madison fell off her centile...

[corban's mum]

...apparently mads isn't gaining quickly enough (has sorta been an issue since birth)  she's currently coming up to 6 weeks old weighing in at 10lbs 14oz her birth weight was 9lb 5oz but she did drop down to 8lb 4oz....

....the nurse who weighed her recommended i stop co-sleeping as baby may be settling to sleep during the night without feeding as she is too comforted by being close to me, also she said to supplement with formula, but i really REALLY don't want to start down that road unless totally needed

she's also had loose poops for a day two days ago, then yesterday no poops at all.  i fed her yesterday for 9 hours without leaving the bed and MAN she ate! hoping that may make more milk come in, though im not running low anyway lol

also i've started eating flaxseed and pumpkin seeds and upping my wholefoods and turned to soya milk/avoiding dairy

any other tips for helping a slow-grower to bloom?  i hate the idea of not co-sleeping and formula but bottom line i will do anything (of course) to make her healthy as poss

thanks in advance xxx

[CherryBomb]

How far far off has she fallen?  My dd3 fell off at the beginning, but then maintained her curve (1st percentile!!  She's 32 months and still on that 1st percentile curve).  She was 8lbs 6oz at birth so she wasn't teeny to begin with, but she wound up that way.  How's her weight compared to height?  How many times has she been weighed since birth?  I wouldn't freak about it yet.  If she maintains this curve then it's probably normal for her.  If she keeps falling, then that would signal an issue.

If you're wanting a milk replacement, I'd avoid soy milk (allergenic) and go with rice or almond milk (I think they taste better, anyway!)

I think cutting out cosleeping seems counterintuitive.  We (LLL) usually encourage moms who's babies are slow gainers to cosleep.  If you don't feel she's eating enough at night (she should be nursing at least once) I would just set a clock and wake her to nurse.

[CherryBomb]

Oh, and here's a kellymom link that might be helpful!  http://www.kellymom.com/babyconcerns/growth/weight-gain_increase.html

[corban's mum]

thanks, just looking thru her record now, she's been weighed 6 times since birth, only gained 1.5oz between week 5 and 6

they dont measure height here and i dont have a tape measure to hand but she was 21 at birth and 22 by three weeks when i measured her at home.

she was born in between 91st and 98th centile, at four weeks she was at 91st now she's on 80th.......

she grazes at night rather than getting a full feed and i seem to have a lot of foremilk which may explain occasionally her having quite greeny watery poops??

i'll get the rice milk thanks, my son was lactose intolerant as a bubba so maybe babygirlie is too, is that lactose-free cow's milk any good?

[Annemarie42]

how often does she feed at nights? do you feel like you have a good milk supply? I wonder if a visit to a lactation consultant might help? (with my daughter we did one visit where she weighed her before/after a nursing session, it was helpful to see what she was getting.)  

how 

[corban's mum]

she latches on about 4 times during night but i think we both just fall right back to sleep without her getting a good feed, i wake up very full and leaky, but its obviously foremilk.  yesterday i fed her from 2pm until 11pm almost non stop, and twice during the night, then from 9 am until 1pm when she finally let me put her down long enough to gt dressed and take walk to the store. during the walk i felt letdown as i was thinking about my bf concerns and my top got soaked so i must have milk for it to be doing that after a 4hr feeding marathon surely??

im so worried for her :(  she has stopped pooping these past two days as well, though she is wetting, gurgling and smiling, holding her head up etc

[rparker]

If you decide to supplement, you can try using expressed breast milk before going to formula. You could give it to her while breastfeeding with an SNS or you could give it to her after feedings with a syringe/dropper, cup, or bottle. 

In my (totally unprofessional) opinion the advice not to co-sleep is bogus. I've co-slept with both children. One (my larger DD1) woke herself constantly to eat. The other will go 6 hours at night. Identical sleeping conditions. (Both babies shot up above the 90th percentile after birth, DD1 more so than sleepier DD2.) 

My advice is to continue co-sleeping and set an alarm clock and feed her on a schedule until you're no longer concerned about her weight gain. This is what I did with Livia for the first 2 weeks when she was a super sleepy newborn and I was concerned about creating an adequate supply. There's no reason it wouldn't work with an older baby. (If I recall correctly, Livia and Madison have the same birthday?)

Totally anecdotal, but I've always had out of control milk supplies and I eat a lot of soy (mostly tofu, not soy milk) and oats (oatmeal, also Luna bars). I've heard that those foods might increase milk supply. I just eat them because I like them though. I also crave a lot of eggs (which I dislike when not preggo/bf-ing) and it seems like my expressed milk has a high percentage of fat. 

