Supplementing with Solids?

[bh310]

I'm at a loss with what to do with my DS. He will soon be 5 months and while his weigt gain in on track now (but still not on any growth charts), he is now drinking two 6oz bottles during my work day (I nurse him at lunch) and his caregiver is telling me that he is still not satisified after that bottle.

I can only pump 9-10oz a day (thankfully I have a large freezer stash and I pump on the weekends), but still I'm going to eventually run out.

So basically I'm considering letting the caregiver give him some solids after his bottle if he's still hungry, but I'm not sure if this is a good idea or not.

I was considering seeing if some banana's or avocado (higher in calories at least) would be a viable alternative to help him while I'm at work.

He rigtht now will drink 6oz and be starving again 3 hours. I'd love to say he was being overfed, but he was getting 4oz and not gainning weight.. not to mention screaming hungry until I showed up for lunch, or after work.

Sorry to be so long here, basically I'm just looking for advice. I don't plan on weaning him and I would really like to keep him breastfeeding for a lot longer.

BTW I'm on domperidone for supply already and still can't pump more than that so I've tried everything on increasing the pumping amount with no success.

[fell4myfallbaby]

i started solids around that time. just make sure he is ready. and it's not supplementing if you give the breastmilk first. go to wholesomebabyfood.com to find what he is reasy for.

[Amy_G_]

Ask the care giver to break the amount of food he has up into smaller amounts with a small break in between. Give 2 ounces, let it settle, burp well and then give 2 ounces more, let it settle and then give 2 ounces more, let it settle. He will probably feel more full for longer.

when you are together, encourage him to nurse more often to up your supply better than domperidone and a pump will. Also if he eats more while you are together, he won't be as hungry when you are apart.

I'd consider co-sleeping or waking him in the night to nurse if he's had weight issues. It would encourage him to reverse cycle (eat more at night than during the day) if you are just unable to pump more for him. He needs a certain number of calories a day--and if he gets them when he's with you, he won't need to get them as much when he's away from you. kwim?

Honestly, if he's had weight issues, and you cannot provide enough breastmilk, I would look into private milk donation (link in KerryS sig line) or formula. For the most part, breastmilk is more calorie dense than any solids will be, and if he needs the calories, the solids really aren't gonna do him any favors.

When the two of you are together, can you nurse him on one side only and pump the other side to stimulate more supply? does he nurse on one side or both sides at a feeding? If you keep him on one side, it helps ensure he gets both foremilk and the fattier hindmilk. If you switch sides, he may fill up on a lot of foremilk with some hindmilk and be hungrier faster and not grow at his intended growth rate.

Based on the number of posts about babies that can't poop that just started bananas, I might do avocado before bananas. :) I always did cereal first--you can get better ones than gerber wallpaper paste--or make your own. I then combined breastmilk with the cereal, and if there were weight issues consider a breastmilk fortifier in powdered form (formula) to give a more calorie dense food. Or do the same with cereal, avocado and a bit of breastmilk to make it runnier. of course, you wouldn't introduce all those new foods at once.

[bh310]

Thanks for the great info!

I do co-sleep now and he nurses 3 times during the night. If he's with me all day (weekends) he still nurses every 2 hours all day and I do an extra pumping in the mornings even on the weekends. Through the week I pump 3-4 times a day. He doesn't take any paci's and I'm not sure if he nurses so much on the weekend because he just can't get full, or if he just needs more mom time. Either way I figured it was better for my supply.

My supply took a big dip about a month ago (we both got ill) and it is back to normal now, and he is fine when he is with me, I'm just looking for alternatives to adding more milk whille I'm gone. With the addition of the extra 4 ounces a day while separated his weight gain is back to an ounce a day. More or less right now it's that he isn't happy with the amount we are giving him.

His caregiver is awesome with the bottle. He has a slow flow nipple and every two ounces has to stop, burp, pause, and she switches the arms she was holding him in. All in all the bottle takes him 45 minutes (don't get me wrong he would gulp it down in 15 if we let him). So she's tried everything to streach it out.

I guess were I'm at is deciding if solids are a better option than formula at his age. I will continue with my frozen stash until it runs out, I'm just unsure where to go from here. My ped is fine with either.

[Amy_G_]

If he is showing signs of readiness for solids, I'd consider solids.

If he isn't really ready for solids, and needs more, I'd consider private milk donation or formula.

Signs of readiness means he meets all of these:

*Baby can sit up well without support.
*Baby has lost the tongue-thrust reflex and does not automatically push solids out of his mouth with his tongue.
*Baby is ready and willing to chew.
*Baby is developing a “pincer” grasp, where he picks up food or other objects between thumb and forefinger. Using the fingers and scraping the food into the palm of the hand (palmar grasp) does not substitute for pincer grasp development.
*Baby is eager to participate in mealtime and may try to grab food and put it in his mouth.

