Feeling discouraged and inadequate

At our 9 month appointment last week, our ped indicated she's concerned with Will's small weight gain (he gained about a pound over the course of 3 months ). I have been BFing the boys as much as I can, and they get bottles of EBM while I'm at work. The ped told me that the amount in their bottles is fine.

Some of you may remember that I have to pump a little in the morning before BFing so as to not choke the boys because I'm so full. What I had been doing is mixing my morning pumped milk (mostly foremilk) with the milk I pump at work in order to fully replace the freezer amount pulled for the day. I thought this would be fine, but my ped told me to stop doing it because it was messing up the ratio of foremilk to hindmilk. She suggested adding 2 oz of formula to the EBM in the boys' bottles, but I don't really want to do that unless I have to. I decided that I'd start feeding Will first (I don't tandem, and I typically start with John because I found that he can handle my let-down better) and see if that helps his weight. And now I have all of this foremilk that I have to dump because I can't use it (aside from what I use to make their cereal).

I'm just feeling really discouraged and wondering what I've done wrong. I've noticed that when I pump at work, I don't get nearly as much as I had been getting. I used to get close to 20 oz over the course of 2 pumping sessions, but now I struggle to get 12-16oz. I'm eating and drinking plenty, and getting enough sleep. I'd really like to continue to BF as long as possible (at least a year), but if I'm not pumping enough at work to replace what I pull from my freezer stash, what else can I do? I don't want to supplement with formula, but I know that if I need to in order to help him, then I will.

Not to mention that both boys now have to take iron supplements because of low levels... :unsure:

ETA: You ladies are such a huge source of encouragement to me. I would've quit a long time ago without this forum! THANK YOU!

 

Becky,

I know some of the ladies on here will have a lot of advice for you. I just wanted to say I'm sorry you had such a difficult ped. appointment. :hug:

I'm sure you will be able to figure something out!! Hang in there - you have/are doing such a wonderful thing for your babies!!

 

:hug: You have done great getting them your milk for so long!! Have you tried not pumping in the morning and just feeding now that they are bigger/older and can possibly handle the 'fullness?'

Are the boys crawling now? Are they very active? Could that be the reason for the small weight gain? Some kids are just petite. :hug:

 

QUOTE(JicJac @ Dec 5 2008, 09:15 AM) [snapback]1098541[/snapback]
:hug: You have done great getting them your milk for so long!! Have you tried not pumping in the morning and just feeding now that they are bigger/older and can possibly handle the 'fullness?'

Are the boys crawling now? Are they very active? Could that be the reason for the small weight gain? Some kids are just petite. :hug:


Nope, I haven't tried not pumping first because A) I use the milk I pump in the morning for their cereal and B) I don't want my supply to drop if they don't empty me. Maybe I should... what do you think? I still mix the milk I pump from work with some from the morning, but not nearly as much as I was doing.

Yes, they are crawling. John is actually a lot more active than Will, but his weight gain was higher (stats in my siggy). Will crawls all over the place, but many times he's content sitting and playing with toys. Developmentally, he's a bit ahead of his brother (babbling, clapping, etc.). The ped mentioned that he might just have DH's body type - DH is 6'1" and weighs 140lbs on a good day. Makes me sick! But she still wants to see if we can get his weight up. According to her chart, he's only in the 3rd percentile for weight.

 

What about nursing first and pumping after, if they haven't drained you? They'd be getting full bellies that way, and you'd still keep your supply up.

 

One of my girls is the same. She is very small and has had some concerning weigh-in's. She is the more active of the two. I never thought of it as an inadequate on my part though. Plenty of other things are, but not that. Babies grow how they grow. If they are offered proper nutrition then they are fine IMO. What are you doing for solids?

 

QUOTE(girls! @ Dec 5 2008, 02:36 PM) [snapback]1099029[/snapback]
One of my girls is the same. She is very small and has had some concerning weigh-in's. She is the more active of the two. I never thought of it as an inadequate on my part though. Plenty of other things are, but not that. Babies grow how they grow. If they are offered proper nutrition then they are fine IMO. What are you doing for solids?


Up until last week, for breakfast they split 6T of cereal and 1/2 a jar of fruit and for dinner, the same thing except substituting veggies for fruit. We've now added "lunch," which consists of some Cheerios or puffs, and pieces of banana or cheese, etc. And they're now splitting an entire jar instead of 1/2.

When I came home from work today, Will didn't look right to me. It almost looked like he had lost weight in his face. Not sure if it was because he had just woken up or because I had just gotten home, but I'm going to keep an eye on him.

Dielle - thanks for the tip. I may do that.

 

:hug: I'm sorry you're worried about this!

How are his diapers? How many pees/poops a day? Is he generally alert and hitting milestones?

Ditto Dielle's suggestion. Even if you skip pumping altogether in the morning, it shouldn't decrease your overall supply. You'll make as much as they take.