[rparker]

From your description it sounds like you have a pretty good milk supply. As I understand it, fore milk is always going to come out first and then hind milk later as the feeding progresses. Although I've also read that more recent researches suggests that it isn't an either/or scenario and that there is some amount of fatty milk present during the entire feeding and that it just increases the longer the baby nurses? (Maybe cross-post in breastfeeding if you haven't already and a pro can clarify.) 

I do know from personal experience that block feeding (using one breast per feeding or for several consecutive feedings) increases the amount of hind milk that the baby gets. DD1 had a lot of green, frothy poops and even worse reflux until I started doing that. But it can also dramatically decrease your milk supply so I would be nervous about doing it with a baby who wasn't pooping/gaining adequately. (Maybe it would be ok to do that if you were also supplementing with expressed breast milk? I'm not sure.) 

How long does Madison typically nurse? Does she take one side or both sides? 

[ShwarmaQueen]

To supplement with Formula is just a HORRIBLE idea all around. If she's having trouble digesting the cow's milk proteins that are passing through the BM, how is she going to tolerate formula? And not to mention the cascade of supply issues you'll inevitably have once she takes less breastmilk. That nurse sounds VERY uneducated and has certainly given you bad (or none) breastfeeding advice. :hug So, you need to see a lactation consultant. You might have transfer issues. Has your baby been checked for anatomical problems? DS had posterior tongue tie that made him drop 2 percentiles before we caught it. There are other things that can cause low gain. Allergies are another. She may not be absorbing nutrients properly if she's having allergic reactions. The lack of pooping is a red flag, sounds to me like she's not getting enough milk period. The SNS would solve the problem immediatly (but please pump and use your own milk to supplement and NOT formula) but a long term solution is to see an LC and get a personalized plan.

:hug Stick to your guns mamma and don't fall for a boobie trap! If you choose to supplement her, pump.

[corban's mum]

aww yeh they do birthday share :D  i LOVE eggs but have been avoiding them as most things i hear are anti-eggy but darnit if im craving them then im gonna eat them :) my DS gained 1lb a week at first so this is all new to me, i just assumed she'd be like him too *duh* so im having to have a crash course in feeding.

 would it be a good idea to pump n dump foremilk before feeding?

[corban's mum]

shwarma queen- i was told sometimes bf'd babies skip a day or two pooping and that's normal? especially if they're going thru a growth spurt?? she HAS pooped, but only once/twice a day since the day she had real bad watery poops, and not a large amount either time which is unusual for her, she normally poops loads 6times a day lol. and if she is peeing regularily and when she occaisionally spits up there is a load. plus last night when i was bouncing her softly to burp her i could actually hear milk sloshing in her tummy, like when you down a glass of water (is it only me who can make liquid slosh in my tummy lmao) so i dunno if it's that she isnt getting enough (apart from at night but ive got a plan in place for that now, wake up and get outta bed to feed her)

i dont think she has tongue tie as she frequently pokes it right out at me n it's long n pointy :D

maybe i just make crappy milk :(

[rparker]

Don't dump the fore milk! Save it and freeze it if nothing else... you never know when it could become really useful to have on hand in the future :) Pumping/expressing a little at the beginning might help with the green poops though. Have you pumped very much (recently or in the past)? I ask because even the milk I get after 5 minutes of pumping has a pretty decent layer of fat on top if I let it sit for a little bit, so fore milk can't be completely skim. 

I say definitely eat the eggs if you're craving them! Allergies could be causing her issues, but it's more likely an issue with frequency of feedings or actual milk transfer. Is your diet very different with this baby than it was while nursing your son? If you think your diet might be lacking in fat and that that's the issue you could try loading up on good fats for a week or two and see if that makes a difference... peanut butter, eggs, avocados. 

It might just be that Madison needs to be reminded to eat more frequently. Maybe she has a high metabolism. My friend's son was small (20th percentile?) and wanted/needed to nurse around the clock; he also ended up being a very active baby/toddler (and is tall and skinny like his dad). Alice also needed to eat really frequently to maintain her top of the growth chart weights. She got really tiny once she stopped nursing so often (and she's pretty darn active). On the other hand, Livia maintains her weight with way less frequent feedings... I would have been totally confused/freaked out if she had been my first baby and Alice my second. I guess my point is that every baby is different and maybe Madison is just one of those babies that needs to eat every 45 minutes during the day and every 1-2 hours at night to maintain her weight? 

[corban's mum]

today ive tried the waiting until one breast is totally empty and she is point blank refusing to suckle on it before swapping to the other breast, just tried hand pumping off some foremilk into a pad after letdown and she fed for ten minutes on this second breast and has FINALLY passed out all floppy and full up looking with plenty of fatty white milk on her lips so fingers crossed we're getting the hang of this at last.

when i express using a hand pump i have trouble getting more than 2oz though it settles with a lil layer of fat, when i used the electric pump this morning i got 5oz outta one breast in a little over 5 minutes, though the first 2oz were clear then the white came in for the final three. i've seperated it into two 2.5 oz top-up feeds to give her via syringe tonight after she has her last marathon feed, sound good or should i be trying something differently??

