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Thread: Avocado for 4-Month-Old Preemie? (long)

  1. #1
    Join Date
    Jan 2008

    Default Avocado for 4-Month-Old Preemie? (long)

    Hello! I'm new the forums and have introduced myself over on the introductions board. I have a question about my youngest child, Robert who is 4 months old.

    Robert was 6 weeks premature, so he's 18.5 weeks old but 12.5 weeks gestational. He nurses well, good latch, lots of swallowing, etc. I'm his pacifier, so he nurses 'all the time.' He has plenty of wet and poopy diapers each day. I have no concerns about his intake.

    His weight gain is slow, however. He was 4lbs 5oz at birth, lost down to 4lbs 1oz, and is now (at 18 weeks) 9lbs 4oz. We have a scale at home, and I weigh him each Friday. Four a while, he gained only 3 to 4 ounces per week, then it went to 5 ounces per week. For 4-5 weeks recently he gained an ounce per day, but now his gaining has slowed down again. This previous week, he gained just 4 ounces. Overall, it's an average gain of 4.9 ounces per week.

    Last week, he started fussing at the breast and tugging at my nipples, getting frustrated, which made me wonder if he wasn't getting the milk he wanted (whether the amount or the speed of flow). Today I think I'm noticing more frequent let down, so maybe he's stimulated an increase.

    Before I start talking about solids, let me say that I used to be an LLL Leader...I've read the Womanly Art of Breastfeeding probably 6 or more times (at least twice since Robert was born....we spent two weeks in the hospital, and I had to have SOMETHING to read ), I've read the Breastfeeding Answer Book, I've read Jack Newman's Ultimate Breastfeeding Book of Answers and all the articles on his website. I've probably spent more hours reading about breastfeeding than I have actually breastfeeding. So I know what the starting solids recommendations are, I know what signs to look for (reaching, interest in food, sitting up, etc). I understand why we delay solids (tiny babies can't digest them anyway, allergies, etc) But since every baby brings up new uncertainties, I have questions!

    I looked at the chart on kellymom.com comparing the calorie and fat content of breastmilk and formula to solid foods (http://kellymom.com/nutrition/vitami...dcalories.html). All of the solid foods were inferior to breastmilk, except avocado. The chart says that per ounce breastmilk has 22 calories and 1.15 fat grams. Unless it's a typo, an ounce of avocado has 46 calories and 4.21 fat grams!

    I know that avocado likely lacks some of the other nutrients of breastmilk (I can't find anything comparing that), but I wonder if giving him a little bit of avocado would give him some extra calories and fat to improve his weight gain.

    I found an article (http://www.drjacknewman.com/index.ph...127&Itemid=170 ) on Dr. Newman's website where he states, "In some cases, it may be better to start food earlier. When a baby seems to be hungry, or when weight gain is not continuing at the desired rate, it may be reasonable to start solids as early as three months of age." He also says, "The breastfed baby digests solid foods better and earlier than the artificially fed baby because breastmilk contains enzymes that help digest fats, proteins and starch." And toward the end of the article he says, "The most common legitimate reason to start earlier than five or six months of age is poor weight gain not corrected by correcting latch, using compression, switching back and forth, using domperidone." We're doing all of those things except domperidone because it's too hard to get in this area.

    So I'd like to know if any of you have any information to share about this issue. Can a little avocado really hurt him at this age? I do plan to talk to his doctor, but I doubt I'll get much extra info. She's a friend of mine, and her kids are younger than mine and she actually comes to me for breastfeeding information

    Thank you to anyone who has thoughts to share.

  2. #2
    Join Date
    Dec 2007

    Default Re: Avocado for 4-Month-Old Preemie? (long)

    I don't have an answer for you, but I am SO happy to see someone with a LO the same age as mine, and the same size as mine! I weighed her yesterday at 9lbs 2 oz! Her ped said that small babies gain slow, and has been happy with her progress. I, however, am a basket case. She has recently slowed way down in gaining, and I'm convinced that she must be starving since i've gone back to work even though her diapers are fine and she nurses like crazy. I wish I knew how to help....
    new mom to yael justine, born 12/20/07 4lbs 7oz

    cloth diapers all the way!

  3. #3
    Join Date
    Jan 2008

    Default Re: Avocado for 4-Month-Old Preemie? (long)

    I don't think the avocado would hurt him if he's up for taking solids, my main concern would be if he ends up consuming less breastmilk to make up for the avocado intake, it might be counterproductive. It sounds like he's gaining weight pretty well now, as long as he continues to grow & have plenty of wet diapers, I don't know if I'd be overly concerned. But, if it's really bothering you, you can always try it and see how it goes, nothing says if it doesn't work out you have to keep giving it to him.

