Re: Low supply, asked to supplement, baby refused formula
Welcome to the forum!
Can you post your LO's weight history? I'm wondering if the issue here may be the charts your doc is using. The are several sets of charts in use these days. The are the old CDC charts, developed using data from primarily white, mostly formula-fed babies, and the newer WHO charts, developed using data from an ethnically diverse population of breastfed babies. The reason why the charts matter is that breastfed and formula-fed babies grow in different ways. Breastfed babies tend to gain weight relatively quickly during their first 6 months or so, and then slow way down in their second 6 months. Formula-fed babies have the opposite pattern; they grow slowly at first and then escalate in the second half of the first year. Measure a breastfed baby on a formula chart, and that baby will tend to appear to grow "too fast" during the first 6 months and "too slow" in the second 6 months.
Even if your baby is being measured on the right charts, weight is only one measure of normal growth. It's very common for breastfed babies to drop some percentiles, even on the breastfed baby charts, as they become more mobile and start devoting more calories to things like rolling, sitting up, crawling, etc. For example, both my girls zoomed up to the 95-99th percentiles on the weight charts between 0-4 months, and then dropped back to the 75-80th as they became more mobile. Many babies drop farther than that, and it's okay as long as they continue to grow in height and head circumference and to develop at a normal pace.
The drop in pump output you describe sounds very normal. 5 oz per pump session is in the overproduction zone. Most moms whose supplies are well-matched to their babies' demand make about 1.5 oz per hour. And most moms do find their their pump output declines with time, especially once their babies start solids and their milk intake decreases a little.
As long as you are not pregnant, not taking a new form of hormonal contraception, nursing on demand, and nursing at least 8 times a day, and the baby is continuing to grow in height and head circumference and to develop at a normal pace, I don't think I would be concerned. I might offer to nurse a little more often- older babies often become very distractible and forget to nurse enough- but I don't think I'd be offering formula just yet.
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