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My nephew is four months old and a big healthy bf'd boy. At his four month well visit, the pediatrician suggested he is too fat. I think this is ridiculous. Dr. suggests he shoudln't be fed on demand. HUNH? And Dr. says she should introduce solids so he gets used to the texture of food.<br><br>
So... how do I respond intellegently to these.<br><br>
As opposed to yelling, "HE's stupid".<br><br>
xo pam
 

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lol<br><br>
"YOU'RE STUPID!!!!!!!!! YOU CALL YOURSELF A PED!??????????? WHERE DID YOU GET YOUR LICENSE? A CEREAL BOX!!!!!!!?????"<br><br>
That sounds like a suitable reply to me <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/lol.gif" style="border:0px solid;" title="lol"><br><br>
Ok... when I get crap like that from relatives I just nod and go "uh huh" and totally ignore them! Its no use trying to TELL them the facts, they know the old myths and accept them as facts and won't hear anything else!<br><br>
My dd had that baby fat thing going from birth to about 5 months, and once she started kicking, wriggling, crawling and becoming more active, she STOPPED putting on weight so rapidly. Instead of putting on weight, she was growing into her body - she no longer looks chubby with rolls of fat hehe, she looks like a little cute person! Her skin is still soft and there is plenty of fat to cushion her developing bones BUT she doesn't look fat iykwim?<br><br>
She is now 8 months old, still exclusively breastfed, still growing and healthy!!<br><br>
Keep up the exclusive breastfeeding and go check out kellymom.com maybe you will find something useful there to print out for your doc.<br><br>
Just introducing solids so they get used to the texture of food is ridiculous, they will discover the tastes and textures for themselves when they are ready to "get used to food"! Also hasn't your damn doctor heard of the AAP's recommendation of at LEAST 6 months exclusive bf'ing and for as long beyond that given that mother and baby are comfortable? Maybe you should quote that one at him!
 

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How big is he? My 4month old is over 18 lbs on breastmilk only. He won't even take it from a bottle so I know there's no chance he's being overfed. Breastfeeding is a lot of work for a baby and,unlike bottle feeding, you can't force it on them. You can't shove your nipple in their mouth and let the milk just run out like a rubber nipple. They have to really try.<br>
Also, re:introducing solids, breastmilk doesn't have any empty calories, like many solid foods. Babies use all of it, which is why breastmilk poop doesn't smell bad. If he starts eating solids he's more likely to gain weight that will lead to obesity later in life. The fat that accumulates from breastmilk is stored up for the active toddler phase.<br>
Also, research has shown that the fat content in breastmilk is related to frequency of nursing. So,if she's cue feeding and baby eats often she will have higher fat milk and baby will be plump and healthy.<br>
Tell her not to worry, many moms struggle to build milk supplies because of bad advice from their ped. She has the opposite problem, which really is no problem at all! She's doing a great job!<br>
Suzy
 

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How about the <a href="http://www.aap.org/policy/re9729.html" target="_blank">AAP policy statement on Breastfeeding and the Use of Human Milk (RE9729)</a>?
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">6. Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months after birth... Gradual introduction of iron-enriched solid foods in the second half of the first year should complement the breast milk diet. It is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired.<br><br>
7. In the first 6 months, water, juice, and other foods are generally unnecessary for breastfed infants.</td>
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If that doesn't work, try <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hammer.gif" style="border:0px solid;" title="hammer"> . <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin">
 

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Just so everyone knows, the AAP is a little out of the research loop when reccing "iron enriched solid foods." Foods with added artificial iron (ie: commercial rice cereal) can actually interfere with the baby's ability to absorb the naturally occuring iron in its human milk diet.<br><br>
If your baby is not anemic (and bfed babies rarely are), your milk, and real table foods, contain sufficient iron to keep him healthy!<br><br>
link abt iron:<br><br><a href="http://www.kellymom.com/nutrition/iron.html" target="_blank">http://www.kellymom.com/nutrition/iron.html</a>
 

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Yeah, that recommendation is 6 years old. But, compared to that idiot ped <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/yikes.gif" style="border:0px solid;" title="EEK!">, it's much better.
 

