To supplement or not to supplement...

[bisous]

It's me again. DS3 just had his 6 mo checkup. He is 85th percentile for height and .9th for weight. The pediatrician is JUST shy of recommending supplementing.

We started DS on fruit last night. I don't anticipate that he will actually consume many calories from "solids" for some time.

For the past month I've been nursing all night, around the clock (approx. every two hours for 1/2 hour each) etc. And it has been difficult. Especially since he's fallen further off the curve.

I COULD keep up with the status quo for awhile but I'm so sick of not knowing if he is getting enough.

I tried pumping last night after DS went to sleep. He just ate though and literally almost nothing came out.

WWYD? Try pumping even more often? I still haven't worked a bottle into the schedule because I can't get anything out!

So what to do. Ramp up solids? Supplement? Carry on? Pump a bottle or two?

I have a lot (a LOT) going on in my life right now. But this may be my last babe and I want to do it right.

TIA,

[BabyBearsMom]

This probably isn't a popular position with a lot of the other moms, but from reading your posts, you seem to be very stressed about this. If you think that supplementing will make things less stressful for you, I think you should do it. You might find that with the stress off of you and a little more sleep that your supply picks up again. You also might find that a bottle or two of formula makes you happier and more relaxed which is important too.

I had to supplement DD from 4 weeks on. I was breast feeding after a breast reduction and just did not make enough milk for her. I remember people saying things to me like "if you give her formula now, you will never produce enough milk!" without knowing that I would never produce enough milk anyway. Supplementing her took a lot of stress off of me, allowed me to be a better, happier mom, and gave DD the food that she needed.

[egoldber]

FWIW, younger DD was like this too. She gained weight, but slowly, and was not even on the growth curve at all until she 15 months old. But as long as she was gaining weight and meeting developmental milestones, the ped was OK with it.

She wouldn't take a bottle either, so that kind of helped to make the decision to not supplement for us. But what I did do was use expressed milk (and you could use formula) to mix in with cereal. You'd be surprised how much milk/formula cereal will hold if you let it sit for a bit and then add more liquid to it. I was easily able to get an extra 2 ounces in her at each feeding that way.

And I just took her to the ped this morning. She's 5 and only weighs 38 pounds. Some kids are just small.

ETA: Just to make it clear, I don't think there is anything wrong with supplementing! Just offering a different option since you did mention solids and adding more calories that way. I know that for me having to buy and make formula and deal with bottles was also a hassle.

[ABO Mama]

Some people (like myself) are just not good at pumping. I bf'd my twins for 18mo, and DS#3 for 2.5yrs, but never could pump more than an once or so. The amount you can pump does not equal the amount your breasts can produce.

Has your DS fallen off of his curve? Has he always been on the .9th? If he just had a growth spurt, and stretched out taller, he could be skinnier right now, and be perfectly fine. Babies/toddlers tend to grow that way...chub up then stretch out, then chub up again (this is from my ped).

I know you said you started your DS on fruits...how about a more calorie rich food, like avocado? I like the Super Baby Food book.

Has your DS taken a bottle before? That can be hard to introduce at 6mo to a bf baby.

All of my boys were skinny babies, and are still tall skinny boys...that's just the way they are.

[niccig]

I did.

DS was on solids, still not gaining, I was stressed, having weight checks every 2 weeks, seeing the LC to try and get more BM into him. A friend said to me "he's already on solids, so you're already supplementing." I gave him 1-2 bottles a day. DH was already giving one bottle of expressed BM a day, so we swapped that to formula.

We kept breastfeeding until he was 14 months old.

DS has never been a big weight gainer, even when on full fat dairy. Like Beth's DD, some kids are small. Supplementing took the pressure and stress off me to be the sole provider.

You need to decide what is best for you.

[AnnieW625]

I would supplement. I had stopped breastfeeding by the time my girl's were four months old, but on a side note both of my girls were tiny. DD1 is still smaller than most 5 yr. olds. My thoughts on the issue are very close to BabyBearsMom. I really think that if you supplement it will help you feel more relaxed and then that might help your supply a bit.

Formula is not evil IMHO, and while we all know that breastfeeding and breast milk is best sometimes I think it is smart to look at the big picture and if you think that formula will make life easier then just go ahead and do it.

Add me to the list of those who were just not good pumper. I got barely 2 oz. per side with DD1; with DD2 I would get 4 oz. per side and thought I hit the gold mine. I ended up pumping just enough so DH could feed them one or two bottles per day. That was enough for me.

[Tondi G]

I don't see any reason why offering a bottle of formula here and there will harm anything. You are starting solids anyways so introducing other foods to your kiddos system. It might just make your life a little less stressful too!

I agree with the previous suggestion to try avocado ... just smash it up and add a little breastmilk or formula to it. It's a good fat and he'll probably love it! You could mix with a little fruit to thin it out and make it sweeter if you think your little one might like that better.

[khalloc]

My DD was almost off the charts as an infant and I didnt supplement. Instead I pumped all the time and kind of drove myself crazy. She didnt really start gaining lots more weight until she was a few years old. So I dont think it would have mattered one way or the other, but I might have been saner if I had supplemented a little.

With my DS he was always about 50th % for both height and weight. But after 7 months I couldnt pump enough and I was going crazy again, so I decided to supplement with formula. At first only his daycare gave him formula. They did 1 bottle a day I think. He also didnt really eat solids till 8 months old. he didnt like them. After the daycare started him on formula, I started slowing using it too, like 1 bottle or so on weekends when I had him all day. I still nursed him until he was 12 months old, but I wasnt going nuts doing it like I did with DD1.

So if its going to perhaps help your son gain weight, and save your sanity, I vote for some supplementing.

[citymama]

I would follow the pediatrician's recommendation. If s/he is just shy of suggesting you supplement, there must be a reason. Since DS3 is going to be on solids pretty soon, if not already, see how that affects his growth? When does your ped. want you back to check his weight again?

Incidentally, my DD1 was 97th percentile for height and 5th for weight for a long time. She was a string bean! Her growth took off when we introduced cow's milk at 13 months, and she moved up to 97th for height and 50th for weight by 18 months, and is still there at age 6. I EBFed and my milk isn't particularly fatty, I guess. (We never did formula for either.) She was walking and talking by 9 months, so it didn't affect her development, just her weight. DD2 has held steady since birth at 75th for height and 20th for weight. She doesn't like cow's milk!

That said, you should do whatever you think best for your DS3. Don't let our or anyone else's opinions (other than a ped. you respect) affect what is needed for his and your well being.

[sntm]

Unless you have a reason not to be producing (your own illness, history of breast surgery, history of supplementing), I wouldn't doubt your production or your ability to provide for your baby just based on what you get when you pump. They are totally different things. If you had to bottlefeed (WOH etc) and weren't pumping enough, that's another story.

Try techniques for increasing supply (kellymom.com) and try (I *know* this is hard) to relax about it. If your baby is otherwise healthy, you are not harming him by giving it some more time. For extra foods, pick only calorie rich ones - avocado, meats, etc. I agree that it is okay to supplement now if you have to, but if so, really make it a supplement - use the formula to mix with foods, etc, rather than replacing a nursing session.

Some babies are just smaller (my son was too!) and the fact that he is 85% for height suggests you are doing something right or he wouldn't have grown so tall! If you try to pile calories on him when his nature is to be long and lean, you won't get anywhere, except maybe setting him up for issues 30 years from now when he's trying to *lose* weight.