Breastfed Failure to Thrive 5Monthold.

First M. you need a big hug or a huge kudos or something to tell you that you are doing a wonderful job! You are doing all the right things. I find it disturbing that the doctor is ASSUMING that it is your breast feeding that is causing the slow weight gain. Do you believe that? Does he cry and fuss while nursing or after nursing or does he act satiated? Did the lactation consultant or the LLL leaders think your son was in danger? Did they have you nurse him while they were there so they could observe?

I completely hear you because I also took the herbs etc., supplemented with the taped on tubes and pumped every two hours under the advice of a not so supportive hospital lac consultant. Simply because she said at three weeks of age his weighing 3oz more after nursing on one breast was not enough. Boy do I wish I had gone to someone else at that point. I lived in fear, stressing myself and giving my son formula through a tube and then finally a bottle because I let someone scare me.

Most importantly please take care of yourself. That much stress is damaging to you. I know because I'm now suffering from adrenal fatigue because of living with constant stress. Find what your heart and gut is suggesting to you and follow it. Surround yourself with people who are supportive and don't say things like you are starving your child.

Second if he were my son I'd want to know if there are other things that could be causing his slow weight gain. Maybe you could ask at an LLL meeting for names of BF supportive doctors. I think it is a serious misjudgement to make assumptions when there are other medical issues that can cause the same symptoms.

Bottom line in my opinion a child at 5 months who is not getting enough to eat to satiate his stomach would be telling you in no uncertain terms that he is hungry. If he is not doing that I'd look for other undermining reasons for his not going weight.

I wish you the best!
S.

My GOD! You poor thing. You are so committed to nursing, and it sucks when your body, a baby or everyone around you doesn't cooperate.

I would suspect that there is not a physical issue with his nursing (for example poor latch or needing to have his frenulum separated) as you would have ridiculously sore nipples by now.

First, get a decent pump. Rent a hospital-grade pump. If you are having nursing issues, many health insurances will pay for it, so check that out. Work with a local lactation consultant to develop suggestions on when to feed and when to pump. Pumping regularly as well as nursing helped up my milk supply tremendously, and when you expressed milk, you know exactly how much your baby is getting.

But if you suspect that your baby is in need of supplemental formula (underweight or cranky-hungry a lot), then don't feel guilty doing it. Even some breast milk is better than none, and as long as you keep pumping when you feed formula, it shouldn't affect your milk supply and should be able to continue breastfeeding exclusively when you are both over the hump. And at 5 months old, you should be able to do some rice cereal, which you can feed with a spoon.

Try every kind of bottle you can find. My friend went insane when her daughter wouldn't take one when she went back to work. She finally found success in this bottle that has a soft top/nipple shaped like a breast.

Those baby height/weight charts drive me insane because they are only averages and don't take into account that some children are just smaller than others. And breastfed babies don't gain weight like formula-fed babies do. My sister's daughter was ALWAYS small. At her two-year checkup, the docs told her to feed her daughter LOTS of fried foods, butter and sweets just to put on weight. How on earth is that healthy?

Good luck to you!!

First of all let me tell you that with my first son he nursed just about 24/7! I am not kidding when I say he nurse at least 20 hrs out of a 24 hr period. I asked the lactation consultant about it and she said "it is "normal" he is just bonding with you". Well let me tell you I was exhausted because I never got enough sleep or even a break. Finally by 3 months old he wouldn't nurse because he had a cold & I was worried about he getting dehydrated so I gave him formula in a bottle & then he refused to nurse again he preferred the bottle. But at least I nursed non-stop for 3 months.
Now with my 2nd I was unable to nurse when he was first born because he had a low blood sugar & needed formula right away. I still tried several times to nurse after his blood sugars came up but he refused the breast. But let me tell you I am much more rested and less stressed. Plus I have a 22 month old to take care of too. But I pumped as much as I could & still do so he gets at least 2 oz of breast milk a day. I was a little sad we did not get to "bond" while nursing but I feel good that he is getting some breast milk.
So you need to do what is best for the baby right now! You can still nurse and bottle feed as well. But hopefully your child will be willing to do both as well. I am sure it will work out fine!

Hi! I have a 3 year old boy and a 10 month old boy. I had supply issues with my 3 year old. My mother is a nurse and was a mid-wife a long time ago in England. She recommended having a small glass of Guiness (yes, the beer) every day. In her words, 'helps the mum and helps the baby!' I have to say, I loved it. I didn't have much of a taste for Guiness at the time, but I grew to like it. And my supply improved and the baby seemed to thrive. So, perhaps you want to give it a shot? But, if all else fails, cut yourself some slack and supplement with formula. (I'm hoping that the baby will take a bottle.) Best of luck. and Cheers!

