need advice for nursing/feeding 8 month old and only 14 pounds - please give advice on diet and BF - Mothering Forums

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#1 of 19 Old 12-14-2008, 05:48 AM - Thread Starter
 
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Hello,
My DD was born at 36 weeks and was 4 pounds, 13 ounces at birth. She has always been small and now at 8.5 months and 14 pounds, the doctor says she is less than the 3rd percentile for weight on their "curve" (adjusted 4 weeks for her prematurity). The concern is that she may be falling off her "own" curve........ She is really active and while she looks small, she doesn't look too skinny or anything. I'm worried, though, that she may not be getting enough calories or fats.......

We EBF until 6 months..... then intro'd solids. I'm always worried she's not getting enough breastmilk as when I've tried to pump, I barely get any (1 - 2 oz usually, although I think there's more in there as I can hand express some as well after). I'm really unsure whether I'm producing enough for her.......

She eats 2 - 3 meals per day in addition to breastfeeding about 5 times per day (although I'm unsure how much she gets through nursing - maybe 3-4 oz. each time?). We're systematically introducing solids and avoiding allergens as I have intolerance to dairy and gluten (and spices) and don't eat these foods myself. So far, she hasn't had any reaction and eats the following: turkey, lamb, buffalo, squash, sweet potato, beets, green beans, peas, olive oil, banana, avacado, carrot.

My questions are:

Has anyone had experience with a "small" baby and what did you do to help her gain weight?

Any advice regarding domperidone (not sure of spelling) for increasing breastmilk? I'm currently trying herbal stuff and pumping after feeds to increase supply, but am always paranoid perhaps she isn't gaining well because I haven't been producing enough milk for her........ :-(

What other foods should we offer that will give her calories and the healthy fats she needs? Should we try yoghurt, even with my dairy intolerance?

What else can we supplement with (I don't want to give formula)?

ANy other advice - I try not to worry as she seems happy and healthy, but I do anyways.......
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#2 of 19 Old 12-14-2008, 10:37 AM
 
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My daughter is just about 9 months and is only 16 pounds. She had a big growth spurt around 6 months so for the first 6 she was very tiny. Just watch diapers and that your little one is meeting milestones.

For solids I would put coconut oil or butter on everything. DD doesn't really do solids yet but she LOVED the drippings/fat from the meatloaf I made. She wanted to taste it when I was taking a spoonful and she loved it and wanted more. She ended up having 3 tablespoonfuls before I thought it was enough!! That may be an option for you? Pan dripping for your little one? My daughter also liked the broth of the Goulash I made the next night.

I know egg yolk is another good food. Sorry this isn't really coherent its 5am and DD has been up and down all night, I have yet to sleep! She just cut her second tooth.

Mama to Belly(5), homesteading in the desert with our chickens and sheep. Fish nerd, really into my reef tank. Baby due Sep 3rd!

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#3 of 19 Old 12-14-2008, 11:48 AM
 
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have you ever done a weight check to assess her ability to transfer milk? That would be the first step. Not everyone *can* pump. that doesn't reflect on your supply. What has her output been like?

Domperidone does a great job of instituting supply, I wouldn't jump right there. It is a drug and does have side effects. I would concentrate heavily on galactagogues if you are concerned. That means not simply *taking* galactagogues but taking them properly. Fenugreek is great, but need to be taken in large amounts for results. I tend to recommend a mixture of fenugreek, blessed thistle, nettle, oatstraw and alfalfa. Goat's rue *can* be helpful depending on why the supply is low. Thing is, with YOU'RE allergy history it is possibly that your supply is compromised so I would recommend drinking infusion of these herbs for the nutritional benefits anyway.

There could be something else going on. My most allergic kid was 16 pounds at a year and wasn't diagnosed until she was 15 months and failure to thrive. She was 8 pounds at birth and was not even on the charts.

I would not give dairy at this point. I would increase healthy fats and nutrient dense foods. You can make smoothies with coconut oil and coconut milk. You can also chuck an avocado in there some days. I would try to incorporate more greens into her diet next, personally but otherwise things look great! Do you have access to an alternative care provider?
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#4 of 19 Old 12-14-2008, 12:16 PM
 
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Quote:
Originally Posted by firefaery View Post
have you ever done a weight check to assess her ability to transfer milk? That would be the first step. Not everyone *can* pump. that doesn't reflect on your supply. What has her output been like?
:

That would be my first step.

My second step would be to GREATLY increase nursings. 5 times a day for a baby that needs to gain seems like way too little.

good luck!

-Angela
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#5 of 19 Old 12-14-2008, 02:57 PM
 
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I've had 4 small babies. My twins were born 4lbs 1oz & 4lbs 8oz. We assumed that was why they were small. Nope. Along comes 8lb 6oz lil sister and then 8lb 13oz lil brother.... and they all fell right off the chart. Some people just make small kiddos

What I did / do. Just nurse as much as they want. I nurse ds before & after solids... always. So he wakes up, nurses, I'll offer some solids, then I'll offer to nurse again. Repeat after nap, etc. I always offer the second side at night after he comes off the first. Pretty much yo0u can lead the baby to good high fat foods and bm, but you can't make them eat. My twins are now 35 & 28 lbs at almost 5. My 3.5yo is smaller than most 2yo I know (she's about 28 lbs and SHORT). The baby is about 16 lbs (if that) and he's 10 months old now.

