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Thread: Early weaning in a 22.5wk old exclusively BF baby following weight loss

  1. #1

    Default Early in a 22.5wk old exclusively BF baby following weight loss

    Hi, I've not posted here before, and am looking for some advice. I am a newly qualified midwife on maternity leave, feeling a bit useless and lost.

    We have a five month old son who was born at 42wks gestation, weighing 3780g. This put him on the 75th centile for weight. He is - to this day - exclusively breastfed, and continued to gain along this centile until he was approx 12 weeks, at which point his weight gain slowed, dropping to the 50th centile, then to just below the 9th, at which point he had lost 10g as opposed to gaining. This was discovered 4 weeks ago. The weight lost coincides with him sleeping through the night more often, and me expressing prior to him waking (I realise I have been feeding the freezer), and also with me joining weightwatchers and losing half a stone. I don't think there was anything pathological causing his weight loss, just me not feeding him often enough and stealing his cream to give to him when I go back to work (for which I feel AWFUL).

    Our GP referred us to the local hospital, and today we say a consultant paediatrician. My son has gained 480g in just under 4 weeks, and so is gaining weight steadily. The paediatrician was happy he was doing fine developmentally, he is bright, healthy boy, but just a touch on the lighter side. He weighs 6.32kg today and so remains just under the 9th centile. I had hoped we could just continue as normal, as this weight gain would suggest my milk is adequate? The paed felt differently and has recommended we start on some high calorie formula and commence weaning with purees. I REALLY didn't want to wean him just yet. I've done lots of research surrounding baby-led weaning, and was hoping to follow that method. Also, he isn't quite able to sit up unassisted, and it just seems a bit soon. I had obviously hope to avoid formula as I have both asthma and eczema and can't help but believe what I have been taught, in that avoiding formula and solids until around 6 months should help to prevent these. I realise this is not a completely normal situation, in that he may have been compromised by the lack of milk, but I think we're back on track. I am wary of disregarding medical advice, but this consultant seemed out of date, particularly when I tried to talk with him about BLW, and about allergies.

    All of this is going on at a time when the 'when to wean' debate is thriving, following the publication of that research review on Friday (http://www.guardian.co.uk/lifeandsty...rt-of-comments). Having read the BFI / UNICEF response (http://www.babyfriendly.org.uk/pdfs/...cle_140111.pdf), I was keen to continue as planned, but the paed seemed to think that following the publication of a single review (not even an RCT), we should all revert back to weaning at 4 months! This is a common response from doctors, but I remember my uni lecturers and lactation consultants being passionate and extremely well informed on this matter, and insisting waiting is better and safer.

    I'm not sure what to do.

    I think we will wean before he is 6 months, but I was wondering if anyone had any advice / similar experiences?

    Also, as he was 2 weeks late, does this mean his digestive system is more able to cope with solids, or does this correlate to time exposed to milk (and not corrected age)?

    I have contacted the lactation consultant at the hospital where he was born / where I trained, but as time is of the essence here, any information or advice would be most welcome.

    Ahh, feels a bit better to have got all of that written down.

  2. #2
    Join Date
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    Default Re: Early weaning in a 22.5wk old exclusively BF baby following weight loss

    Just to clarify when you say weaning, do you mean stop nursing or just introducing solids?

    Amy married to my bestfriend since 10/30/04

    Proud SAHM to DS born 2/17/07 and DD born 9/11/08 Both weaned together 11/2011
    Currently milk, peach, peanut and tree nut free. DD has outgrown her wheat, cheese, egg, garlic, and citrus allergies

  3. #3
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    Default Re: Early in a 22.5wk old exclusively BF baby following weight loss

    Hmmm

    My son was 43 weeks and very definitely post mature and not interested in solids (we did baby led weaning) until about 15 mo

    What worries me about giving solids early to a kid who had some weight loss (don't beat yourself up, it felt like you were following his lead - he started sleeping longer right? You know better now. You are doing your best) is that solids are not as calorie dense so unless you are very certain to nurse just as much just as often you can actually decrease their caloric intake.

    In my opinion little ones are ready for food when they take it from your plate (my daughter started doing that at about 5.5 mo)
    proud but exhausted working mammy to two high needs babies

    • my surprise baby: the one and only D-Man born 3 weeks late (5/5/08) at 9 lbs 14 oz and 21.5 inches, and
    • the shock H-Girl born about a week late (10/7/09) at 8lbs 15oz and 20.75 inches.