I was at this point two years ago my son at 4 months weighed in at 11lbs 12ozs. At 6 months he weighed 12lbs even. I was supplementing pumped Breastmilk mixed with formula. 3 oz BM and 2 ozs formula. He had this only when i wasn't able to nurse when i wa sat work. He also got some solids with the sitter. I also made sure that I nursed as often as I could. for two weeks I nursed as much as i could and fed him infant cereal (oatmeal.)I nursed one breast fed cereal nursed the other side. switched at night which side i used to nurse first. I also did alot of pumping at work and at home after every nursing session. also i would pump a little before nursing to make sure he go the hind milk as well try that.
he put on 1 lb in two weeks!! he was also a thumb or mom baby at this time and only took the bottle after he absolutely had to. My sitter got to feed him his solids more than me as well. he took it better than formula. By nine months he weaned himself.. The bottle could move with him.. I pumped until i was down to 2 ozs a session twice a day.. at a year he weighed in at 18 lbs even.. He is still in the 22nd % And he eat really well now...Hang in there baby will gain....

OMG, I have been there done that. My just turned 1 year old was failure to thrive. We dealt with it from the beginning though. The doctor just kept having us come in for weight checks and then accused me of starving him. It was so stressful. I was looking for any little thing that made him gain weight. He ended up in the hospital for 5 days where they made me stop breastfeeding and just pump. I wasn't getting a lot out of pumping, but they say it's not the same as a baby anyways. My doctor was so insensitive. He told me I couldn't breastfeed him anymore and I had to formula feed him. But he still wasn't gaining enough weight and the doctor just kept making us come in for all these weight checks. Finally I ditched that doctor and found a wonderful doctor who was willing to send him to a gastro doctor if needed. He didn't needed it. Turned out it was acid reflux. It was too late for me though with breastfeeding. I had dried up by now. Don't let this happen to you. I suggest you bring this up with your doctor. Once he was on meds for that he began to thrive. Demand that the doctor do something and test him. Here's what my original doctor was missing in my son. He didn't spit up a lot, but he did spit up like 2 hours after he had eaten. He always sounded congested. I thought it was allergies. Turned out that since babies don't start breathing through their mouth until about 6 months old it was all the acid backing up into his sinuses and stuff. If you don't feel your doctor is doing enough then you need to find a new one. Sounds like you are doing everything you can do. Don't let the doctor tell you that you are starving your baby. Get a second opinion please. Before you are forced to stop breastfeeding and then you dry up too like I did.

M.

well first of all congrats. your stress scale is very high.... make sure you are eating enough and as much as you want to pull away from your play group you may find some support there..... as holistic as you want to be your milk supply is adversly effected by stress so either remove some of the stress or supplement. there is nothing wrong with formula....mother of 13 11 8 and 18 mths breastfed and supplemented K. d

I had this problem when I tried to breastfeed our first son. After only 2 weeks we could see that he was not getting enough, I was totally stressed out and felt like a failure, and we said "this is ridiculous" and went to the formula and bottle. He immediately thrived, gained weight and was healthy as a horse. Best decision we ever made! When I look at his christening picture I cringe because he was so thin. Breastfeeding is NOT for everyone. Do yourself a HUGE favor and go to formula. The baby will thrive and you will have more time for yourself! Good luck

Health insurance may pay for a pump, if you get a script. You can also lease hospital pumps by the week cheap, also find out if insurance will cover. Deb

Hi there,

I am a mom of a four month old who just seemed to refuse to gain weight. She's still pretty petite now (at 12 lbs) but she's healthy. The problem I had was that I had an undetected retained placental fragment. This meant that my body thought I was still pregnant and therefore I had a VERY low milk supply. We started supplementing with formula (which I did NOT like having to do at all). I was pretty upset about it until this wonderful lactation consultant said to me, "You forgot the first rule of having a baby. Rule number one is always 'Feed the baby.' Doesn't matter how. Feed the baby." That made me feel sooo much better. I'm not sure how you would supplement other than what you are doing since your son won't take a bottle though. But if you're not feeling well (low energy, low milk supply, not feeling yourself) and your baby is not gaining weight, you might want to explore the possibility of a retained placenta. Not trying to scare you in any way whatsoever by saying this. It actually made me feel better once I found out what was going on because then I realized I wasn't doing anything wrong!! Best of luck to you!!!

Hi,

I was sooo stressed out trying to breastfeed my son. He just didn't latch on and I went to a lactation specialist. We tried everything including sugar on the nipple. What worked best for me was renting an automatic pump from your local hospital - its not that expensive and they give you it as long as little as you need. This might help and its cost effective.
Let me know what happens..

Been there.. I thought I was loosing my mind...

