Small baby, what would you do?

[osker]

E is five months old this week and only 11lbs, as of just now. At her 4mo pedi apt she was 10lbs 12 oz, so that means she's only gained 4oz this whole month? True, the weighing was on two different scales, but still... she's barely on the charts for weight and her height/weight ratio is only 0.8th percentile.

She's EBF and eats anywhere from 7-10 times per day (including overnight), usually for about 25 minutes, sometimes up to 40 minutes, and at night she co-sleep side lies. If H pumps 2 hours after feeding her she probably only gets an ounce, maybe 2. She's been trying to pump twice after E goes to bed, 2 hours and 4 hours after she last nursed, but then E usually wakes up within an hour and half of that second pumping and so we end up giving her the milk that was just pumped. She LOVES the bottle and generally likes nursing a lot, although she might get mad and start grunting and punching the breast after ten minutes at times. Once she eats for the first time at night she's up and eating or fussing within two hours, her sleep has gotten much worse in the last ten days, although that could be teeth and not food related.

Would  you supplement with formula? Start solid food? Wait it out?  Some days I feel like she's doing really well and meeting her milestones just fine (she rolls both ways, sits up with minimal support, coos, sometimes giggles, grabs toys, moves them back and forth hand to hand)... and other days I'm sure that we're starving her... 

What would you do? We really want to preserve breastfeeding and keep it going as long as possible, and we would both like to avoid formula, but not if it means she's not doing well, you know?

thanks

Edited by osker - 1/28/11 at 4:00pm

[ElliesMomma]

nm

Edited by ElliesMomma - 5/28/11 at 11:43pm

[osker]

Thanks for your thoughts, it's nice to hear that formula isn't a magic answer... i know in my head it isn't, but it seems so EASY, you know?  H started pumping after E started getting into more of a routine where she would go to bed at 5:30pm. We were up, she was asleep, it seemed like a good way to make more milk... H always nurses her first and then gives her the bottle at that first feed overnight, which is usually about an ounce, maybe an ounce and a half. Then other feeds overnight are just nursing. 

After the pediatrician last month we started increasing oatmeal and drinking fenugreek tea all day long. It seems to have increased the milk some, but not much. I really hoped that it would be the answer and by a month later she'd have gained a lot more.

I had to laugh at your question about her interest in food! She's been sitting up since she was about 3 months, and she watches everyone eating intently. She stares at food, watches your mouth as you eat, smacks her lips, drools more, smiles, makes eye contact and raises her eyebrows, and in the last two weeks has started trying to grab food off our plates (she's usually sitting on our laps at meals), reaches for the fork, and grabs at glasses or water bottles and brings them to her mouth and tries to drink.... so, yes, she is WAY interested in food.  

[PatioGardener]

If she was my baby, I would get to a good IBCLC asap.  That weight gain would not be enough for me, and I would want to look into transfer issues (tongue-tie, high palate, funky latch etc.) and supply issues (would do pre and post weights, and likely daily or 48 h weights.)  With that info I would then look into ways to get more breastmilk into her.

[Megan73]

Originally Posted by PatioGardener 

If she was my baby, I would get to a good IBCLC asap.  That weight gain would not be enough for me, and I would want to look into transfer issues (tongue-tie, high palate, funky latch etc.) and supply issues (would do pre and post weights, and likely daily or 48 h weights.)  With that info I would then look into ways to get more breastmilk into her.

I totally agree. It sounds like she needs more milk. But there are tons of options to improve supply and/or transfer before supplementing with formula (and she's too young to "supplement" with solids, IMO). Hang in there, mamas. You can figure this out with some expert help.
 

[stambason]

I would not start solids yet.  Babies really are not ready for solids until 6 months when their digestive systems form properly so that they can eat solids.  Plus the AAP does not recomment starting solids until 6 months.  I would wait it out.  I have experience very similar to what you are experiencing.  My babies are very low on the scale, 0.34 and 0.96% but they are eating well.  They went through a week and a half or so of getting up through the night and seemed to be starving, but now they are sleeping through the night again.  Your baby many be going through a growth spurt or perhaps is teething.  I would not supplement with formula.  You could try going to a lactation consultant and have then weight the baby before and after the feeding to make sure they are getting enough.  Also, you could start pumping after feedings to increase your milk supply; it will take at least 48hr and then give this to the baby.  It is best to feed at the breast because the baby will get what they need then rather than guessing what to put in a bottle.  Keep up the good work and don't get discouraged; babies were meant to breastfeed and the growth charts are based on formula fed babies anyway.