Advise needed - baby fell off growth curve

[audys]

Help! I have been weighing my DS (7 months old) weekly since birth and he has gained no weight over the last 2 weeks. I saw my pediatrician yesterday and they confirmed that he fell off the growth curve (he's been at 5% until now). He has really been liking and eating lots of solids so he had been nursing and drinking EBM less lately. I am decreasing his solids so he'll consume more milk.

I work and have noticed that I've been gradually (over the last month) getting less milk when pumping - I thought it was a let-down problem (my LC has advised me on this previously). When I more carefully inspected my breast pump (Medela Pump In Style Traveler), however, the vacuum was weak. I just fixed my pump yesterday by replacing the face plate but this pump problem has not been helping my milk supply, I'm sure.

From all of this, my milk supply has gone down - BF mothers, have any of you had your milk supply recover from a large decrease? I have started taking Fenugreek and Blessed Thistle, per LC. I'm fearful that weaning off BM and onto formula will not be far away...

If I introduce some formula (please forgive me), should I give some after a nursing or replace a whole breastfeeding session with formula and then pump? I'm mostly concerned that my baby gain weight at this point.

Finally, my DS has his 2 bottom teeth (broke my skin once as these came in when I wasn't fast enough to stop him) and his top teeth are just starting to come in - so he's starting to bite again. Any advise on dealing with the upper teeth?

Whew - many topics covered here. Any input, advise or comments would be appreciated,

Audrey, mother to Graham

http://lilypie.com/baby1/050210/3/15/1/+10/.png (http://lilypie.com)

[nwaddellr]

Your best bet for supplementing with formula if you're still pumping is to do a mixed feeding of EBM and formula in the bottle - that way the baby still gets the benefits of the BM but you can extend your supply with the formula. HTH a little!

[COElizabeth]

The following link has some suggestions for increasing supply (you have to scroll down to the bottom to get to them):

http://kellymom.com/bf/supply/low-supply.html

I've also heard that eating lots of oatmeal (in any form, including cookies) can help.

If you search this forum for threads on supply, you should find other helpful tips. I know I have seen threads from moms in similar situations. Best wishes!

Elizabeth, Mom to James, 9-20-02
EDD #2, 10-30-04

[dr mom]

I had a big supply decrease when I went back to work. My sister was watching DS for me, and whenever he was at all fussy she offered him a bottle of EBM. After a week or two of this she had depleted my whole freezer stash in addition to the fresh EBM I left everyday, and since he was eating so much during the day, he wasn't nursing much when I got home. My supply plummeted quickly and I was in a panic, but was able to restore my supply with fenugreek supplements. I also declared a "nursing crisis" and spent a whole weekend in bed, offering DS the breast frequently, and pumping several times throughout the day. I also changed the white membranes on my PIS, and that helped increase my supply as well, since the suction was slowly diminishing.

No breast pump will ever be able to get as much milk from your breasts as your own baby can, so I definitely wouldn't replace a breastfeeding session to use the pump. You can pump either before or after nursing to give your breasts some extra stimulation, but keep putting DS to the breast, and let him nurse as long as he wants to. Small amounts of milk will keep flowing for as long as he suckles.

Maybe try offering solids after nursing and filling up on milk, or an hour after a nursing session, so he isn't getting too full to nurse? At his age, all his calories should still be coming from milk, since solids don't have nearly the caloric density that your breastmilk does - solids are really just for practice and exploring, not so much for nutrition at this age.

I truly believe breastfeeding is best, but I'm not going to criticize anyone who decides to use formula, if that is what you need to do for your DS right now. I do think you still have LOTS of options available to you before you give up on breastfeeding. You've made it to 7 months, which is terrific. Breastfeeding is NOT hurting your DS or causing him to not gain weight, it's the healthiest, most perfect food that you could be giving him. :)

The growth charts that pediatricians use were developed in the 1950's based on the growth patterns of mostly formula-fed babies, and breastfed babies follow a slightly different curve. As long as your DS continues to gain weight over the long-term, and is height/weight porportional, I wouldn't be too worried about where he falls on the growth curve. Particularly if you and his father are not towering amazons, genetics can account for him being a smaller baby. My DS has had 2-week periods where he didn't gain weight either, but then he'll make up for it with massive growth spurts and suddenly he's outgrown all his clothes again.

You could take him back to the pediatrician in a couple of weeks for another weight check, after offering more frequent nursing and cutting back solids, and that might help put your mind at ease that he is gaining weight again.

Sorry no suggestions on the teeth - we're going through that ourselves right now - and I am dreading the day that the top two finally break through. It hurts enough when he bites with just the bottom teeth!

[stillplayswithbarbies]

Have you replaced the valves in your pump? Is the suction back to normal now?

...Karen
DS Jake Feb 91, DD Logan Mar 03
http://members.aol.com/khowe14494/superpower.gif http://members.aol.com/khowe14494/borntobebreastfed2.gif

[lizajane]

if you decide to supplement, i would only do it AFTER you complete a nursing session so you won't encourgage your body to make less and so that you are sure that he got all the breastmilk he possibly could before he fills up on formula.

fwiw, i have seen a number of skinny babies really plump up after getting some formula. i am not a formula fan, but maybe a little bit once/day would give you some peace of mind. when his weight goes up and your stress goes down, maybe you could stop supplementing.

