfeeding group, or just some friends who can offer some hugs. With your child's current weight gain w/o supplementation, it sounds as if they were gaining just fine, so switching to just nursing should go pretty smoothly for you. Good luck and lots of hugs, you can do it!

Added: seeing how much you can pump is not an indication of your milk supply, as pumps do not work as well as a baby. When I pumped and worked outside the hom, I could often not pump as well on days I was more tense and stressed, which has nothing to do with supply. As far as teething goes, baby may nurse more or less during that time. Babies will often eat more or less depending on so many factors such as how active they were that day, growth spurts, teething, illness, amount of sleep, and just wanting more comfort. It will constantly change. This is normal, and the breast will adjust accordingly. It sounds as if you are micromanaging and obsessing a bit too much, and the stress alone can make it hard for milk to letdown. This may possibly be the true reason for you child fussing at the breast. Relaxation and confidence can do a lot to help your milk letdown.

Can I say I you without it sounding creepy?

[Vegan Princess]

I think that if your daughter were truly hungry, she would take the bottle. My daughter was early and small too and has always been in the 25% (9 months now and still there). But she is steady there. I truly do have low supply do to breast surgery and have always had to supplement - I use bottles half the time and a lactaid half the time. Lately due to a cold and perhaps getting more from me than I think, she has been refusing both as well. Though she will chug a bottle a couple times a day..but she pushes it away a lot of the time. She'd been erratic with nursing too bc of her stuffy nose and my supply started to go down. I pumped after some feeds and got it back up though and I did a weighed feed today and she got more than I thought she would. So I guess she is just satisfied right now with what I have been producing. Her dr said not to worry about it. I'm sure your daughter is getting enough and just doesn't want the additional. But if you are insecure about your supply while she is teething you can continue to pump after some feeds to help increase it.

Cindy

[LilMomma83]

The weight gain sounds good to me...but, I've had 2 slowish gaining babies (my oldest caught up to growth charts around 2yo), but, they were totally fine - I think all babies are different.

If you want to use a sippy cup you can, my oldest used one by 4mos - I just took the rubber "non-spill" valve out...he loved it! He would not drink milk out of it though...but, every child is different.

[zensven42]

So how are things going? Does baby seem happy and satisfied?

[Blessed_Mom]

Update

Originally Posted by zensven42

So how are things going? Does baby seem happy and satisfied?

That week she was fine , thank you for asking but things have been steadily going downhill since then. Am in the classic "my milk's drying up at around 5 and 1/2 months' " pattern. All the symptoms are there - so I cannot be imagining it. DD is teething so is doing the latching -unlatching thing a lot and tanking my supply. I was already borderline to begin with. I haven't stopped pumping (sorry...I do need the extra for supplementation. She does end up taking atleast an ounce (or two max) from lactaid). I have just introduced solids to her (have a thread in the Life with a Babe subforum) and may have given her too much oatmeal - she pooped hulls

Am veering dangerously close to wanting to take Dom (which I am so dead against).

This last week's gain was 1.5 ounce so I know I am not imagining it. I don't know what else to do?

[Megan73]

Originally Posted by Blessed_Mom

Weird thing about lact-aid is I have to adjust the tube on my nipple at the start of a session (when my nipple is harder ) else the tube won't sit well in her mouth and she empty-sucks. BUT - the start of the session is when I have a great letdown and she gets overwhelmed I think (with the lact-aid in , I mean).

Have you tried getting the tube placed in her mouth at the beginning of the session but pinching it off in the little notches then just starting the flow after letdown?

Originally Posted by Blessed_Mom

Am veering dangerously close to wanting to take Dom (which I am so dead against).

This last week's gain was 1.5 ounce so I know I am not imagining it. I don't know what else to do?

Why are you so opposed to taking domperidone?
It sounds like it might be the answer to your problem if she's consistently not gaining enough. Average weight gain at her age is 4-5 ounces a week although I wouldn't worry if she's gaining well overall and has one off week.

