Happy Mothers Breastfed Babies
Results 1 to 9 of 9

Thread: Various Questions after 4 Month appt

  1. #1
    Join Date
    Jul 2011
    Location
    Maryland
    Posts
    71

    Question Various Questions after 4 Month appt

    So, long story (hopefully) short, my son is a peanut. He has been a slow gainer since birth. His weight started in the 5th percentile, dropped to the 3rd around 3 months, and now he's in the 2nd. (He's always been around the 25% for height.) I've always worried about the amount he eats because he's always been a sleepy eater. Even now, at 4.5 months, 75% of the time I can't do anything while feeding him because my free hand has to be used to mess with him to keep him awake. I've consulted an IBCLC (who I found to be a little lacking, but we don't really have the money to see another). I've tried switch nursing, co-sleeping, different holds, more bottles of EBM (at the LC's suggestion - but son had less interest in nursing then), fewer bottles of EBM, finger feeding, walking around while nursing, offering more often, offering less often, dark rooms, light rooms...Ok, you get the point that I've tried all kinds of things! I feel like nursing is still consuming my life...yet my son is still having trouble gaining weight. Am I doing it wrong? Am I hurting him by being stubborn and refusing to give formula? He is a happy, active guy. He rarely cries to eat. He's never done cluster feeding. He's just really laid back (which I blame on his father's genes! ). I pay attention to diaper output, but it's hard to tell what exactly is a great diaper, especially since we use a few different kinds. It seems like his output always meets the minimum.

    ANYWAY, on to the real questions! We had his 4 month check up yesterday with a new pediatrician (because his old one moved out of state). Her basic assessment of him is that he's healthy and developmentally right where he should be. She even said that I should try to worry less about his size. (She obviously doesn't know me well if she thinks I'm capable of worrying less!) However, she suggested we think about starting him on rice cereal for three reasons: 1. weight gain 2. iron 3. to help him sleep longer. I didn't tell her that I'm fine with him "only" sleeping one five-hour stretch at night. Then again, I didn't tell her we co-sleep for the other part of the night, either! So, what's the deal? I thought I'd read that rice cereal will not help with weight gain more than BM. I've also read that it doesn't help with sleep necessarily. My real question is about iron, though. She seemed to think he needs the boost of iron to help grow faster. Is this true? I was considering skipping rice cereal all together for various reasons.

    I'm feeling lost. Everywhere I turn, I find conflicting information. I want to do what's right for my son. Any thoughts on rice cereal or iron consumption in bf babies? Any more suggestions on how to get him to gain weight? Any thoughts on how I could RELAX a little more about his weight?! I'll include a weight history just for fun.

    Oh, finally, the LC suggested not offering the breast as often so he'll be hungrier when I do offer. (She suggested every 2.5 hours but earlier if he seemed really hungry.) Any thoughts on that?

    Thanks for any help or support you can give!

    Weight history for my son:
    Birth: 6 lbs 4 oz
    5 days old: 5 lbs 10 oz
    2 weeks: 6 lbs
    4 weeks: 7 lbs (weighed on produce scale )
    6 weeks: 8 lbs 4 oz
    2 months, 1 week: 9 lbs 10 oz
    3 months: 10 lbs 10 oz (weighed with onesie on and with diaper that should have been changed first!)
    3 months, 2 weeks: 10 lbs 13 oz
    3 months, 2.5 weeks: 11 lbs (on LC scale)
    3 months, 3.5 weeks: 11 lbs 4 oz (LC scale)
    4 months, 3 days: 11 lbs 9 oz (LC scale)
    4 months, 1.5 weeks: 11 lbs 11.5 oz (new pediatrician's scale)

  2. #2
    Join Date
    Apr 2008
    Posts
    4,047

    Default Re: Various Questions after 4 Month appt

    I agree with the Pedi in that you can stop worrying about weight gain but I don't agree with anything else this new paediatrician said

    Babies shouldn't get solids until around 6 months because their stomachs just aren't ready until that point. They should also be meeting other criteria before you offer solids (which includes cereal). Here are the criteria: Developmental signs for solid readiness

    As for iron, breastmilk contains everything your baby needs (including iron). After 6 months you could check his iron levels and begin to offer solid foods that are rich in iron if there is a deficiency or a concern, but foods that are fortified with iron (cereal for example) are not the best way to increase his iron anyway. Fortified iron is harder for baby to absorb and foods naturally iron rich are much easier.

    Your baby is steadily gaining and following a nice growth curve His output is fine which means he's getting enough. He may just be little Keep in mind that the charts are just a guide and there has to be babies at the 0 and 100 percentiles for the chart to even function

    I would not offer less or use any timed schedule. Feeding when your baby shows hunger signs is the best way. This way of "on demand" feeding encourages the baby to self regulate and be in control of his own eating. You're doing a GREAT job mama

    And no. You are not hurting him by refusing to give formula. You are helping him. There are no indications that your supply is low and he is growing well. Keep on keeping on
    Last edited by @llli*sch.mommy; September 11th, 2011 at 09:18 AM. Reason: spelling... as usual...
    ~Jenn~


    mother of 2 boys!
    08/14/98~~03/20/08

    Birth: 7lbs 12oz, 1 year: 22lbs 11oz
    until he self-weaned 4 days before his third birthday ... still on occasion ... and happily

    ************************************************** ************************************************** *****************
    People need to understand that when they're deciding between breastmilk and formula, they're not deciding between Coke and Pepsi.... They're choosing between a live, pure substance and a dead substance made with the cheapest oils available. ~Chele Marmet

