I think I'm starving my baby

[emilyjace]

So I've been paranoid about my milk production from before day one (some LC told me that it was possible I might have hypoplastic breasts before I even had LO). My love was born a robust 10 lbs 4 oz (at home, thank you) but has fallen off the growth chart since then. He's actually off the charts for height but at his last visit he was in the 25th percentile for weight. He's very active. Always kicking and playing and laughing. At my last pedi apt she suggested I start rice cereal. Which I know is insane so I didn't do it. I tried pumping more often, tried some herbs etc. They may have worked a bit but he only ended up with green poo, so I ditched the herbs.

So now that we're playing with solids a bit, I'm more and more convinced that I'm starving him. I'm even considering a bottle of forumla a day or something. But that would break my heart. But it can't be about me. So I would highly value your input. Today I was eating a muffin and he was literally screaming at me and reaching for it. We sat down in his bumbo with the tray and I gave him some apples and sweet potato that I'd cooked earlier and he had a few nibbles--not sure if any got in though. I'm home every day but work 3 nights/week. During the day I let him nurse whenever he wants. And he always wants both sides, sometimes several times. And he gets so frustrated sometimes while we nurse. He pulls on and off and arches and comes back and really seems unsatisfied. I'm small busted and again, think I have just the minimally-necessary supply and I am afraid it's just not cutting it for him as he's getting bigger.

I would appreciate your thoughts, suggestions, input, etc.

ETA: LO is almost 6 months. And yes, he's super tall. I just adore him and it breaks my heart to think that he could be hungry all the time

[Krystal323]

well, you don't mention how old he is, but you do say that he's very active, laughing and playing all the time, so to me that's a huge sign that he's not starving at all the both sides bit doesn't sound off to me either--but the arching and pulling away sounds like either he's gassy/has reflux/something. when you say "off the charts for height" i'm assuming he's taller than average, correct? and FTR breast size has absolutely nothing to do with milk production your milk ducts are just spaced closer together when you have less tisue there. good luck!

[katelove]

Is he gaining weight still? Having the right number of wet nappies? If so I wouldn't be too concerned. Has he always been on the lower side for weight or does the 25th percentile represent a sudden, big drop? That *could* be a cause for concern if it persists but a one off when everthing else is ok is probably not significant.

Is the apparent frustration at the breast a new thing? He may be working on increasing your supply with the frequent feeds. Or, if you are feeling stressed about him not getting enough, your letdown may be affected.

Unless he is over one year old, solid food shouldn't be providing the bulk of his calorie intake anyway so pushing the solids would not be my first solution. If you think your supply is dropping or not keeping up with his growth my first plan would be trying different things to increase it. If you think your supply is ok and he is still gaining then he may just be a tall, skinny person

[LynnS6]

If your child is over 6 months, it sounds like he's ready for solids. If he's close to 6 months, I'd consider it. It sounds like he's ready.

In terms of the arching, he could have gas or reflux. It's also possible that your let down is too fast for him. Our ds had issues with this. The green poo might also be because of too much foremilk. Make sure you empty the breast completely to get the rich hind milk. Let your ds suck for as long as possible on the breast before switching.

The best thing you can do to make sure you are producing enough milk is to make sure that you nurse your son as often as possible. If you're nursing on demand, you might not be able to pump that much. It could take a week or more to build up so that you can pump more than an ounce or two.

I wouldn't worry too much about his weight if he's active, growing and meeting his milestones. Our ds was in the 95th percentile for height and the 15th for weight for a long time. It's his body type. Thankfully, our ped was not concerned. Even today at 8, he's in the 95th+ percentile for height, and is all the way up to near the 50th for weight. Our new WiiFit called him 'underweight'. He's not.

[Ammaarah]

Emily, I understand you want to breastfeed exclusively, and I hope the tips people offer here help you do so. But if you do decide to supplement, I hope you can feel OK about it in time - after six months when the baby is trying solid foods, you don't have to feel like you messed up his virgin gut or anything by giving him formula. It's a supplement like any other food you'd give him, just a complement to your milk.

Hang in there and whatever happens, cut yourself a break. You are doing a great job.

[SunshineJ]

You know, just like with everything else, 6 months for solids is a general guideline. There is no one size fits all when it comes to children, and some babies will want solids a little earlier, some a little later. It's all good, especially considering he's close to the 6 month mark. If you think he's really hungry, try feeding him more. If he doesn't want it, be it formula, bm, or some type of solids then he's not hungry. If he does want it, then you know to adjust accordingly. It won't hurt him. And don't be hard on yourself - figuring this stuff out can be tough. Too bad they aren't born with a little personalized instruction booklet attached or something!