[Blessed_Mom]

Originally Posted by Megan73

Have you tried getting the tube placed in her mouth at the beginning of the session but pinching it off in the little notches then just starting the flow after letdown?.

No - I can try it. She is very wary about the tube - she notices it but keeps quiet during certain times and spits it out during others. I basically stop breathing once the tube is in her mouth and keep completely still until she finishes the bag (which I never fill more than 1.5 ounce anyway because she has always drawn away around the 1 ounce mark (max) and after that she fusses and protests and spits it out until she gets my bare boob)

Originally Posted by Megan73

Why are you so opposed to taking domperidone?
It sounds like it might be the answer to your problem if she's consistently not gaining enough. Average weight gain at her age is 4-5 ounces a week although I wouldn't worry if she's gaining well overall and has one off week.

No - she was fine until the 5th month mark - when her weight gain started dwindling. First low week was 3.5 ounce and this past week was 1.5 ounce. Next week's measure is on Wednesday and am dreading it.....because last 15 days I have felt (and seen my pumped output steadily decreasing). I started her (introduced really) on solids this week. Which was 2 months earlier than I had ever wanted to

DOM - what can I say? I am very leery of its side effects in her. Don't care what it does to me. BUT - the possibility of a QT and heart murmurs in her scare me to pieces. ALSO that once I take it - then it is the valley of no return. I don't think I will be able to feed her at all if I stop taking it considering how borderline my supply already is. It feels unnatural and am afraid for her. I do think about why our FDA would ban it so vehemently too? Considering they approve of so many drugs with seemingly far worse side effects.

Am truly depressed about my supply. For the first time since she has been born - and believe me we have struggled. I somehow always held out hope. Now I am at the end of my tether.

[Megan73]

Originally Posted by Blessed_Mom

DOM - what can I say? I am very leery of its side effects in her. Don't care what it does to me. BUT - the possibility of a QT and heart murmurs in her scare me to pieces. ALSO that once I take it - then it is the valley of no return. I don't think I will be able to feed her at all if I stop taking it considering how borderline my supply already is. It feels unnatural and am afraid for her. I do think about why our FDA would ban it so vehemently too? Considering they approve of so many drugs with seemingly far worse side effects.

I have never heard about potential side effects for the baby but I do know that dom used to be prescribed for reflux for babies and experts believe far less than that gets into mother's milk. A number of pediatricans - including drs. Jay Gordon and Jack Newman - say domperidone is safe and effective and have spoken out about the FDA statement here http://www.breastfeedingonline.com/O...atements.shtml
I know it's been used safely by thousands of mothers and babies and frankly I think any potential risk - and any drug has risks - is offset by the many benefits of breastfeeding to me and my baby.
Nor do I think my supply would disappear if I stopped taking it. I used to take 90 mg a day and have gradually weaned down to 50 mg a day without losing supply. I plan to wean down further because I want my fertility to return so I can TTC. Dr. Newman suggests that when your supply is where you want it you can start gradually weaning off - and that many mother successfully do this. If your supply does dip you can then return to the lowest effective dose.
Here's the link: http://www.drjacknewman.com/help/Dom...%20Started.asp
The above link also includes all the things you should try before trying domperidone.
HTH

[Blessed_Mom]

Megan73,

You say "Dom used to be prescribed for babies for reflux". Would you know why it is not being prescribed for them anymore?

Thank you for your answers.

[Megan73]

Just by googling I got references to domperidone being prescribed for infant reflux. I presume doctors stopped prescribing it because of the FDA warning and the fact it's not available in the US – except from compounding pharmacies – anyway.
I don't have time to do more research. Here is a link to an AAP table on drugs and breastfeeding – it says there are no reported symptoms in infants.
http://aappolicy.aappublications.org...s;108/3/776/T6

[Dov'sMom]