    If I am here I am covered in baby (probably two) and fighting for control of the keyboard.

    Family beds are awesome

    Wondering if you have PPD? Take the screening and see your doctor. You deserve to feel better.

  4. #4

    Default Re: Early weaning in a 22.5wk old exclusively BF baby following weight loss

    Sorry, I want to breast feed for as long as possible, so just to introduce solids in addition to breast milk.

    The question is when, and in what form, and do I need this SMA high calorie formula?

  5. #5
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    Default Re: Early weaning in a 22.5wk old exclusively BF baby following weight loss

    If it were me I'd try high calorie solids like avocado before I introduced formula. Or just increase the number of nursing sessions and see if that helps with weight gain. I prefer to wait until my kids showed more signs of readiness before introducing solids but I'd not do formula unless I felt it was medically necessary and I had tried everything else.

    Some babies just slow down in the weight department. But it sounds like he is doing well, thriving and hitting other milestones, right? If that's the case then I wouldn't rush into formula yet. Continue to nurse, nurse, nurse and see what happens for a couple of weeks. It sounds like a case of him maybe needing an extra session or two, not that your milk is deficient. mama

    Amy married to my bestfriend since 10/30/04

    Proud SAHM to DS born 2/17/07 and DD born 9/11/08 Both weaned together 11/2011
    Currently milk, peach, peanut and tree nut free. DD has outgrown her wheat, cheese, egg, garlic, and citrus allergies

  6. #6

    Default Re: Early weaning in a 22.5wk old exclusively BF baby following weight loss

    He's doing great in terms of milestones. Really good head / neck control and strength, can sit well if supported. Reaching for objects with accuracy. Really happy, friendly baby. I am inclined to agree about food over formula. I will investigate other calorie rich food and dicuss with my boyfriend. Thanks for the advice x

  7. #7

    Default Re: Early in a 22.5wk old exclusively BF baby following weight loss

    Good point. Thank you.

    I've somehow started two identical threads? Oops

  8. #8

    Default Re: Early weaning in a 22.5wk old exclusively BF baby following weight loss

    I think "weaning" is used differently in the UK (introducing other foods in addition to breastmilk) than in the US (stopping breastfeeding altogether), so sometimes there's a bit of confusion.

    Your baby's weight gain for the last month has been great! It definitely sounds like you're back on track. I guess your doctor wants to see him catch up to where he might have been if his weight gain hadn't slowed down?

    Something to consider about adding solids at this point is that most foods commonly fed to babies have less fat and fewer calories than breastmilk (except for avocado!). So adding solids may not be beneficial for weight gain if they replace nursing.

    Do you think you could squeeze in a few extra nursing sessions? Nursing every hour and a half or two hours during the day for a while would probably give his weight gain a boost.
    Karen
    Forums Admin

    Find an LLL Leader or Meeting | Get one-on-one help from a Leader online | Become a Member of LLLI

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  9. #9

    Default Re: Early in a 22.5wk old exclusively BF baby following weight loss

    Quote Originally Posted by @llli*vivie View Post
    Good point. Thank you.

    I've somehow started two identical threads? Oops
    No problem! I merged the two.
    Karen
    Forums Admin

    Find an LLL Leader or Meeting | Get one-on-one help from a Leader online | Become a Member of LLLI

    Feel like you need professional help? ¿Es usted necesita ayuda profesional? --> Find an International Board Certified Lactation Consultant (IBCLC) <--

  10. #10
    Join Date
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    Default Re: Early in a 22.5wk old exclusively BF baby following weight loss

    Quote Originally Posted by @llli*LLLKaren View Post
    No problem! I merged the two.
    Awesome admin
    proud but exhausted working mammy to two high needs babies

    • my surprise baby: the one and only D-Man born 3 weeks late (5/5/08) at 9 lbs 14 oz and 21.5 inches, and
    • the shock H-Girl born about a week late (10/7/09) at 8lbs 15oz and 20.75 inches.


    If I am here I am covered in baby (probably two) and fighting for control of the keyboard.

    Family beds are awesome

    Wondering if you have PPD? Take the screening and see your doctor. You deserve to feel better.

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