[Liquesce]

Originally Posted by Krystal323

well, you don't mention how old he is, but you do say that he's very active, laughing and playing all the time, so to me that's a huge sign that he's not starving at all

Really no. I realize it's common advice on these boards, but just no. Lethargy, a downtrodden appearance, etc, are signs of extreme malnutrition -- malnutrition of a kind that is well past the point at which it should have first been addressed. I know everyone who repeats these things means well, but this kind of advice can actually be very dangerous at times.

To the OP -- hugs, first. You can't beat yourself up over this. I totally get where you're coming from ... when my son was about seven months old my milk started to dry up, and he started dropping percentage points and then weight outright. For a few weeks I fought his doctor tooth and nail on pushing solids and introducing formula on the principle that breastmilk should be adequate at that age. When I received his FTT diagnosis in writing on a nutritionist referral form I cried.

Obviously I don't know that any of this is what's going on with you, but I do know the feelings that come alongside the concern that it could be.

Really, just take a deep breath. If your child nurses and still seems hungry, it's not going to hurt him to offer something. Even if that something is formula, but so long as your milk is mostly enough for him it probably doesn't have to be. Pay attention to whether he seems to be wetting enough, or if his urine is dark. Pay attention to whether the soft spot on the top of his head feels sunken, or ask your pediatrician if you're not sure. Don't be afraid to ask for that pediatric nutritionist referral if you're very concerned ... a breastfeeding-friendly nutritionist can provide a lot of reassurance sometimes, and some good advice on age appropriate calorie-dense foods that you're comfortable with. Maybe talk to a lactation consultant again.

Above all don't let yourself feel guilty over doing whatever you might need to do for your child or, as it may turn out to be, just your own peace of mind.

[PoppyMama]

I agree with Liquesce. I also want to plug avocado as 1st food it really helped my hungry thin guy.

[ameliabedelia]

What is his weight curve like? You said he dropped off the charts, but then you said that he is 25% for weight. If he dropped down to the 25% for weight, but is STAYING there (and not continuing to drop off the curve) then I wouldn't worry much.

However if he is continuing to drop then I would be concerned and work to get more calories into him..whether that is supplementing or more solids, etc.

Birth weight is not an accurate indicator of where a baby or child will be on the growth curve as they get older. I believe birth weight is more a factor of maternal factors (maternal nutrition, gestational length, etc.) than the baby's individual genetic make-up.

There are some babies that are born big, but are not genetically destined to be a big baby or child...so at some point that baby does have to "drop" on the growth curve...however they shouldn't keep dropping...once they reach where they will end up, they should maintain that growth curve.

Ironically enough, my oldest child was only 6 lb 12 oz when born, yet she went to the top of the growth charts by 6 months old and has been there ever since (now 7.5). My middle child was born an entire lb heavier (7lb. 13 oz) yet is now 20% for weight (and reached that growth curve at around 6-9 months...she is now 5 years old). My youngest was born a few ounces heaver than my middle child (8 lb 2 oz) and is only 10-15% for weight as a 22-month old. All 3 of my children were born (naturally) at the exact same gestational age (38 weeks and 4 days).

I would try to keep a more accurate record of his weight. Perhaps try weighing him every month and see if he maintains his growth curve, or if he keeps dropping.

[lyterae]

From a mama who does have breast hypoplasia:

My dd was born 7lbs 7oz, at two weeks (nursing exclusively nearly 24 hours a day it seemed) she was 7lbs 2 oz, at one month she was 7lbs 4oz. She would nurse almost constantly and seemed to never be satisfied. I was on herbal supplements, reglan, pumping in between her very frequent feedings and it still wasn't enough. She has enough dirty diapers but it wasn't until a friend donated breastmilk to us that I saw the standard breastmilk diapers. We did end up having to supplement with formula and she has been steadily at about the 95th percentile ever since, if your LO is dropping off the chart I would be concerned but if it seems to be his normal I think you're doing just fine.

[mamazee]

I agree with the others that I'd only worry if he's changing where he is on the curve. If he's been steadily at the 25th percentile, I wouldn't worry, but if he was at the 75th, and then the 60th, and hten the 40th, and now the 25th, I'd supplement.

[annettemarie]

I'm going to move this over to Breastfeeding

[mrskingred]

Originally Posted by mamazee

I agree with the others that I'd only worry if he's changing where he is on the curve. If he's been steadily at the 25th percentile, I wouldn't worry, but if he was at the 75th, and then the 60th, and hten the 40th, and now the 25th, I'd supplement.

