Little weight gain in 5 month old

[tykayausjak]

OK I will try to keep from being too long winded. My baby is just over 5mos. He gained pretty well upto 2 mos. Between 2 and 4 mos he barely gained half a pound. His doc had him on Neosure after bfing to help him gain. I was also pumping after each feeding. (only getting a few drops at most) He did well after two weeks so I stopped supplementing. It has been another 2 weeks of only bfing and no weight gain. He is very impatient while nursing and after the first let down gets very upset and won't stay on. So I have been going back and forth between each breast several times at each feeding. (about every 2 hours) He doesn't like this much either. I am concerned about my supply and not sure what else I can do to help. I have taken fenugreek, pumped after each feeding, and really increased my water intake with no noticable increase in supply. Am I doing something wrong?? What else can I do to help? I really don't want to go to formula but I am getting worried about my little guy. TIA

[KerrySmithIBCLC]

I would really recommend that you see an IBCLC in person who can evaluate you and your baby. There had to be a reason why your supply decreased so much at around 2 months of age. A common cause is a poor or lazy latch from birth. During the first couple months of breastfeeding, an overabundant milk supply can compensate for a poor latch, but once your supply regulates (which happens at around 8-12 weeks) you suddenly develop low supply and poor weight gain.

Are you taking any medications? Are you on birth control?

When supplementing, you should never discontinue all at once (as you discovered). Supplementation should be discontinued slowly, over several weeks, to allow time for your milk supply to build up to meet his needs.

Do you do breast compression when you nurse him? If you don't, I really recommend it as a way to keep him at the breast longer, and to get more milk into him. Here's a link to describe how to do breast compression:

http://www.kellymom.com/newman/15breast_compression.html

Here is a link to information on slow weight gain after the first few months, what might be causing it and what you can do:

http://www.kellymom.com/newman/25slow_weight_gain.html

Pumping between feedings is a good way to help increase milk supply, as long as it's not wearing you down and interfering with bonding with your baby. You might look into taking domperidone to increase production. More information here:

http://www.kellymom.com/newman/19a-domperidone1.html

Don't be afraid to give him the supplementation that he needs in order to maintain appropriate weight gain. As he gets older and bigger, you may find that he becomes more effective at the breast and your supply will increase over time. You might consider giving him the supplementation at the breast, with a nursing supplementer. Info here on how to use a homemade nursing supplementer:

http://www.kellymom.com/newman/05lactation_aid.html

Above all else, don't give up! Even if you're never able to meet all his needs exclusively at the breast, he's still getting very important nutrition from you. I went through something similar with my third baby and it was very frustrating and frightening, so I know what it's like. But if you can figure out why your supply decreased, there's no reason to believe you won't be able to bring it back up again over time.

Please let me know if you have other questions.

[tykayausjak]

Wow that's alot of info thanks. I can't really think of anything that would have caused my supply to drop except that he started mostly sleeping through the night around then. I have never really had a ton of milk even at first. There was one point early on that he wasn't having enough wet diapers and I was able to use fenugreek to help. I really don't know what is going on. I din't mind pumpng but it is not always easy to fit in since I have 3 other kids. I had similar troubles with my last baby but it was much more severe due to a toung tie. How would I go about getting the domeperidone? One other question. He has always had terrible smelling gas it doesn't seem to bother him but smells awful!!! While I was supplementing it went away then came back when I quit supplementing. Any ideas???
Thanks for your help.

[KerrySmithIBCLC]

You can purchase domperidone at In-House Pharmacy:

http://www.inhousepharmacy.com/

As far as the smelly gas - it's possible that you have a foremilk/hindmilk imbalance (he's getting too much foremilk and not enough hindmilk). Doing the breast compression will help with that. You might also try giving him a probiotic (like bifidus powder).

[tykayausjak]

Thanks so much for all you help. One last question, how do I go about finding an IBCLC that I could work with? I worked with a specialist at the local hospital but i don't think she is certified and didn't really help much.

[KerrySmithIBCLC]

http://www.breastfeeding.com/directory/lcdirectory.html