Originally Posted by zensven42

If breastfeeding normally, without pumping, women do not lose their supply until the baby weans, which can be many years. It is a myth that women will ever not make enough milk to feed their baby, and will ever need to supplement with formula. In reality it is only 1% of women who will ever have a true medical condition which affects normal breastfeeding permanently. The best way to deal with supply problems is to nurse more without using a pump. Babies are much better at stimulating milk production than pumps, and pumps can interfere with the process. What I would suggest is that you spend some long quality time with the little one, hang out with your shirt off and just nurse, nurse, nurse. Drink loads of water and eat some oatmeal cookies and relax. Be sure to nurse a lot at night as well, as often as the baby wants it. (Babies sleeping "through the night" at an early age is also a myth. Babies need nighttime nutrition for a long time) Your supply should adjust so you have just enough milk for baby. Yes, it is a responsibility to be the sole provider of your child's nutrition, but this will be the case for many years, even when solids are involved. Children are a responsibility, that is just life. If you are feeling overwhelmed, I would suggest finding some support in your community, whether it be a local LLL or other breastfeeding group, or just some friends who can offer some hugs. With your child's current weight gain w/o supplementation, it sounds as if they were gaining just fine, so switching to just nursing should go pretty smoothly for you. Good luck and lots of hugs, you can do it!

Added: seeing how much you can pump is not an indication of your milk supply, as pumps do not work as well as a baby. When I pumped and worked outside the hom, I could often not pump as well on days I was more tense and stressed, which has nothing to do with supply. As far as teething goes, baby may nurse more or less during that time. Babies will often eat more or less depending on so many factors such as how active they were that day, growth spurts, teething, illness, amount of sleep, and just wanting more comfort. It will constantly change. This is normal, and the breast will adjust accordingly. It sounds as if you are micromanaging and obsessing a bit too much, and the stress alone can make it hard for milk to letdown. This may possibly be the true reason for you child fussing at the breast. Relaxation and confidence can do a lot to help your milk letdown.

Well, I guess I was mistaken when I thought my milk supply tanked when DS1 was 6 months old (and I was home full time, nursing on demand and all through the night) and it was just my imagination that he started to lose weight, his wet diapers dropped to 3 or so a day, and he started to look dehyrated.

And my SIL was just imagining it when she nursed (both) her kids around the clock, with copious lactation consultant advice and consultation for #2 and they still hit 4-6 weeks at or under birthweight.

Now for me, I happened to be pregnant, and that's why my supply tanked. So maybe you'll agree that my problems were real but they shouldn't count toward your "1%." But I will say that there are fewer than 25 women who confide in me in detail about their personal lives, and two of them had serious serious issues nursing and it was not from lack of trying. That's a lot more than 1%. Maybe with much medication and virtually abandoning the rest of their lives (including other children) they could have made it to the point where they could have nursed exclusively (though I doubt it for my SIL at least because I know how much pumping/supplementing/nursing/etc. she was doing) but that doesn't mean that their struggles are not "true medical issues."


OP, when my supply tanked when DS1 was 6 months, we were also in the position of having to supplement a kid who had never willingly taken a bottle and who was revolted by the taste of formula. DS1 was five months when I got pregnant, and at six months we started to notice signs that my milk was decreasing -- he suddenly upped his nursing dramatically, and never seemed satisfied. At first we figured he'd just take a bottle if he needed more, but within a few weeks he started to get dehydrated and lose weight so it was clear we had to be more proactive. He was closer to 7months when we got aggressive. Some of the things we did to keep him healthy until he gave up the struggle and agreed to take the formula were: I'd nurse him till he was sleepy and then slip a bottle into his mouth when he was still suckling gently; often he wouldn't notice and would drain the bottle half asleep. I'd serve him some kind of food and milk -- peas in milk, cheerios in milk, (using formula, of course) and give him one cheerio or pea in a full spoonful of formula (I am convinced he knew what we were trying to do and that's why he refused to drink the spoonful by itself). When he figured out our game and insisted on picking out the solid food itself, we started feeding him cereals like oatmeal or wheat cereal, adding only enough cereal base ot he formula to make it viscuous, so it FELT like food, but was really mostly liquid.