Supplementing & Breastfeeding

Well, my first concern would be to ask you, according to whom is your baby not gaining enough weight? Those charts are based on an average of all american babies. Is your baby average? Ofcourse not! Perhaps you are of a different ethnicity than the "average" or you are taller. Who knows? Does your baby look healthy to you? Does she seem content? Remember, no one knows better than you what is best for your babe. You might try changing pedis if you dont trust yours 100%. You might try giving Kathy Truslow a call. She is ours and she is incredibly caring and i love her very much.
My next concern would be that a little one so young should not be on any sort of timed schedule for feeding. When my boy was a newborn he nursed about every 45 min. If you let your little one nurse more often you would get more milk and it would go strait to her- no need for pumps (man i hated mine) or concern about nipple confusion. Also, breast pumps are not really very good at stimulating more milk production. I think that our body is smarter than that. So i suggest just letting your little girl nurse more often. Our bodies are amazing and will, except very very rarely, always provide just what our babes need. If you are having a hard time finding more time to nurse i suggest trying one of the wraps that allows you to nurse with them in the wrap so that you are hands free. I used a Moby Wrap. I am a single mom. If i had not had my Moby i think i would have starved to death or worn drty clothes for the first 6 months, for lack of a chance to get anything done.
You might also try adjusting your diet. Are you getting enough fatty acids? Try foods like avocado, almonds, eggs. Be sure you are not 'dieting' in any way. If you feel your little one is not gaining enough weight, that means what you are eating is not proving enough fat and protein. Good luck, and just keep in mind that you know best, and your body will provide what she needs.

I am a single mom who breastfed as well( I had problems with my daughter gianing weight at 11-13 months old), may I ask how much she weighed when she was born and how much she weighs now? Is this something her doctors are telling you or is it your personal observation? (Sorry if I am too nosey) :) I have a friend who is a Certified Lactation Consultant and she could give you detailed answers to help you out so that you probably wouldnt have to even supplement with formula... if you are interested?

laura-
one important thing to remember, and i realize how hard it is with a newborn, a 3 and 5 year old, is to make sure that you are eating enough calories. your newborn was fairly good size (mine was 8lbs 15oz) and my doctor always reminds me to make sure i take in enough calories. if you are not eating / drinking enough, your milk will be of lower caloric value. i wouldn't worry about timing - nurse on demand and realize that exclusively breastfed babies gain weight at a much different rate than babies on formula (and the growth charts do not take this into consideration.)
best of luck.

Make sure your doctor is using the new WHO growth charts. The charts in current use in the US are based on a small study of suburban Chicago, bottle-fed babies in the 1950s and are simply innacurate when applied to breastfed babies. Your pediatrician might not have enough experience with exclusively breastfed babies to know what 'normal' growth is.

You can find a copy of the WHO chart to take with you to your next appointment at:
http://massbfc.org/news/growthChart2.html

There's also a great 'provider quiz' intended to see how savvy your pediatrician really is about breastfeeding issues. If you can talk him/her into taking it, (and you might want to, too!) that's at:
http://massbfc.org/cgi-bin/mbc-quiz.pl

Good luck and congratulations on your daughter's birth!

Hello, I can hear your frustration. Is your daughter's pediatrician concerned with her weight? If you want more milk, breastfeed more. Schedules are definitely not recommended with breastfeeding. Watch your baby for feeding cues (mouthing, rooting etc.) and nurse her then. Let her stay at the breast for as long as she wants, no time limits (years ago we would say 20 minutes on each breast, but that was never scientifically proven and was causing huge problems). Offer both breasts at every feeding. She may nurse from the second, but may not. Either is OK. Start the next feeding on the breast you ended on. If she wants to nurse after the second breast, return to the first. You are never empty. This will help increase your milk.

If you wish to supplement, use your own milk. If you pump after a feeding, use that milk to supplement with the next feeding. Formula sits in the gut for approximately 3-4 hours, so your daughter will not be looking for the breast. Breastmilk digests effortlessly, thus sits in the gut only 60-90 minutes. This is why breastfed babies appear to eat more. It is just that their nutrition is superior.