I am so impressed with all that you have done to ensure that you son is getting the best food and all of the other wonderful benefits that nursing your baby has to offer. You are great mom.
I have also had a baby that was labeled failure to thrive (he was just under 12lbs at 6 months). It is devistating to have a child labeled this. It is like a slap in the face when every moment of your days and nights are devoted to ensuring that your child is thriving. It is hard not to take it personally.
My son is now 4 and is a healthy, happy and very thin boy just like he has always been. At 4 he is only 27lbs. We have had several (normal) bloodtests, worked with his breastfeeding friendly dr., done diet charting/calorie counting, and seen nutritionists who were of course also breastfeeding friendly. Hindsight is great because I watch him eat as much as any child his age, if not more, and realize that he has a very fast metabolism. I can look back and know that I was not "starving" him and that with the measures that I took, my supply was quite good. He processes food very quickly.
1st off, take a good look at your little one. Is he happy, healthy, hitting developmental milestones? You mention that you sister had a similar growth pattern which is reassuring. Is it possible for you to buy or rent a pump? Has your child had any basic blood tests to rule out thyroid or metabolic issues? Getting blood work may give you some reassurance. Don't worry, you are not producing "skim" milk but it is important that you are eating well. Is it possible to buy a baby scale in order to do a once/week weight check? They are about $100 on line. At under 6monthes he should be gaining a minimum of 4oz/week preferably 5-6oz. The rate of weight gain tends to slow a bit after 6 months, especially once they start moving.
Quite frankly I am shocked that your pedi said that you are starving your baby. It is extremely important that your Dr. be supporive of you and to look at your baby as a whole, not just a weight. If at all possible try to interview some other dr's in the area.
What worked for me was was exclusively breastfeeding on demand 24/7 and pumping 3-4 times/day in order to supplement with my own milk. The first pumping was first thing in the morning after he nursed. This is when I got the most milk. The other pumping sessions were 2-3 other times during the day right after he nursed. I would get 3-4 oz in that morning one which I would save to give him in the evening (supply is usually lower in the evening) and the other sessions I would usually only get about an ounce which I would give right away. Pumping right after was a good way to make sure he was getting more hindmilk. He wouldn't take a bottle so I cup fed him or used a large medicine dropper/dispencer. I also did breast compression/ massage during the end of nursing sessions to help get just a bit more milk into him when he nursed. Between 8-11 months decreased my pumping to 2 times per day as he took in more solids. He still nursed a ton though and once he hit a year I put that pump away for good. We enjoyed a lovely nursing relationship well into his toddlerhood.
Since you have started solids remember to nurse first then give solids. Your milk is more nutritious and it will help to keep up your supply.
You mention that you have been taking fenugreek since he was 2 weeks old. You were not specific about how you take it but you should only do it in high doses for no longer 2wk stretches at a time. It is not something that you take as a regular suppliment. Also, oatmeal can help to increase supply as well.
If your child is growing (even if it is slow), happy, healthy, and hitting milestones than take a deep breath and relax a little. Still take whatever measures that you think are necessary to ensure that he is getting enough but rest assured that some babies, like some adults are just thin/small.
Check out the La Leche League website www.llli.org . There is a discussion area where you can email your issue and lots of breastfeeding savvey ladies are there to help (there is great advice here as well :)). You can also explore their resources area and find articles that you may find helpful. Get as much info and support as you can. Remember that you know your baby the best so trust your gut.
You are doing a great job.

Good for you being so dedicated to breast feeding. Hang in there! This is not an easy time- it sounds like, not only are you worried about your baby's weight gain, but you don't have much support. Even when everything is going perfect, having ones support network in place with such a young baby is so vital. So give yourself a lot of credit for working though this solo right now! As far as your baby's weight issue... perhaps being sick is part of the reason why. My 1st born gained weight great until he hit a sick spell and it slowed down drastically (temporarily). Keep nursing on demand and follow guidelines given to you by the lactation consultant (this is their specialty, so if the individual you met with wasn't helpful, find another one). Also, rather than supplement with formula/bottles, add in some more solids. I started mine at that age - they were so hungry - the different cereals and avocado, as you noted, is a great high calorie/good fat food! Reading your baby's cues for their appetite is the logical thing here as far as when to start solids (this was my pediatrician's advice when mine where that age). And make sure your diet stays full. You need the calories to keep producing your breast milk.

Hi M.,

I don't have personal experience with this issue with my children but my best friend has been going through this with her daughter. The doctors and other people had her so stressed out over her daughters low weight but she refused to give up nursing. They threatened the possibility of a feeding tube if she didn't gain weight. After every test uder the sun was run they found nothing wrong with her. She has met all of her milestones and is a happy little girl who didn't hit 16 pounds till after her 1st birthday. After months of stress and test after test they have accepted that she is just small (as was her father and his sister). She is now on mostly solids but still nursing a couple times a day. Listen to your gut and do not let anyone make you stop nursing if you do not want to. I know it is easier said then done but try not to stress too much since it can effect your milk supply. I wish you the best of luck no matter what you choose. You obviously love your son very much- you are his mother and know him better then anyone. Trust what your gut is telling you! Best of luck!!!

