Friend's 6 m/o not thriving... UPDATE

[mamandedeux]

A good friend of mine has a 6 m/o DD who only weighs 10 lb. She was almost 8 lb when she was born, but she stopped gaining at around 3 m/o (after gaining very slowly). Her ped is now concerned and sending her for very invasive testing (ultrasounds, blood work, MRI...). They obviously want to rule out major issues, but I suspect that perhaps my friend simply isn't feeding DD enough. From day 1 she's complained that she really doesn't like BF and that she would do formula if only it wasn't so much work (so that rules out pumping). I noticed that she would go 5-6 hrs at a time without nursing DD, even at 1 month. Now, at 6 m/o, she says she nurses her 3 times a day, and never at night (so 3 feeds/24 hrs). I BF on demand, and DS1 nursed every 2 hours from birth until he self-weaned at 2, and DS2 is on the breast all.day.long, so perhaps I'm not a good reference... The ped told her to increase feedings, but I've seen her attempts at doing so, and they are pretty feeble (she'll put DD to breast and if she doesn't latch on right away, she'll say "oh, I guess you're not hungry after all..." and wait another 2 hrs before trying again). I don't think she's depressed or doing anything intentional here, but I simply don't know what to say to encourage her to nurse more. How much/often should a 6 m/o nurse minimally? Any advice? Thanks!

UPDATE: So my friend saw her ped on Thursday. We grew up together so I suggested that perhaps she'd like my mom to go with her (they know each other well). My mom lives really close to her, in my hometown (I've moved away). So they went, and the good news is that the baby has gained almost half a pound in 3 weeks, and is right on track developmentally, but the sad news (which my mom has confirmed) is that the ped is indeed telling her that nursing 3-4 times a day is enough for a soon to be 7 m/o. The babe is just starting solids and eats a fair amount of cereal and some fruit (all homemade from organic stuff - at least!). My mom is also concerned about the DD's weight, but at the same time, she never nursed, so she can't really say much. She did tell my friend however that she had doubts about what the ped was saying. I also echoed the same feelings to her again, but my friend's only response is, "I think it's plenty of milk...". Ugggghhhhh!!!!! I sent her a copy of the Nursing Mother's Companion and highlighted sections where they mention minimum feeding amounts (and stress that a babe that age should nurse 7 times a day or more). She is growing very impatient with my insisting, and I have a feeling our relationship is not very good right now. But fingers crossed!

[Bokonon]

That's really sad. A "normal" 6mo nurses about 7-8 times a day. When trying to increase weight gain (and likely increasing her supply too, as that's probably necessary at this point), she should be nursing 12+ times a day, and I would think supplementing too. Did she think that nursing only 3 times a day was normal or healthy? She needs to put forth the effort to feed her child, whether it's breastfeeding or formula. It sounds like a very dangerous situation - is the baby meeting milestones at all? Dehydrated?

Was she following some kind of scheduled feeding "plan" like BabyWise or 12 Hours of Sleep by 12 Weeks Old? I'm just so sad for that baby.

[PatioGardener]

12 times a day PLUS working to increase her supply, which has likely plummeted from not breastfeeding often.

This may be a baby who would be healthier fed from a bottle.

[3*is*magic]

I think breastfeeding is the bomb, but that baby needs food NOW. At this point her need for calories and sustenance trumps nursing. Babies are WORK. Either nurse enough to nourish the baby or bottle feed - but don't let the baby starve .

[Bokonon]

Originally Posted by 3*is*magic

I think breastfeeding is the bomb, but that baby needs food NOW. At this point her need for calories and sustenance trumps nursing. Babies are WORK. Either nurse enough to nourish the baby or bottle feed - but don't let the baby starve .

I agree. And I can't stop thinking about that baby. Her mother is neglecting her. All the tests in the world aren't going to help if the food isn't being given to the baby! OP, please talk to your friend and tell her your concerns, or if you know who her pediatrician is, call him/her and let her know. This is a very dangerous situation and needs to be fixed ASAP.

[CookAMH]

That poor little baby! I feel so badly for her and it's heart-wrenching for how hungry she must be and has been for months. That makes me so sad to picture her. I wonder if she has just sort of shut down after a while and doesn't cry or fuss to be fed anymore? Poor baby.

Since she didn't feed her very much as a newborn, I'd be doubtful about her supply increasing very much. Is there a way you can come along side her for the next few weeks and help her with this?

I'm subbing to this thread...please let us know what happens.

[RiverSky]

Please call the pediatrician anonymously and tell him/her what you have seen so that the pediatrician can call CPS (mandatory reporter).

How terrifyingly sad for that baby.

[mamandedeux]

Sadly, she doesn't live close enough for me to visit regularly anymore ( a 10-hour drive). But based on what I've heard (and seen when I last saw her DD last month), the baby is alert, happy, and hitting all milestones. She was smiling, making great eye contact, lifting herself up on her knees and elbows at 5.5 months, and just generally very cheerful. But very small. I've had a lot of people react negatively to my bf approach (on demand) so I'm always worried that I'm way off base here. This friend is very mainstream when it comes to parenting, so she definitely doesn't share my parenting philosophy. She doesn't co-sleep, babywear or believe in bf on demand, which doesn't make her a bad parent, but it does make it very hard to talk about my concerns. When I did try to bring it up (in person at 2 m/o and 5 m/o, and a few times over the phone) she says, "if you like bf so much, why don't you nurse here for me ahahahah". Part of me is thinking, heck yes, I would! The reason I originally posted is that she is seeing her ped again on Thursday, and I was debating whether to call in anonymously before she did. But my friend says she told the ped she's nursing 3 times a day, and he thought that was ok, so I'm not sure what my call would do. Also, she isn't the only person I know who nurses so little - another friend also has her DS (not sure how old, perhaps 5 or 6 months) on a 4-hours schedule, and completely weaned at night, so that also means she's nursing 3-4 times/24 hrs. And my MIL told me when DS1 was born to alternate between the breast and a bottle of water, or he'd want to nurse all the time. If you google breastfeeding schedule for 6 m/o, some sources will say that a baby that age only needs 3-4 nursing sessions a day. Perhaps that's where she is getting her advice, and perhaps her ped truly believes that it's enough. I really hope the ped tells her to at least supplement at this point... I really hate to think this baby could be hungry. I'll call her again before she sees her ped and perhaps point her to this thread and hope she still wants to be my friend... Thanks!

