Breastfeeding

Dr. sent me home with formula at 9 mo

We went for our 9 month appt today and got sent home with formula.  LO is 17lb 12 oz.  I was told he was in the 7th percentile, he had previously been in the 15th.  When I asked him if the chart was for all babies or just breastfed babies, he said it was all babies.  LO is healthy, meeting all milestones, doesn't have fat rolls but still has chubby thighs and cheeks.  

I went back to work at 3 weeks (self employed) and still have a good freezer stash and was planning on breastfeeding until 1 year.  LO has not been to quick to start solids, actually, he hardly eats them at our house, but eats good at daycare.  

The Doctor wants me to add formula to the pumped breast milk to get extra calories.  If it were just me and LO at the appointment I would have left the formula in the office, but DH was along.  I am actually thinking about taking it back.  So I come to the almighty bump breastfeeding board for advice.  

Should I need to add formula to pumped breast milk? 

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Re: Dr. sent me home with formula at 9 mo

  • imagemexicolombiana:
    Nope.  I would also switch pediatricians asap.

    Ditto.  The only time I have seen formula supplements recommended is when a child drops off the charts or for preemies who need to make up for time lost in the womb.

    Check out the average weight gain information on Kellymom, Here:  https://kellymom.com/bf/normal/weight-gain/

    Also, the growth charts for breastfed babies differ, here:  https://kellymom.com/health/growth/growthcharts/

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  • I don't know sounds like a tough call. I would maybe call back for clarification. I'd want to know exactly what the concern is.  

    I know our pediatrician looks for answers if the kids have dropped in percentile. To our doctor it shows that "something might be up" because maybe the child isn't growing steadily.

    Has your baby been sick? Teething?

    I tend to side with doctors on things. In my opinion they have a better overall picture of health. And, if I was you, that is what I'd want an answer to.

    I will say and I really don't mean to "compare" but my 5 month old LO is 17 pounds. And, while it may seem big, my LO isn't even at the top of percentiles.

  • I'd recheck the percentiles on the WHO charts. https://www.who.int/childgrowth/standards/weight_for_age/en/index.html

    Then I'd find a new pedi.

    I wouldn't add formula. If YOU are concerned, I'd try to add an extra feed per day. At that age, a dream feed before you go to bed can be an easy way to do it.

  • I wouldn't do it! I would absoultely switch pediatricians. Some kids are just smaller...God made them that way!!! That doctor would have to give a better reason than just that he is at the 7th percentile in weight. Are there other signs of malnutrition? If not I would absoultely not do that.
  • What the pediatrician is saying is that your LO needs more calories. If you think you can do that through BM, then add a feeding, or a few ounces of pumped milk. Do a weighed feeding to get a sense of how much he is taking in. A lot of women experience a significant drop in supply around 9mos, so it is possible that the extra calories need to come from other milk (frozen/formula) or solids. You pedi was just suggesting formula for the health of your LO.

    slow weight gain is not the same as a drop in percentiles. Even if they'e been using the cdc charts, it's still a drop in percentiles, which means slower than average growth.

  • Thanks for all the replies. LO did have rsv 3 weeks ago and was eating very very poorly ( I was waking him at night to nurse). He just started STTN 8 days ago and I know that has cut his milk consumption, but he is eating better.  I think I will start a dream feed.  

    After posting this I did get him to eat some puffs, a couple bites of avocado, and 1/2 package of pur?ed food.  That is a huge meal at our house. I think I will take the formula back along with tho WHO charts. I'm not going to switch family doctors, I am educated enough to know when to listen and when to question it.  Everyone has opinions, and sometimes they won't be the same as mine.  

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  • Hmm, my 9-month old was about 18 lbs at her appointment and she was listed as being in the 30th percentile.  I don't know why doctors think it's absolutely necessary to feed our children so much!  If your kid is happy, meeting milestones and otherwise healthy, there's no reason to add formula if you don't have to.  This is where I would probably switch to another pedi.
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  • imagetheresat858:

    No. And a fall from the 15th to the 7th percentile is not a significant fall.  I would not add formula.

