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Thread: How to Supplement a Breastfed baby/Feeding cues

  1. #1

    Default How to Supplement a Breastfed baby/Feeding cues

    Our pedi is really just not worried about my baby. But the IBCLC I've been seeing at the health department is a little.

    I want to try to put some weight on her, but how do I do that?

    She's 4 months and 12 lbs, 14 oz. She mostly just plays with a bottle nipple. She has good output, but she's just gaining so slow. One week, she only gained 1.5 oz. I can really only nurse her well in her sleep.

    Should I offer a bottle of expressed milk after a couple of feedings? She's never taken more than 2 oz. from a bottle. Sometimes I think she's got the hang of it but then she doesn't. Should I just try 2 oz. a few times a day?

    Also, the IBCLC has me feeling like I don't know my baby. I wait for her feeding cues. She will be really seriously mouthing her fist and just be antsy. And I'll realize it's been a little while since she nursed so I'll offer. I'd really like her to eat every 2 hours, but they told me that's too often, but then they don't really like her weight gain.

    She will fuss at the breast if I can get her on there alert and will suck and pull off, suck and pull off, and will sometimes pop off when my milk letsdown. She resists even being held in the nursing position, so I can't do nursing up hill where I recline.
    So all those little feedings make me feel I should offer more often.

    I'm dealing with too many issues here!

  2. #2
    Join Date
    Sep 2011
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    381

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    If your little one has good wets/poops, good weight gain trends, your pedi is not concerned, and she seems happy/content and is meeting milestones, then why supplement? it sounds like you may be getting poor advice.
    You know your baby best.
    I found my girls got very antsy around 4 months while nursing. They realized the whole was moving around them and wanted to be in on the action. I had to nurse without the tv on and sometimes in a dark/quiet room. It took a few weeks but got better. Have you tried different positions, locations while nursing?
    It sounds like you are doing great!
    Full time working Mom to 3, DH is my hero as a SAHD:
    DS July'09, nursed for 12 weeks
    DD1 & DD2 April'11, tandem nursed for 16 months

  3. #3

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    When I say pedi is not concerned I mean, she didn't say we need to begin doing weight checks or anything like that. We do suspect some reflux and she started some zantac yesterday. I KNOW that she's been a slow gainer because of the weekly weight checks at the IBCLC. And they are getting kinda nervous.

    She started refusing the breast around 11 weeks and was found to have a sore throat. I suspected reflux, but another doctor and friend talked me out of it. Now, she's 4 months old and I think again that's what we're dealing with and wish I would've listened to my gut, because now my baby will hardly nurse during the day. I've tried all positions. And she will only nurse in a quiet room side lying during the day a little and in her sleep in my lap at night.

  4. #4
    Join Date
    Sep 2011
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    381

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    I don't have any experience with reflux, maybe head to one of the other forum threads (health?) to ask mamas with experience.

    How often is she nursing during the day/night? Are you currently supplementing, pumping, etc? have you tried any herbs to increase milk supply?

    What has her weight gain been like?
    Full time working Mom to 3, DH is my hero as a SAHD:
    DS July'09, nursed for 12 weeks
    DD1 & DD2 April'11, tandem nursed for 16 months

  5. #5
    Join Date
    Jun 2009
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    6,562

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    You should listen to your instinct and feed her as often as you see those cues. It sounds like you said that she wants to nurse every 2 hours but "they" said that is too often? If I were worried about weight gain, I would nurse every 2 hours through the day and not allow more than one 5 hour stretch of sleep overnight.
    Tracie

    Mommy to
    Lilah 10/08 nursed 25 months
    Beatrix 01/11 nursed 30 months

  6. #6
    Join Date
    Jun 2008
    Location
    Landof2toddlers, Oregon
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    3,113

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    Every 2 hours is normal. And a baby with any possible weight gain issues should be at the breast as often as possible. Your LC sounds like she is giving different advice than anything I have ever heard. Listen to your baby and yourself.
    proud but exhausted working mammy to two high needs babies

    • my surprise baby: the one and only D-Man born 3 weeks late (5/5/08) at 9 lbs 14 oz and 21.5 inches, and
    • the shock H-Girl born about a week late (10/7/09) at 8lbs 15oz and 20.75 inches.


    If I am here I am covered in baby (probably two) and fighting for control of the keyboard.

    Family beds are awesome

    Wondering if you have PPD? Take the screening and see your doctor. You deserve to feel better.

