My baby is too small

[katiekat09]

I just got home from my DD3's well baby I'm feeling pretty low. She was 8lbs 6oz at birth but lost 1lb in the hospital. She gained 26 oz by two weeks, but since then she has only gained a pound. At her last well baby her doctor said she was growing in length, so it want a big of a concern (she had only gained an ounce and a half since her 6 week check). This time we had to see a new doc, as out old one has left the practice foR life as a SAHM. My DD3 only gained 4 oz and dropped off the charts completely. She is the size of a 2 month old. They really made me fell like I was doing something wrong. She grew in length again. She is meeting her milestones And Is a very Happy and content little girl. She just doesn't have enough fat. Basically they said my breastmilk want good enough for her and they want me To supplement a couple of times a day With Formula. It was Really heartbreaking to go To the doctor and be told you are doing a bad job. They did not seem concerned that there was anything medically wrong with her, just that my breastmilk Wasn't Sufficient. Does anyone have any suggestions or run across this before?

[luckypirahna]

Do you know what growth charts they use?

I know the US charts can be off for breastfed babies, so using the WHO charts (found here) can give you a better idea of where she is...

I also have seen doctors worry about kids who are in the 3rd percentile, just because they are small, but someone has to be on the small side. As long as she is healthy and growing I, personally wouldn't worry too much....
 

[Asiago]

I have some choice words for the doctor's very unprofessional advice but will refrain from using them. She should have referred you to a lactation consultant if she lacks the education on lactation to give sound advice.

Some suggestions that may help:
-put baby to breast as frequently as possible, several times an hour if you can, better yet wear baby in a sling or carrier if not doing so already.

-cosleeping encourages more feeding. Babies who cosleep feed more than those who do not. I believe they get on average of two additional feeds per night.. Plus your milk production is plentiful between 1-5 am due to high prolactin levels.

-breast compressions (sandwiching your breast in your hand as baby feeds) will get more milk into baby and the more milk 'out' the more milk your body will produce.....supply and demand. Your body is a finely tuned milk machine making as much as your little one needs.

- learn about tongue tie, relying on your doctor or the hospital birth staff to have checked is not enough. If baby cannot latch sufficiently then baby cannot compress the milk ducts nor get good milk transfer.

-google some video tutorials on breast feeding latch to get a good visual. Seeing it is so different than reading about it. These are the things mothers, aunts, sisters used to share with new moms but now we have to rely upon other sources.

-contact your local Le Leche league chapter, even a phone conversation can be helpful.

I wish you all the best. I am sure members will be able to help you out. Take care and contact a lactation consultant if need be.

[katiekat09]

I thought we would be ok because she is meeting all of her milestones. The doctor was just really condescending. I am going to make a trip back to our hometown and see our old pediatrician. I will look at the print put they gave me And see which one it was. Thanks!

[katiekat09]

Asiago thanks. She does have a good latch and I can feel her drain my breasts. I will definitely try more feedings. She is currently taking her last between 11 and 12 and her first between 6 and 7. Maybe I will get her up during the night, as that's when IM up doing homework anyway.

[MrsGregory]

So, ya'know... some babies are just smaller! Are you a pretty slender lady? Try pointing that out to your pediatrician.
I'm the proud Mama of a pleasantly chunky but quite, quite petite Little Miss. I would be fuming if the doctor had written us off as "too small" at such a young age... she's still establishing her growth pattern that young! Mine is 14 months now, and has gone several months now without growing in height. (She was at the 10% for height, and may have dropped off the height charts at this point.) I have to admit, I suspect the next appointment will involve some discussion of that concern if she hasn't grown again, but like yours, mine meets her milestones and is generally happy and healthy and is growing in some sense, so what gives with your doctor? Really! Size is a sensitive thing with our babies.

Bring those WHO charts with you to the next appointment, and yeah, tank her up overnight. I really recommend co-sleeping if you're feeling comfortable with it. Little Miss still eats at night, once usually, at 14 months old. Nighttime is an awesome time for babies to eat, since they're not distracted and all.

At a younger age mine didn't like to eat much... I scheduled her, which I found helpful. I'll throw that out, not everyone likes schedules, and I want to be sure to note that they eat when they're hungry or at their scheduled time, they do not wait to eat at the scheduled time. But the schedule helped me get more breastmilk into her.
It's funny because I was just with a Mama who has a beautiful boy who is the same age and much taller than Little Miss, and she worries that he's skinny. (He's not. He's perfect!) We laughed about the fact that the little man eats non-stop, and Little Miss must be tempted into her meals, she might eat 3 times a day and nurses before nap and bedtime and once at night. She's shy about food... but you'd never know it to look at her fat knees.

A small baby doesn't mean you're failing or doing something wrong.

[katiekat09]

Co sleeping i can't do, but feeding her overnight for sure. She was on a good schedule and really happy and content when she's not hungry or dirty. My hubby said hr would help with house work i could feed her more frequently. Love him! I'm actually not thin, I'm overweight. Mt first thought after I calmed down this afternoon was "you mean to tell me the only thing on my body that's 'lean'is my breast milk!" My middle daughter is short and at one point was in the 14th percentile. I supplemented her though because I had to go right back to work after she was born. I kind of wonder if it would have been same story with her. They even look the same. I keep comparing baby pictures to see if they had the same features at the same stages.