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Okay, I'm the sister with the fat baby. And my doctor said he was fat. But, he didn't say I shouldn't feed on demand, he said maybe I should try to hold him off so he isn't feeding every two hours, which I sort of agree with. Every two hours seems a bit much considering that he sometimes spits up afterwards and he doesn't seem to need it considering his weight. He also said I might want to consider introducing solids, but did not say I should. and he gave me a handout with his philsophy that said that the baby should be able to sit up before solids and my baby is nowhere near the sitiing up stage. So sometimes when your mom comes with you to the doctor and tells your sister what happened , you need to take it with a grain of salt. I am not sure I'm in love with my doctor, but he hasn't said anything to make me too crazy yet. Thanks for the AAP policy and the kellymom web site, they were interesting. Any more advice would be appreciated.<br><br>
mindela
 

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double post
 

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<div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">he said maybe I should try to hold him off so he isn't feeding every two hours, which I sort of agree with. Every two hours seems a bit much considering that he sometimes spits up afterwards and he doesn't seem to need it considering his weight</td>
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If you were talking about cow's milk or formula or solid food, that would be one thing. But human milk cannot be overfed. When a baby is thirsty, they can nurse in one way so that they get a more "watery" milk. When a baby is hungry, they can nurse in a way that gives them more fat, and the fat in breast milk is a healthy fat with nutrients in it that the baby needs for brain and bone development.<br><br>
A would be very, very skeptical of any doctor who says to nurse less than the baby wants. To give less cow's milk or other foods, maybe. But to schedule a breastfed baby can quickly harm your supply.<br><br>
I'll try to find some links for you.....<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Breastfeeding is blamed for everything<br><br>
True! Family, health professionals, neighbours, friends and taxi drivers will blame breastfeeding if the mother is tired, nervous, weepy, sick, has pain in her knees, has difficulty sleeping, is always sleepy, feels dizzy, is anemic, has a relapse of her arthritis (migraines, or any chronic problem) complains of hair loss, change of vision, ringing in the ears or itchy skin. Breastfeeding will be blamed as the cause of marriage problems and the other children acting up. Breastfeeding is to blame when the mortgage rates go up and the economy is faltering. And whenever there is something that does not fit the "picture book" life, the mother will be advised by everyone that it will be better if she stops breastfeeding.<br><br>
myth: Physicians know a lot about breastfeeding<br><br>
Not true! Obviously, there are exceptions. However, very few physicians trained in North America or Western Europe learned anything at all about breastfeeding in medical school. Even fewer learned about the practical aspects of helping mothers start breastfeeding and helping them maintain breastfeeding. After medical school, most of the information physicians get regarding infant feeding comes from formula company representatives or advertisements.<br><br><br>
Myth: Pediatricians, at least, know a lot about breastfeeding<br><br>
Not true! Obviously, there are exceptions. However, in their post medical school training (residency), most pediatricians learned nothing formally about breastfeeding, and what they picked up in passing was often wrong. To many trainees in pediatrics, breastfeeding is seen as an "obstacle to the good medical care" of hospitalized babies.</td>
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These quotes are from pediatrician Dr. Jack Newman, who is very knowledgable about breastfeeding, from <a href="http:" target="_blank">http://www.breastfeedingonline,</a> handouts number 13 and 14.
 

