4 1/2 month old not gaining weight. Ped concerned!!

[@llli*mrsvitz]

My DS is BF mostly and had formula to supplement. He was 7lbs 8oz when he was born and left the hospital at 6lbs 13oz. He is now 19 weeks old today and weighs 12lbs .8oz. His Ped is concerned and said that he isn't getting enough to eat. So I was told that he needs to be getting 30-32 oz of BM/Formula in a 24 hr period and he needs to be eating solids 3 times a day. I am trying hard not to worry, but the Ped said that he looks great in everything else. He is hitting all milestones, is very happy and content, just too small for his age. I was told that after nursing that also need to give him a bottle of BM or Formula to make sure he is getting enough. He has atleast 6 wet diapers a day and poops at least once every two days. So I have decided that since I can't "count" his nursing sessions in with his daily oz, that I am going to exclusively pump for a while until this is under control. My schedule is going to be to pump at 6:45am, 9:00am, 11:20 am, 1:40pm, 4:00pm, 6:20pm, 8:40pm, & 11:00pm. Do you think this will be enough to up my supply?? I don't know how much I am getting in a full day because I have never exclusively pumped before?? I am taking Fenugreek also. Any advice would be helpful and please no mean or stabbing comments, I am honestly trying to have a happy and healthy baby. - Stressed out mom!

[@llli*mumtothomas]

I would strongly advise against exclusively pumping--it won't give you an accurate measure of what your baby is getting when he nurses, and your baby will do a much better job of boosting/maintaining your supply because he can remove milk much more efficiently than the pump can. I personally also would not worry about the solids issue; the general recommendation is to begin around six months, but the first six months or so of solids (so until one year of age) is just for practice/experimentation; nutrition is provided by nursing (or formula). My son was still not eating three "solids" meals a day by a year but was nursing well and getting what he needed there.

If he is growing well, meeting milestones, and has sufficient wet and dirty diapers, I would nurse on cue (minus the formula etc) only and see how things go. My son was 7 lbs 15 oz at birth, and at one year was just under 16 lbs, but was healthy, happy, and developing well. He was small compared to many other babies, and I worried myself sick about it, but he was growing the way he was meant to. If you can--and I know it's much easier said than done!--see how it goes with just nursing on cue. He will go through growth spurts that will boost your supply as needed, and sometimes it will be frustrating, but it sounds to me as if he's actually growing well. Hang in there!

[@llli*carm3]

According to Kellymom.com, exclusively breastfed babies from 1 to 6 months take an average of 19-30 oz per day http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/ so I think your pediatrician might be expecting quite a lot in terms of quantity. I'm not sure how much formula babies who are formula-fed need. Also, according to Dr. Sears, breastfed babies gain 1-2 lbs/month in the first 6 months http://www.askdrsears.com/topics/bre...ding-baby-gain. Looks like your baby is just on the lower end of that, having gained 5 lbs in 4.5 months.

Can I ask why/when you started supplementing with formula? did you have supply issues?

[@llli*browncow]

I'm sure someone will be along to ask some more detailed questions and give more detail than I can from my phone but from the info you've given I'm not sure why your Ped would be so concerned! If it were me I would consider a second opinion with a doc that's breastfeeding friendly! I agree with pp I don't think exclusively pumping is going to help and its going to be a ton more work than just nursing. If you really need to know exactly how much your LO is taking in there are better ways to go about it than exclusively pumping.

Has DS been following his growth curve on the WHO growth charts? Looking at his lowest and current weights I suspect he has since he's almost doubled in weight by 4.5 months! My DD hasn't done that yet at almost 10 months, though I think she's close. The big red flag I see is the three meals a day already though. The AAP doesn't even recommend starting solids until 6 months and even then it's a slow process! Not to say some kids aren't ready earlier but it's defiantly not necessary.

I know it's hard but at this point I would really try not to worry and just keep doing what you've been doing while gathering some more info. Hopefully there will be someone with some good links shortly. Unless theres something im missing I really think your Ped has you worried about nothing!

[@llli*blueberrysmom]

I could not agree more with PP!!!! No offense to your pedi, but I do not think you should follow those orders. First of all, like PP said, solids are recommended at 6 months and are just for exploration. Your milk has MANY MORE calories than solids. If you want to help your little boy gain some more, he needs more milk. Cereal is definitely not going to help, and will more than likely stopper him up at his young age.