Good luck . If you need any more specific tips feel free to PM me. There is a tribe somewhere of small babies, not sure where it went though....

Mom to:

Three big girls  twins.gif (10) + joy.gif (almost 9!); 

One little boy ROTFLMAO.gif(6) and a full on toddler diaper.gif  (8/12) born with TAPVR heartbeat.gif (repaired at 6 days old).

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#6 of 19 Old 12-17-2008, 09:49 AM - Thread Starter
 
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Thanks everyone for their fantastic advice.......

We did a milk transfer assessment about two months ago - she got about 2.5 ounces (from one side I think), but it also wasn't a complete feed as she always has trouble nursing when we're out as she is SO distractible. The dietician at the time said that was a bit low...... But I do think now she's getting between 3 - 4 ounces each feed (total from both sides) and we're actually doing about 7 feeds a day (maybe 8 depending on how often she wakes at night). I do nurse "on demand," but she never "demands." I feel like since birth I'm always gently encouraging her to nurse..... and now that she is so "busy" and easily distracted it takes a lot of patience on my behalf to get her to nurse longer than 4 - 5 minutes each side. And sometimes I KNOW there is more milk in there and she doesn't take it. And sometimes I think there isn't any more milk and I wonder if that's why she's done so quick. I've tried to increase nursing and she just pushes away..... I do continue to offer though. I feel like it's a fine balance between encouraging her to nurse more and not pushing too hard.... I always thought babies would just love to nurse (and she does sometimes, but not as often as I'd like!).

Anyways, we started egg yolk and next on my list is to test coconut oil, so I can add that to her foods too. She's currently got red cheeks which I'm hoping are related to her current teething and not a food intolerance - although I think I'll definitely wait on dairy for awhile longer - maybe high fat yogurt closer to 11 or 12 months.....

Thanks again! Appreciate all the advice.
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#7 of 19 Old 12-17-2008, 09:58 AM
 
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If you can't get an accurate weight, you can use sposies and save them up for a day to weigh. They each weigh 1 oz. You can subtract the weight of the sposies. What goes in comes out. You will know that way how much she is getting. My ds nurses more than 5 times a day, more like 10 at 12 months old. Maybe try to offer more in a dark and quiet room? Mine will always nurse hungry or not after a bath. Just an idea.
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#8 of 19 Old 12-17-2008, 02:14 PM
 
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I did not take domperidone but the other drug (forgot the name) and I was miserable on it, so after a week I stopped. Fenugreek and milk thistle are great. You just need to take enough fenugreek to smell it on your skin.
My baby is very chunky, and I always wonder why because he does not to seem eat a lot to me at all. But he actually slowed down at about 6 months after we introduced solids. I believe that milk is still more nutricious and more bioavailable for the baby between 6-12 months. I think their bodies still learn to digest the solids and really get benefits from them. So I would definitely try nursing more. I know my son nurses the longest to sleep. He still also nurses at night.
I think also your diet will affect how good your milk is. Do you have enough healthy fats in your diet? Take supplements? Whole foods suplements are the only ones that I would take. Do you take any Omega 3 supplements? Is your thyroid functioning properly? Low thyroid function may affect milk supply.
And also stress would affect milk supply and let-down. So if you stress about that you have low mlk supply you may not let-down as easily.
Now that I am pregnant and my milk supply dropped badly, I coud not go w/o my 2 phase Medela pump, I simply need couple of let downs to get enough milk out, so if you have difficult time with let down your LO may not be patient enough to keep sucking for the next one and the same with your pump, you will pump out 1-2 oz. on one let down and you think you are done, and with 1 phase pump it is so hard to get next let-downs, that is why I loved my 2-phase and I am glad I got it.
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#9 of 19 Old 12-17-2008, 02:55 PM
 
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Reglan. Horrible stuff.
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#10 of 19 Old 12-17-2008, 04:20 PM
 
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Yep, it was Reglan. Maybe I do not want to remember its name LOL. Horrible!
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#11 of 19 Old 12-17-2008, 04:37 PM
 
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I have no idea WHY they prescribe that! It pretty much promises disastrous side effects. The info *could* read take this if you NEED to be depressed. Sorry, mama. Just know you aren't alone.
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#12 of 19 Old 12-17-2008, 04:42 PM
 
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My 9 month old is 15 lbs and so what! She is happy and healthy and fell off the curve from 10% to 3%. I give her 1 tsp of olive oil on her cereal and fruit every morning for a little bit of healthy fat. She eats solids 2-3 times a day and nurse 5 times a day and 3 times at night. If my supply needs a little boost i drink a glass of beer and my boobs fill right up. I take omega 3 sup, along with a multi.

