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Houston Babies
Need advice--BF, low baby weight and supply issues
We had Allie's 4 month appt today and I am feeling a little down. I should have listened to my insinct about a month ago telling me that she wasn't gaining enough weight.She only gained an ounce from 2-4 month appts and is below the 5th percentile for weight but still tracking on the 25th for height, I am feeling like it may be nearing the end of me BF her and I feel so bad. I feel like her weight issues are all my fault and that I haven't been giving her what she needs. She is a happy baby and is meeting her milestones so far. She has lots (at least 5) of wet diapers and usually at least one poop diaper a day. Any advice would be appreciated!
Problems that could be causing the weight issue:
1) Supply-I have no idea if she's getting enough BM when she eats. It's hard because you can't see oz like on a bottle. I used to wake up really engorged but now that she's been sleeping a solid 12 hours for about the last month and a half, I have felt my supply decreasing. I feel like she doesn't get enough in that last feeding of the day and have been giving her a bottle of frozen or fresh milk to supplement. I spend my days lately feeding her and pumping. I am guessing the supply dropped since I was feeding or pumping 7-8 times a day until about 2 months to about 5 times a day during months 2 and 3. We were using nipple shields for latch issues, but I finally weaned her off of them this weekend. When I used to pump, I could get about 5-6 oz total from both breasts in a 15 min session. Now, I am lucky if I get 3 oz. Any ways to increase supply? I try to eat oatmeal a few times a week. I haven't tried Fenugreek because I don't think I would remember to take 3 pills 3 times a day, but I guess I could try it if it would help.
2) Schedule-She typically eats about 5 times per day and I give her one bottle of 5-6 oz of fresh (if I have enough) or frozen expressed milk. When she eats from the breast, she feeds for about 40 minutes and sometimes still acts hungry. I typically was feeding her from my left side because it has always produced about twice as much as the right. The doctor said that her feeding this long for 5 times a day expends a lot of her energy so that could be another reason for not gaining enough...like she was burning all the calories she was ingesting.
3) Reflux--For a while she was spitting up several puddles after every feeding and crying like she was in pain. We put her on Prevacid for a couple of weeks and things seemed to get better and she wasn't spitting up as much so I took her off Prevacid. Doc said maybe she just wasn't getting enough to eat which is why it seemed the reflux just went away. I may need to put her back on the Prevacid if the spitting up continues or it seems like she is in pain again after she eats.
Her pedi wants to do a weight check in 2 weeks. It seemed like from our conversation today that if she doesn't gain and my supply isn't adequate, I don't have much choice but to supplement her with formula. I have such mixed feelings....it seems like it would be easier with formula but I feel like since I made the decision to BF and have done it this long, I need to keep trying.
Thanks for reading this very long post!!
This discussion has been closed.
Re: Need advice--BF, low baby weight and supply issues
First of all, don't feel down. I know that's easier said than done. I went through the exact same thing around 4 months with DD, I too felt very bad that she wasn't gaining weight. I felt as though I had done something to cause this. After really sitting down and having a heart to heart with myself I realized that though BF was something I'd been pretty adament about, I took her weight gain (or lack thereof) as a sign that it was time for me to stop. Afterall, I made it to just over 4 months BF and that's longer than some people can. I knew in my heart of hearts that I'd made the effort. My body wasn't producing enough milk and there wasn't much I could do to change that. Switching over to formula wasn't nearly as hard as imagined it would be. When I first thought about having to do this, I was literally losing sleep over it. When the time was right for me/us, I just took the plunge. I continued to pump so that she could have equal amounts of breast milk as formula each day and I slowly started taking the breast milk out of her diet until she was strictly on formula.
I am, by no means saying that you should stop BF. I am, however just letting you know that we went through this and this was our solution. You are her mother and you will know what to do and it will be the best solution for both of you, I'm sorry that you are dealing with this and I hope everything works out.
Another side note, I know that most pedi's are very big into weight issues, but it is very possible that she is just a skinny kid. DH is, and has been for all his life (he's 6'4" - 135 lbs) and YES! I do feed him.
For years they put him on weight gain meds, and did series after series of testing b/c no one could fathom that this was normal, after everything no doctor could find anything wrong with him and to this day he is completely normal aside from being reallllllllly skinny! I also have a 3 year old neice who is this way. Good Luck!
I'd rent a baby scale first thing so you could see how much exactly she's getting in per feeding. That's going to tell you a lot to start.
Also, try pumping a few minutes after each feeding to tell your boobs to produce more and that might help.
j+k+m+e | running with needles
First of all - this is NOT your fault!
Second, I don't have much advice but...try the Fenugreek. I take it with my meals so maybe keep it in the kitchen? Also, drink a LOT of water. I can tell on days that I'm not getting enough - I'll go from getting 4-5oz while pumping to only getting 3.
