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*Update and I am so upset. My 6mo is losing weight.

Posted by on Dec. 18, 2012 at 1:46 PM
  • 27 Replies

I cancelled Wednesday appointment.  She obviously is not the right physician for us.

UPDATE
So I have been doing things differently these past two weeks and thought things were going so much better.  I was confident going in today.  Well then I left there in tears.

I honestly feel like they ganged up on me.  In 2 weeks she gained an ounce.  So she did gain something but not enough.

They want me to stop breastfeeding for 2 days and give only formula.  Then to pump not to keep my supply up but to record how much I expressed.  ? Makes absolutely no sense. 
She said if she doesn't gain what they want (which I didn't even ask because I don't want to worry about it these two days).  She did say that at 6 months babies should be gaining a 1/4 of an ounce a day.

Then she said if she doesn't gain enough by Wednesday that they will admit her because there could be something else going on.  Like it was a threat.
 
I want to cancel the appointment but in the back of my mind I think what if something is wrong and I ignore it then I will be doing more harm then good.   Her 9 month appointment is with a different doctor!  All my babies have been smaller and off the chart so why are they being like this with me now.



So my 6mo old went to the doctors yesterday and apparently dropped a couple ounces.
At her 4 month check up the PA suggested I start supplementing with formula.  Kylee is my 3rd and all my babies have been small so that went in one ear and out the other especially since she had gained some weight.  
Kylee was in around Thanksgiving for being sick.  On 11/30 she weighed 12lbs 5oz.  Again gained from the last time she was in there.  Yesterday she weighed 12lbs 1oz.   So they gave me formula samples and want her back on the 12/31.

They suggested I nurse her like normal and give her 2-3oz of formula afterwards.  I haven't done it yet but I feel like I should.  I am tempted to give her BM (instead of formula) in a bottle after nursing.  I have plenty of milk so I was shocked.  
She nurses both sides about 6x a day.  She nurses on demand so it varies but that is the average.  Plus plenty of dirty diapers.

This is the longest I have EBF and I really thought it was going well but now I am seriously second guessing myself. 

I should add her birth weight was 7lbs 3.8oz and her lowest  weight was 6lbs 14oz.  So she hasn't even doubled weight yet.  :(  

What would you do? I would love your input.  

 

by on Dec. 18, 2012 at 1:46 PM
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Replies (1-10):
annaica
by on Dec. 18, 2012 at 1:53 PM
There is no reason to supplement with formula if you have breastmilk available to supplement with.
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annaica
by on Dec. 18, 2012 at 1:54 PM
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But personally, I wouldn't supppement. I would just try to nurse a little more :)
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K8wizzo
by Kate on Dec. 18, 2012 at 2:01 PM

I would try to nurse more often--every 1-2 hrs during the day--instead of supplementing .  She could have lost more agter the ill appointment if she was still sick and is now working on gaining that back.  Does she have any signs of a tongue tie?

Is My Baby Tongue-tied?

Now that more mothers are breastfeeding, tongue-tie (ankyloglossia) is on the forefront of medical research again. Some tongue-tied babies breastfeed without difficulty, others cause their mother pain, don't get enough milk, or have difficulty swallowing properly and are very unhappy during and after feeding.

If you are concerned that your baby may be tongue-tied, the following may help you decide if you need more help. An IBCLC (International Board Certified Lactation Consultant) can help with breastfeeding, and many different dentists and doctors can help if your baby needs treatment for tongue-tie. Seehttp://www.lowmilksupply.org/frenotomy.shtml for a list of doctors and dentists who are particularly good at diagnosing and treating tongue-tie.

The first thing to assess is whether your baby can stick out his or her tongue. If you touch your baby's lips, he will probably open his mouth. You can then touch the front of his lower gum with your fingertip. This makes him stick the tongue out. We want to see the tongue come out flat over the lip, without dipping down or pointing down. If your baby can only stick his tongue out when his mouth is closed, that can indicate a posterior (further back) tongue-tie.


Next, we want to see if your baby can lift her tongue way up to the roof of the mouth. All the way up is perfect, half way is enough for most babies to be able to breastfeed. Again, her mouth should be wide open. Most tongue-tied babies can only lift their tongues when their mouths are mostly closed.


Obvious and Sneakier Tongue-ties:

This baby (figure 3) has an obvious tongue-tie. You can see the membrane right at the front of the tongue, and you can see how it makes it hard for him to lift his tongue up.

figure 3

The baby in figure 4 is also tongue-tied. If you run your finger along the outside of a baby's lower gum, her tongue will try to follow. If the tongue twists like this, it's a sign of tongue-tie.

figure 4

The baby in figure 5 has a sneaky (posterior) tongue-tie. You can see that it is difficult to get a finger under the tongue. If you press on the front of the little membrane under the tongue (the frenulum), a tied tongue will pull down in the center like this. This shows that the frenulum is tight and does not allow the tongue to move well. This diagnostic trick is called the Murphy Maneuver after Dr. Jim Murphy of California.

figure 5

Figure 6 shows a very sneaky tongue-tie - a posterior or submucosal one. The frenulum (membrane holding the tongue down) is hiding behind the floor of the mouth (the oral mucosa). You can see that the tongue doesn't lift very well, and that the floor of the mouth is tented out a little.

figure 6
figure 7

Notice how when the baby in figure 6 tries to lift her tongue (figure 7), nothing at all is visible except the limited ability to lift the tongue up.