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<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">A breastfed baby gets custom-calorie milk. The fat content of breastmilk changes during each feeding and also at different periods of the day. At the beginning of a nursing, when a baby is most hungry, she gets a large volume of foremilk, rich in protein and carbohydrates, but low in calories. If the baby is very hungry, he continues sucking and the fat levels in the milk rise (the "hindmilk"), telling the infant that it's time to slow down because his tummy is getting full. When you watch breastfeeding babies at the end of a feeding, you will notice how they radiate contentment, sucking needs and appetite both completely satisfied. When a breastfeeding baby is thirsty rather than hungry, or just wants to soothe himself, baby sucks in a way that makes the breast deliver only the lower calorie foremilk...<br><br>
The fat content of mother's milk changes as baby's growth decelerates. Breastmilk changes from "whole milk" to "reduced fat" sometime during the second half of the first year, another biological sign that Mother Nature favors leanness. In fact, recent research has shown that <b>breastfed babies, after the first four to six months, are leaner</b> than their formula-fed peers, as they gain proportionally more height than weight. Formula-fed babies tend to get solid foods earlier and gain proportionally more weight than height, suggesting an early tendency away from leanness.</td>
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<a href="http://www.askdrsears.com/html/4/t043700.asp#T043705" target="_blank">http://www.askdrsears.com/html/4/t043700.asp#T043705</a><br><br>
In other words it's appropriate and healthy for a 4 month old bf baby to be chubby, and they will slim down later.<br><br>
 

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double post!
 

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<div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">There are hazards in limiting growth by putting a baby on a diet. The young child is a dynamic body builder, producing cells of all kinds, brain and nerve cells as well as fat cells....There are no "empty calories" in breast milk....<br><br>
it must be remembered that fat accumulated in the relatively inactive pre-toddler stafe is preparatory for the highly active time when a busy toddler hardly has time to eat....<br><br>
breastfeeding is the first preventive measure against obesity in adult life....Children who were breastfed were found to be less likely to be overweight in adolescence....</td>
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from the book "The Womanly Art of Breastfeeding."<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Babies who gain quickly during infancy often start to slim down once they become more mobile; ie. rolling, crawling, pulling up, walking, running, etc. Often toddlers are very picky eaters and/or become almost too "busy" to take the time to eat. The fat laid down in infancy ensures that there are ample stores to pull from during the active toddler years.<br><br>
Keep in mind, too, that breastmilk is a perfect food. There are NO empty calories or fillers. ....<br><br><b>Do not try to limit your baby's nursing by stretching out feedings, limiting time at the breast,</b> using a pacifier to "hold baby off" until a specified time has passed, or offering water so that baby nurses less. <b>It can be dangerous to limit your baby's growth by limiting nursing, as your baby needs the nutrients and fat for proper growth and brain development. Only by continuing to feed your baby on cue will you ensure that his needs are perfectly met and that your milk supply is maintained.</b></td>
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From the link below:<br><br><a href="http://www.kellymom.com/bf/normal/weight-toomuch.html" target="_blank">http://www.kellymom.com/bf/normal/weight-toomuch.html</a>
 

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I think it's still hard at times to know when he really is hungry or when he just wants to suck or for me to hold him. If I put my baby at my breast at any time of the day he will eat. I know there are babies out there who only eat when they are hungry, but my Noah will eat all day long if I let him. Any advice on that? I have only seen him refuse once in the four months of his life. I want him to eat good meals where he is getting the hind mild and if I feed him when he's fussy (which unfortunately is very often) he won't eat for long periods of time, he will fall asleep. Then when I put him down, he'll wake up and if given the option, he'd go right back on the breast. I have read that breast fed babies are more in control, but I feel like mine is confusing the need to suck wtih the need to breastfeed and that is why I wasn't shocked when the doctor said I might want to hold him off if I could. What do you think?
 

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Just a thought...<br><br>
Do you hold him alot, just to hold him (<b><i>including</i></b> when he's asleep, and whether or not he's fussy)? Or do you put him down whenever he's <b>not</b> fussing/eating/other specific reason to hold him?<br><br>
If so, could he just want to be held while sleeping... and have figured out that you hold him when he eats, so he eats to get held??<br><br>
I don't know... just a random thought that popped into mind, thinking back to my velcro-napper* DD when she was 4mo old and wanting to be held a lot...<br><br><br>
* Just for the record, I got the term "velcro-napper" from someone on MDC but can't remember who (sorry)...
 