Hi M.,
I just had to repsond because I was in a similar situation. When my daughter was 7 weeks old, we packed up our home and moved from California to Maine! I couldn't get farther from my friends and family. Yes, stress is a factor. Without emotional support, it is hard. Moving and taking care of children also keeps us so busy we forget to eat/drink enough which diminishes our supply and possible makes it not taste very well. Keep bottles of water or gatorade around the house so at least when you are nursing you will drink.

Okay, my suggestions may not be very popular, but it worked for me and I ended up nursing my daughter until she turned one, so it was successful and she is thriving. I supplemented with formula. One bottle a day (given by my husband or me) gave me time to rest, relax and not stress about "how much is she getting" routine, etc. We usually did this before bed and it helped me be nice and full to nurse for her next feeding. I also had very sore nipples, so it was a break for them. :-> However, it sounds like you may be opposed to formula and are trying to pump? Then go to the hospital and rent a good pump. My pump was so-so and so i hated pumping--which therefore causes us to not pump well- you have to be relaxed. Rentals are normally cheap and it will get you through this rough patch you are having and increase your milk supply. A good pump is well worth the money, too. I plan on renting one for our next baby to see the difference in my supply. Also, M., often times babies lose weight at no fault of you. Sometimes babies do not thrive on mother's milk alone so i would follow any advice from your doctor to start a little cereal/vitamins and see if that gets his weight going.

But I am also encouraging you to not feel like a failure if you decide to quit nursing. You have done great so far and have tried many different things. At five months, your son has gotten plenty of your milk to benefit him. Sometimes lactation consultants are more like activists and make us feel like we are bad mothers if we choose a different route or supplement. Your happiness and relaxation will benefit your children more than you know. At least you gave it five months and many tries! You have done awesome, so don;t fret if you decide to wean. Hang in there girl!! D.

Are you pumping at all? I pumped as well as BF (and was staying home too) but we 'topped off' after my son ate with a small bottle to make sure he was getting enough (he was a preemie and we needed that double chin!) so maybe you can pump some extra and top off to make sure he is getting enough..or extra..

Hi M.,
I totally understand where you are, I was there 16 years ago. My daughter was born a month premature with a hole in her heart. She weighed 5lbs. 14ozs. and was 21", She looked like a frail G. bean. We put her on a bed pillow and passed her on that because everyone was afraid to hurt her. At 3 months she had surgery for a double hernia and went from the 25% to (the upper ;-) 2%. Her cousin was born full term a month later a 10lbs. and by 3 mos was 24lbs. Well I was the bad mother because I was nursing and starving her. I practically nursed her 24/7. They had me do the tube supplement as well and she wouldn't nurse at all. When she began on solids they said put butter in her food, she would eat one bite with the butter and a jar without. My M-i-L would come by and give her pudding and she would miss the next two meals. She just doubled her weight at 6 mos and barely tripled at a year. After that she was on polycose and pediasure. She was just a petite girl and wore the size of her age instead of twice that with the formula fed babies. You are right about the charts, they are made for formula babies not breast fed. My daughter is now 16, a junior in high school and we share clothes. She never put on weight no matter what we did until she had open heart surgery at 5yo. So try to drink lots of water and get plenty of rest and buy some ear plugs. I breast fed all 4 of my kids exclusively and not one of them has ever had an ear infection which the moms of bottle fed babies can't say. Stick to your instincts. You will know when to worry. As long as he is latching and you are getting let down keep at it.
Best of luck,
D. C, Mom of 4: G16,B14,11&8

How much did your son weigh at birth? Twelve pounds at 5 months doesn't sound outrageous to me.I just went through something similar with my daughter at 10months. She was in the 1st percentile on the standard charts but about the 25th on the WHO's charts for breastfed baby girls.
I would absolutely bet that the cold he had contributed. I also think genetics is a big factor. My children were bean poles too- my eldest now is 19, about 5'10" & he might be 145lbs soaking wet.

I am curious what type of build you and your husband have. My oldest was a chunky baby but is now stick thin but Evan has been thin from day one. He has always been off the chart for his weight and in the upper percentage for his hight. He is 18 months and barely weighs 23 lbs he still wears 6-12 months for clothing if he is meeting his milestones rolling over, smiling, cooing, etc I wouldn't be overly concerned. Some people are just small especially if you and/or your hubby are on the thin side. If your pedi is suggesting you are starving him when infact you are not perhaps its time to look for a new one. I've noticed some are just out there to find something wrong with everyone. I have 2 cousins that were below the chart and the doctor ran every test out there on them but if you saw my uncle and aunt it would make perfect sense to you why the girls are small they both are. A lot of size has to do with genetics so take a close look at people in both of your families and see how they are sized. Good luck.