Is there a reason that you started supplementing with formula? If it's just because you thought he wasn't getting enough, then there is a good chance that you can make all that milk yourself by increasing your own supply. This takes a little patience and more booby time, but on demand feeding works wonders! If you feed him, and then 20 minutes later he seems hungry, put him back on! That will cue your body to make more milk If you give him formula after you nurse him, that tells your body that you DON'T NEED to make that milk, and you do, right? I would assume you would rather so all nursing and no formula? Often times, pedi's don't know enough about nursing and they say you need to give supplements after nursing. This works against the whole process, so I would honestly get rid of the formula! When he demands more milk from you, your supply should rise! You will obviously do what you think is best for your baby, but I think that exclusively pumping would just add stress to your life. I know that when I have to pump for w/e reason, I stress about whether or not I can get what I need. I think adding nursing sessions to your day would help your baby boy more.

How often are you nursing now? Is he STTN? About how many sessions are you getting in in a 24hr period?

Seeing his diaper output and other signs, like a happy and healthy baby, sounds to me like your pedi is making you worried for nothing!

You can do this mama! If you are committed to nursing, I think you can make it work for you and your son

[@llli*djs.mom]

I don't want to make mean or stabbing comments but I think that moving away from EBF to Exlcusive pumping is a terrible idea and that it will certainly damage your breastfeeding relationship if it doesn't end it altogether!
If you want to up your supply bring your baby to your breast more and if need be, add in pumping sessions to get the extra bottles to supplement. But DO NOT move to exclusive pumping. Because it will take you TWICE AT LONG AT LEAST. Because you have to nurse the pump every time. And then feed the baby. And then clean bottles. And a pump. And if the baby doesnt' finish the bottles, THROW OUT THE MILK. So please, please don't do it.
And in reading yorur post you only have 8 pump times listed. And if that is how often you are feeding that could be the problem right there. If you want to up your supply you should be feeding your child AT LEAST 10-12 times in a 24hour period. So if you could fit an extra 2-3 sessions in in a 24hour period that could maybe give your child the calorie boost you need to tip the scale.

[@llli*mrsvitz]

Just to give you all the info you are asking;

Carm3 - I think my Ped is expecting alot in regarding quantity too. I started supplementing because I have supply issues & work 40-50 hrs a week. I take fenugreek, it seemed to help but my supply is the worst it has been now!

Browncow - I haven't been able to take my son to his monthly visits because of insurance issues. He has always been up to date on his shots, but hasn't had a check up/well baby check up since he was 2 wks old. His Ped wants to see him every 2 weeks to see why he has dropped on his growth charts.

Weight at birth 7lbs 8oz = 49%
Weight now 12lbs 0.8oz = 0%

Height at birth 19.5in = 49%
Height now 24.5in = 14%

I just read what everyone wrote about exclusively pumping and I wish I would have read/listened sooner. My supply dropped a ton and I am hoping I can get it back. I am so discouraged and ready to just quit. I have pumped 3 times since I have been at work and have only gotten 5 oz. That will give my son ONE BOTTLE!! That is why I am supplementing, I think that I am starving him. I stuggled so much with my first DS too! I don't know why this is soooo hard for me. I seriously sit at work and cry and pump. I am not saying this to get sympathy, I am just angry and venting. I know woman who pump twice a day at work and get between 14-20 oz. I don't know what I am doing wrong or why I can't provide for my son like I should be.

I guess what I am trying to say is my Ped is concerned because he has dropped so much on the growth charts that he is trying anything to get him up. He is not discouraging from BF. He says that I can give him a bottle of pumped BM after he nurses, but that for right now, nursing just needs to be a comfort thing for my son and not an actual meal. That is why I thought it was a good idea to exclusively pump so that ALL my BM would count toward his daily intake. Am I making any sense at all???

Thanks for all of your advice and time! I really do appreciate it. When I get home I will nurse again. I just hope that I am not tooo late and that I will be able to up my supply again.

[@llli*lllmeg]

hey, i just saw your other thread...

ok so, how long have you been back at work and how much milk/formula was your baby being fed when you were at work?

Any chance of taking some vacation time, family leave for health issues, something? With the right care you could possibly get this turned around in just a few weeks but I will be honest with you, doing that is going to be way harder if you are working full time as well.

What kind of a pump do you have? How old? Have you done any pump troubleshooting? Can you rent a hospital grade pump for a month?

Was baby weighed at two weeks and at the 2 month visit for shots???

[@llli*lllmeg]

I know woman who pump twice a day at work and get between 14-20 oz.

that is seriously abnormal. trust me.

[@llli*alilwest]

Hi mama. I struggled with supply issues for the first 2.5 months and the one thing that I believe helped my supply is cosleeping. There are safety precautions you have to take, however if it is feasible for you and your family, I highly recommend it.