[mamadelbosque]

every 4 hours doesn't make 3-4 times in 24 hours unless baby is magically sleeping 8-12 hours at a stretch. And I seriously doubt that. Ever 4 hours would work out to more like 4-5 feedings in a day, easily... at 5-6 months *with* some solids that might be OK for some babies. I personally can't imagine that as my DS2 is still EBF, but if you added a bunch of solids in there it might work out OK. But just 3x in a day is nuts. Absolutely nuts.

[3*is*magic]

Two babies that are the same age and nurse the same number of times a day may not be getting the same amount of milk. It would depend on the mother's overall supply, the length of each nursing session, the mother's nutrition and hydration, the strength of the babies suckling reflexes, etc. There are too many variables. Any ped who looks at a 6 mo old that's gained two pounds since birth and thinks that's "OK" because mom is nursing 3x/day is living in Crazyville.

At 6 months, my DD2 did sleep through the night (from about 7 or 8 pm until 6 or 7 am). She then nursed at 7 am, 10 am, 1 pm, 4 pm and 7 pm - so 5 times a day.

[JayJay]

Okay, I'm just gonna say it like it is:

No, being "mainstream" and not sharing your views on parenting doesn't necessarily make one a bad parent, but frankly, feeding a 6 month old only three times in a day DOES!!!

As the parent of one DD who is no longer with us and another who's parenting I take VERY seriously and who I darn well DO feed on demand because she is a baby, and knows better than me what she needs to grow (!!!) I have a pretty strong opinion on this matter! I mean seriously, no wonder she's sleeping through the night: the little one is probably starving! Underfed babies are notoriously easy to care for - they're not getting the nutrients needed to get cranky or interact. Come on now, 10lb at six months is SCARY! SCARY!

No offense intended but gosh - is this lady ready to be a mom? If there are problems that need taking care of so that she can effectively parent her little one, are they being helped with? Is she feeling overwhelmed and perhaps would benefit from the aid of an extra caregiver here? There are many reasons why children are not taken care of the way they should be, and it's not always because the parent is an awful person per se - but because the parent simply can't cope...

Either way though this baby needs food. Seriously - something ought to be done. I second the "call CPS" vote up there because they are likely to be able to find her some help. Children are rarely removed from their parents care, but it seems like this lady needs help if she can't even be bothered to mix up a bottle of formula in lieu if the breast - CPS would help her do that, and keep an eye on the child to make sure she actually starts thriving.

I hope this didn't come across as harsh - but this situation is frightening and needs to be fixed pronto! Too many times, people don't take action and a child is left at risk or *heaven forbid* dies. I just find this scenario so insanely scary...wow!

[Latte Mama]

OMG, I seriously have tears in my eyes reading this. WHAT is your friend thinking????
A baby is being starved, I'd speak up. I would. Forget embarassing her, I'd simply state" friend, your baby is not gaining weight and instead of all these tests, please try feeding her more often.". Or suggest helpfully that she get baby weighed after a feeding to "make sure" that she's getting enough. It's a stretch but if baby is taking in 8 oz (doubtfully) then 3 feedings is not so bad and something else may be going on. But we know that's probably not it, and a weighed feeding would most likely show something like 3-4 oz. So total feeds of 9-12 oz a day would show both mom and pedi that yes, baby is in fact starving!

Good luck with your friend and that poor sweet baby. If you cannot get through to her, I would call child services. This is neglect.

[bender]

Just as perspective, my son is a slow grower (currently sitting quite happily on the fifth percentile line), and I was encouraged at one appointment to cut his nighttime feedings so he'd sleep through the night, even though his weight gain was low. It seemed nuts to me.

My guy nurses 5-6 times a day with an SNS, cosleeps/nursese, and gets 1-2 solid meals a day at 7 months. He finally started putting weight on at a good rate once we introduced solids, but he's just barely at 5%.

[Lil'Momma]

nak

You never said if your friend was giving any solid foods... If baby was only getting ~12ish ounces a breast milk a day but 200-300 calories worth of solid food then she wouldn't be starving per se... I do think that is too much solid and not enough bm, but she would hardly be starving...

I have a friend who only nurses three times a day and everything else is solids. That really seems to be a mainstream trend... not one I agree with though.

I would talk to your friend, a serious conversation before you go to her ped. or cps. I have a 12lb 9 mo who eats 30 oz of bm a day plus four LARGE solid meals. We have had cps called twice and it hurts, is humiliating and causes all kinds of problems with having to have her ped. call them and interview with them every time it happens... of course, we have the blood work to back up her issues...

[honey-lilac]

I was just going to say after reading the OP that my 6 month old EBF daughter weighed about that too. But she was very healthy otherwise and bright and right on schedule for development (considering she was born a month early, I guess she was even ahead of schedule) and she was nursing all day every day. I wasn't concerned; pedis probably would have been but we didn't do WBV's so the issue never arose.

But this situation sounds a bit different. ETA: We did co-sleep, babywear, and nurse on demand (which was like all freaking day!).