Hi M.,

I am so sorry for your distress. I'm M. and the mother to a beautiful 15month old daughter, Angel. I am a single working mother since I was 6 months pregnant, so stress has definitely been a factor in my life. Angel lost the normal amount of weight when we left the hospital following her birth, but then had a hard time gaining it back. I was breastfeeding, pumping, but it wasn't enough. So I started supplementing with formula after just a few weeks. I was very lucky in the fact that she accepted the bottle, however soon after she started rejecting the breast. So I would pump and alternate between formula and breast milk. I have always used the Avent bottles. I know it's going to be a transition, but keep trying with the bottle, breastmilk and formula. Angel is now in the 98th percentile for height and weight and loves to eat. Good luck.

I love what Tracy G said about feed the baby. I had to relinquish my view on 100% breast feeding when despite enormous effort I couldn't meet demand. My lactation consultant had me nurse, then supplement a couple of ounces formula. (She also prescribed Guinness!) The relief you feel when your baby starts gaining steadily is indescribable. The tubing is hard, but eventually my son got comfortable switching between a bottle & breast. Good luck, hang in there - got to those mom groups if you can - I moved to NH the month before I delivered and my new mom friends are a god send! Good luck!!!

Oh my...

Your post had in me in tears and wanting to give you a hug. I understand your need of wanting to breast feed. I have a really nice electric pump that I'm done using. It's yours if you want it. I'll mail it, my expense

It's OK to supplement, Mama. Be kind to yourself. My daughter is 15 months old and I'm still breastfeeding but she throws back a bowl of soup and a cup of juice like the sky is falling. You CAN have the best of both worlds. Feed your child the best way you can. It's such a small phase of his life and such a small battle in the grand scheme of things.

Let me know if you want the pump.

~K.

My doctor tried to tell me once that my daughter was small about the same size as your son. I stopped him right then and there. My daughter was happy, not starving. Also my husband and I are both small people. That was how she was going to be. She still is very small, but very active. Some kids just have a high metabolism. I hate the docs are always trying to fatten up the kids, so that later we have to put them all on diets.

I do not have a lot to add to your direct question but wanted to state (as a current stressed out mom whose husband is out alot for a second job so that we can make ends barely meet right now) that you are doing a fabulous job. It is so hard to realize that when you are the only one and when the day is long or stressful or both. So, to you a big hug and kudos because it will all work out. Keep working with your pedi and the lactation specialists. The play groups might hlep with your older child for now....to ease some of the entertaining off of you for a bit.
Bless you and know that you are doing a great job!

This sounds just like my 2nd son. He was off the charts small in weight & height until his 8 month check up. At the 6 month check up, his pediatrician (who has been practicing for like 40 years) asked me if I was concerned about his size. He was 11 lbs 12 oz. I said no, he eats fine, sleeps fine, he's a happy baby! He gets enough to eat, he's just small. My husband was also a small baby and now is a tall, skinny man. The doc said I'm not concerened either, don't worry, he'll catch up. And sure enough, he did. He started eating more solids and I started supplementing (b/c I had to go back to work when he was 6 mo and I can never pump enough, either) and now, at 8 months he is in the 7% for weight and 9% for height. I think some new pedi's get too worked up and are too "by the books". If YOU aren't worried about his health, and he is a happy baby and not acting hungry, just chalk it up to him being a peanut. You know him best.

M.,
How totally stressful!!! You are doing so much for your baby-he is so lucky. The one thing I learned is that you know what your baby needs-don't listen to anyone else. It sounds like you have a lot on your plate and you should take it easy on yourself. My daughter was always petite and she cluster fed-which means I fed 24 hours a day. The nurse at my pediatrician's office said she was manipulating me-can you believe it? Luckily I did not listen to her. But I did supplement with formula, because I had to for sanity's sake. I breastfed for 18 months, but I did supplement early on. I was part of a breastfeeding support group at my local hospital and they saved me. No one judged the weight of the babies or the techniques of the moms. Now that you are introducing solid foods, it should meet some of his nutritional requirements and take some of the pressure off you. Pumping is probably the best way to increase your supply (I found that Fenugreek actually didn't agree with my daughter). Can you rent one from your hospital? As for the bottle-you can keep introducing it and maybe if you are able to pump and he tastes the breastmilk, it might help. Also, One Step Ahead makes "breast-like" bottles. I don't know if I'm actually giving you any good advice-I just wanted you to know that you are doing an awesome job and whatever you do, I'm sure it will be the best for your baby.

