"they" say my baby its too small
Have you started taking hormonal birth control?
When she nurses, can you hear swallowing? Have you seen a lactation consultant to evaluate her latch and see how effectively she's transferring milk?
The diapers sound good.
The first suggestion I can see is to try to get her to nurse more often. I would go for at least every two and a half hours during the day. For example, 6:30am, 9am, 11:30am, 2pm, 4:30pm, 7pm, 9:30pm and midnight. If she wants to sleep from midnight to six, that might be ok (though the extra calories at night could help).
Also, rather than formula, you could consider adding calorie dense foods to her diet- egg yolk (no whites yet!) and avocado, for starters.
If that doesn't work, you could request an ENT consult. I knew someone whose baby had a small windpipe and she was working so hard to breathe, burning so many calories, that she couldn't gain weight.
This is a great article to read:
The ENT idea is a good one. I was also wondering if babies could have high metabolism. There are times where her body temp goes up for no apparent reason and she gets sweaty. Then it goes away.
i would just nurse her all.the.time instead of giving formula.
45 minute sessions are long sessions. keep doing those, but start adding in at least four more 15 minute sessions interspersed.
are you nursing overnight? this is the BEST time to get the richest milk your body can make. the hindmilk, the "fat" milk
if you are in a position of needing some therapudic (sp) weight gain and up against "needing" formula, you can probably bypass that situation if you focus on nursing, nursing, nursing, around the clock.
I'm going to go with- not babies that young. Generally, growth is an indicator of good health.
It looks like she had good gain the first two weeks, but only gaining a pound from 2 weeks to 4 months is definitely concerning.
I would say that her "output" seems normal, so she is getting milk, but, I agree, the fact that she is not gaining weight is worrying. Have you tried weighing her before and after feeding her? This would give you an indicator of her intake. If her intake seems good, too, then I would ask for additional testing of her digestive system before switching to formula. There are a few metabolic disorders (I don't want to freak you out, but cystic fibrosis come to my mind) that can be pretty easily ruled out (or confirmed).
That's great improvement compared to her previous growth. She reminds me of my daughter (now 20 mo) who tracked similarly (and was a concern - she needed to eat more) her first four months. She ended up having tongue tie and lip tie and once clipped, it helped some. I kept up for about 9 months of picking her up to feed her before I went to bed around 11p, and I also got myself up around 5am to feed her again (did that till about 6mo), just to get those extra feedings in. I eventually tapered off, but at 2-4mo, my goal was 9-10 feedings a day. While yours nurses long, mine nursed very, very short and as a result didn't get much or stimulate much supply. Her jaw tired, I believe, because of the tongue tie. After clipping, she started nursing longer and falling asleep while suckling (she NEVER did that before getting clipped).
I never supplemented, and started solids when she sat up around 6.5mo but did not reduce nursing until about 9-10 mo. She's still smaller for her age, but healthy. I was committed to avoiding formula for her long term health as an adult.
Keep up the extra feedings. She does need to grow more at that age - it's too early for weight gain to taper off. Until around 4mo, 5-8oz a week is a good guide. With her situtation, 4oz is great and hopefully that'll keep up.
Also, I just *knew* when she was gaining and growing without her being weighed. I could tell after several days of picking her up if she was staying the same...it was usually consistent with what was going on. I knew she was healthy, but I also knew she did need to grow and that fat on babies is very good. I wasn't needing her to be a chub, but wanted her growing more. It weighed on me a lot.
Also, did I read correctly that this is your third child? If so did you happen to exclusively nurse the first two with good weight gain? It would be a definite indicator that your body does in fact make milk enough to sustain a baby!
Hope you are well!