Frustrated & Confused..teething, formula, pumping etc...

[@llli*hanks.momma]

Hi! I've read through the posts to try answer my questions, but im still at a loss, every baby is a different! First off here are my sons measurements.
Birth- 8lbs 20 in
2 week- 8.12 lbs 21.5 in
2 month- 12lbs 24 in
4 month- 14.9lbs 27in (this was 2 weeks ago)

At his 4 month appt. doctor recommended we start formula because he is "skinny". I told her I was going to try and increase my supply and would get back to her at his 6 month check up to let her know how it was going. He also is still not sleeping through that night which i know is normal but my ped thinks its because hes not getting enough. He goes 3 hours between feedings at night except for the last one before he wakes up he will go 2 hours.

I went to the nutrition store that we shop at and talked with the owner who was a LLL leader. She said that he may appear to be "skinny" but he is just very long (his dad is 6'10" btw). She suggested to try and increase the fat content of my milk to see if that helped him sleep longer/ gain some weight. Per her advice i have been eating a tablespoon of coconut oil every morning and night (bleh) and have tried to add good sat. fats to my diet. He is still sleeping on the same schedule when bf. Sometimes he will go 4 hours though (woohoo).

I work 4 days per week, my schedule varies but im normally away from him from 8-10 hours and I bartend so its normally at night. I pump every 3 hours and I also pump after his morning feedings. I have a medela advanced pump in style and I always double pump. I almost always get at least what he's eating when im away, sometimes less but my morning pumps make up for it. He does fine with the bottle and drinks anywhere from 10-15oz. He seems to sleep more when he is bottle fed. He will always go a 4-5 hour stretch and then its back to 3 hours (once im bf-ing him). When I bf him sometimes he will be done in 5 minutes sometimes it takes 45.

Also within the last 2 weeks he has gotten one of his bottom teeth. He is not nursing as frequently and is very fussy (teething im assuming). Im trying to keep my supply up so I put him on the breast as often as possible but it usually goes something like this: go into his nursery where it dark, try and get him to latch, he arches his back, turns away, pushes away, I force my breast into his mouth and squeeze a bit of milk out, then he latches and sucks for a few minutes. After that its near impossible to get him back on until the next time I try.

Sorry for the crazy long back story, I just want to be thorough...here are my questions:

How can I know for sure he is getting "enough"?
Does teething cause a decreased appetite?
I do not want to start formula, is there a way to make sure he is getting the hind milk?
At almost 5 months, is sleeping in 3 hour stretches at night "normal"?
When I pump I feel like my milk looks watery, and sometimes it has a green tint, is that normal?
Should I start cereal before 6 months? (My mom & mother in law are hounding me about it and swear it will help him sleep but everything i've read says that's not always true.)

Thank you in advance

Karlie

[@llli*hanks.momma]

I should also mention I have been taking fenugreek, using brewer's yeast and eating oatmeal for breakfast to try and increase my supply.

[@llli*rakoonz]

It sounds like you're being hit with a double-whammy of the "four month fussies"/distractability and teething, which probably account for the decreased interest in nursing during the daytime. We had to go into a darkened room and lie down and be boring. I had to pretend I was sleeping to get him to settle to nurse/nap for a while there. I'd be willing to bet the frequent night-waking is due, at least in part, to the teething. When my son is working on teeth, sleep (day and night, his and mine) is the first thing to go out the window. When it seemed like he was waking up in agony (like waking up banshee screaming) I'd give him a little ibuprofen/tylenol once we waltzed around 'til he calmed down enough. It really sounds like your baby is acting exactly like almost all other babies of his age.
Another mom on here was saying you could start baby out on the breast used at the end of the last feeding to get the fattier milk out of that breast first. But really there is no dividing line between foremilk and hindmilk; rather a gradual increase in fats, since they cling more tenaciously to the milk ducts, so they come out a little slower. And honestly, it sounds like your kiddo is destined to be lean.
It is recommended to wait until 6 months to start solids, to allow baby's gut to finish sealing. Also your milk (yes even the "foremilk") is far superior in nutrition to cereal, since your breastmilk is the perfectly balanced meal for your baby. Here's what kellymom has to say about cereal and sleeping and point 3 has a link to early solids introduction risks: http://kellymom.com/nutrition/starti.../solids-sleep/

[@llli*rakoonz]

I'd also add that many of us don't use cereal as a first food even after 6 months, but rather do "baby-led solids" and introduce real whole foods like fruits and veggies once baby meets the requirements for starting solids: http://kellymom.com/nutrition/starti...s/solids-when/

[@llli*mommal]

Oh gosh. Since when is being 14 lbs at 4 months "skinny"? If you check out this weight-for-age chart for breastfed baby boys: http://kellymom.com/images/growth/growthcharts.gif you'll see that your baby has been cruising right up the 50th percentile for weight. That is perfectly normal. Remember that there are healthy babies in all percentiles- you don't "fail" the growth chart because you're under the 50th percentile. Statistically speaking, there are just as many healthy babies in the 1st percentile as there are in the 99th, just as many in the 25th as the 75th, etc.

If you have a particularly long baby, it may appear that your baby is skinny for his height. This is OKAY. Babies do not have to have their height and weight percentiles match exactly. My kids, whose dad is 6'9", have generally run in the 95-100th percentile for height but only the 75-85th in weight. There's nothing wrong with that- I mean, as a culture, don't we idolize the people who grow up to be tall and slender?