I think you've gotten some great suggestions already. It really isn't your fault, and whatever you decide to do, you are doing what's best for your kids. I agree - supplement with formula, if you can get her to take a bottle from someone else. Yes, "breast is best" but hundreds of thousands of children have grown and flourished on formula. She would still be getting all of the "good stuff" from breastmilk, just some extra calories from the formula. I had to go to a lactation consultant with my second, and she said "the most important thing is to feed the baby" - it made me feel so much better about supplementing. I obviously didn't want my son to be hungry, and it really put it in perspective.

Cut yourself some slack - you've got a lot on your plate with the move, the older child, and the new baby. I think if you supplement, once you get over the guilt (which you should dispense with right away) you will actually be able to enjoy being a mom of two more than you are right now.

Good luck!

Well, I exclusively bf so I know how it can be, and my 8 week old will not touch a bottle eather. This new stress could be a factor. I know that can mess up your milk supply. Are you going to be starting him on solids? That may help with the weight gain. It seems like all of this change may have messed up your routine. Hang in there, and try not to stress about it too much cause stress does not help anything. He is not off the charts.

Wow M.! The first thing I would do is stop stressing about every pound that he gains(or doesn't gain), stop focusing on "percentiles" this alone will drive you crazy! Every baby is different in how they gain weight, he could be on the verge of a growth spurt, or maybe you need to adjust some of the techniques for breastfeeding. I would definitely get a sling for nursing (Over the Shoulder Baby Holder is best for side lying nursing)and wear him in it as much as you can. I can go shopping, hiking etc. while nursing in a sling! Also, when you sit down to nurse, put him in the football hold and let him completely empty the breast before switching to the other side, this will help him get the fatty hind milk. Also, is he nursing for long enough? Do you let him stay at the breast enough? Please stop stressing about this, he will be okay! Stressing just makes it worse. I would not supplment with formula, this will male your milk supply go down, just nurse him as much as you can and make sure he is getting enough at each nursing. if you need any more advise my mom is a lactation consultant, doula, former le leche league leader and mother of seven, she is always willing to answer these tough questions, I can give you her email address! Good luck!

I went through something very similar with my son. I was lucky because he took to the bottle fairly easily. But, I was determined to breast feed only. I would consider more solids pending what your doctor says is good for him. If he doesn't like them, just keep trying. Cereal with breastmilk is usually best. But I went throug it all, the supplements, the tubes, the pumping every 5 mins. (ok, it seemed that way). Just keep in touch with his doctor. Keep trying new things. He's a stubborn baby. I really thing cereal and solids is the way to go. Good luck.

Hi M. - My daughter was very petite, and was in the 5% for weight most of her first year. She was my first, so I didn't know enough to be concerned, but my Mom was worried sick. I wanted to breast feed exclusively, but soon had to supplement for her health and development. My daughter wouldn't take a bottle from me (naturally, she wanted to nurse), so my husband tried, and it worked. I waited until it was time to nurse and started with breast milk in the bottle (you may have to try several different types), then I did 1/2 breast and 1/2 formula until it was all formula (you can then add a little cereal). It was a compromise, but it was what was best for her. If your husband is not home, perhaps you could enlist the help of someone form your Mom's group. Good Luck.

The most important thing I want to tell you and that I think you need to hear is " It's not your fault". Say it out loud and repeat it until you start to believe it. then repeat it some more until you can respond to any curious people with calm and peacefulness and a surety that your child is healthy- you did lead with that- despite his small stature. You make a good point that some could be related to genetics. I breastfed for 9 months and whenever either I or my daughter was sick, we hit a big road bump. When it was me, she nursed constantly which seemed to indicate the calorie content wasn't sufficient. This also occurred whenever my stress level rose! My daughter also would not take a bottle and so tansitioned right to a sip-cup. Food should help- have you introduced rice cereal yet?
Can you get outside help for a bit- maybe a pre-teen mother's helper for your 3 year old for a few hours in the afternoons so you can rest?
I'm sure you will get lots of good advice, but the main thing to remember is that no matter how you will proceed, you are keeping the best interest and health of you, your baby and your family at heart, so no matter what you choose to do you shouldn't feel guilty. We all do the best we can at any given time and that is to be championed and celebrated, never ridiculed or demeaned! Good luck and God Bless!