    If LO could benefit from additional calories, I would focus on solids with higher calorie content like avocado, banana, etc if LO will eat them.  Maybe try adding a nursing session if you can too.

    This.  You're not that far from having LO's diet be mostly table foods with some BM or whole cow's milk.  Not sure why formula would be any better than more solids or more high calorie solids.

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  • I would take a look at the WHO growth chart for breast fed babies an then make a decision. The one by the CDC that most doctors use does not take the weight of a breast fed baby into account.
  • imagemexicolombiana:
    Nope.  I would also switch pediatricians asap.

    This. LO is getting to the age where a pattern will develop. Like some people are tall and lean, others are short and chunky... DS went from 80 to 50 about then. His pedi said to just make sure he's eating well and is healthy. He said I could  try adding formula, but it wasn't necessary. DS is now 6yrs and is very tall and lean. He weighs 50lbs and is 51" tall. He's the tallest kindergartener in his class, but he is also one of the skinniest. I'm also guessing your little one is more active now, which should slow weight gain as well.



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  • imagetheresat858:

    No. And a fall from the 15th to the 7th percentile is not a significant fall.  I would not add formula.

    If LO could benefit from additional calories, I would focus on solids with higher calorie content like avocado, banana, etc if LO will eat them.  Maybe try adding a nursing session if you can too.

    This!  

    I wouldn't use formula.  Try to increase BM intake during the day too.

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  • On the WHO chart, your LO is just a teensy smidge higher than the 15th percentile for 9 months. Your doctor needs to be using the right charts based on whether baby is FF or BF. You should check the WHO chart to see if he's been 15th percentile so far as well on it - if so, everything is great! It sounds like he is doing just fine. My DS is only 5th percentile and I feel like the doctor thinks I'm doing a horrible job feeding him, but I think he is just small - go by the baby's disposition and milestones.
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  • DS was only 1 lb bigger than that at 1 year.  I'm not finding it all that alarming.  I would add higher calorie foods and no go with the formula.  I hate how Drs push it.
  • What I don't get in instances like this is why the doctor says, "You must feed formula now!" and no effort is made to work with families-to see if there really is a problem, what may be causing it and what possible solutions there may be. Obviously we all want our children to grow well.  And it would be great if we could work with our health care providers to make sure everyone is healthy.  It's troubling that the choice is always, follow the doctor's orders or doctor shop. What happened to communication?

    Personally I would not jump right to formula.  I'd nurse more frequently and stop feeding puffs.  Feed a snack with some calories, not just air!  Formula definitely has it's place, but in a 9 month old who is otherwise healthy I think there would be other options to try first.  

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  • imagetheblyaneys:
    I wouldn't do it! I would absoultely switch pediatricians. Some kids are just smaller...God made them that way!!! That doctor would have to give a better reason than just that he is at the 7th percentile in weight. Are there other signs of malnutrition? If not I would absoultely not do that.

    I agree with this! My LO is in 5th percentile, has been for a while, he's 6.5 months. Pedi isnt concerned, they are happy Im BF. Every baby is different. Not every baby has to be chubby to be healthy!

    I would call pedi back for clarification. GL!

  • imagepumpkinwife07:

    I will say and I really don't mean to "compare" but my 5 month old LO is 17 pounds. And, while it may seem big, my LO isn't even at the top of percentiles.

    You can't compare babies, though.  My LO is nearly 8 months, and was only 15 lbs, 2 oz when he was weighed at an appointment 2 weeks ago. Yes, he's only in the 4th percentile (which is  a huge milestone for us as he fell off the charts around 4 months), but he's meeting all of his developmental milestones, and loves to eat. He's just a small kid - except for his head, LOL. He's crawling, sitting up, loves to stand (with help, obviously), "talks" to you, smiles and laughs, picks up things, etc. Every baby gains weight differently, and falling 7 or 8 percentile points after being sick shouldn't be a huge cause for concern.

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