[audys]

Thank you everyone for the advise - my breast pump is working better now but my milk is still down.

After one week of increased nursing/some formula, my baby has still not gained weight. My pediatrician has "cast her net" for an array of diseases including cystic fibrosis, renal tubular acidosis, celiac disease (scary things). I am now supplementing my son with formula after each breastfeeding session per ped.

My son had saggital craniosynostosis (prematurely fused growth plate on his skull) - he had skull surgery for this 3 months ago so I think my ped is being being very reactive due to his history. The cause of his skull condition is not known (not syndromatic). He is normal on milestones and is a happy baby with a normal physical exam.

I'm hoping that this is just a scare and he has just temporarily plateau'ed but it's an unsettling period...

Audrey, mother to Graham

http://lilypie.com/baby1/050210/3/15/1/+10/.png (http://lilypie.com)

[mommd]

Don't get scared of all these horrible diseases when your DS is most likely healthy! I have experienced the same thing you are. My DD lost weight and fell off the charts at about 7 months. I was also having supply issues. After trying Fenugreek and oatmeal without help, I went on Reglan for 2 weeks. That did help, but I did not want to stay on it because of possible side effects. I now take a supplement called "lactate support" that has a mixture of herbs known to boost supply, and it is working. I also cut way back on solids. As far as pumping goes, I replaced the white membranes and now pump in the morning and at night. I get 4-6oz total at each session, where before I was only getting 1-2oz, so a big difference.

Anyway, in the month that I have been on the supplement, pumping twice a day and cutting back on solids, my DD has gained 1 pound and is back on the charts. Formula should be used as a last resort in this situation, because for every ounce of formula you give, your baby will take less from you and lead to more supply problems. Good luck and you can PM me is you want with more questions.

[sntm]

It's probably nothing -- your ped is just, as you said, being cautious.

Remember that babies don't actually grow on a curve -- those are averages. Growth occurs in fits and starts, no growth for a few weeks, maybe even a slight loss, then a big growth all of a sudden. They only look like smooth curves because they are averaged over hundred and hundreds of babies, so all the little blips get smoothed out.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03
mama to Jack 6/6/03
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Breastfeeding 16 months and counting

[Rachels]

Most breastfed babies eventually fall off their curves-- the curve is a norm of formula-fed babies from 40 years ago. Formula fed and breastfed babies don't grow in the same way, especially in the second half of the first year and into early toddlerhood. Watch your baby, not the charts. Abigail isn't even ON the charts anymore for weight, but she's healthy and thriving and talking in complete paragraphs. The numbers are unrelated to her development.

-Rachel
Mom to Abigail Rose
5/18/02


"When you know better, you do better."
Maya Angelou

http://www.gynosaur.com/assets/ribbons/ribbon_sapphire_24m.gif Two years and counting!

[audys]

All of the blood tests came back as normal, thankfully - I've been breastfeeding at every opportunity with some EBM or formula afterwards. I'm also pumping a lot - my milk has definitely been increasing... My baby is also gaining a little more weight (finally, after a month).

Your words of support and thoughts are very much appreciated,

Audrey, mother to Graham

http://lilypie.com/baby1/050210/3/15/1/+10/.png (http://lilypie.com)

[calebsmama03]

I just skimmed the responses and didn't see any on the teeth. C also bit a little when he got his teeth. He was slightly older when he got his top teeth (11 mos) but when he'd bite I would take him off and say "no biting" or "that hurts mama" and put him down. It only took a few times of this before he got the idea and quit biting. If he got upset I'd pick him up and comfort him but no nursing till next time. I also found he bit when he was just 'Hanging out" and largely done nursing.

I'm glad DS is starting to gain some weight. I'm curious, though, whether you have a specific reason for weighing him every week? If not, I'd encourage you to cut down on it! DS was never above the 10th % (at his 2 mos apt) and at every other apt was between 3-5%. He "fell off the curve" at 9 mos, but was still healthy and thriving. It is perfectly normal for BF babies to slow down their weight gain and drift lower on the charts after 6 months! As long as you've got confirmation that there is no underlying disease, please stop worrying yourself and stressing so much. Is your baby active, alert, and generally happy? A baby who is not thriving will be lethargic, sleepy, perhaps moody. The increase in mobility that occurs in the second half of the first year also causes a slowing of gain. Your DS is using more energy. Focus on getting good nutrition into him whevnever you start solids. Avocado, whole milk yogurt, cheese are all good (your ped may advise waiting till 9 mos for yogurt and cheese - everyone has different thoughts). Don't stress mama! I always told my MIL (who was concerned about whether he was gaining enough) that there is a curve for a reason - someone needs to be at the top, and someone needs to be at the bottom! Remember it is just a range of "normal" growth patterns - doesn't mean anything if your son happens to be at the low end of a normal pattern :)
Good luck!
Lynne
Mommy to Caleb 3/3/03
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Oh my!! #2 5/05