I think mostly I just felt unsupported. The conversation literally was
"she doesn't have enough body fat. Pump and measure it."
"I'm not Comfortable with that. I haven't responded well to that in the past."
"well some people do need that physical contact to produce milk. You have to supplement her feedings with formula. Only let her nurse 10 minutes each side then give her a bottle."
"there isn't anything i can do for my milk."
"no it's just too lean."

Ugh! I had never seen this doctor before and i probably won't again!

[Kaydove]

I personally think the advice to limit feedings per side then switch sides sets people up to have a hindmilk/foremilk imbalance! Drain each breast so baby gets all that good fatty hindmilk or if you're comfortable, nurse two sessions on one side before switching to the next. Its a form of block feeding that I used when I had overproduction and forceful letdown so DD was getting too much foremilk. Sounds like doctor might be using the formula growth charts instead of the breastmilk ones from the WHO. Such antiquated advice. Babies weight growth slows for breastmilk babies as they get older. DD weight dropped from 80th percentile to 75th (at 6 months) and now down to 50th percentile at 9 months but her height has stayed consistent at 90 th percentile since birth.

Sent from my Kindle Fire using Tapatalk 2

[KristyDi]

Originally Posted by katiekat09 

Co sleeping i can't do, but feeding her overnight for sure. She was on a good schedule and really happy and content when she's not hungry or dirty. My hubby said hr would help with house work i could feed her more frequently. Love him! I'm actually not thin, I'm overweight. Mt first thought after I calmed down this afternoon was "you mean to tell me the only thing on my body that's 'lean'is my breast milk!" My middle daughter is short and at one point was in the 14th percentile. I supplemented her though because I had to go right back to work after she was born. I kind of wonder if it would have been same story with her. They even look the same. I keep comparing baby pictures to see if they had the same features at the same stages.
I think mostly I just felt unsupported. The conversation literally was
"she doesn't have enough body fat. Pump and measure it."
"I'm not Comfortable with that. I haven't responded well to that in the past."
"well some people do need that physical contact to produce milk. You have to supplement her feedings with formula. Only let her nurse 10 minutes each side then give her a bottle."
"there isn't anything i can do for my milk."
"no it's just too lean."
Ugh! I had never seen this doctor before and i probably won't again!

This conversation tells me that this dr is not BF friendly at all. Limiting BF makes no sense. Baby needs to gain weight, and the first step is to limit the primary food source? He has NO way of knowing ANYTHING about the composition of your milk. To know that there'd have to be lab work or something.

1st thing I'd do would be to look up the WHO charts and plot your DD's weight from birth to see if she's really dropping in %tiles.

Based on that you can make decisions on whether or not you need to change anything else.

It stinks to have someone who is supposed to be an expert tell you that you aren't enough for your baby. I'm glad you're smart enough to look for more info and not just blindly accept his bad advise.

[Sol_y_Paz]

Contact LLL

http://www.llli.org/webus.html

I have a smaller baby and never have been told that before.  

[katiekat09]

She did drop off the WHO chart too. She only weighs 10lbs. I do have an SNS if i absolutely have too, but i think I'm going to try some of this advice until her visit with the pediatrician in a week

[womenswisdom]

If she's off the WHO charts, the first thing I would do is a before-and-after feed weight to see how much she is taking in. She could be having trouble with transfer and not be getting enough due to a problem such as tongue or lip tie.

[KristyDi]

OK. I would find a lactation consulant. You need someone who can observe you and your DD and offer options rather than just saying, "Too bad, breast milk isn't working. Go to formula."

Personally, I would not limit nursing, but in the situation your describing, I would consider supplementing. I think I'd go through the SNS so the baby could get as much breast milk as possible as well as the supplemental formula.

I'm sorry you're going through this Mama. I know it's stressful. I hope you can find some local support.

[katiekat09]

I just wanted to thank everyone for you're advice and give you an update. We saw a Pediatrician on Thursday. She did not agree with the first doctor that breastmilk was the cause. She said because her growth was normal to start with. They ran a full blood panel, checked for a UTI,and scheduled a heart echo and an appointment with a GI specialist. Her blood work came back today and she has a low white count, slightly elevated platelets and liver enzymes. She hasn't been sick lately so we will be repeating that soon. The doctor said no supplementing because with her white count being low she needs more support from me. Although I am still worried about her health, I really feel heard this time. Oh, also, we are doing 2 hour feedings round the clock and she gained 4oz last week. Its not perfect, but its an improvement

[Asiago]

Thanks for the update, wishing you and baby the best.

[Silverring]

I'm glad you found a doctor who has done necessary tests and is looking after your baby rather than asking you to measure breast milk.

It sounds like she is in very good hands and you can feel confident with her care.  Well done for getting this sorted out.