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Mindela...<br><br>
You know him best.<br><br>
But I also know it's normal for babies to nurse every hour or more...and I don't believe they will drink/eat more breastmilk than they need since there is no waste in it, unlike junk food with an older child that you need to control.<br><br>
I mean I can eat ice cream or cookies even after I'm full...but if it's a veggie salad and everything in it is good for me, I stop when I'm full, KWIM?<br><br>
In many other cultures moms give babies frequent feedings...sometimes a few short feedings an hour even. It is perfectly normal if a baby wants lots of short feedings rather than a smaller number of larger feedings.
 

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Adding my $.02---In the Womanly Art, it talks about different nursing styles. Some babies are gourmets, tasting, pulling off to express approval, then going back on. Some are nip and nappers, a little milk, a little sleep, a little more milk. Some are barracudas, you know what that means: on, eat like a ravenous beast, off and they're done for 3 hours.<br><br>
The first two babies will be comfort suckers, liking closeness and very orally fixated (hint: get a sling and learn to wear a baby like a pocketbook). The 3rd category baby will be more of a self soother, lower in oral fixation, or perhaps preferring his own thumb for comfort, refusing to nurse unless he is really hungry.<br><br>
Then you have the storage capacity of the mother's breasts to take into consideration. Some will deliver a lot at once, some deliver less quantity per feed, so need to nurse more often throughout the day.<br><br>
If your baby loves to suck for comfort, but you have lg storage capacity (lg supply or overactive letdowns), he may get overfull on your milk. Offer one breast only for a 2-4 hour periods, so he can get lower volume. Express only to comfort, from the fuller side while doing this, as your supply regulates.
 

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Ione<br>
Yes I do hold him a lot. That's a really good point. He always wants to be held. I wear him in my Ella Roo all the time, and when I put him down, that's when he gets fussy. He falls asleep best when I am holding him too, but I can't hold him in the prone position otherwise he'll go for my breast at all times and I can't hold him inward with my baby carrier for the same reason. He does the same thing to my sister when she holds him inwards. Sometimes when I think he wants to eat and I pick him up, he stops fussing. So I guess it's just a really good work out. I still have a few pounds to lose from the pregnancy<br><br>
Momtwice,<br>
You're right about the overeating. I too could eat all day if it were the good stuff. Still just a little concerned about the hindmilk. I know it will all work out in the end. I would never deny the baby what he wants so I hope if he gets smaller meals more frequently, he'll get what he needs out of the milk. For now, I have no major problems and I don't really stress about the pediatrician, because he can say what he likes....ultimately its up to me and my husband.<br><br>
mindela
 

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Discussion Starter · #18 ·
<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/duh.gif" style="border:0px solid;" title="duh"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shake.gif" style="border:0px solid;" title="shake"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/blush.gif" style="border:0px solid;" title="blush"><br><br>
... guess I overreacted a bit. But, Min, I'm glad you are here and can get some input from other mamas and LLL leaders etc.<br><br>
Thanks for helping my sis and nephew everyone! Sorry, Min.<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love"><br><br><br>
xo pammi
 

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welcome! my baby sister's name is mindy <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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And just for weight context, 18 pounds at 4 months doesn't sound excessive/"fat" to me. Ds#1 was 8#12oz. at birth and 21 pounds at six months, exclusively breastfed. At 12 months he was 24 pounds...a negligible increase in the second six months. My DO (bless his soul) explained that breastfeed babies gain weight on a bell curve over the course of he first year...a lot in the first six months, petering out over the next six months for an average weight gain equal to a ABM fed baby over the course of a year. A ABM fed baby should gain gradually over the course of 12 months to weigh somewhere in the same range as a BF baby of the same age at 12 months.<br><br>
SO, if your baby were fed ABM, in all likelyhood he would be gaining weight too quickly for his age. But because he is breastfed, you and your doctor should expect a spike weight gain in the first six months and a slow weight gain in the next six months as baby becomes more physically active and more interested in the world (which means less time to nurse...too busy <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> ).<br><br>
Just some "food for thought" (pun intended) <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 
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