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Thread: Solids displacing milk?

  1. #1

    Default Solids displacing milk?

    My daughter is 10.5 months old. We've been struggling with poor weight gain since her first week - she was born at 85th percentile for everything but is now at 25th for height and 7th for weight. (Head is still 85th percentile.) Her weight had stabilized around 15th percentile for a few months (months 4-6), which was good, but at our last checkup the pediatrician was worried that it had declined to 7th percentile.

    She's cheerful and doesn't act hungry. She used to go on strike a lot, but for months now has been accepting breastfeeding from me and bottles of pumped milk from her dad when I'm at work.

    Her milestones are ok but not great. She just started pulling up. She's active, scooting everywhere on her belly and exploring everything.

    She's been eating solids fine since 6 months. The pediatrician recommended high-calorie, high-fat foods, so we've been doing lots of custard, cheese, hummus with extra olive oil, cream added to foods. She's been constipated at times, but now that I'm giving her bran flakes every day she's more regular. She's been eating 3 meals a day of 2-3 tablespoons of solids.

    She had blood and stool tests to rule out absorption issues. It seems that she is absorbing the nutrition fine. She has never had reflux or other problems. We saw several different lactation consultants and they didn't find anything wrong with her except that she didn't want to eat much.

    She's always had a smaller appetite than most babies, it seems, so given the slower weight gain yet taking a normal amount of high-calorie solids, I wonder if the problem is that she's taking less milk. She takes 6-9 oz of pumped milk between 3 pm and bedtime, but I don't know how much she's taking from me during the night and morning. She's waking to feed 2-3 times nightly.

    I started weighing her wet diapers, and they're only around 12 oz. daily. I know some fluid must be going to stool, water vapor, etc, but she's not producing much stool (one or two little globs daily). The urine looks light-colored and is not smelly. My understanding is that she should be getting at least 24 oz of milk, so 12 oz of urine makes me think she's not getting that.

    My plan is to reduce her solids to two meals a day in hopes that she will drink more to make up for it. We're also starting to stretch bottles of the pumped milk with formula. I'm not too worried about damaging my supply at this point, since it's only 6 weeks until she'll be a year old and we can give her cow's milk as a drink as well. At this point I care much more about getting her enough calories and enough fluid than about preserving my supply. We've tried giving her cream of wheat and other foods made with formula, but she's not too into it.

    Does my plan of reducing solids make sense? Does anyone know how much of fluid intake turns into urine? Thank you.

  2. #2
    Join Date
    Jun 2009
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    10,754

    Default Re: Solids displacing milk?

    More breastmilk is of course never going to hurt anything, and may help, and the easiest way to up that, typically, is to offer to nurse more often.

    I am not at all sure that a 10 month old who is eating a good amount of healthy, fatty solids throughout the day 'should' be getting 24 ounces of breastmilk daily. Do you have a reference for that figure? 24 ounces is the average needed intake for a younger baby who is exclusively eating breastmilk only, while also gaining/growing at a much faster rate than a 10 month old can be expected to. And even that is just an average.

    I am also pretty sure that weighing wet diapers is not going to give you useful information. Is your child showing any signs of dehydration? It takes a while for a child to move from slightly dehydrated to seriously to dangerously and there are indications along the way. In other words, I do not think a well looked after child as your obviously is, is in danger of becoming dehydrated with no one noticing.

    I would suggest the book My Child Won't Eat. The typical pattern is for appetite to decrease even more at about the 12 month mark or so. If you and your pediatrician are already worried, I think this book will help you have a less alarming perspective to consider. If there really is a problem with your child having an inadequate appetite, then perhaps tests are needed and the author also suggests when that may be needed.

  3. #3
    Join Date
    May 2006
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    24,794

    Default Re: Solids displacing milk?

    with all the above. Re: weighing diapers, remember that milk intake is not going to be the same as pee output. A baby is going to offload water in 5 different ways: pee, and also respiration, sweat, drool, and poop (all poop contains some liquid, thank goodness, or it would not be pleasant to have a bowel movement!). So while your baby might take in 24 oz of liquid per day, it's unlikely that she's going to output 24 oz of pee.

    Unless your baby absolutely will not take plain formula, it is recommended that you not mix it with breastmilk. The storage guidelines for breastmilk and formula are different; unfinished breastmilk bottles can go back in the fridge, unfinished formula goes down the drain. So if your baby doesn't finish a bottle of mixed formula and breastmilk, you have to dump the whole thing and that means some fraction of your hard-won milk gets discarded. If your baby will take plain formula, offer her a breastmilk bottle first, and then top her off with a formula bottle.

  4. #4

    Default Re: Solids displacing milk?

    Thanks. She will not take plain formula, so the mixing seems to be our best option at this point.

    I'm offering her breastfeeds every 1-2 hours during the time I'm with her, and she often refuses, so I'm not sure how to encourage her to nurse more.

    It looks like I was wrong about how much milk she needs at this point - I'm seeing sources say 16-24 oz milk for a 10 month old, which sounds more like what she's doing.

  5. #5
    Join Date
    Jan 2015
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    101

    Default Re: Solids displacing milk?

    Quote Originally Posted by @llli*juliadw View Post
    She's been eating 3 meals a day of 2-3 tablespoons of solids.
    This does not seem like very much for a 10.5 month old. I, personally, doubt that such a small amount of solids is significantly displacing her milk intake.

    My daughter is 8.5 months and eats quite a bit more than that. For the first six months of her life she was EBF and, like your daughter, just didn't want to eat much. I offered to feed her constantly day and night and she just wasn't that interested. Her weight slipped from the 50th percentile to the 25th percentile. Solids, though, have been an entirely different story. She's LOVED them from the get go (at 6 months). And, we've done baby-led, so it's not we're shoving a spoon in her mouth - it's all self-directed. At first I tried to limit her intake so that she wouldn't displace her milk but what I found is that it really made no difference. Lots of solid or not, she would take about the same amount of milk. So, I stopped fighting it and let her eat as she wishes and as of last weight check she's back to the 50th percentile.

    Will she eat more solids? If so, I'd say let her go for it.

    Other high-quality food ideas: avocado slices, sweet potatoes roasted or sauteed in coconut oil, egg yolks, meat (ground beef, chicken thighs, salmon), cooked squash mashed with breastmilk or coconut milk.

  6. #6
    Join Date
    Jan 2014
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    Default Re: Solids displacing milk?

    Babies do drop percentiles at around that age so I don't know if that's so concerning. My baby was in the teen percentiles and is now in the single digit percentiles and his doctor is not at all concerned about it. Is your baby growing in height?

    You can give yogurt which is healthy and fattening.

    I found that no matter how much solids I gave, my baby always nursed for the same length of time. At 10 months my baby was barely eating solids, though. More like a few spoonfuls here and there of whatever I thought he might like. He didn't REALLY start until a year, and that was like 1-2 "meals" a day.

    You can try dreamfeeding if you want to throw in an extra feed if your baby is reluctant to nurse more. That often worked well for us as my baby wasn't always the happiest nurser on the block so this way I could "trick" him into eating more.
    Mom to Samuel J.
    born 7lb. 10 oz. and 22" tall
    on Saturday, October 19, 2013.

    My breastfeeding experiences: http://www.breastfeedinghacks.com/

  7. #7

    Default Re: Solids displacing milk?

    Thanks, all.
    It sounds like she's probably not getting too much solids at this point. (I was guessing at the quantity - we let her finger-feed, so a lot goes on her tray and some ends up inside, some on the tray - you know how it goes. So I'll continue with three meals.

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