4 Months and told to supplement

[@llli*bootz]

Hello All,

First time post. So glad this forum is here, and I have some questions related to my recent doctor's appointment.

So my son is 4 months this week, and we went in for his appointment. He was gaining weight normally at his 1 month and 2 month appointment. However, he has stopped gaining weight at a normal pace.

Month 1 - 4.03kg/8.9lbs
Month 2 - 5.03kg/11.1lbs
Month 4 - 5.57kg/12.3lbs

His height and head circumference has continued to grow as normal, but they are worried about him only gaining a bit over a pound in two months. Now that I look back on it, I can see that he might have been hungry and not fussy.

I was thinking things were going well, but I was losing a lot of weight and exercising a lot, and am almost back to my pre-pregnancy weight. Perhaps I wasn't getting enough calories? Would this do it?

Also, I was hyperthyroid before, with Grave's Disease, but was tested postpartum, and 2 months after and have been fine. Just to be safe I went in today to get another test, but this might be fine as well. I do stay on top of checking my levels quite a bit, but maybe this time that is the issue.

In the meantime, what should I do? I am now supplementing about 200ml/7.1ounces of forumla a day, and he is eating it all as I can see he was very hungry. I make sure he eats this ONLY after he finishes the breast. Then I have started pumping 2X day after he feeds for an additional 15-20 minutes. Getting very little milk (like 25-50ml) but hopefully it helps increase.

What else can I do to try and fix this? I have these "more milk plus" vitamins I will start. I have also massaged before feeding. I am also getting a scale so I can track exactly how much he is drinking each meal, so I only supplement the needed amount.

Is it reasonable to think I can pump an extra 200ml a day and feed him that, or will that dimish my supply? I heard this will diminish it, but only for a couple days then it will come back. Should I even risk this when he is not gaining weight?

I am so confused, but I have an electric double pump, money for vitamins, and determination to try anything so please give me some tips. Also, what if I AM hyperthyroid? Will I have to stop, or can it be increased as well, even despite a condition like that?

Thank you all so much in advance. I really need the help.

Michelle

[@llli*bfwmomof3]

Hi mama, welcome to the forum!

So first, a couple questions. Between month 2 and month 4, before you started supplementing with formula, how many times in 24 hours was baby nursing? And now, how many times in 24 hours is baby nursing? When you are giving formula, how much formula are you giving each time? And how many times a day are you supplementing with formula? Any other problems with nursing - painful latch for example?

The good thing is, baby was gaining weight initially - so somehow something must have changed between months 2 and 4, and all you need to do is change it back! At this point the best thing to do is to nurse baby as often as possible. If baby demands, nurse. And even when baby doesn't demand, offer. If baby is sleeping a long stretch at night, offer a "dream feed" during the night.

Regarding your question of whether it is reasonable to pump an extra 200 ml a day - yes, of course that is reasonable. You are getting up to 50 ml each time you pump, so if you pump 4 times a day, you have an extra 200 ml. And no, that will NOT diminish your supply, that will INCREASE your supply. Breastfeeding is supply and demand. The more you nurse and pump, the more your supply will go up. To the extent that you pump anything extra (whether 50 ml or 200 ml) and feed it to your baby instead of formula, it will help slowly wean your son off the formula and simultaneously increase your supply. And it is certainly a good idea to pump each time you give the formula, if you can, because that is a time when baby is not stimulating your breasts to make more milk, and, additionally, the formula is less easily digested so it may delay when baby next asks to nurse. However, even if you can't pump every time, any pumping you do will help speed the process of increasing your supply to match baby's demand. Here is more information about weaning from supplements: http://kellymom.com/bf/got-milk/basi...rease-formula/

Also, pumping between 25 and 50 ml is not actually as little as you might think. A typical meal at the breast is about 60 ml to 120 ml. So if you are additionally pumping 50 ml, that's almost as much as a feed might be! (That's also why I ask how much you are supplementing at each feed, because you don't want to overfeed baby with formula. How are you determining whether baby is still hungry? And are you using paced feeding techniques when you are giving the bottle? Here's a link about bottle-feeding the breastfed baby:
http://www.llli.org/docs/00000000000...astfedbaby.pdf)
And if you've just started pumping, you may well see an increase in your pump output. It takes time to get used to the pump.

Was your weight loss and exercising influencing your supply? Generally supply will be maintained except under rather extreme conditions approaching maternal starvation - it's nature's way of protecting baby in times of famine. But certainly you want to maintain healthy food intake and the recommendation I've generally seen is to not try to lose weight too quickly when nursing.

As for your Grave's disease, whether or not you would have to stop would depend on the treatment plan, if you needed treatment. I think it's a good idea to have your thyroid checked but it sounds like you are not experiencing any symptoms, so hopefully that will be fine.

I really think you can get back to exclusive breastfeeding mama!

[@llli*mommal]

So first, a couple questions. Between month 2 and month 4, before you started supplementing with formula, how many times in 24 hours was baby nursing? And now, how many times in 24 hours is baby nursing? When you are giving formula, how much formula are you giving each time? And how many times a day are you supplementing with formula? Any other problems with nursing - painful latch for example?

Also, were you scheduling feedings, offering a paci a lot, swaddling baby at night, trying to get him to sleep through the night? And are you using any form of contraception, and if so, which one?

It's very common for moms to experience postpartum thyroiditis. The progression is often for a mom to be euthyroid (normal) following birth, and then to cycle into a hyper phase, and then go into a hypo phase before returning to normal function, though many women remain permanently hypothyroid. So I have to wonder if maybe you went into the hyper phase, and being already hyper, went to a place where you were much more hyper than usual? The fact that you lost some weight suggests that this is a possibility, since being hyper is associated with weight loss- though of course it could just be the hard work you did at the gym! You might want to think about making your peace with bigger jeans for a while... Estrogen damps down on thryoid hormone production, and the fatter you are, the more estrogen you tend to have. If being hyper is causing problems for you, a little more fat might be your friend. Hypothetically, anyway!

It's very reasonable to think that you can supplement with your own milk. But in order to get 200 ml (almost 7 oz), you probably need to pump more often than just 2x per day. After nursing, it's normal for a mom to get relatively little milk, particularly when supply and demand are well matched. I'd aim to pump several more times per day and see what happens.

Sorry you hit this bump in the road, mama! It's probably fixable, though.

[@llli*auderey]