We experienced the same thing with my daughter, who is now 4 months old. She was born weighing 8lbs 6 oz and came home weighing 7lbs 13 oz and then went down to 7 lbs 10 oz. She always seemed content, but would rather sleep than eat. My pedi suggested supplementing 1-2 oz after each feeding, which I did, until my milk supply went up, which it did. Try not to be so hard on yourself. I also have 2 other children to consider, 2 1/2 year old twins, so I completely understand how you feel with the schedule. All I can say is that it seems to have fallen into place. I'm sure you are doing a great job!

Hi Laura,
I had a problem with my daughter gaining weight, still do and she's almost 3, but I didn't suppliment with formula because I knew she was getting enough to eat. I'd discuss it with your pediatrician and see if you *need* the extra. My daughter has been very active since birth and she wiggled off almost all the milk immediately. Talk to your Pediatrician and see what he would reccomend. I hope this helps.

C.

HI laura,
First of all, congratulations and good for you being a committed breastfedding mother. I had similar problems with my daughter. (After 4 weeks she was only at her birth weight) My advice is keep doing what you're doing and only after she has completely nursed offer a bottle to "top off". She will probably not be as interested in 2 hour nursings, since she will be completely full from her prior feeding. That's ok. It's the hard part I know, but it is ok. Also, you might try an herbal supplement called fenugreek. It will help boost your milk supply, but how much varies from person to person and the reasonings behind a lower milk supply. Also, please get some support. Your OBGYN or hospital could hook you up with a lactation consultant and contact the Le LEche League in your area. (They are an exceptional resource!)
It took me months to accept that my daughter really did need to supplement, (I had hormonal issues that screwed everything up) but she never preferred the bottle over nursing and I know that she got every drop of milk my body produced. With two other kids you might just need a few good days of rest and nourishment.
Good luck with it all!

Laura,
BOTH of my babies did not gain weight and needed supplementation. It was not the quantity they were getting, there just wasn't enough fat in my breastmilk. This is a very rare problem, and it has to do with a few of my own health problems.

Our breastfeeding clinic, and a pediatric dietician got us the help that we needed.

My 1 year old is almost 12 lbs (born 3 mo premature weighing less than 2 lbs). She is still TEENY TINY but at least she is growing now. Her situation is extremely complicated, but some of the things with her mimiced what happened with her older sisted so it helped us get her on the right track faster.

It is great that you caught her lack of weight gain early. Don't stress too much over it though. There are a lot of reasons why children grow at different rates. The most important thing is to make sure she is well hydrated and that her head circumference is growing. Pay a little attention to her development also. Weight isn't everything about a baby's health :). Both of my babies have trouble gaining weight but are "otherwise" considered healthy.

We went through a LOT trying to figure out the lack of weightgain in our oldest and are still working on finding out the route of the problem with our youngest. This is something I've been working on for 3 years now, so if you have any questions please feel free to contact me :). I have/am supplementing both of my children.

Let me know if you have any questions.

A.

I wouldn't supplement. The beauty of breastfeeding is that it automatically corrects for supply and demand. If you are planning on breastfeeding for the long haul (up to one year), then don't introduce formula...it will make your production go down, totally defeating your purpose. I have breastfed all three of my boys and they are all thriving!! Good luck.

my daughter was teeny and i was feeding her every 2 hours but she was actually burning more energy to eat
i pumped for her from the time she was 2 weeks old to 9 weeks to help her gain weight
now i'm breastfeeding her again the nutritionist from childrens hospital told me to add 1 tsp of formula for every 3 ounces of breast milk and this helped her gain weight too without having to keep giving her formula i also gave her one bottle of formula a day and feed her every 3 hours

One thought I had - if you are pumping right after feeding you might actually be producing more milk than your daughter needs so that when she breastfeeds she only gets the foremilk and none of the richer and more nourishing hind milk (that would be what gets pumped at the end. Since she is satisfied at the end of feedings, I'd say drop the pumping altogether or if anything pump at the start of the feed or between feeds.

My pediatrician (who I love) says it takes a few months to work out which percentile your child is at anyhow so not to take a higher birth weight followed by a lower weight too seriously. Breastfeeding so frequently with two little kids must be a challenge - I just have one 2-year-old as well as my newborn. I would also agree with the other mom who said to just nurse on demand and ignore timing. My son does cluster feeding where we wants to eat in little bursts and then he'll go a few hours without eating. He seems to keep more milk down that way, don't know if your daughter is spitting up a lot but if she has a severe reflux problem it could prevent weight gain.