  7. #7
    Join Date
    May 2006
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    21,271

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    Every 2 hours is normal, and frequent small meals are often very helpful to reflux babies because breastmilk going down neutralizes the acid that's coming back up, and because a baby is less likely to have an upset tummy and a big reflux if the amount in the tummy is smaller rather than larger. And then there's the weight gain issue- if your baby has trouble gaining weight, the best thing is always to feed him/her more often rather than less.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  8. #8
    Join Date
    Mar 2012
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    98

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    In your other posts you had said that your baby struggles with your let down/ flow, the slow weight gain is probably to do with this as she finds it difficult to nurse! My baby also has reflux because of my fast milk flow. I give her infant probiotics which seem to have helped, but make sure that they are dairy free. I have been taking sudafed for my oversupply and it seems to have calmed down slightly, therefore my baby is able to feed a little better which seems to be making the reflux worse as she is getting too much too fast. I have been giving her a quarter of a dose of colic calm before each feed today and it seems to have helped so far, so it could be worth a try. If your baby is suffering from reflux, she will want to nurse because sucking helps keep the stomach contents down, but she won't want loads of milk pouring down her throat as that will make it worse! If your oversupply is under control, then she should be able to have a more relaxing nurse after the initial gushing, so when you can get her to feed, be sure to leave her to comfort nurse for as long as she likes so that she also relates a good experience to the breast, this , I have found, also helps with the pain that my baby experiences after getting too much too fast at the beginning of the feed. If you are struggling to get your baby to nurse, then I certainly wouldn't give her a bottle unless it is the Medela supplementary feeding system (which requires the baby to use the same technique as breast feeding). I think, however, that cup feeding, spoon feeding or syringe feeding would be preferable as you don't want your baby to start having a preference for bottle over breast. Also, to help the reflux, I don't have dairy in my diet, that may be worth a thought. Feeding little and often is meant to be better for reflux, but with so much milk, I don't think it is ever possible for my baby to get little. I do try to note what times of day my baby will feed and then try to offer at around those times each day. It is really difficult to follow your baby's cues when they are reluctant to nurse because you think that they are hungry, but when you offer the breast, they refuse. However go with your instincts because they are usually right, be persistent, but not forceful as your baby needs to feel in control. When she does feed, even if it is for a short while, praise her and if she does pop on and off play with her in the nursing position. I hope some of these suggestions help, I know how hard and worrying it is!

  9. #9
    Join Date
    Jun 2009
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    5,770

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    I'd really like her to eat every 2 hours, but they told me that's too often, but then they don't really like her weight gain.
    This is the kind of stuff that gets me steamed. There is no way to nurse a baby "too often." Some babies are snackers and that is teh way they prefer to eat, so limiting nursing for those babies could lead to poor weight gain!

    If you can express enough milk to supplement with ebm, then why not simply nurse more if baby is willing? Nurse at earliest cues and also offer just when you feel like it. Nursing more would have the same result and, in many cases, be easier, than dealing wiht pumping and bottles.

    if the issue is baby is getting too little at the breast, like, the baby is unable to extract milk effectively, what is being done about that? Did the LC watch baby nurse, do some b4 and after nursing weight checks (more than one-one does not give enough info. I would suggest at LEAST three.) and have you been given tips on how to help baby get more at the breast, such as doing breast compressions? Is the health dept LC an IBCLC who is trained to help mothers nurse, or is she just looking at babies weight gain and freaking you out? I am sorry but the sad fact is some LC's are not that supportive or even knowlegable about helping mothers breastfeed. They have the same focus as too many doctors, and it becomes all about weight gain. Weight gain is important but it is ONE sign of good health. There are others, and the whole baby, head circ, length, developement/milestones should be considered when assessing the health of baby.

    Slow weight gain, if it is not related to a serious medical issue, or is not just the normal heatlhy growth pattern for that baby, is almost always caused by baby not getting enough breast milk. Babies don't get enough milk for 3 main reasons- 1) baby is not nursed often enough, 2) baby is not good at extracting milk, or 3) mom has low milk supply. It could be a combo of those too. OALD would have to be extremely severe to cause a baby to not gain well, it would have to be so bad baby is refusing to nurse. Usually OALD and oversupply have the opposite effect and baby gains rapidly. Also If you have oald or oversupply, the last thing you want to do is pump, as extra pumping would increase supply.

  10. #10
    Join Date
    Feb 2012
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    20

    Default Re: How to Supplement a Breastfed baby/Feeding cues

    My babe has reflux (4 months) and takes Zantac. We just had a reflux flare up so all the nasty symptoms were back! The main ones are giving nursing cues but pulls off after latch, then refuses by crying and arching. He cries even in any nursing position when he doesn't feel good so I don't fight him but I offer the breast frequently (every 5 or so mins) when I know he is hungry. It can take an hour or more to get to a calm nursing. I have a strong letdown so sometimes I say, here comes the let down so take a break if you need it, and I feel like he handles it when I do that. ??!?! I have also taken him off for the let down. It helPs to stuck to a schedule with the meds to prevent any flare up. And like others have mentioned, my babe nurses often, sometimes every hour or after twenty mins, or ??? Whatever he wants! Because he doesn't always eat a lot at once. It's like he self regulates so that he doesn't get too much and feel bad. We have managed to gain well and all that so hope that helps!! Good luck!

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