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Breastfeeding
EBF babies have slower weight gain??
I thought I remembered seeing something on here a while ago about how an EBF baby initially has quicker weight gain than a formula fed baby, but then it slows down sometime around 4-6 months compared with a formula fed baby. In conjunction with that, I also think I remember something about how a lot of pediatrician's use CDC growth charts but should be using WHO growth charts when tracking the growth of a EBF baby. Can anyone confirm this?
Reason I'm asking: My son just had his 4 month appt yesterday He weighed 13lb 9oz, which was the 30th percentile. At his 2 month appt he was 11lb 11oz, which was the 50th percentile.
The pediatrician was concerned that he had dropped from the 50th to the 30th and told me to start solids right away. I was originally planning on waiting closer to 6 months.
For whatever it's worth, he always seems satisfied after nursing and has plenty of wet and dirty diapers per day. Guess I'm just trying to figure out if I should be worried about his weight gain or not. I really struggled with breastfeeding my older son, due to him having a milk protein intolerance and me not being able to eat enough calories to make enough milk. While breastfeeding seems to be going MUCH better this time, I am paranoid about having enough of a supply given my previous experience.
Thanks for any and all advice!
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Re: EBF babies have slower weight gain??
Totally totally normal!!
If it makes you feel better, Eleanor went from the top of the charts (10 pounds) at birth and has dropped ever since. She was around 75th at 2 months, 50th by 6 months and at her 15 month was only 21 pounds so down below 25th. Our pedi has never been concerned as many babies change percentiles over time. Better to go by baby's behavior and output.
Check out the WHO charts - you may still see a drop in percentiles but again that in and of itself is not a concern!
Breastfeeding Counselor with Breastfeeding USA
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Yes--there is some misinformation about this point. Actually, according to the WHO charts (that should be used for EBF babies), an EBF baby should gain more weight, more quickly until 6 months old. At that point, the EBF baby should level out and not gain weight as quickly as a FF baby.
So, if your doctor is using a CDC chart to tell you percentiles, then your baby would actually be in an even lower percentage on the WHO (EBF) chart. But really, the large drop in percentiles (on either chart) is what is concerning your doctor. They only get to see you every 2 months, so he is worried that by the next visit there will be a serious problem. One of the girls on my BMB has a baby that went from 50% at birth to 25% at 4 months to 7% at 6 months--still EBF (and the doctor finally informed her she should supplement with formula/increase solids--I would be pissed at my doctor if he let it go for so long without saying anything). Low weight babies are much more prone to get sicker faster--they don't have any fat stores to carry them through an illness, which can cause problems to escalate. Also, fat is what builds a healthy brain--so your doctor's concern shouldn't be easily dismissed.
If your pediatrician suggests solids, and your LO seems ready, why not go ahead and introduce them? There are several recent studies that show that babies who are introduced to solids earlier are less prone to allergies--that is what my pediatrician told us (and cited the studies so we could read them), when she recommended C start solids around 4 months.
Not gaining weight at a certain rate is not a problem per se--but if your doctor is concerned and has made a recommendation and you decide not to follow it based on what you are reading on the internet, maybe you should also find a new doctor, since it seems there is an issue where you don't trust your doctor to make good recommendations regarding the health of your child--to me this is a big issue.
This kind of advice worries me. Your LO has dropped percentiles enough that YOUR doctor is worried. We here on an internet forum do not know enough about your individual situation to know why he is concerned--just that he is concerned. If you go against your doctor's advice on this issue, then you are saying that you don't trust his medical advice and don't believe he has the best interest of your LO at heart. Based on that, you should probably get a new doctor if you just think "yeah, you tell me I should be worried and should get more calories in my LO, but I am not concerned, so I am not going to do it." If your child gets sick and has dropped to a low weight percentile, it will be harder for your child to fight off that sickness. Further, low-weight babies are at higher risk for mortality, according to the WHO. Just be careful and ask your doctor more questions if you are confused. The PP talked about a drop from 25% to 15%, and said her doctor was concerned about just a 10% drop. Just because her baby made it through fine, doesn't mean your baby will have the same outcome if you disregard your doctor's concerns as meaningless.
Many many many doctors are not taught about bfing as much as they should be, especially if they've been out of school for awhile.
Plus food before one is for fun! The main source of caliories should be from bm at this age.
Op I'd call and ask the dr why they were worried and why you should start solids. Many dr say four months because it's what's been said forever, where six months of ebf has been shown to be better.
I would see if you can make an appointment for a month to see if your lo is gaining or not if you want to wait and see.
Original poster--please don't listen to this advice. You will never see any doctor or medical professional say that "food before one is just for fun." Children should be getting "some" calories from food and trying new tastes/textures well before their first birthday. If they don't, they will not only likely be picky toddlers, they will also have a much higher risk for food allergies.
As for the poster's comment that "the main source of calories should be from BM at this age," I totally agree. But the problem is that the doctor has identified that you are simply not producing sufficient BM right now to meet your baby's growth needs, and that your LO has slipped very far down on the growth chart (not "following the curve"). In other words, yes your baby needs more milk/formula/calories from solids--and your doctor has advised you of this. While, in some circumstances, doctors are not concerned with this (i.e., maybe height has also slowed down, or maybe baby was born at a large weight, but then levelled out at a new growth curve after 2 months, etc.), your doctor IS concerned. None of us can morally/ethically tell you that your baby doesn't need any more nutrition than you are currently providing.
Please talk to your doctor now if you want to about the "why" behind his concerns, but, in the mean time, start supplementing according to the doctor's suggestions or go find a new doctor, if you do not trust that your doctor has your child's best interests in mind. Don't wait an entire month, as suggested by the previous poster (who is not a medical professional). As I said before--a low weight baby is much more prone to getting sick, in addition to not getting the brain food that it needs to thrive!
Additionally, for what it's worth, our pediatrician is an attending professor at our state's Children's Hospital, in addition to having a private practice. She recommended we start solids at 4 months, due to very recent studies that are showing a much reduced chance of food allergies the earlier foods are introduced. So, previous poster's statement re: starting at 6 months is no longer the most "up-to-date" recommendation.
Again, I really ask you to follow your doctor's recommendations--or find another doctor whose recommendations you trust. Don't take the word of random people on the internet to disregard your doctor's instructions--when these internet people have not seen your LO, don't know your LO's history, current health status, etc.
Thanks everyone for all the advice. I really do appreciate it.
Sooner1981: I honestly appreciate how much you care for me and my LO, considering you don't even know us or our situation
I absolutely love my pediatrician and have no intent of changing anytime soon. Do I think he is a great doctor and the best person to care for my child when he is sick? Absolutely. Do I think he is the most pro-breastfeeding? Nope.
AmyG: Thanks for letting me know what questions to be considering and asking. I'll go do some research on the growth charts and see what that looks like. My LO has been sleeping 10-11 hours each night so maybe adding some more nursing sessions during the day would be helpful. For whatever it's worth, he seems to be meeting all milestones just fine - is starting to sit up tripod style, rolls both directions, smiles, giggles etc... he seems perfectly content for 2-3 hours at a time between feedings. And, after every feeding I am able to still hand express more, so I really don't think it's a supply issue. I appreciate your insight and advice!