Also, he may be teething, and the pressure of the bottle nipple on his gums feels good. so be sure he has plenty of things to chew on. you could consider a baby safe mesh feeder with frozen breastmilk ice cubes (they are about 1 ounce of milk).

[bh310]

Are the frozen BM just a cube in the feeder??? I have one of those and I'm thinking of trying that out for sure.

I don't think he's quite teething, but since he can't tell me I will give that a try. I also planed on trying the breast milk slushie too. I'm thinking that could entertain him and see how he does with a spoon. Maybe we could make it the extra month with this...

Again, I really really appreicate the advice!

[Nipple_nectar]

Would you mind sharing your pumping/nursing schedule? Maybe we can help you tweak it a little:)

Tell me what kind of pump are you using?

[madelsmama]

nak

I would not consider introducing solids prior to 6 months of age.

http://www.kellymom.com/nutrition/solids/delay-solids.html

[majubee]

He rigtht now will drink 6oz and be starving again 3 hours. .

did I miss something? after 3 hours he is hungry again, sounds normal to me. my baby is 9 1/2 months and still nurses on demand, which is every 1-3 hours.

[bh310]

He's actually never happy with the 6oz bottle, but both my LC and Ped said that he shouldn't want to eat again in 2-3 hours after consuming that much by bottle. From our before and after weights we know he only takes 2-3oz by breast so that is almost 3 times what his intake by demand feeding is. Of course he's always nursed every 2 hours never 3.

[majubee]

He's actually never happy with the 6oz bottle, but both my LC and Ped said that he shouldn't want to eat again in 2-3 hours after consuming that much by bottle. From our before and after weights we know he only takes 2-3oz by breast so that is almost 3 times what his intake by demand feeding is. Of course he's always nursed every 2 hours never 3.

it only makes sense that he would be hungry again after 2-3 hours. the amount in the bottle shouldn't matter IMO. if he wants to nurse every 2 hours then it only makes sense that he would be hungry again after 2 hours since his bottle.

does he take a pacifier? maybe he just has that over whelming urge to suck.

bottles are quicker to drink from so lots of babies drink more when they take a bottle than when nursing.

it just all sounds normal to be and it sounds like your peida and LC are a bit confused.

sounds like to be he should be offered a 3-4 oz. bottle every 2 hours anyway since he normally nurses every 2 hours. I don't like the idea of putting a baby on a schedule. I nurse on demand but I guess that is hard to do when you gotta work.

[KerryS]

At that age, if the option were between formula and solid foods, I'd go with solid foods. However, if you absolutely NEED to supplement with something, I'd consider private milk donation first (see my sigline), but only after I've pumped as much as feasibly possible in order to provide my own EBM to my baby. In order to maximize that, I'd try taking domperidone and fenugreek in order to maximize pumping output. So, I'd try the following steps in this order:

1. Pump more often
2. Take herbs/medications to increase pumping output
3. Donor breastmilk
4. High quality, nutrient and calorie dense fresh fruits and veggies
5. Formula

I really think that he's being overfed by the DCP, and that he doesn't NEED as much EBM as he's getting or that the DCP thinks he needs. I'm wondering if he has a high suck need, rather than hunger. You say he's not satisfied after 6 oz. of EBM. That right there is the biggest clue. 6 oz. should MORE than fill up any baby. If he's still unhappy after that much, then it must be something other than hunger going on. Not to mention, he's satisfied after taking 2-3 oz. from you when he nurses, right? So clearly, 2-3 oz. is what's needed to fill him up. He's looking for something other than food, IMO.

[KerryS]

it only makes sense that he would be hungry again after 2-3 hours. the amount in the bottle shouldn't matter IMO.

Why would you think that the amount given wouldn't matter?

Let me ask you this:

Are you just as hungry 2 hours after eating a huge Thanksgiving dinner as you are after eating a snack? No, of course not. More food in your stomach means that it takes longer for it to be digested. Ergo: more food SHOULD equate to being able to go a bit longer before eating again.

[majubee]

Why would you think that the amount given wouldn't matter?

Let me ask you this:

Are you just as hungry 2 hours after eating a huge Thanksgiving dinner as you are after eating a snack? No, of course not. More food in your stomach means that it takes longer for it to be digested. Ergo: more food SHOULD equate to being able to go a bit longer before eating again.

maybe so but a baby drinking a 6oz bottle doesn't mean he shouldn't be hungry again 3 hours later especially when he normally nurses every 2 hours.

[KerryS]

maybe so but a baby drinking a 6oz bottle doesn't mean he shouldn't be hungry again 3 hours later especially when he normally nurses every 2 hours.


I'm not arguing that a baby being hungry every 3 hours is unusual. My point is only that he probably doesn't need 6 oz. per feeding.

[bh310]

My LC agrees that 6oz should more than fill him up too. He doesn't take a paci and I'm pretty sure that he misses mom more than anything. I do go and nurse him at lunch so he is only separated 3-4 hours at a time without seeing me again.