Hi M.,
I think you are doing an awesome job!!! While I am no expert, if your baby is happy in between feedings he is probably just fine!!! Remember your milk is perfect for him and he will take what he needs. You even said your daughter is tall and thin- that says something right there about the genetics. I hated those tubes and they never worked for me. The problem is they will interfere with supply and demand of breastfeeding. If you don't want to formula feed then don't. Lose the tubes and just nurse. Get yourself a sling so your baby can nurse on demand and you still have your hands free. Keep him on one side as long as possible so he gets fattier milk. Also, if you can pump a little before you nurse, you can get out some of the skim milk and just give him the heavier milk. (do keep the milk and freeze it to use later in cereal etc.) Of course if you want to use formula, that's ok- it just tends to reduce your supply which sounds contradictary to what you are trying so hard to accomplish. Avacado is a perfect first food too- lots of healthy fat- but healthy fat is healthy- not a weight gainer but good calorie- my babies loved it best blended with fresh pear puree. You are doing great. Take a deep breath and just look at your daughter who turned out fine- you're a great mom!!

Congrats on being such a great mother!!!

Your stress levels are completely understandable - but can be counter to your goals. So when I faced similar problems with my youngest son (now 3 yr) I was so upset by people telling me to be less stressed. Eventually I listened to one of the NICU nurses who was also a very effective Lactation consultant. She said that a good relationship with my son and his relationship with a healthy (in all areas) mom was most important. I had to go off Reglan (can't use it when facing postpartum depression) and move to fenugreek, which was not as effective. I felt horrible, but Chris helped me see that I was doing the best for my son - whatever you choose to do, it will probably what is best for your child and your family.

Hospital grade pumps are MUCH more effective and less painful. I mixed BM and formula for a 28 calorie mix to help my son gain weight (a good Lac. consultant would have the recipe for each type of formula) - he wouldn't take frozen milk but would take a mix of formula and fresh BM. As a preemie, he was never breastfed exclusively - and it took me a while to get over it. Once I did I cam e to enjoy the nursing sessions we did have.

We tried several different bottles before we found one he'd take that didn't make his reflux worse. Look into reflux too.

I hated the SNS the first time I used it - but not the second time (same baby a few months later). It really helped up my supply too!

One thing I haven't seen mentioned - skin to skin contact can make a difference. I nursed topless (at home, but NOT in public! ha ha) with no shirt on my baby. Sometimes we'd nap like that (use a sling to keep baby close and warm). Also, trying all sorts of different positions to help drain the hind milk (I had baby lie down on back and I leaned over on hands and knees - not comfortable but okay for a few days to get a jump start on the supply and hind milk). A really helpful book is Breast feeding your special needs baby - even if your baby isn't special needs. It gives lots of great advice.

Take care of yourself and your children - and things will work out okay. When you get to his wedding day, this will all be a distant memory and not such a big deal. I danced at my older son's wedding and we didn't focus on the all the stress and strife of childhood - but celebrated the man he grew into.

Hi M.,
I am so sorry that you are going through all of this!! How difficult all of this must be for you - all of this change and stress.

Have you gotten a second opinion from a different pediatrician?
I know that my daughter was exclusively breastfed, and she was always petite, and my Dr. always seemed to have a good handle on the difference between formula fed babies and BF babies...
It also seems that since your daughter was so petite that there might indeed be a genetic component to your son's weight?
My daughter was always petite but I think she might have been around the 15th percentile...but there was a time when we were really watching her head circumference as it was really small. I did some consultations with a lactation consultant in the beginning, and she was wonderful and very reassuring that my daughter was fine and gaining at an OK rate.

What I am concerned about for you is your stress level, which I do believe can impact your milk supply. Can you find a good mother's helper? Please join your local Mom's Club or other organization ASAP to find other new moms and to get some emotional support - or find a good therapist - or both! Can you hire someone for a few weeks (or even a few hours) to get some rest for yourself?
Are you willing to get a second opinion from a pediatrician familiar with breastfed babies? I love mine (we are in Framingham, MA - let me know if you want her info).

Keep breastfeeding, and keep up whatever services feel supportive to you. How is your son doing? Is he having the requisite number of wet diapers per day (isn't that an indicator of how much he is getting?).

Let your intuition guide you - if YOU feel your son isn't doing well, then seek other solutions, but if you feel he is doing fine then seek another Dr.

I am sorry my response has been so long (and maybe a little rambling) but my daughter is now 2 1/2 and isn't so petite any more! We go next month for her 2 1/2 yr check up, but I think she will finally be out of the 20th percentile for height and weight.

Good Luck to you! Take good care of yourself, it is the best thing you can do for your son and for your milk supply - and keep up the fluids!!
Warmly,
E.