One way I think you can increase your supply is to pump after she eats. It seems like your supply may have dropped, but it will take a while to build it back up. I've also heard about "power pumping." You pump for 10 min, take a 10 min break and repeat for an hour. It's supposed to build your supply but it will take a few days/weeks.
Hopefully she'll start putting on weight, but I'm also in the camp that a little formula (as a last resort) won't hurt. But that's a personal decision.
Good luck!
I'm so sorry that you're dealing with this! I had supply issues as well but quit at 5 weeks. DS was still jaundiced at his 2 week appt and had lost weight instead of gaining, which is when I found out my supply sucked. I tried to get it up with no luck and finally decided it was too hard on me and that we just needed to switch to formula. It was a very difficult decision. If you decide you want to keep trying to BF, I'd start pumping like crazy, drink lots of water, take fenugreek, eat oatmeal, etc. I'd offer her pumped breast milk if you have it or formula after every feeding to see how much more she takes. In the end, all that matters is that she's growing and thriving, and if that means she has to take some formula, then that's ok. Not that you said this, but I know I felt this way - you're not a failure if she needs supplemented formula or if she ends up just on formula. My thoughts are with you, I know how hard it is to find out your supply isn't good and being torn on what to do. It sucks. No matter how it turns out, you're being a great mommy trying to make sure your baby is getting enough to eat. Best of luck with your decision and improving your supply.
Also, try to get in with a LC and do a weighted feed to see how much she gets when she eats.
BFP with no treatment!
Hugs! Went through this with both kiddos. We bought a scale and would 1. weight before and after feeding to see what she was getting and 2. per pedi weighed a naked baby at the same exact time every day. Like us they will fluctuate but it was a good way to track.
Like pp try pumping after you nurse. It will trick your body into producing more if you indeed need more. Also, do you have a huge freezer stash? At one point the pedi advised me to try to give Abby a little extra from a bottle after I nursed to make sure she was getting enough.
I was very adamant about not switch to formula and was able to make it work. However my pedi who is very pro-bf was on my side. Had she ever said to switch to formula I would have. Make sure not to stress yourself too much which I know is easier said then done. It will effect your supply too though. Ultimately you need a happy mom to have a happy baby.
Hugs again and good luck!
Crazy Christmas Kids!
Ditto the baby scale. Also, I had supply problems and tried EVERYTHING under the sun. What worked for me was 2 tablespoons of brewer's yeast and 2 tbsp of ground flaxseed per day. I put them in Crystal Light, stirred vigorously, and gulped. What was left on the bottom, I had to eat with a spoon. It made for a VERY gritty and disgusting drink. However, it was worth it to me to do whatever I could to continue to BF. I also nursed whenever I could, and even made my daughter try to nurse even when she didn't want to. Seems like a bad idea, but after only a couple of days, it worked itself out. If I had just supplemented like about a million people suggested, my body would never have known how much milk to make.
If I had listened to everyone and given up, I would not still be nursing my daughter at 15 months. Trust me, I know it is EXTREMELY hard, but it is totally worthwhile. Good luck!
Granted I'm not a doctor, but this sounds sketchy at best. Breast milk is very high calorie and I don't think laying there and sucking would expend that much energy. FWIW, this was a similar schedule to my daughter and when I increased the number of feedings, I think it helped. If you're not working, Don't give her a bottle-freeze that and nurse all you can. Pump extra feedings if you want, but the baby gets more than the pump can, so the more you actually nurse, the better.
Pretty much since birth we supplemented with formula, very little in the beginning, and gradually more so as he has gotten older. We are at over 7 months now and he gets about half BM and half formula. I felt like there was no harm in supplementing, especially if it eases some of your stresses relating to ebf. Good luck to you and little Allie - from another Allie
(lurker un-lurking to add my two cents) We went through this exactly...the latch issues, reflux and low/no weight gain! I sooo know how you feel. My lo only gained 3 oz in between her 2 and 4 month appts. She also had reflux and had stopped spitting up as much (which I thought was great, but it was in fact due to not getting enough to eat.) I felt horrible, my supply was tanking and so we had to supplement. We were able to do this successfully for a few months and finally we switched over to formula only. I am by no means saying you need to supplement, just telling you our situation, and hoping it will give you some insight on yours. I know you are so stressed, the fact that she has lots of wet diapers is a good sign! GL!
<Hugs>
I don't know what you should do. Probably, check with the doc in two weeks and go from there. Try not to be hard on yourself or her in the meantime.
If it helps, Lucas slipped to the 5%ile for a weigh in. The doc was very grave about it and gave me the same spiel. Sure enough, next time he was weighing in his usual 10%ile. I know that the men in my family tend toward string beans as boys, so I was less worried than the doc. She eventually accepted that Lucas was a 10%ile person -- and as long as he trends there, she's ok these days.
