IUGR baby not gaining - Doc says wean him

[@llli*mykidsrock]

My 10 month baby is IUGR - born at 37 weeks but looked like 34 (4lbs 14oz), now he is 14lbs. My doc has been concerned with weight gain all along. She told me to wean at 4 mos too. My LLL leader and a public health nurse helped me get him nursing better and his weight gain improved. (I was so proud to say he had such good weight gain with no bottles or formula - doc was surprised).

Now at 10 months, he's dropped a little on his growth curve, and doc says I have to wean. I need to bring him back in 4 weeks and show her how many oz of formula he can take per day. (Yes you read right, no breast-milk allowed, regular over the counter formula is apparently better) I could scream!! I am going to start pumping again. I'm going to try and get him on the bottle, but unless they start prescribing a duocal type of formula, I'm not dumping my breast-milk. I don't feel I have a choice this time. If he doesn't improve at next visit (and IUGR babies often stay on a slow growth curve), then I do need to prove that I am feeding him so that they don't label him with failure to thrive or me with neglect.

Here's where we need help though. How can I gently wean him? He still will only take 1 oz from a bottle. I don't want to starve him out, and I don't want to force feed. (both options my doctor approves of...yeah, don't like her!).

Help!

[@llli*carm3]

I don't really know anything about IUGR, but I fail to see how formula would be more nutritious than breast milk! I have a couple questions though - which growth chart is your doc using? Is it the WHO one for breastfed babies? I know that there are some differences from the CDC chart. Also, how is his solid intake? Could you try to increase his calories with avocados, olive oil and coconut oil? And lastly, if you're pumping anyway, what about double cream bottles? Where you let the fatty stuff rise to the top, and then combine it with another bottle of breastmilk?

I can see that you're an experienced mom - how do you feel about baby's overall development? Other than weight, how are things going? It sounds like you've overcome a lot of challenges with this LO - it would suck to wean him unless it's something you want to do. And I don't really have any advice to offer on that front! Hopefully someone else'll chime in.

[@llli*amysmom]

I also don't know much about IUGR. However, would it be possible for your LLL Leader and Public Health Nurse could help you to find a new doctor that is more breast feeding friendly? I'm no professional, but a baby who has already had health challenges should need to be on breastmilk even more than the average child. It would seem to me that there should be a more supportive doctor who is concerned about working with you both as a unit rather than how many mls of formula she can get into a baby.

[@llli*mykidsrock]

Part of my problem is that LO won't take the bottle. I plan to put breastmilk in the bottle, but he'll only take 1oz, then he gets mad. I weighed him myself one month ago and found his growth slowing, so I've been trying to get him to eat avecado, crackers with butter, sweet potato baked with butter... He doesn't like to take a lot of solids, but none of my babies did until after a year. This baby is actually eating more solids than some of my others, but he just isn't growing as well. *sigh*

Right now the little guy has a cold, so I"m going to wait until next week to push things. I'm also hoping I can talk to the pediatrician's office and see if they will prioritize him. If I can get in with her before my next GP app't then I won't wean the little guy.

My doc uses the CDC charts, but I follow on the WHO chart. We disagree as to what percentile he falls into, but his growth did slow between 6 and 9 months. His height did not increase either. I'm hoping the ped will run some tests, because I think it's odd that his height has stayed the same. So he's gotten chubbier, but not taller. odd.

[@llli*carm3]

It's not unusual in and of itself for weight gain to slow down. I'm not so sure about height though! Hopefully you can get in to see the pedi and get a second (and hopefully more breastfeeding friendly!) opinion.

As for the bottles, what about sippies? My LO started drinking water from a sippy fairly well by 10 months - might be worth a shot!

[@llli*mommal]

I really think you need a new doctor.

Has the doc explored any possible explanations for the slow gain other than a problem with nursing? For example, has baby ever been diagnosed with or treated for reflux? Have allergies been suggested? Growth hormone issues?

Were your other babies on the small side?

[@llli*lllkaren]

Wow, that sounds like a really stressful situation. I understand there's extra concern about weight gain in babies who had IUGR, but the doctor insisting that you go to straight formula and bottles when your baby won't even take a bottle puts you in a terrible position.

I don't have anything to offer except that it sounds like you're doing all the right things. I hope you can get in to see the pediatrician soon. Please keep us posted!

[@llli*mykidsrock]

Well, today was a better day. LO actually sucked on the bottle a little. He still only took 1 oz, but he was sucking rather than chewing. I'm still nursing though. I'm not going to cut him off if I'm not sure he'll transfer to the bottle. It's hard to find time to pump with all my little ones running around! Still really hoping we'll get an appointment with the Ped soon.

I noticed the toddler formula out there for 12 mos plus. It's flavoured to make kids want to drink it. They have added cornsyrup... yuck! I was wondering about adding a couple of drops of maple syrup to my breast milk to make baby want it. Crazy? Real maple syrup would sweeten it without adding chemicals. Just for a day or two to motivate him to drink it. I don't know if I will, but I'm considering it. I think once he realizes how fast he can down a bottle, he might go for it.

Thanks all.

[@llli*krystine]

I'd keep offering the solids. I'd add olive oil to everything, prunes, carrots, anything can get drowned in olive oil. I got 12 oz in 2 weeks on one of my twins who didn't gain in a month that way. Then again, my little guys love solids.

Breast milk is already so sweet! Have you ever tasted it? Like if a drop falls off when you pump or something? I've had a drop here and there because it freaks me out to waste it and it's really really sweet. My 4 yr old said it's like M&M sauce. I don't really think it needs more sweetener.....

And yes I'd find a new doctor. One of my friends had a 3 lb baby IUGR at 34 weeks and he is still tiny at 2 yrs but still nurses.

[@llli*mykidsrock]

Thanks for the encouragement everyone. It's so hard to know what to do when you fundamentally don't agree with your doctor's perspective.

My LO is really not emotionally ready to wean. He is so sad when I offer the bottle instead. I'm really torn.

I'll call the Ped's office today and see if they think they can get him in this month.