Michele,
I know that you want to make sure that your child is thriving. First thing that I would say is RELAX. As fragile as they are, babies are also resilient.
My son has always been under the chart. His doctor was concerned when he was an infant and I got nervous, too. I worried that I wasn't producing enough milk. He was fine! I did things that you are doing: making fenugreek tee, etc.). I would say that the most valuable things that you can do are to get enough sleep and eat healthy. I made up a container of cut veggies (carrots, celery, sweet peppers, fennel, G. beans, cucumber...) at the beginning of the week and snacked on that instead of sweets. I tried to have lots of fruit around and good cheese. Drink lots of water and snack often. Babies can zap you of energy pretty easily. I had a hard time sitting down to regular meals when my kids were little, especially when I was nursing two. Noshing really helped (especially if I was able to snack wisely).
Keep checking in about the baby's weight gain/loss, etc., but trust that your son will thrive on love and snuggles (and you are doing everything right). It took until Ethan was 1 1/2 before his pediatrician was comfortable that Ethan is just a small kid. Remember that the chart is just a guide. Trust your own instincts. You are doing a great job! --- S.

Boy can I empathize and I am still going throught the whole weight issue. My son was born 6 lbs 6 oz and I breastfed him also. At his first appointment...the one about a week after he is born..and they told me that he was hungry and slightly jaundiced. From that moment on, I started to pump. As much as I wanted the whole breastfeeding experience, I needed him to eat and to relieve myself of some worry and guilt. He still got breast milk till he was 9 months, just through the bottle. I also had to take Fenugreek because my milk supply was not enough. Everywhere I went, people thought he was months younger than he was, and now at almost 13 months, they still look astonished when I tell them his age. He is 17 lbs. and considered VERY underweight, but he is 30 inches and his head circumference is right in line. When he was little, my pedi told me not to put cereal in his bottle. I am a first time mom and I wanted to do everything by the book. ALL of my mom friends said, "you'll regret it...put cereal in his bottle." I wish I had. I know that motherhood is trial and error and pediatricians are to be listened to because that is their career, that is what they went to school for, but sometimes you have to listen to your gut instincts. After last weeks appointment, I went crazy...bought pediasure, carnation instant breakfast, pudding, anything and everything with calories. Instead of Cheerios, he now has pancakes and maple syrup for breakfast. He has started to eat more. I think I was babying him toomuch. He wants FOOD, not baby food. The point I am trying to make is, I know you are worried, but it will pass. Try any and everything. If you have to give him formula...give it to him...he will eat and thrive, and you will be less worried.

Good luck

This is pretty much my story to a tee! I feel so bad for you because I know the emotional hell you are going thru! I had a 4 year old daughter when my son was born, I was never successful at pumping, my son was not gaining weight, etc. I, too, was attending LLL meetings and refused to give up nursing, tried the SNS, etc. I was SO torn! Long story short, I switched to formula (which to me felt like giving him poison), but continued to nurse as much as possible and did this for 6 months until my supply seriously dried up. I was on Fenugreek and Domperidone and neither was working. Eventually, he was refusing the breast and I was forcing him to latch on and at that point I realized that it would be better for our relationship to just give formula and stop trying to nurse him.
He has thrived on formula and is at 50% across the board. I would be the last person to tell you to give up nursing, so I just want to remind you that your emotional well-being and relationship with your baby is very important, so just do what makes you BOTH feel better.
As for your baby not taking a bottle, maybe you want to focus on that and see if the LCs have any suggestions. Try different bottles...even cup feeding is known to work!
I hope you find peace soon. Whatever your decision, it will be the right one for you and your baby.

M.,

I'm sorry for all the trouble you are having. I have a preemie so I know what you mean by everyone being so shocked when you say how old the baby is and how small. I had gone to LLL when she was 3 months old to talk about some trouble I was having and there was another mom there that seemed to have the same problem you are having. She was under stress, she wasn't eating well (her doctor never treated her for acid reflux thru her pregnancy and she thru up constently and her stomach couldn't handle real food any more) anyway her son was labeled as failure to thrive and she started supplimenting but her son would spit that right up. LLL told her to try and eat small meals all day long. Leave nuts and raisins out so you can grab some on your way to get the laundry, that kind of thing. Avocado, whole milk yogurt, cheese and crackers, babanas, things like this. They also said to start your day with protein and have protein 3 times a day. I found a recipe on the food network for these little eggs cups. Basically you put ham and cheese and herbs into a greased cupcake pan, beat eggs with milk and pour that onto the ham and cheese and bake. Eat some right away and save the rest in the fridge. This is great for me. I can just pop a few in my mouth while I'm fixing my daughter breakfast.
The other thing is to drink water. Not an over amount but enough to keep yourself hydrated.
You mentioned you started your son on Avocado's this week. Have you given him some cereal? If you make it up with breastmilk that more calories for him and iron too. All good things for him.
Of course there is the age old, rest when the baby rests and get some more sleep but do what you can with all that. When you go back to the doctor's make sure he knows how your daughter's weight was when she was a baby. And remember your son probably will not make up all the weight in a couple of weeks but he will over time.
I hope this helps a little. Stay true to your heart and heart your children.

Good luck,
L. M