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Thread: Supply decrease or just slim baby?

  1. #1

    Exclamation Supply decrease or just slim baby?

    Hello All,
    My son just turned 7 months and despite my best efforts not to worry, I am concerned about his continuing slide down the weight percentile charts. He is my second child. He was born in the 55th pc for weight and 75th for length. He continued to follow roughly these percentiles for the first 2 months. However between 2 months and 4 months he dropped down to the 25th percentile for weight but gained on the length chart, reaching roughly the 90th percentile. His paediatrician tutted that she didn't want to see him slide any further down the weight pc chart. However he has now slid down to the 5th percentile. He wasn't measured for length most recently but he seems very long still so I expect he's still high on that percentile chart, but I'm really starting to worry I have been dealing with a low supply issue all along and just not realised it; reassurance from friends always put this down to growth spurts and genetics but I'm wondering if really I've a less than adequate supply due to chronic stress and having been ill recently. Chronic stress in the form of having had my son while coping with a sick 2 and a half year old, who then went on to have an operation to make her better, to moving countries for my husband's job, which has led to a total toilet training regression with my daughter. I then developed a boil on my face which required two weeks of taking 2 antibiotics.
    I question my milk supply because I honestly feel my body and breasts have reacted differently this time round and my supply has been less robust. Despite having been able to pump alongside feeding my firstborn for a freezer stash this time round even in the early months I was barely able to pump an ounce between both breasts using a double electric pump, and didn't find my supply increased after days of pumping.

    I would greatly appreciate it if someone could tell me what this sounds like to them, what it means when a baby rises on the length percentile while simultaneously sliding down the weight percentile.

    Lastly I would love to know what you think my next steps should be. Dr Jack Newman personally replied to my advice request when I reached out at 4 months and suggested it sounded like I'd suffered from late onstage milk supply decrease and his advice was to be prescribed domperidone however I am not comfortable taking a prescription medicine for this, so am looking for alternative solutions if they exist. I feel after the months of mental and physical exhaustion of all our family toils, I am even ready to consider supplementing with a cup of formula a day, if it is concluded my son should be gaining faster than he is.

    Apologies for the long post and thank you for taking the time to read it!

  2. #2
    Join Date
    May 2006

    Default Re: Supply decrease or just slim baby?

    Welcome to the forum!

    I know we're programmed to think that stress- especially chronic stress- must be really bad for milk production. But it's not. Which is a good thing, because otherwise how would our species have survived the vast majority of human history, during which people were routinely subjected to war, famine, oppression, and epidemic disease? When it comes to milk supply, what you really have to do is nurse frequently. Doing that one simple thing is generally enough to maintain good supply.

    When a baby grows more in height and head circumference than in weight, it can mean absolutely nothing. Some babies are just destined to be tall, thin people. Know any guys who are over 6 feet tall and yet weigh less than 200 lbs? I know I do! If your family and your baby's dad's family tends to have a lot of taller, more slender people, then maybe your baby's growth pattern is just genetics.

    Can you tell us a bit more about your nursing journey? It would help to know how often the baby nurses (on average), whether he sleeps through the night without nursing, how nursing feels, whether or not your general health has been assessed lately, etc. anything you think might be relevant!

  3. #3

    Default Re: Supply decrease or just slim baby?

    Thanks so much for your fast response and helpful points. As nursing my daughter was not straightforward in the beginning (born full term but small 4lb11oz), I was lucky enough to receive a lot of bf knowledge from a good friend of mine and learnt more from my local LLL group and books too. So I know I should feel reassured that stress shouldn't cause supply issues, but this time round I feel aware that although nature will have designed our species to thrive, it also allows for natural selection so will inevitably have allowed for x% of us to not fair so well...whether that really is my case, I don't know! You are spot on about tall and slender people! I know as a child I was a tall and skinny girl. My husband's side of the family though seem to have made average height and weight kids.

