At what age is it safe to introduce pediasure?

[Jilian]

DS2 was not born premature but he was born very small and with a heart defect. He had open-heart surgery @ 2 weeks old and suprisingly gained pretty well after. Now he's not only dropped out of his curve but he's way off the charts. I've tried giving him higher calorie foods and he's still very small and has poor muscle tone. Our holisitc pedi suggested that it was time to supplement with either formula or pediasure. I'm opting for pediasure but thought the baby had to be at least a year to start - is this true? DS2 is 10.5 mos and has been breastfed since birth. He's been eating solids for a few mos now.

[aris99]

Hi,

I never gave my youngest pediasure but I certainly packed in the calories! She was on neocate formula til about 18 mos. Beyond this age she still had problems w/reflux which made it difficult for her to gain weight so I found a smoothie recipe that fit the bill. Not only did it pack in the calories but it was also high in EFA's (good fats) and protein. I preferred to go w/something I made myself BUT I know there are others who have had good luck w/pediasure. I guess it's really whatever works best for your child.

If it were me and I could get hold of a good, heavy-on-the-calories formula I would probably choose this over pediasure til my child was about 18 mos.

How big is your son? My eldest was born 4.5lbs fullterm. She didn't really catch up growth-wise til she was about 3yrs...and her growth curve was by no means straight !

[Jilian]

He is 17 lbs and 10.5 mos. I've been loading him with oatmeal and avocado the past month and that brought him from 16 to 17 lbs. I did read about pumping and tossing the foremilk and just feeding him the hindmilk and I think I may try that first. But pediasure is our backup.

[CallMeMommy]

I know there's a recipe out there for mixing breast milk and formula, I think you add a scoop of formula powder to 2 ounces of breast milk. I'd try that before straight formula or Pediasure, but obviously you'd have to ask your doctor or a nutritionist for the recipe (I've googled but can't find it, and the board I got it from back in the day is now defunct).

[sarah1972]

Pediasure is safe at 1 year of age and beyond. Are the doctors worried about his weight gain? The reason to delay Pediasure is because it has milk proteins which are harder to digest, but at 10.5 months he's very close. You might want to try and wait a few more weeks and then, if you are definitely going to do Pediasure, start out with perhaps 1 bottle a day and then increase. You'll be able to notice immediately if he has digestion problems. There is also a Pediasure with fiber, which is what we use. My son is exclusively Pediasure fed, but I do plan on making his own food once a nutritionist has reviewed his situation and tells me exactly what he needs.

If you decide to supplement with formula, look on the can because it will tell you how many scoops will equal 20 k/cal an ounce, which is what breast milk is supposed to be. You could probably figure out how much to give from the can.

I'd talk to a doc before jumping to Pediasure, just because it is such a drastic change from BM, but if you do decide to do it you can get the generic brands at a much cheaper prices with the same ingredients. Pediasure is expensive!

[Jilian]

Oh I wasn't planning on switching to pediasure instead of breastmilk, I was looking to add it in addition to breastmilk. I hope to nurse for at least 18 mos.

His pedi is worried about the fact that he's fallen off the charts and off his own curve. I am worried about dairy because DS1 has some serious sensitivity to diary issues. I think I will hold off for the full year now that you tell me about the milk proteins.

[Flower of Bliss]

It must have been very difficult to have your baby have open heart surgery so very young. I can't imagine what that must have been like. You are doing a wonderful job nursing your little one.

You may want to try to increase his breast milk consumption instead of introducing formula or pediasure. Maybe offering the breast more often. It may also help to do block feeding to make sure that he is getting plenty of hind milk. Breast milk is certainly fattier than avacado or oatmeal. I would worry that pediasure or formula supplements would end up filling his stomach and replacing some of the breastmilk he is getting. Have you checked out the WHO growth charts to see where he falls on them? 17 lbs at 10.5 months doesn't sound that tiny to me.

[baby duck]

If you are wanting to increase the calories in expressed breast milk:

a half teaspoon of regular formula added to 3 ounces of breast milk will give you 22 cal/ounce.

a full teaspoon of regular formula added to 3 ounces of breast milk will give you 24 cal/ounce.

My Little Bit weighs 21 lbs at 27 mos. We did the fortified breast milk for quite a while and then switched to whole milk with pediasure when she was about 15 mos old.

Flower - I think the concern here is not really the size; Evan appears to be still on the charts, it's that he is no longer following a steady growth curve.

[Jilian]

Yes he is even off the WHO charts, he's in about the zero percentile for the WHO boy's chart. We've done block feeding since birth and I nurse around the clock. He still wakes up at least 3 times a night to nurse.

I just read in another post about only feeding hind milk. I'm going to try that. I'll start pumping today and dumping the foremilk and just saving hind milk.

[irangel]

12mos, same as cows milk (though I know some doctors that will say 11mos is okay).

[munkeesmama]

For kids under 1, I would start with formula..Higher calorie formula. Pediasure has ALOT of sugar in it and is considerably hard to digest/break down. We began pediasure when my daughter was about 13 months old (she has a feeding tube and was/is tube fed) and it still required some transitioning.