Again, some babies with posterior or submucosal tongue-tie can breastfeed, others have a lot of difficulty. Moms breast and nipple shape and milk supply can make things easier or more difficult for the baby.

The best way to diagnose a posterior tongue-tie is to lift the tongue with a grooved director. Doctors who treat tongue-tie usually have one.


The final thing to do is watch your baby cry. If only the edges of the tongue curl up like in figure 9, that's a sure sign that the frenulum is tight.

figure 9

Now that you have an idea whether your baby has normal tongue movement ability or not, you can decide what kind of help may be most useful.


piwife
by on Dec. 18, 2012 at 2:07 PM
That is not supplementing that is full on formula feeding. 2-3 oz is a full feeding so by nursing then doing that is horrible advice. 1st is causing your supply to drop and 2nd is causing your baby's tummy to stretch out. Like others said check if baby is tongue tide.
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_Mrs.H_
by Member on Dec. 18, 2012 at 2:10 PM

No tongue tie.  We had a painful beginning so that is one thing that they checked but it was just a bad latch that was corrected.
I figured being sick probably added to it.  I was waking her to eat during that time because all she wanted to do was sleep. 
 

Quoting K8wizzo:

I would try to nurse more often--every 1-2 hrs during the day--instead of supplementing .  She could have lost more agter the ill appointment if she was still sick and is now working on gaining that back.  Does she have any signs of a tongue tie?

_Mrs.H_
by Member on Dec. 18, 2012 at 2:42 PM
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So glad I came here.  I figured you guys would be my reassurance on not giving the formula.

I was searching the web and one of them said about expressing some milk before nursing so baby gets more hind milk.  Does anyone think that is necessary?  I do plan on putting her to the breast more.  Hopefully that does the trick and I won't have to worry about this anymore.

melindabelcher
by mel on Dec. 18, 2012 at 3:16 PM
1 mom liked this
The nutritional makeup of foremilk vs hindmilk is the same. Matter of fact oversupply moms usually have large babies and they get primarily foremilk.
Can you give a full weight history? how are wet.diapers? Milestones?
Expected weight at 6 months is 12.14 so hes really right on.
My post "holy 9mo old" my dtr is 9mo and weighs 12lb10oz only gained 4oz since mo. shes very high needs, fussy nurses 15-20 times a.day but makes adequate diapers and is meeting all her milestones.
Google watch the baby not the scale. Theres much more to overall health then the scale and realistically weight would be a late sign of a problem.
Your doing great mama.
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mostlymaydays
by Group Admin - Stacy on Dec. 18, 2012 at 3:40 PM
This is true! Breastmilk averages 22 cal/oz versus formula at 20. So if you have breastmilk to supplement with them that should be your first choice.

Neither of my girls doubled by 6 months. They're "on their own curve" below the dreaded growth chart. Whatever. I'm small, too, probably "below the charts" for females my age.


Quoting annaica:

There is no reason to supplement with formula if you have breastmilk available to supplement with.
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K8wizzo
by Kate on Dec. 18, 2012 at 3:58 PM

Blockfeeding reduces supply, and thus calorie intake for babies.  SWITCHFEEDING (offering both sides 2-3 times during each feeding) increases supply and thus calorie intake.  Research shows that it is the VOLUME of milk that affects infant weight gain, not hindmilk vs foremilk.

OP, you can do compressions while nursing which will increase the fat content in your milk, but when you are in a situation where supplementing is being talked about you NEVER want to decrease your supply.

Info about foremilk and hindmilk: http://thefunnyshapedwoman.blogspot.com/2011/05/foremilk-and-hindmilk-in-quest-of.html and http://kellymom.com/bf/got-milk/basics/foremilk-hindmilk/

Quoting bloomsr:

You could also try block feeding to get more hind milk to your baby (nurse on o raise for a few hours and then nurse only on the other side for a few hours).


_Mrs.H_
by Member on Dec. 18, 2012 at 4:07 PM

Yea then she is not too far off.  The PA said that she wouldn't have suggested it if she gained a little to stay on her own curve.  I think I have my mind made up to try some more things before I offer the BM in a bottle and certainly before the formula.  I am really afraid she will prefer the bottle and then that will make everything worse.  
Birth she was 7lbs 3oz
1 Day 6lbs 14oz
2 Days 7lbs even
1 month 8lbs 12oz
1 month 9 days (sick) 8lbs 15oz
2 months 10lbs 5oz
4 months 11lbs 14oz
5.5 months (sick) 12lbs 3oz  One week later 12lbs 5oz
6 months 12lbs 1oz 

She is doing great with milestones.  Not much of a talker but she rolls both ways to get where she wants and can sit unassisted.

She has about 6-7 wet diapers and usually one soiled diaper everyday.  Rarely does she go without pooping but this past Thursday and Friday she didn't go.

I will be sure to check that one out.  I don't think I came across that in my searches last night.

 

Quoting melindabelcher:

The nutritional makeup of foremilk vs hindmilk is the same. Matter of fact oversupply moms usually have large babies and they get primarily foremilk.
Can you give a full weight history? how are wet.diapers? Milestones?
Expected weight at 6 months is 12.14 so hes really right on.
My post "holy 9mo old" my dtr is 9mo and weighs 12lb10oz only gained 4oz since mo. shes very high needs, fussy nurses 15-20 times a.day but makes adequate diapers and is meeting all her milestones.
Google watch the baby not the scale. Theres much more to overall health then the scale and realistically weight would be a late sign of a problem.
Your doing great mama.


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