  3. #3
    Join Date
    Jun 2006
    Posts
    4,894

    Default Re: Various Questions after 4 Month appt

    PP said everything I wanted to say. I have never given either of my children rice cereal. My daughter was a slow gainer and even now at 5.5 years old only weighs 35 pounds. She is perfectly healthy and lean. Not everyone fits into the mean, which is why it's the mean and not the only number.
    If you obey all the rules, you miss all the fun. - Katharine Hepburn

  4. #4
    Join Date
    May 2006
    Posts
    23,809

    Default Re: Various Questions after 4 Month appt

    Jenn nailed it. The only suggestion I would add is that you might want to think about baby vitamins, if you have any reason to be concerned about your baby's iron status. I have read that babies who are iron-deficient can grow slower than they should- so if your baby is lacking in the iron department, a dropper of vitamins would probably fix that without you needing to mess with rice cereal or early solids. So, how likely is it that he's deficient? Not very! As the PP said, breastmilk generally contains all the iron a baby needs. However, there may be reason to suspect that a little additional iron would be a good idea, even prior to 6 months, if mom is anemic or the baby was premature (because a baby's iron stores aren't fully stocked until term).

  5. #5
    Join Date
    Jul 2011
    Location
    Maryland
    Posts
    71

    Default Re: Various Questions after 4 Month appt

    Thanks for all your support and suggestions! My son was born at 37.5 weeks, so maybe iron is an issue for him? We've been giving him Vitamin D drops. The pedi suggested switching to (or at least alternating with) PolyViSol for the iron. I think we'll do that. I always thought I'd exclusively bf for the first 6 months, so I think the suggestion of cereal made me feel a little bit like a failure.

    My son's never really shown signs of hunger (except occasionally crying). For the first 6 weeks of his life, I had to set my alarm for every 3 hours to feed him because he never cried (or even woke up!) to eat. I tried offering less often recently, like the LC suggested...but he seemed to eat with the same amount of sleepiness or disinterest, which meant he was actually getting less, so I went back to offering more often. He's just a laid back eater, I guess!

    Are there any links about the cereal? My husband - who usually doesn't trust doctor's 100% - would probably be more willing to put off or skip cereal if I had some articles to support not giving it to my son now (or ever). It's not that he's completely in favor of the cereal, but he wants to make sure my son is getting everything he needs. Articles about the "completeness" of bm might be helpful, too, I think.

    Some days I just feel like I'm doing everything wrong, you know? Thanks for the encouragement.

  6. #6

    Default Re: Various Questions after 4 Month appt

    I think we all have those days sometimes, but you are doing wonderful! We have just started doing some solids, but nothing in the cereal department, and mostly it is just practice for him. At the moment he only eats solids once a day, and only because he really demanded to be included in eating (stealing food from my plate, and yelling about it) and he was also ready with other eating readiness milestones. On a side note we let him eat earlier in the day because not only does eating in the evening not help him sleep better, but he sleeps worse I'm assuming because of all the digesting it takes for solids.

  7. #7
    Join Date
    Jun 2011
    Location
    Southern NM
    Posts
    712

    Default Re: Various Questions after 4 Month appt

    Here are some links. What to note in particular is how well iron is absorbed from breastmilk and how poorly it is absorbed from cereal.

    http://kellymom.com/nutrition/vitamins/iron.html
    http://www.pediatricnews.com/article...296-6/fulltext
    I am Erin--happily married to the nerd of my dreams for 15 years
    High School Science Teacher
    Mother to: Thing 1 9/23/01, bf 15 mo, diagnosed with stage 4 neuroblastoma 1/29/02, officially cancer free for ten years in August 2012
    Thing 2 6/6/05, bf 12 mo, obsessed with dynamite
    Glowworm 2/18/11, bf 15 months and counting

  8. #8
    Join Date
    May 2006
    Posts
    23,809

    Default Re: Various Questions after 4 Month appt

    Articles on the completeness of breastmilk:
    http://www.pediatricsdigest.mobi/con...16/3/e432.full (Note the following: "Human milk expressed by mothers who have been lactating for >1 year has significantly increased fat and energy contents, compared with milk expressed by women who have been lactating for shorter periods. During prolonged lactation, the fat energy contribution of breast milk to the infant diet might be significant.")
    http://www.ncbi.nlm.nih.gov/pubmed/261532 (Note the following: "although the composition of breast milk is not constant from 1 mother to another or at all periods of lactation or even hourly throughout the day, the mean concentration of protein, fat and lactose in milk from women lactating for more than 1 year was the same as milk composition during the 1st year...Calculations to show the nutritional value of breast milk in the 2nd year indicate that it may supply 1/3 of all protein needs.")
    http://www.cdc.gov/breastfeeding/faq/index.htm (Note: "Even when babies enjoy discovering new tastes and textures, solid foods should not replace breastfeeding, but merely complement breast milk as the infant's main source of nutrients throughout the first year. Beyond one year, as the variety and volume of solid foods gradually increase, breast milk remains an ideal addition to the child's diet.")

  9. #9
    Join Date
    Jul 2011
    Location
    Maryland
    Posts
    71

    Default Re: Various Questions after 4 Month appt

    Thank you so much for all the links! I have looked through some of the first links, and I will continue to gather information from the additional ones. It seems my husband trusts my judgement on the matter of cereal, but the more information I have, the better I'll feel about the decision.

    Now if only I could figure out how to worry less about his weight...

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •