Babies: 3 - 6 Months

EBFers Question/thoughts. (XP in May 2011)

So DD had her 4 month appointment on Monday and she weights 13 pounds 6 oz.

At her 2 month appointment she weighed 12 pounds 7 oz. 

The Dr was concerned about her not gaining enough weight. Her height and weight are both in the 29th percentile, so it's not like she's super underweight, the Dr just wanted it to go up and not just taper off on the chart. 

I only BF & don't pump. I've tried pumping but only get about 1 oz when I do so it's not worth it. I feed on demand and she doesn't seem to be hungry or extra fussy after I feed her but she does get very distracted when she eats (eating for a couple minutes, then whipping her head around, then going back for a minute & so on....)

Aaaaaaaaaaanyway, the Dr wants me to start giving her rice cereal and oatmeal. I asked her if that would mess up my supply even more (if that's the issue) because she would be getting fuller from the rice and oatmeal. The Dr said no.

I'm so torn. I really wanted to just EBF for the first 6 months but if she's not getting enough, I don't want to be hindering her growth. I guess I should also note she's still waking up every 3-4 hours at night to eat. I always feed her when she wakes up but I also heard that means she's not getting enough during the day.

Thoughts? What would you do?
BabyFetus Ticker

Re: EBFers Question/thoughts. (XP in May 2011)

  • She's gained weight and the 29th percentile is entirely appropriate. She doesn't seem hungry after meals. Did I get that right?

    I think  your doctor is causing you needless anxiety.

    2 girls and a dog
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  • my lo was 11# at 2 month appt, 13# at 4 months.  Our pedi has made no mention of her being underweight or introducing any foods.  He actually asked us to hold off til 6 months if we can.  
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  • imageheather_09_15_07:

    She's gained weight and the 29th percentile is entirely appropriate. She doesn't seem hungry after meals. Did I get that right?

    I think  your doctor is causing you needless anxiety.

    She seemed really surprised that I was only BFing. Normally the nurses and doctors and supportive but she was really pushing me to give her formula and solids :/

    BabyFetus Ticker
  • I wouldn't worry about it.  Just keep doing what you're doing.  I also EBF and when I pump I hardly get anything, but I think that's because I've established a good milk supply for my daughter and not my daughter+pump.  If I were to keep pumping on a regular basis+bfing then my milk supply would go up and I would pump enough milk to stash, but I don't pump on a regular basis so that's why when I do pump there isn't much there.  I think maybe you're in the same boat.  Don't give your daughter anything that your not comfortable with.  If she's happy and having enough dirty diapers then I'm sure she's fine.  Maybe find a new pedi?

    DD born 6.13.11 at 37w5d

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  • imageheather_09_15_07:

    She's gained weight and the 29th percentile is entirely appropriate. She doesn't seem hungry after meals. Did I get that right?

    I think  your doctor is causing you needless anxiety.

    this.  we just returned from our 4 mo appt, my little guy is in the 25% for weight, doctor was not concerned one bit.  and I asked about rice cereal, she said to wait until 6 months unless he seems not satisfied after BFing.  I'm in no hurry to start cereal or solids so it was good to hear.

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  • Waking up every 3-4 hours is normal for a breastfed baby.  It does not mean she's not getting enough.  29th percentile is perfectly normal.  Maybe pump right after she eats and see if you get anything...if there's anything left in there that means there was plenty there and she ate til she was full and stopped.  I think the distracted eating is normal for this age...there's so much new stuff to see! :)  I don't think giving her cereal would mess up your supply, you're supposed to supplement her normal feedings with the solids, not replace any feedings.  I agree that the doc seems to be causing you undue stress.  Sounds like you're doing great! :)
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  • Keep in mind, too, that bf babies are typically on the thinner side.

    I wouldn't start solids until you are ready. Don't let the doctor guilt you into anything.

    2 girls and a dog
  • I think you're right about messing up your supply more. I'm all for listening to pediatricians on most things, but 95% seem clueless when it comes to breastfeeding. I'd have asked how something relatively low-cal and low fat (rice cereal and oatmeal) was meant to help my LO gain faster when breastmilk is high cal and fatty. You have a 29 percenter -- nothing wrong with that! I just will never get why pedis freak about 29% when they'd never freak about 71%. Babies have to make up both ends of the chart!