[corban's mum]

it may be her having her dad's approach to food - doesn't really care and cant put on weight no matter what

she has also been poorly the past few days with slight snotty nose, runny bum up until weds and puking twice a day which isnt normal for her, she had been exposed to chicken pox so who knows.  at least she is smiley and alert, not refusing the breast and holding her head up right??

[corban's mum]

P.S thank you all so much for being here xxxxx

[rparker]

2 oz is a normal amount to express and 5 oz is pretty good :) (And, remember, response to pump is no indication of supply anyway since some women with excellent supplies can't express very much.) 

[Melly24]

If she hasnt been well, then it's totally normal for her to be not gaining as much. Breastfed babies also go through periods of gaining heaps/well and then they'll plateau for a bit with not as big gains. I think that weekly weigh in's for otherwise healthy and thriving babies are too stressful on mums and make them worry excessively. Why don't you weigh her again in two weeks and I bet you'll see a "satisfying" gain.

x

[stellamia]

Avocados and steel cut oatmeal are fantastic for upping your milk supply! My DS1 had problems nursing and I ended up renting a hospital grade pump and nursed him every two hours from the start of one feeding to the start of the next, 24/7 for one week straight. I had to wake him up to eat and at times spooned the milk into his mouth because he wouldn't wake up. It was really hard, I only got 45 minutes of sleep at a time, but boy did it work! He gained a pound in one week and then my lactation consultation told me I could trust him to do the work from there, and he did! 

I think you should keep co-sleeping! Most babies who co-sleep wake up more often to feed. I wouldn't supplement unless it was absolutely necessary. You need YOUR milk to increase and it won't if he's getting fed from another source. 

I hope she begins gaining soon and you can get the peace of mind you need. I know how scary it can be.

[honeybee]

There's nothing wrong with your milk supply or your dd's growth. Seriously. Look at her. Does she seem healthy and thriving? If you didn't have any numbers to look at, would you think she was okay? Do you really expect her to stay at the 90th percentile her entire life? That means she would be heavier than 90% of the other children. With babies that's not significant, but obviously at some point she's going to "slow down," unless you or your dh are exceptionally large people genetically?? Also, keep in mind that if you had IV fluids in labor, her birth weight was probably inflated due to excess water weight.

My son started at 7 lbs 8 oz. At four and a half weeks he was at 8 lbs. 11 oz. That's really not much of a gain for a month... and he did not stay on his curve. But he grew 3 inches, and his head circumference increased appropriately. He is fine, and my milk supply is fine. Our family doc actually joked with us about starving him... knowing he is perfectly healthy. So, my oldest and youngest are long and thin. My two middle kids were at about the 50th percentile for birth weight, but then jumped up to the 99th percentile on the charts... and stayed there for about a year. Then they stopped gaining weight, and just grew up and thinned out, and went back down to the 50th percentile, where they've basically stayed. They're all perfectly healthy. Kids all have their own growth patterns.

If you need more reassurance, plot her out on the WHO growth charts, which are based on multicultural breastfed babies in thriving environments. Here's the link below. Click on the "girl's growth record" to download the charts. The charts your doctor is using is based on a small group of formula fed babies. Babies and children do not grow on a predictable "curve." There are spurts and plateaus. The CDC has actually adopted the WHO growth charts, but they haven't made their way to doctors' offices yet, and most are still using the old charts. Or, get a second opinion from a lactation consultant or another doctor.

Your dd is still gaining. She is fine. Find a new doctor. Even if she was having growth difficulties, the advice you were given on how to remedy that is completely illogical and counters research. Cosleeping babies sleep lighter... which is a good thing, because they feed more often and it also protects against SIDS. Check out some of the research by Dr. McKenna.
Formula is just a bad idea in general.

http://www.who.int/childgrowth/training/en/

http://www.nd.edu/~jmckenn1/lab/

[oliversmom7213]

Ingrid's poop changed at about 4 weeks and she only goes once a week if not once every week and a half. The ped nurse said at about 6 weeks bf baby's poops change and they go longer. I tried the thermometer trick before i called the nurse and there was no poop on the thermometer. She stated it was most likely b.c Ingrid was using everything in the milk. She has tons of wet diapers, and is gaining lots, I can totally see it in her face and how round it is becoming. So I wouldn't worry that your baby isn't pooping a lot.

Otherwise I heard the precentiles is not important, it's only important that they are going up. My ped when ds (a pretermer) was a baby said as long as they are gaining weight it's all good. They never want to see them going down, like from 10lbs to 9, obviously. So as long as she is going up on the curve, she is fine.