He's small at only 11lbs and one thing that I'm dealing with is that we are a least trying to keep his weight gain constant. He was only getting 4oz of EBM and he was gainning a whole 1-2oz a week.. not good...

I'm on Domperidone now, but can I take Funegreek with it? I was taking More Milk Plus capsules and even tried Latosa Virosa, the the compounding pharmacist said he didn't know if it was safe to mix these so to only take the Domperidone.

I may see if I can increase the does of Domperidone, I'm only taking 1 tablet 3 times a day (lowest dose).

BTW someone asked my schedule.. well overnight he gets to nurse on demand, we co-sleep. He eats 3-4 times during the night (basically moms a pacifier but I don't mind), then he nurses at 6:00am, I pump on the way to work at 7:00 (yield 3-5oz), then he nurses at 8:00am before I leave for work. He takes a 6oz bottle at 9:30am and I pump at 11:00(3oz), then I come to nurse him at 12:30 and he takes his next bottle at around 2:30 (6oz) and I pump at 3:30pm (3oz) then I nurse him again at 5:30 when I pick him up. He then nurses on demand until I start over the next morning.

I'm at least 2-3 shy of his intake each day right now, but I do have a lot of frozen milk so we have supply to work with for now.

I also use a PIS double pump.

[KerryS]

That dosage of domperidone is not high enough, based on current recommendations. The lowest recommended dose for increasing production is 30mg, 3x/day. It's acceptable to go up as high as 40mg, 4x/day. I can't imagine you're seeing ANY results on only 10 mg, 3x/day.

Since fenugreek and domperidone work to increase production by two different methods (fenugreek stimulates sweating and domperidone increases prolactin levels), I feel okay taking both at the same time. I think what you were taking before is Lactuca Virosa (a homeopathic remedy, which I don't personally believe work, so that's not something I've ever tried).

[bh310]

Oh I should mention that I hate the scheduling too!!! My first two children went to work with me and nursed on demand so all this is so new to me that I'm not sure what is right or wrong, so I've had to depend on my LC and Ped a lot for advice. Not to mention Kellymom.com!!!

I really do appreciate the advice, I started my oldest daughter on cereal at 4 months because my Ped pushed me into it. Big mistake, she weaned early at 6mo. My second child I was older and more determined started solids at around 6 mo and nursed till she was 15 mo. She was early like him and also smaller in size (although bigger than him at this stage). So I don't panic over his weight too much. I just don't want him going hungry.

I don't want to rush him to solids either.... I go to do a weight check again on Wed, and if he's on track I just will continue to wait out this month.

[bh310]

I'll call about my dosage then for sure!!! Actually on that dose my output went from 6oz to -10oz, so I did think it helped a little... ;)

[Amy_G_]

ok, with more information, I'll give it another go.

Don't give 6 ounces every 3 hours. give 3-4 ounces more often, every 1.5-2 hours. If I am hungry at 5 and have to wait til 6 then I'm more apt to overeat, and then be miserable.

there is a good possibility that if he's still unhappy after 6 ounces it's because he's eaten too much and his tummy hurts. and for a young baby, they think if anything is wrong, nursing/sucking will fix it. I'd push a pacifier or his thumb or something else to suck. I'd also check for teething as a reason for being unsatisfied with 6 ounces.

If his weight is a problem, feeding him more often with smaller meals will help him to grow more. Until his weight comes up and you feel comfortable with his gain, I'd consider changes to your schedule just a bit to get in one more pumping session and break up his bottles of 12 ounces into 3 or 4 bottles of 3 or 4 ounces instead of 2 ounces.

Right now he's nursing at 6:00am,
pump at 7
nursing at 8 am (2 hrs later)
then a huge bottle at 9:30am only 1.5 hours later?
pump at 11
then you nurse him at 12:30am,
he takes another huge bottle at 2:30pm
pump at 3:30
nurse him again at 5:30

Is he nursing on one side only per feeding, or are you switching him to the other side? If he's switching, he may be getting a bit too much foremilk, and not the richer hindmilk that may keep him full longer and more importantly, help him grow more.

I would try to nurse at 6am,
pump at 7
nurse at 7:30am, or a bit before 8 if possible. If you've just pumped on the way there, he'll probably get more hindmilk in an almost empty boob.
Then give a bottle of 3-4 ounces at 9 or 9:30 (try earlier) and another at about 11am of about 3 ounces
then nurse at 12:30 (can you pump on the way home from daycare to eeek out an ounce of hindmilk?)
then give 3-4 ounces at about 2
and again at 3:30 or 4 with 3 ounces
then nurse at 5:30
then pump on the way home to eek out a bit more.

If he gets 3 ounces every 1.5 to 2 hours instead of 6ounces every 3 hours, he may be more satisfied and grow better.

Otherwise, what Kerry said about upping Domperidone. But if you up your dom, you may need an extra pumping session in order to deal with any engorgement.