If you're at all worried, supplement either with food or formula, however, my ds started off at 97% H and W, but then started to drop the % so (looking at his chart here), he was 75% W at 4.5mo, between 25 and 50%W at 6 mo, 25%W at 9 mo, between 10and 25%W at 12 and 15 mo. His H dropped to 75% at one point and is now between 75 and 90%. DS snatched a plum at 6 months, so I started solids then.He's still BF. Our ped was never concerned about his growth, although I was, so I do understand your concern.

[PatioGardener]

In order to find out if baby is on his curve, I recommend plotting his weights on the WHO growth curves. These are the gold standard of growth curves and represent typical, normal growth in babies who are in optimal conditions for growth (that is, breastfed exclusively, transitioned appropriately to nutritious complementary foods etc.)

ETA: The CDC growth charts do not reflect normal breastfed baby growth and are often misleading. The WHO charts are much better.

You'll have to calculate baby's weight in kilos, but it is worth the math!

here is the birth to 6 month chart: http://www.who.int/childgrowth/stand...boys_p_0_6.pdf

and the birth to 2 year chart: http://www.who.int/childgrowth/stand...boys_p_0_2.pdf

If it looks like he is falling off the curve on the WHO charts, first I would suggest working to increase his intake of breastmilk. Check out the 'low supply' sticky at the top of the breastfeeding challenges forum - there are lots of ideas! Jack Newman also has a good checklist for an older baby that has slowed in weight gain. I'd add tongue-tie as a possibility too. http://www.nbci.ca/index.php?option=...tion&Itemid=17

If you have maxed out on breastmilk production, have you thought about supplementing with donor milk?

And here is a great chart from kellymom that shows the calorie content of solids. Breastmilk is 22 cals/oz, so you want to make sure that any solids are up there in calorie contant too. Avocado and sweet potato are great! http://kellymom.com/nutrition/vitami...dcalories.html

[April Dawn]

You've gotten some good advice re: how to tell if he needs more. I just wanted to mention that if you use formula, you might be interested in using an at breast supplementer rather than a bottle. You could use the SNS (http://www.medelabreastfeedingus.com...ing-system-sns) or the Lact-Aid (http://www.lact-aid.com/). I hope you get it all figured out, and wish you luck!

Edited by April Dawn - 7/5/11 at 8:33pm

[meardonna]

please stop worrying!!!
if he's six months and you've fed him for all that time and he's still active and happy then you have nothing to worry about. growth charts were only for guidence but medical proffesionals have became obsessed with them. My oldest child was born big and tall and yes he dropped a few on the charts but he always fed well he's now 7 nearly as tall as me but slim and fit. my daughter was born small and gained steady weight but is now becoming tall so all he growths going into that. Your child may be crying out to try food, now that he's 6 months, try baby-led weaning and continue to breastfeed and know that you are doing the best job and giving your child the best

[SallyN]

*hug*

You could also do a weighed feeding (take weight before he eats, then nurse him, then weigh (using same diaper)) This will help you know if there's a milk supply/transfer inadequacy or if your supply is fine and he's just really enjoying solids and putting things in his mouth (very normal at 6 months!)

Ditto also to plotting his weight on the WHO charts (The average curve for formula-fed babies is different than the curve for breast-fed.)

[gbutterflykissesm]

I know it can be stressful to worry about whether your baby is healthy. It's so easy to become paranoid. I think your best bet to find out if you are really feeding him enough is to do the weighed feedings. If you try to pump, it is not going to be a good indicator of how much milk you are making, and can really scare you into thinking you're not making enough, when you really are. Weighed feedings (probaby best to do a few within a few hours period if he eats small amounts more frequently) are probably the most accurate way to find out his bm intake.

You can start solids, but it could take a long time for baby to eat enough to really make him feel full... so don't try to stuff him with that for now, although you can certainly start experimenting with foods.

I would start with the weighed feedings, and that will tell you if you really need to start supplementing with donor BM or formula. This should be your child's nutritional basis until he's 1 anyway. Solids aren't going to offer the same nutritional benefits.

Does your town have a breastfeeding center? We have one, and they are really helpful. You can do weighed feedings there if you don't have a sensitive scale.

[bebebradford]

Honey.. I'd start him on solids.. mix some applesauce with whole grain rice cereal.. It's not going to stop him from breastfeeding, but it sounds like he's ready for more.