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February 2014 Moms
kak808
member
who would I talk to about making a feeding schedule/strategy?
kak808
member
I just came back from LO's 4 month appointment and her weight has dropped to the 23 percentile, whereas she'd been consistently around 50% 
She hasn't gained any weight in the last month, but grew quite a bit length-wise. The pedi was a little concerned and said that we should give her bigger bottles and solids. However, I can't pump enough to give her bigger bottles, so he said to supplement with formula. I also didn't really want to start her on solids so early. He didn't give any more guidance, despite my husband and I asking a lot of questions. I don't really know how to go about figuring out how to do this and would prefer someone to give me some help. Who would do this? Should it be the dr? Since he isn't helpful, should I talk to a lactation specialist? Or should I just suck it up and do some trial and error?
She hasn't gained any weight in the last month, but grew quite a bit length-wise. The pedi was a little concerned and said that we should give her bigger bottles and solids. However, I can't pump enough to give her bigger bottles, so he said to supplement with formula. I also didn't really want to start her on solids so early. He didn't give any more guidance, despite my husband and I asking a lot of questions. I don't really know how to go about figuring out how to do this and would prefer someone to give me some help. Who would do this? Should it be the dr? Since he isn't helpful, should I talk to a lactation specialist? Or should I just suck it up and do some trial and error? 
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Re: who would I talk to about making a feeding schedule/strategy?
Mom to Lily and Colin!
And how to help weight gain: https://kellymom.com/health/growth/weight-gain_increase/
Ditto CodyPup's questions about how often is LO feeding?, bottles/breast?, how much in bottle?, how much is she sleeping at night? have you ever done a weighted feed? Ideally you'd do as many as you can in a 24hr period to see how much LO is taking in over a whole day since the volume can vary at any one feeding. Generally, you can't overfeed a BF baby (at the breast) but you certainly can feed LO too little - meaning not often enough. While feeding on-demand is generally best practice, sometimes LO just doesn't ask to eat enough and you have to offer more frequently to ensure she's nursing enough.
You may want to seek out an IBCLC who can help you trouble shoot what's going on and how to best help. I'm sorry your Dr wasn't more helpful. That sounds incredibly frustrating.
Link to searching for LC:https://www.ilca.org/i4a/pages/index.cfm?pageid=3337
So, LO is in DC 3 days/week. On those days, I BF in the AM and twice in the PM and she gets 3 5 oz bottles while I'm at work. I pump in the AM and 3 more times at work with the occasional PM session as well. This gives me usually 15-20 oz for the next day. On my off days, she gets 6+ feedings and I feed her at least every 3 hours, but more if she's hungry or if I need to do so in order to make sure she gets 6 feedings in.
It seems like I'm producing enough so I'm not really sure where I'm going wrong!
Today I gave 6 oz bottles to DC and she ate them up. I also tried to give extra BM after the first evening feeding, but she only took about an oz.
I'm thinking I'll just give DC 3 formula bottles to offer after the BM and also offer it after the first evening feeding. I have a ton of milk first thing in the AM and she nurses to sleep at the last feed of the night so I think I'll leave those feedings be. The days I'm home I'll offer formula for the same feedings as DC I guess?
LO had been sleeping through the night until the past month, but even when she's up I don't think it's hunger...although I have successfully nursed her back to sleep.
There's an LC at the pedi who I may talk to, though I wasn't totally impressed with her previously. I've never done a weighted feed but would be very curious. You do that with the LC, right?
Hmm I'm curious about the growth charts... Still, even if she's a higher percentile on the EBF chart, she's still gained literally no weight in the past month so that's provably bad regardless. Oddly she's been at DC for the past month -- not sure if/how that could play a role...
Thanks again for all of the support and responses!!
A few more questions - has she been back for another weight check? When she was weighed, was it same state of dress? For example, my pedi always weighs LO naked, to avoid potentially skewing weight with a wet diaper, kwim?
How's her growth been prior to this past month? I know you mentioned her length was growing, what about head circumference increasing? Meeting milestones?
IMO - you have to look at the whole baby, not just one weigh in when evaluating. A consistent pattern of lack of growth would be alarming, but if everything other measurements are increasing and only weight has stagnated (resulting in drop in percentiles but not actual weight loss) I would do a re-check in a week or two and see if ounces have increased before immediately assuming there's a problem. It's entirely possible that she is doing just fine and just had a big growth in length and will now be adding ounces.
You can consult with a LC and they will help with weighted feeds/etc, but you can do those at home too. I have an infant scale from amazon that was around $50, it measures to the half ounce and LO always weighs within an ounce of what she weighs at the pedi so it gives me a good idea of how she's doing between appointments. Although I'd recommend outside of doing weighted feeds, only weighing LO 1x a week because you'll drive yourself nuts if you weigh her daily and see the up/down pattern that is totally normal in weight.
Think of it this way, a normal adults can weigh +/- 5lbs given how much they've had to eat/drink/etc. Scaled proportionally down for babies, if you weigh them daily, you'll see fluctuations in the ounces up/down.
You can always try to get more feeds in as well, a lot of Moms have success with a dream feed boosting slow weight gain. So say you put LO down at 8pm, before you go to bed at 10p gently get LO and feed her without really waking her.
I'm confused why a pedi would want you to supplement if you have enough milk.
Mom to Lily and Colin!
She's been weighed a number of times recently because she was sick, so this isn't a fluke. Her weight has been pretty consistent for the past month or so over probably 5 or 6 weigh-ins.
She's always been weighed naked. She was slow gaining weight right after birth but was gaining ok after that and was consistently ~50% from months 1-3. Height increased to 92% and head circumference has remained consistently big at 89%