    Baby Birthday Ticker Ticker
  • imagekaydogger:
    imageheather_09_15_07:

    She's gained weight and the 29th percentile is entirely appropriate. She doesn't seem hungry after meals. Did I get that right?

    I think  your doctor is causing you needless anxiety.

    She seemed really surprised that I was only BFing. Normally the nurses and doctors and supportive but she was really pushing me to give her formula and solids :/

    That does not sit well with me. All of the doctors, nurses, etc. I have ever talked with really pushed breastmilk over formula. As a PP mentioned, if she is growing proportionately and doesn't seem hungry, then it seems like your pediatrician is making you worry for no reason. :-/

  • feeding her solids shouldn't impact your supply as you should feed her AFTER she has nursed.

    also, do you always only ever produce 1 ounce when pumping? maybe you are not producing enough  milk and although she eats frequently isn't consuming enough food? talk to a lactation consultant about it

  • imagedaniella2727:

    feeding her solids shouldn't impact your supply as you should feed her AFTER she has nursed.

    also, do you always only ever produce 1 ounce when pumping? maybe you are not producing enough  milk and although she eats frequently isn't consuming enough food? talk to a lactation consultant about it

    Just for the record, pumping does NOT indicate supply. Some women can't pump enough, and some women can't pump at all, period. If you've only ever been able to pump an ounce, I'd bet money that you're one of the women who can't pump enough. If you used to pump a lot and now can't pump much, that's another thing altogether, but that doesn't sound like your issue.

    The only things that indicate a good supply are a happy baby who isn't frustrated at the breast, a growing baby (and once a BF baby hits about 4 months, growth slows considerably), and lots of wet diapers.

    Baby Birthday Ticker Ticker
  • I thought it was only an issue if LO was close to being in the 10%?  I think if LO was in the teens that would be when it is something to watch out for, not when LO is almost 30%.

    Also, what growth chart was your doctor using?  They are different for BF and FF babies.  WHO is for BF, AMA I believe is for FF (I THINK...I'm not looking at Kellymom to back me up on this, but I think that's what I remember).  If your doctor is looking at the wrong growth chart that would probably explain his concern.

    But remember, someone has to be at a low/middle/high end of the growth spectrum.  That's how we get the %....I don't think there's really any cause for concern.  I think your LO weight is in a really good place on the spectrum.

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  • https://kellymom.com/nutrition/solids/solids-when.html#myths (scroll down to "Your baby is small so you need to start solids")

    Since you did say she gets distracted when feeding, have you tried nursing in a dark, quiet room? But really I wouldn't worry about it unless she starts plummeting down the growth charts - and your pedi is using the correct BF-only growth chart... which from the sound of his attitude toward BFing, I wouldn't be surprised if he isn't.

    I don't know why this is, but many many pedis seem to be totally clueless about BFing and the effects certain actions will have on your supply/ability to continue nursing. So I take what ours says in regard to feeding with a huge grain of salt.

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  • My ds was a whopping 12 lbs at his 4 month appointment and in the 5th percentile.  My doc wasn't worried though because he has steadily stayed on the curve and is having enough wet and dirty diapers, seems satisfied after eating, is still fed on demand, and only eats once and more often not at all over night. 

    She said I could start him on  cereal if I wanted, but definitly to start him by 6 months.  I wouldn't worry too much about your child if you feel they are getting enough.

    Baby Birthday Ticker Ticker
  • Just my two cents, but I wouldn't worry and I wouldn't do anything you're not comfortable with.

    When we went for our 4mth. LO was 75% for length and 40% for weight.  Pedi (who is also a LC) was a little concerned about that because there was such a spread and suggested nursing in a dark room so he's less likely to get distracted.  She also said to try some purees after one or two feeding a day to help him get a few more calories. (he's not really interested in the purees unless he's just tasting it on his own hands, so for now I'm laying off of them)

    She said that as long as I was nursing first it wouldn't have an effect on my supply.

    imageLilypie Second Birthday tickers image
  • Thanks ladies. I think I'm going to get in touch with a lactation consultant & feed her as I normally do and try giving her a bit of rice cereal w/ breast milk after her last feeding before bed. We'll see how it goes ;)

    BabyFetus Ticker
  • My DD only gained 12 ounces between her 2month and 4 month check-ups.  She is now a healthy 3 year old though she continues to be lean.  You might want to check out Dr. Jack Newman (google him, he has a web site).  He's a well known lactation expert in Canada.  He has suggestions for increasing your supply if that is an issue. 
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