  4. #4
    Join Date
    Jun 2006
    Not around here as much :(

    Default Re: Avocado for 4-Month-Old Preemie? (long)

    Frankly I think the weight gain you detailed is good for mr Robert! Given the information given here and here.

    In addition this page talk about the potential for slower weight gain after the first few months and if it's a problem or not (not being it's not even considered "slow") ... Here's a page that talks more about 'putting on' more weight in baby.

    Now this page may have more info that might work for your situation as it might just be part of this trend starting - distraction!

    Hope something there helps

    In any event, looks like you've done some good research and will make the best choice for baby.
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  5. #5
    Join Date
    Jan 2008

    Default Re: Avocado for 4-Month-Old Preemie? (long)

    Thanks for the responses! I'm glad to see what others think about the situation. I did buy an avocado today but haven't given him any yet.

    Thanks for the links, Number3. Some moments I think his weight gain is good (five pounds in four months...pretty good!) and other times I think "He's four months old and only weighs nine pounds!!!"

    Bakelite, WOW!!!! I am so excited to know there is another four-month-old in the world who weighs nine pounds! I was 100% certain that Robert was the only one who had ever existed That is so heartening to me! I am going to private message you

  6. #6
    Join Date
    Jan 2006

    Default Re: Avocado for 4-Month-Old Preemie? (long)

    That's true, but he's only 12.5 weeks adjusted, right? So, that means that he has spent a good bit of his life outside the womb making up for the "baking" he missed since he was born early. Preemies have different growth curves than full term babies and it's generally considered "okay" that they gain at a slightly slower rate (as long as they are on their own curve, of course). I used to have a link for that, but I no longer do. I bet it's google-able info, though. You didn't say, but I assume your baby is growing in length and head circumferance? Meeting milestones? Peeing and pooping plenty? Generally content? If yes, then remember that weight gain is only ONE marker for health. The whole picture is what is most important.

  7. #7
    Join Date
    Feb 2008
    Pullman, WA

    Default Re: Avocado for 4-Month-Old Preemie? (long)

    Premie weight gain is tough. I don't think solids are your answer though, even if his weight gain is slow. I do agree with PP's: he is premie, so don't think of him like a full term kiddo. He is 12.5 weeks. Also, remember that his system is much more fragile in some ways than full term kids. He needs you to continue to breastfeed him and protect him. Although avocado has plenty of fat and calories, he may not be able to digest it yet. And it can cause him digestive troubles. You've done lots of reading--remember that the lining of his gut is also immature. The cells lining the gut at this age are spaced apart from each other, which can let in all sorts of big proteins. It's fine if it's breastmilk, but not if it's a foreign protein. Those cells will mature and you can feed him those other foods once he's 6 months old (CORRECTED AGE). If he was not gaining, you could look into ways to boost calories in your breastmilk, like human milk fortifier a couple of times a day. There's even one out now that is made from banked human milk.

    Is his doc a pediatrician? Is he seen in a follow-up clinic for premies? He may indeed need some more calories, but the only way to know this is to chart his growth on a premie chart. And I think being followed closely by a premie clinic is a good idea for this. Then, if there is indeed a growth problem, he can be evaluated by nutritionists that specialize in premies.

    Remember, just because your doc asks you BF questions doesn't mean she can't handle your LO's issues. I am a nurse in a NICU, and I had to ask a lot of questions when my son was born. He was term and HUGE. I had never seen such a big baby, and I rarely teach moms how to breastfeed--pump and tube feed, yes. So, keep in mind that she may have plenty of specialized knowledge. And if you don't feel ok with her suggestions, ask another doc. It's ok to do so.

    Hope this helps a little. I would err on the side of caution and get things checked out, chart his weight gain (and length, and head circumference), and then come up with a plan for more calories IF he needs them. One option could be nursing, then topping him off with your pumped milk.

    Don't worry about people's comments on how small he is. He is small. Don't be embarrassed by it. Be proud of him. He's a little fighter who got through a rough time. Not all babies get through. Go, Robert, go!
    Stephanie, mom to Jaime Hoban 11/04/07 and Annika Jayne 12/21/09

    We . . . no room in the bed for more!

    We love our cloth diapers!

  8. #8
    Join Date
    Dec 2006

    Default Re: Avocado for 4-Month-Old Preemie? (long)

    I thought his weight gain is pretty good too. He already doubled his birth weight right. Personally, if it were me, I would have waited at least until he is 4 months adjusted age especially with all the allergy issues that premiees are particularly vulnerable to. If he is healthy why mess with it is my approach.

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