Good luck, and don't stress about weight gain too much - your daughter will be fine if she keeps meeting developmental milestones no matter what she weighs.

Hi there! I have been having exactly the same issue as you. I have had some good feedback from Moms on Mamasource. Here is what I do... I supplement 2 times per day with 2 ounces of formula (usually at 12pm and 12am). Otherwise, I have been nursing whenever my 4 week old is fussy or chewing on her hands. We occasionally supplement with a 2 ounce breastmilk bottle as well. I pump 2-3 times per day... 1-2 times after she nurses and 1 time when she gets the formula I pump. It seems to be working well for us. In 3 days time she gained 7 ounces! Before we started with this feeding schedule she was only gaining 2 ounces per week. So, good luck! I definitely know how you feel! Stick with it!

I went through this with my son, too. It took me awhile to get enough milk for him. What helped me was Fenugreek. You can get it at any GNC. It is super safe to take (it's what they flavor some maple syrup with) and worked really well. I took some ridiculous amount like 16 a day (like I said, the Dr. at the breastfeeding clinic I drove down to the shore line to see assured me it was super safe) and I saw a difference almost immediately.

Another friend of mine tried this very recently with her son, but only during those times she felt like she didn't have much. It worked for her, that way, too. She was only on it for a week and only took 3 or so about 2 hours before the last night time feeding.

Hope this helps!

When my daughter was 2 weeks old we brought her in for her 1st doctor's appointment and found out that she had lost a little weight. The pediatrician didn't tell me to supplement, but I kind of freaked out and started giving her 4 ounces of formula a day. By her next visit she had gained a significant amount of weight. However, this made me fall back on "the bottle" which I regret now because it led to me not pumping as much as I should and when I went back to work she had formula while I was gone and I fed her as soon as I got home, during the night, and first thing in the morning. Eventually she started sleeping through the night and by 3.5 months she had completely weaned herself off me. I was devastated. I guess my point is, I agree with the suggestion of seeing a lactation consultant if you'd rather not give her formula. Maybe there's some vitamins you can take to give your milk supply a boost.

While I was babysitting my nephew I supplemented formula for him in one bottle in the morning because my sister couldnt pump enough to get him through the day. But I nursed my son and he is the tineiest little guy but healthy and up to speed so I woulnt be to worried about it.

Hi Laura, the 1 st thing you want to do is breast feed your baby then supplement.that way you get the stimulation on your breast that you so need, after you nurse your baby you must pump.AND when you supplement you can do that with a small soft sided cup or a medicine dropper or even a spoon babies do not always need a bottle to get their supplement. You can also add breast milk to formula if you cannot pump enough. I know that is a taboo, but we want a healthy baby & mommy. One keeps the other one healthy. Make sure you pump 1st thing in the morning, after the 1 st feed. that is when you will get the best yeild of milk & do it on a regular bases......it works on a supply & demand...no demand & no supply
..no stimulation...no milk.....good luck...Kathy

I always found that nursing my three kids on demand worked best. My first daughter was very small (under 6 pounds) and I remember arguing with the nursing staff who wanted to give her sugar water.... She is still small for her age (40% percentile - but very healthy and almost 16 years of age). As long as she is healthy and your health provider agrees, let her be. In a few months, you can give her solids anyway! Good-luck!

Are there still wet diapers and bowel movements?

I exclusively nursed all three of my babies, and they all gained weight at slower rate then the norm.

My daughter Willow is a tiny thing... But doctor wasn't concerned, he said as long as their diapers were wet, they were getting enough to eat.

My daughter didn't break the twenty pound goal until she was eighteen months old...
But has always been happy and healthy, and a smart little cookie...

A great way to meet your baby's needs at night is sleeping with your baby, or using an Arms Reach Co-sleeper. This allows us Moms to get as much rest as possible! Good Luck, and stay away from supplements as that will only make you lose your milk. Remember that the period of time your baby will be nursing so frequently is really such a short period of time. And nursing is so much more than food. You are doing a great job!

It's good that you got the scale--knowing exactly what your child is getting is key to deciding whether or not you need to supplement. I would HIGHLY recommend seeing a lactation consultant as well to help you decide the best course of action.

