Amy Spangler

Should I supplement with rice cereal?

At Catie's four month check-up she weighed 12 pounds 10 ounces (her birth weight was 6lbs. 13oz).  Her pediatrician is concerned that she isn't gaining fast enough.  She has been sick this winter, first with pneumonia and then with RSV. During this period, she didn't eat well.  The past two weeks I've gotten her to take an additional feeding (for a total of nine feedings a day).  Her doctor suggested giving her rice cereal twice a day, but it was a battle to get her to eat it, so I quit after five days.  My question is:  Is she getting enough to eat from nursing alone, or should we try supplementing with cereal again (I refuse to give her formula). Thanks!





Based on the information you have provided, your daughter's weight gain appears to be acceptable for an exclusively breastfed baby.  However, the weight gain pattern may suggest otherwise and may explain your pediatrician's concern.  I think that an alternative way to achieve additional weight gain could be to do what you are doing - provide two extra breastfeedings per day. What is most important is that whatever you choose to do, you communicate your plan to your pediatrician and get her support.

Can't keep up with baby's demand to nurse!

I am hoping you can help me.  Breastfeeding has truly been hard for me.  I hear all about growth spurts, but Daniel has been on a growth spurt since birth.  He has never gone beyond eating every 1 1/2 hours.  He is always hungry.  His weight is excellent.  I have researched and read a lot.  This is what I have concluded:

We got off to a bad start.  I had no idea I wanted to breastfeed or no intention at all until he was 2 hours old, when they brought him to me.  He couldn't latch on, he didn't eat for 72 hours.  When I arrived home, I found the problem was his nose was clogged with hard stuff from my c-section.  I cleared it, and he latched right on.  No one told me about supply and demand, therefore I didn't express at all during that time.  There are other reasons as well that made me high-risk for underfeeding.  Now I am afraid I am not keeping up with the demand.  I tried to estimate his consumption from pumping and supplementing for 2 feedings to compare his actual need versus what I was producing.  After trying everything to increase my milk supply, I have begun to supplement with formula, something I'd rather not do.

What I am worried about is I was going to express when he took formula, to try and keep up, but I have never been able to let down without it being my son latched. Again, I've tried it all, Medela electric pump, hand expression...nothing works.  I get maybe 1-3 hours sleep every night, so worn out, I'm ready to do what I need to do to make us both happy.

Is it possible for me to keep breastfeeding as long as I will produce milk plus formula?  I try often to consult a lactation consultant - never can get through.  I talk to his doctor, it's just a growth spurt that continues that I can no longer keep up. Please help





It would be helpful to have more history related to your breastfeeding experience. Is this your first baby?  Have you breastfed successfully before?  A prior successful breastfeeding experience is usually a good indicator that a mother can have another successful breastfeeding experience.  Do you have any medical history that would influence your milk production? A history of breast surgery or breast injury can affect milk production.  How much did your baby weigh at birth?  How much does he weigh now?  If he doubles his birth weight well before 6 months of age, you might want to consider introducing solid foods prior to 6 months of age.

You should be reassured that there are some babies that breastfeed frequently until 4-6 months.  For many babies, 4-6 months is a milestone at which time they extend the periods between feedings.  To encourage this, breastfeed well on the first breast and when your baby seems satisfied or falls asleep, wake him and offer the first breast again, then offer the second breast.  The advantage of this feeding pattern is that the baby gets more hindmilk and less foremilk.  Hindmilk is higher in fat and calories than foremilk. Another suggestion, while you are feeding on the first breast, gently massage the breast when the baby stops suckling, to increase the flow of hindmilk.  We know that when you massage the breast while the baby feeds, more fat enters the milk.

Since you are breastfeeding every 11/2 hours, I see no need to continue pumping.  Use this extra time to take care of yourself and your baby.

What's the best ratio of breastmilk to solids?

I am concerned about the ratio of breastmilk to solids. Daniel LOVES solid foods.  He literally screams if we eat in front of him without sharing.  I always nurse him before solids, but most days now he will have three feedings of solid foods a day.  I mostly give him finger foods because I realize it is primarily for the experience and oral motor development.  He gets bread, a banana, goldfish or cheerios.  He also will get some homemade baby food - anything but meats - he loves it all.  I would say he averages about 6-8 oz. of 'solid' foods a day.  He nurses anywhere from 6-10 times a day. What should the ratio be of breastmilk to solids, and how can I regulate it not knowing how much breastmilk he is getting?





There is no ratio of breastmilk to solids that is necessarily recommended.  At your son's age, the schedule you are using is certainly appropriate. If he is satisfied and growing well, just continue to do what you are doing.

How much solid food should my son be eating?

Emric is very active at this point.  He's crawling all over the place and standing up everywhere.  I'm more concerned about solid food intake.  Since he is more mobile he got thinner and lost a lot of baby fat, and since he's discovering the world he doesn't spend as much time on the breast.  So, how much should I be concerned and how much should he be eating (average, knowing that every baby is different).  I also noticed that the size of my breast has shrunk since the baby is more active (I'm not pregnant for sure).  Thank you!





During the second half of the first year of life, breastfed babies gain less weight than bottle-fed babies.  In terms of your son's need for solids, three meals a day plus morning and afternoon snacks are appropriate.  Because he is so active, I suggest that you offer finger foods, such as soft-cooked vegetables (carrots or peas) or soft fruits (bananas).  Many babies like to feed themselves, so you many find that this is an easier way to get him to eat solid foods.

The decrease in your breast size is normal.  As you make less milk, your breasts will be less full and may seem smaller.

Worried baby is not thriving on breastmilk

My daughter was born a healthy 8 lbs 4 oz.  She was strictly breastfed until about a month ago.  At her 1-month check-up she weighed 9 lbs 12 oz and at 3 months she weighed 11 lbs 8oz, at her last check up, she was 4 1/2 months old and only weighed 12 lbs 9 1/4 oz.

I am worried that she is not thriving well on my breastmilk. I have begun solid foods and am supplementing her with 4 to 6 oz of formula, thinking the extra calories in the formula will help. Am I right about the formula, or is her weight OK?  Otherwise, she is a very active and happy baby. Thank you





Typically, we hope to see babies gain 4-8 oz per week during the first 3-6 months of life.  Based on this formula, your daughter is gaining weight appropriately, but at the lower end of the range.  To introduce solids at her age is certainly acceptable if she shows an interest in solid foods.  Take the lead from her, though, and do not force her to eat solids if she resists.  You may try offering finger foods, such as soft, cooked vegetables or soft fruits. Many babies at this age enjoy trying to feed themselves.

You ask about supplementing with formula.  I am reluctant to recommend formula.  I think you could achieve the same results by simply adding one or two extra breastfeedings each day.  This will increase your supply of breastmilk as well.



 

Important Disclaimer

This Breastfeeding.com service is designed to help visitors obtain advice and guidance. You are solely responsible for the outcome of any services and/or advice you are given.   Breastfeeding.com is not responsible for any services and/or advice given by the consultants, and shall not be liable or responsible to any person or entity for any loss or damage caused, or alleged to be have been caused, directly or indirectly by the information or ideas contained, suggested, or referenced. Your participation in this service is solely at your own risk