It sounds like Allie might be getting enough. Sean was eating three 4-oz. bottles at school at Allie's age, and then nursing poorly (one breast) at home. It sounds like she is taking more than that. He has managed to gain in a modest fashion - not as skinny as his brother but no spring pig.
Can you suggest a hybrid method if the doc decides you need to supplement? Nursing some sessions and feeding others?
Whatever you decide, you've done a great job. When making up your mind about giving up feeding, remember it will be a hormonal adjustment. You might want to make yourself ready for that. For some, it's easy, for others harder.
I like to use this site to get some ideas about quantity: https://wholesomebabyfood.com/solidfood4to6montholdbaby.htm
<hugs to you and that baby girl>
Big hugs to you guys!
I haven't been in this situation (thankfully. i know i am very fortunate to have avoided any big BFing issues) so I can't offer any real 1st hand advice. I would definitely check out kellymom.com and definitely get a scale. that way you really can know how much she is eating.
as far as supplementing, you know i am about as big a boob nazi as you can get BUT i also know that some formula does not erase the benefits of BFing so if you have to supplement, it's ok. you can continue a good routine with nursing and give some formula as needed. she will still get all the benefits of nursing!
but i also have to say that those growth charts kind of irk me. the way the numbers are presented is sometimes scary and confusing. what being in the 5th percentil means is that she is bigger than 5% of babies and smaller than 95% of babies at this age. it doesn't mean she is malnourished or anything. sometimes its hard to keep those numbers in perspective. i have also found that many pediatricians are not well educated about BFing so, while i know we have doctors for a reason and they are good at a great many things, i would definitely call an LC for some "professional" advice.
again, BIG HUGS! she is beautiful and happy and that is what is most important.
I'm going through a very similar situation right now. I was very very adament about bf'ing----I didn't want him to ever have formula. I can't explain why, nothing has changed, but my supply has just started tanking in the past 2 weeks. Like you I used to get about 6 oz. when I pumped, now I get 2. I do everything the same, I just don't understand what's happened. I think some of it has to do with working, it's hard to pump at work.. Yesterday and today I had to supplement, I gave him a 4 oz bottle yesterday and a 4 oz today. He's done fine with it, I thought it would be worse than it is. I still pump for his regular feedings but I know that pumping isn't a good substitute. I just know that I'm not getting nearly enough to send to daycare and feed him in the evenings so I had to give in. It sucks but I know that I've come this far and don't intend to stop but I had to feed him.
One thing to keep in mind... Your supply will fluctuate. And it's SCARY, I know! About two weeks ago, I was having similar issues. Hormones and stress can affect your supply big time. While I didn't have AF start visiting again... I'm certain it was just "that time" and my body responded with a lower supply. I had this happen with Kaitlyn also. It gets better... where the dip isn't as noticeable, but the first few with K were very frustrating!
Now, two weeks later, I'm pumping more than I was before! (Although, I do eat oatmeal at work every day and I drink "Milkmaid" tea before lunch everyday... This is what I did with Kaitlyn, so I started the same routine to keep my supply up when I started pumping 5 days a week because I knew it worked/helped before)
Everything else the other ladies have covered!
Hugs! I know what you're going through since I had low supply and we had to supplement since day 2 in the hospital. My milk did not come in for 5 days and Rena had jaundice and lost so much weight the first week. I continued to BF and supplement until she was 3 months. I had such low supply that I could only pump 2 oz at a time. And around 3 months I pretty much had no supply. I was so upset about it and felt like a failure. But once she was on formula and thriving, I felt much better about everything.
I hope you are able to continue BF and the scale is a good idea. But just know that if you do have to supplement or stop BF, you are not a failure! You BF for this long and that is a huge achievement!
Good to know! I just had to take more milk to dc because he didn't have enough. I will be eating oatmeal every day now! That makes me feel better, and honestly it really could be stress------I don't know if I've ever been this stressed.
I just discovered city boards and I thought I'd de-lurk because we had a similar experience, although it was early on. At DS's 2 week appointment we learned that he hadn't gained any weight from the week prior. In that time my supply had come in and really started to leave. We were able to turn everything around but it did require some formula supplementing (more in the first few days but very much tapered off within a week, gone in two). We are now EBF.
I met with a LC and she had us on a feed, supplement, pump schedule. WIth each pumping session the supplement became more BM and less formula. Essentially I gave him back whatever I pumped from the previous feed. Like PP said, drink tons of water, oatmeal and almonds are great to add to your diet, and nurse as much as possible. And definitely rent a scale if you can to do before and after weights. You may also want to consult with your pedi or a LC to figure out how much of a supplement she should be getting for her age (I put both pedi and LC because our doctor wasn't very informative when we had our issues. He just said to supplement with BM or formula but didn't give much direction otherwise; the LC was more helpful in that regard).
It will require work but I really think you can get back on track! GL!