To answer your specific questions:
- You know a baby is getting "enough" if he is continuing to grow in height, weight, and head circumference, producing enough wet diapers, appearing satisfied after nursing, and meeting his developmental milestones.
- Teething can cause either decreases or increases in nursing. It depends on the baby.
- Don't start formula, and don't worry about the "hindmilk". There's no such thing as hindmilk or foremilk. You only produce milk. The milk your produce at the beginning of a feeding is relatively low fat and high in sugar, and as the feeding goes on it becomes increasingly creamy- but there's no abrupt transition from foremilk to hindmilk. And even the milk that comes out at the very beginning of a nursing session contains fat and fat-soluble elements, so there's no way that your baby could be eating a diet of "skim" milk.
- 3 hour sleep stretches at 5 months, and well beyond, is entirely normal and has nothing to do with baby not getting enough. my kids were always huge and never slept more than 3 hours at a stretch until they were close to a year old.
- If you wanted to gain weight, what would you eat more of: milkshakes, or rice crackers? Rice cereal does not increase weight gain and does not make babies sleep through. Solids should be introduced starting at 6 months.

[@llli*worknpump]

I agree with mommal - 14 pounds at 4 months doesn't sound too skinny to me! I was just looking back at DS's records because this was bugging me. He was 7pounds, 9 ounces at birth, and at 4 months was 13 pounds, 10 ounces (25th percentile) and 24 and 1/2 inches long (75th percentile). So, he was also long and lean. Our ped is very old school but is also breastfeeding-friendly and NEVER expressed any concerns about his weight. I don't think you need to start formula. It might even be worth meeting with another ped who is more breastfeeding-friendly.

His sleep sounds totally normal for his age. And teething and distractability can be a real issue at this age.

Hang in there and don't be afraid to get a second opinion. You're doing great!!

[@llli*lllmeg]

I am glad mommal looked at the chart I also thought the weight gain sounded fine. I have a long & lean son too. Personally if I ever had any concerns my baby was not getting enough to eat I would figure out a way to nurse more as bmilk has so much healthy fats compared to anything else

[@llli*hanks.momma]

Thank you for all the advice!! I truly appreciate the moms on this forum! One more question ! As a first time mom having an unplanned pregnancy I feel like my mom and mil are all over me when it comes to feeding son sugessting formula and cereal. My mom told me tonight that she feels bad that he's not "getting enough to sleep through the night". I personally have read every bf book I can find. All say my situation is normal but because my doc doesn't agree they think I shouldn't be "going by the books". Any suggestions for dealing with them? My husband and I were both formula fed after 3 months and "slept through the night". But I know every baby is different. Im working full time, in school full time, my dh is out of the country so I'm on my own essentially. I haven't had more than 3 consecutive hours of sleep in almost 5 months and I'm exhausted. BUT I know bf is best for my ds. How can I explain that to them?

[@llli*djs.mom]

Don't try. You don't need to defend yourself. Just listen and smile and then change the subject. Make it sound like it's not up for debate. Next time one of them asks about STTN just tell them FINE and then ask about THEM. You don't have to explain yourself. Formula fed kids sleep longer because formula is harder on their systems and take LONGER to digest and the baby has to creat MORE WASTE since they don't absorb NEARLY as much of it. THe milk does not adapt and grow with the baby so their bodies have to work much harder to absorb it. Nothing about your post sugests ANYTHING is wrong. Your baby is steadily gaining and growing and on track to double his birthweight by 6 months. Which is FINE. Also 3hour stretches are well within the normal range and I know women who would give their left eye to get 3hours of sleep in a row! Your doing great. If you are getting enough wet diapers in a 24hour period, you know your baby is getting enough to eat. 6-8 wets in a 24hour period and continual weight gain means your baby is getting enough. The end. Don't stress. And don't supplment. You can do it Mama. You ARE doing it.

[@llli*mommal]

with Shelley. Some subjects just have to be "we will agree to disagree, let's not have any more discussions".

Just FTR, it is totally normal for both breastfed and formula-fed babies to wake frequently throughout the night, because babies have shorter sleep cycles and awaken more easily than adults. Frequent waking doesn't prevent a baby from getting "enough" sleep. Adults wake in the night, too. We just don't remember it because we're good at putting ourselves back to sleep- but babies and young children often need assistance to go back to sleep.

Formula isn't the cure for frequent night-waking. I still remember seeing my formula-feeding friend with terrible bags under her eyes- she'd been up all night with her baby, and because he didn't nurse (he was a terribly frustrating non-latching baby), she had to rock him, and make bottles, and do all sorts of things that breastfeeding moms don't have to do. We can just roll over, pop a breast in baby's mouth, and everyone drifts back to sleep. If you're co-sleeping, that is- which I suggest trying if you're having to get up to nurse multiple times per night.

If your doc doesn't agree with your nighttime parenting choices AND is giving you a hard time about your so-called "skinny" baby, find a different pediatrician. And stop telling your Mom and MIL about what the pediatrician says about sleep- you're just handing them ammunition to use against you.

Oh- and for sleep issues I recommend reading Elizabeth Pantley's book "The No-Cry Sleep Solution". It has breastfeeding-friendly suggestions for getting a baby to sleep longer and more independently.