    About our journey, unlike his big sister who like I say was born small (but thrived and went from being off the growth charts to land on the 10th for weight and 60th for height until about 2years, since then on the 25th for weight - breastfed till 19 months)...my son was born a pretty bouncy looking 7lb 12 Oz. Contrary to his sister who nursed literally round the clock for the first 2 or 3 months or so, within the first few weeks he went about 4 hours between feeds during the night and about 2 hours during the day. Never more than 3 hours apart daytime. I have always fed on demand and when I got pretty worried at around the 6/7 week because he was nursing furiously and impatiently, I discovered it was probably a growth spurt but that also I should remember to offer the breast more often; because he let me go longer between feeds (compared to my daughter) I had been encouraged to let him...ever since I have asked myself if I missed the window of opportunity to really stimulate production in those early weeks. He has always been a placid baby who loves to suck his thumb and hands but perhaps some of the time this was making hunger. Saying that, ever since I have been more conscious and actively offered the breast regularly, whether or not he was originally asking for it.

    Regarding how nursing went and felt, he latched shallowly on and off for several weeks. He'd often correct himself but could then just slip off and I'd have to intervene to correct the latch. I asked the midwife and community paediatrician to check for tongue and lip tie and was told he was fine. The funny thing is that from 3 months to 6 months old, once I felt reassured enough that he was just becoming taller and slimmer, our bf relationship started going more smoothly and he didn't latch poorly anymore.

    What I will say is that I am small breasted, normally a 32B. I know this doesn't have to affect bf success in itself but occasionally can tie in with too little glandular tissue...In my first pregnancy I didn't notice any significant increase in breast size however after the birth when my milk came in they did increase significantly and stayed significantly larger for the first 6 months until I introduced solids. This time round was different: I noticed a modest increase in size during pregnancy but after the birth, which was a totally natural and drug free one, my boobs grew ever so slightly. I actually had to ask if my milk had come in because it was so subtle. I hardly had any "oversupply" that one would expect at the beginning. Within only a few weeks my boobs were the same as before I was pregnant. Long before I would have expected them to be.

    Night feeds continue. As I mentioned earlier, in the early weeks he had already spaced out feeds a bit to at least one gap of 4 hours in the night but since about 4.5/5 months he's started waking a lot more...we co sleep at least so it's not difficult to feed him.

    We began solids when he turned 6 months and very gradually. Been trying to go down the BLW route, at least once a day and give him a little bit of purée another time of the day so as not to affect supply drastically.

    My health: I have always been generally healthy, if a little lacking in doing exercise! The last blood test I did was late August and all was normal but it didn't check for thyroid activity, which I would have liked to check out. Are there any other deficiencies that would be worth checking out? I will ask at my new doctor's if they could get me a comprehensive blood analysis done. Hope they'll approve it. I've already learned the hard way that they're not the most pro breastfeeding doctors surgery I've been to! Almost had me pumping and dumping for the 2 weeks I was on antibiotics but luckily I found out it was ok to continue.

    Lastly about baby. He appears to be doing great. He's a chirpy chappy, very lively, never been sick in any way. Always had lots of wees every day. He has less wees now but still probably 3 or 4 pretty wet ones daily. From one month old started to space out poos to every 3 days or so. Now with solids being introduced I've found he gets constipated very easily and can go about 5 or 6 days without going.

    Thank you again for your interest in this. I know I should look at the bigger picture and probably rest assured that all is just going as genetics intended but my mental and physical exhaustion just causes me to fear the worst. On December 1st we are getting him weighed and length and head circumference measured too by the doctor so will be able to see how he's been getting on since being on solids.

  4. #4
    Join Date
    May 2006

    Default Re: Supply decrease or just slim baby?

    I think the bigger picture does say "all is well". Slim baby from a slim mama, with a slim sister? That makes sense. Mama nursed her first for 19 months and saw plenty of breast changes with her first nursing journey? Great, that means she has plenty of glandular tissue. The fact that you didn't see a huge change in breast size with this pregnancy probably means nothing; it's entirely normal not to experience much if any engorgement or oversupply. Every baby and nursing journey being different, after all.

    My concern here is that YOU clearly feel that something isn't quite right. Mental and physical exhaustion can be normal for the mom of 2. But they can also indicate something going on with you physically. I think it makes sense to go in and see your doc, and I would definitely want to get checked for iron- anemia can make you exhausted- and also thyroid function. I personally think that all moms should be tested for thyroid function in the postpartum year, and I would even consider, er, shall we say "exaggerating" some symptoms if your docs seem reluctant to order the bloodwork.

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