Pumping is no indication of supply. I can barely get 1 oz.

You are your baby are fine. Trust your body!

Me(33), Mama to a crazy DD (6), Wife to a wonderful mountain man(32) BF my babe for 2 years.
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#13 of 19 Old 12-23-2008, 04:24 AM - Thread Starter
 
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Thanks so much for all the great tips and things to think about...... nursing in a very quiet and darkish room seems to be helping.... also, think she's nursing slightly more - or longer anyways, since I've started the "More Milk" supplement. I don't smell it on my skin though so perhaps I'm not taking enough...... how much is typically "enough?"

I'm trying to offer more and we're up to about 7-8ish feedings, although some are very quick - seems like she nurses better for a couple days, then doesn't for a couple days..... pumping with my hospital grade rental after feedings I think may be helping too. Lily7 you mentioned needing a couple "let downs" - I have NEVER even felt let downs so not sure why that is or if that has anything to do with it.

I could get my thyroid checked - anyone know.....would I have any symptoms if this were not functioning properly?

Lydiah - thank you! Your message made me smile. I'm trying to trust and not worry ;-) Sounds like our "little ones" are nearly identical sizes. Mine will be 9 months in a week and we're thinking she'll weigh in at 15 pounds. :-)
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#14 of 19 Old 12-23-2008, 10:31 AM
 
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I've had two little ones with allergies. If you just introduced egg yolks and she's got red cheeks, I'd worry that eggs are the culprit. No one tells you until you're seeing the allergist that it's virtally impossible to separate the white from the yolk and eggs are pretty high on the allergen list, right after dairy and wheat. I agree with coconut oil to add good fats and calories.
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#15 of 19 Old 12-23-2008, 11:15 AM
 
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I think I was taking 4-620 mg capsules of fenugreek, your sweat will smell little like curry.
I do not feel the let down either, but I can see it happen when I pump and observe how my DS is sucking. He sucks fast till let down and then slow with swallowing when the milk flows, then milk stops flowing and he needs to start sucking fast again for the next let down. Before my problems couple of months ago, I was able to pump 2-4 oz. bottles of milk on one let down, then I started having trouble and once the milk stopped flowing I had to turn my pump to fast pumping phase and would get next led down and more milk. With just regular pump speed I could never get the second or third let down.
I am not sure if your pump has two speeds, but I love my Medela PIS Advanced for that reason.
I really think that breastmilk is still the best food for your LO. And as one poster said she is just that way and perfectly fine.
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#16 of 19 Old 12-25-2008, 03:01 PM
 
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I don't have much time to post but wanted to say that my DD is 27 months old and weighs 22 lbs. We have never been to a ped but I know that she probably would have been labeled "small" and "needed to gain weight".

As long as she is happy and you're making an effort to feed her regularly I don't think "gaining weight" is an issue. Every kid is different. My DD was 20 lbs for a 9-12 month stretch, she just stayed the same.

At 8 months when they start crawling and becoming more active I think their weight stays flat for a while. Afterall they are burning more calories.

It sounds like you are very in tune with her. Trust your gut.

Alina
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#17 of 19 Old 12-25-2008, 05:59 PM
 
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Originally Posted by alinajoy View Post
I don't have much time to post but wanted to say that my DD is 27 months old and weighs 22 lbs. We have never been to a ped but I know that she probably would have been labeled "small" and "needed to gain weight".

As long as she is happy and you're making an effort to feed her regularly I don't think "gaining weight" is an issue. Every kid is different. My DD was 20 lbs for a 9-12 month stretch, she just stayed the same.

At 8 months when they start crawling and becoming more active I think their weight stays flat for a while. Afterall they are burning more calories.

It sounds like you are very in tune with her. Trust your gut.

Alina
OT but Alina. :::
I hope you are the Olive and Bean Alina, thats who I am thinking.
This is Lizzie I talked to you about selling knit dolls in your shop like two months ago.

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#18 of 19 Old 12-25-2008, 06:22 PM
 
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My daughter was 17lbs at 1y. Oh wait, 17lbs 1oz. She was also small when she was born, 4lbs 7oz and has been in the lowest percentiles for growth. She is reaching milestones a little behind her full-term peers but other than not getting that feeling of "ah ha my baby is a genius because she did X early!', my little girl is right on track. She barely eats any solids at all, has refused all solids until about the last few weeks (she's 15m today) beyond the occasional corner of toast or single cracker or 3 grapes... lol She won't eat meals and we offer solids throughout the day for her to graze on.

I'd say trust your gut, but I'd also say that it's easy to see those things and get worked up about them unnecessarily. What does your heart tell you? When you look at her, does she seem to be lacking/behind?

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#19 of 19 Old 12-26-2008, 12:12 AM
 
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My dd is nearly 10. She weighed 16 lbs. 8 oz. at 1 year! Now she's about just above average for height and still thin. She reads waaay above grade level and will eat just about anything.

If your dd is happy, meeting milestones, and has plenty of dirty diapers, dont worry!!!
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