I will tell you that it does sometimes happen that there are women who simply do not produce enough breast milk, no matter what they do or how often they feed. I was very resistant to supplementing, but in the end, I had no choice: I was one of those women. I took fenugreek, more milk plus, drank beer, ate oatmeal, had the baby attached to the breast almost without breaks, pumped every two hours--you name it, I did it, and in the end--my Son is now 6 months old and myself and my LC recently decided that I just wasn't going to make more than I make! I supplement 3-4 times a day with anywhere from 3-6 ounces of formula (I can't pump enough to supplement with breastmilk). I base my supplementing on HIS cues--he only gets a bottle when he starts to get frustrated at the breast, and then, I feed him until he is no longer frustrated.

I do not produce more than an ounce from BOTH sides put together at any given feeding--this is what the scale revealed, and this is what my pump confirms.

Don't feel guilty--don't let others make you feel guilty--but DO see an LC and DO do what is best for your child, whatever that is. I sincerely hope that you are not like me, that you CAN get your production up. If you ARE like me, however, my son still LOVES to nurse, he gets every bit of milk that I am capable of making, and he is tracking just fine in the 25th percentile.

Best wishes to you in whatever you decide to do!

I strongly feel that supplementing is not the best idea. As long as your daughter is gaining a little and not losing, she should be fine. If she doesn't seem hungry all the time, I would hold off on formula. Drink lots of fluids. Try other methods of stimulating milk production, if possible. It seems like doctors freak out if your baby isn't on the same curve as everyone else--but you know what? to some extent that is ok. I am sure this will work itself out in a couple weeks! Good Luck!

nurse longer and more often nursing every hour and for longer intervals if the baby will take it will bring in more milk

Laura,
I had a very similar situation with my first child, but it was at 6 weeks that I was told to supplement. I would nurse and then offer her a bottle of pumped milk or formula. She would take 2 oz or so. Then I would pump (to stimulate more milk). And then 3 hours later or so, we would do that again. As time went on (I did this until she was about six months), she would take up to 4 oz by bottle afterwards. However, she did start sleeping thru the night...like 10p-6a at 9 weeks..and did so most nights (or there was the 2 am feeding). I'm glad I did it as she was much happier, less fussy, easier to handle. Also, because she was my first, I really had no idea what else to do. I think you can stick to solely breastfeeding, but I would consult an excellent lactation consultant for a plan as to how to do that. Either way, you've got to get her to gain a reasonable amount of weight.

Good luck. H.

I also had the problem of not having enough breastmilk for my son, although we had to deal with the problem much earlier and resorted to supplementing formula much earlier as a result. I tried everything that was recommended to me (fenugreek, brewer's yeast, pumping, cluster feeding, etc) to produce more milk, but nothing lead to my producing enough for him to gain weight. In fact, he continued to lose for a good 3 weeks after birth, going from 9 lbs. 12 oz to 8 lbs. 6 oz. Once we broke down and supplemented, we settled into a routine. By 8 weeks, my son was down to 7-8 feeds/day (that was what worked for us getting sufficient naps and meals -- he was a very slow eater then). Anyway, whenever he nursed, he would nurse both sides until I was empty, and then if he seemed to want more, I would supplement with 1-2 oz. formula. Instead of spending all that exhausting time pumping, you could try giving the formula through a supplemental nurser. That way, your breasts are still stimulated to make more by the baby nursing, but you save yourself some time and effort!

All that said, this was a typical day for me when he was 8 weeks:
3:30 am -- RL 20 min.
6:30 am -- LR 25 min. 2 oz. form. -- nap 8 - 9
9:10 am -- RL 30 min. 2 oz. form. -- nap 10:25 - 11:35
12:00 pm -- LR 40 min. 2 oz. form. -- nap 1:30 - 3:20
3:30 pm -- RL 45 min. -- nap 5 - 7
7:00 pm -- LR 30 min. 2 oz. form -- bed 8:30, woke for feed
10:10 pm -- RL 30 min. 2 oz. form. -- bed 11 - 3:35

I was very committed to breastfeeding (and was able to continue it until he was 8 months or so and I was pregnant again -- he refused to nurse anymore), and I felt terrible when so many people told me "the body is made to do this; formula will wreck your breastfeeding" etc. I felt like a failure. Thank goodness I had other friends who encouraged me and supported what we ended up having to do. Know that Mother Nature doesn't always work the way she's supposed to, and your body doesn't always supply what's needed, no matter how hard you try! You can breastfeed and supplement at the same time, if it comes to that. I'm proof of that. Just don't let it beat you down! :)