[ShyDaisi]

I don't normally post in this forum but read the thread when it showed up at the top of the Life w/ a Babe forum. My ds is a little runt (said with the utmost ) and we didn't have to go through the trials that you have -- just worrying about weight gain is stressful enough

I just wanted to show you a growth chart that helped set me at ease...This is on the kellymom website. You had mentioned that your son had even fallen off of the WHO charts, but according to this chart he has not. He is not the average or 50%, but it does look like he would be about the 20th.

It is normal for a babe's growth to level out between 6 and 12 months as he becomes more mobile. FWIW, my son was about 17-0 at 9 months, 17-3 at 10 months, 17-10 at 11 months, and 18-3 at 12 months. But has really started to pick up his weight gain in the last couple of weeks as his appetite has increased.

HTH and good luck!!

Oh, I don't really have any advice about the pediasure, but I personally wouldn't offer until 18 months or so....

[Jilian]

I checked this chart (http://www.kellymom.com/babyconcerns/growth/chart1.html), and at 10.5 mos and 17 lbs he's in about the 0% But he was on the low end of that WHO chart, so that makes me feel a little better.

The issues is that he has not become more mobile at all. He has hypotonia and can only sit. I am worried about him losing weight when he does become mobile. I've been offering avocado every day now and adding other healthy fats into his diet. We have a weight re-check in a month and we'll see if he's gained. I've decided to hold off on pediasure until he's at least over a year.

[miche28]

The other thing you might try is seeing if you can feed him coconut oil - perhaps even mixed into your breastmilk in a bottle or cup. Since this is a question of upping calories, the coconut oil (which is also very high in the saturated fat his brain needs) may be helpful. It's sort of semi-solid at room temp and DS would eat it off a spoon (BLECH - there goes my rule about not feeding my kids anything I wouldn't eat!).

Also, while weight is part of it, there may be more going on than calorie intake and absorption, so be sure that your ped is looking at the whole picture as you may want to consider early intervention with physical therapy in addition to his nutrition.

[readytobedone]

Originally Posted by Jilian

Now he's not only dropped out of his curve but he's way off the charts.

17 pounds at 10.5 months is fine. it's not "way off the charts" at all and i don't know why your doc would be telling you that. if he's hydrated and he's alert and healthy, then just keep doing what you're doing. you don't need pediasure or formula just for a small-ish baby. especially if he's always been small, i really don't see the concern.

he sounds perfectly fine to me!

ETA: i see now that there are other health concerns. i can't speak to that, but it's very normal despite what some docs say for babies to "fall off their curve." DD was well over 95th percentile early on for several months and now she's like 20 something.

[Jilian]

Originally Posted by readytobedone

17 pounds at 10.5 months is fine. it's not "way off the charts" at all and i don't know why your doc would be telling you that. if he's hydrated and he's alert and healthy, then just keep doing what you're doing.

According to their silly charts he's way off. He's also off the kellymom chart, but I guess I misread the WHO chart because he's still on that at the low end. I think his history scares people, and they take any little thing and blow it out of proportion. I honestly think his pedi is scared of his history and is being overprotective. KWIM? No one wants to be the one to say the heart baby is ok and then it turns out something was wrong. I think I need to find a pedi who is more familiar with children born with heart defects.

[intorainbowz]

Ped had us start pediasure at 11 months. She's still nursing, darn her.

As for mixing breast milk and formula, I'd take caution on that. I've read this can be hard on the livers of babies.

Store brands cost about $2 less than "real" pediasure. Chocolate and strawberry stain, vanilla and banana do not in my experience.

[felix23]

My ped had us start dd on pediasure at 8 months old. She was also still nursing a lot. She flat out refused to drink any type of formula and our other option was to put in a feeding tube which I didn't really want to do and our crappy insurance wouldn't cover, so I went with the pediasure. But she was waaay off all charts. She was still less then 8 lbs at 8 months old and she was starting to lose weight and had horrible developmental delays. She never had any problems with it and it really helped her gain.

[Khourtniey]

Honestly.. Id never give my child pediasure.. Which is why my 3 year old is still EBF.. I do have to add formula to fortify.. but not pediasure. We use neocate Jr

You mention your ped being scared of the history.. Sounds like it to me! A lot of peds just deal with typical kids.. When they get a special needs one they freak out. My child is the only special needs kid that my ped has.. Sure, he has some preemies, but nothing like my son. My ped straight up told me that he knew nothing about him and that if I called him for information that he would just send me to the childrens hospital... but I always call childrens first anyway I dont think your ped should be handling issue like that though.. Id take it to somebody who specializes in it.. like nutrionist. I dont call my ped for pulmonary issues and I wouldnt call pulmonary for ped issue... same with nutrition..

[Le Bec]

Originally Posted by Khourtniey

Honestly.. Id never give my child pediasure.. Which is why my 3 year old is still EBF.. I do have to add formula to fortify.. but not pediasure. We use neocate Jr

What is it about pediasure you don't like? I only ask because I'm not sure they sell anything other than toddler milk for normally growing kids is pediasure.