One thing you could try - instead of putting 2 oz of formula in his bottles, how about mixing a little formula powder into the EBM to boost the calories? Since my DS was so tiny in the beginning, we were adding Enfacare powder to EBM to make it 24 calories/oz, and I've even seen instructions somewhere on how to make it 27 cal/oz.

Also, have you thought about adding some other foods to their (solid) diet? From your post, it sounds like they're mostly getting cereal, fruit, and veggies. That's all good stuff, but adding some richer foods might help too. Avocado, cheese, egg yolks, whole milk yogurt, meat (if you're not vegetarian)... You could stir a little olive oil into his veggies too. And I've heard of adding avocado to fruit smoothies (sounds gross to me, but apparently some kids love it! )

Oh, and how much do they nurse when they're at home? Is there any way you could sneak in an extra nursing session or two?

:hug: It will be ok! Please keep us posted on how things are going.

 

QUOTE(fuchsiagroan @ Dec 5 2008, 09:05 PM) [snapback]1099634[/snapback]
:hug: I'm sorry you're worried about this!

How are his diapers? How many pees/poops a day? Is he generally alert and hitting milestones?

Ditto Dielle's suggestion. Even if you skip pumping altogether in the morning, it shouldn't decrease your overall supply. You'll make as much as they take.

One thing you could try - instead of putting 2 oz of formula in his bottles, how about mixing a little formula powder into the EBM to boost the calories? Since my DS was so tiny in the beginning, we were adding Enfacare powder to EBM to make it 24 calories/oz, and I've even seen instructions somewhere on how to make it 27 cal/oz.

Also, have you thought about adding some other foods to their (solid) diet? From your post, it sounds like they're mostly getting cereal, fruit, and veggies. That's all good stuff, but adding some richer foods might help too. Avocado, cheese, egg yolks, whole milk yogurt, meat (if you're not vegetarian)... You could stir a little olive oil into his veggies too. And I've heard of adding avocado to fruit smoothies (sounds gross to me, but apparently some kids love it! )

Oh, and how much do they nurse when they're at home? Is there any way you could sneak in an extra nursing session or two?

:hug: It will be ok! Please keep us posted on how things are going.


This morning I purposely pumped less than I normally do to see if he'd eat more. He appeared to nurse a little longer, so maybe that helped. I'm seriously rock hard in the mornings...

His diapers appear to be normal, and he's hitting milestones ahead of the curve (clapping, babbling, etc. already at 9 months). He was constipated earlier this week b/c he loves bananas so much, but that cleared up a couple of days ago.

Now that we're doing lunch, we're doing more finger foods. They get Cheerios or puffs, banana, cheese, etc. I just bought some more whole milk yogurt (that stuff's expensive!), and I need to get some deli meat too. What about the yogurt bites that Gerber makes? Would those help? And I do need to start trying to introduce egg yolks.

We nurse 3 times a day - 1st thing in the morning, 1st thing when I get home from work (4ish), and right before bed. On weekends, we nurse 5 times (adding a breakfast and a lunch session). During the week, I'm not sure there's the time to fit in another session, as the boys go to bed at 6:30.

If I put formula powder into the bottles, how much do I need to add? I like that idea the best (other than adding more fatty foods, of course ).

Thanks Holly (and everyone else too)!

 

QUOTE
His diapers appear to be normal, and he's hitting milestones ahead of the curve (clapping, babbling, etc. already at 9 months).


Those are really good signs!

Your weekdays sound really busy, but I wonder if it would work to add an extra nursing session on weekends. Oh, and with egg yolks - mine didn't like them plain at first, but you can always mash them into other foods.

I'll try to dig up the formula/EBM info. If I try to remember off the top of my head, I think we were adding 1/4 tsp per 45 ccs (1.5 oz). (That was 1/4 tsp of Enfacare, which is higher calorie than regular formula.)

Oh, I also just googled and found this:

QUOTE
To prepare a 22-calorie/ounce breast milk:
Add 1/2 teaspoon of regular formula powder to every 3 ounces (89 mL) of pumped breast milk.

To prepare a 24-calorie/ounce breast milk:
Add 1 teaspoon of regular formula powder to every 3 ounces (89 mL) of pumped breast milk.


(source)

Good luck!

 

My girls didnt gain that much when they started moving. Is he still on his curve or is he not gaining on his curve?

Will he eat avocado? Its loaded with good fat!

:hug:

 

Hey babe!! I am still on vacation but had to respond to my lil' sis

My honest answer is not to worry :hug: I know how hard that is as I have truly BTDT when mine were about the same age. I had little porkers until about 6/7 months and then ds in particular thinned out a lot. It is quite common for bf babies to gain more early and then thin out after 9 months, and that is perfectly ok. As they start to move (rolling, sitting up, crawling and finally walking) they burn a lot more calories. And older babies in general tend to thin out nad not gain as fast.
When this happened to me I started offering ebm sippies with meals vs water. Focusing on fattening solids (yogurt w/ cereal mixed in, avocado, banana, sweet potatoes, butter on toast to chew, etc).

But trust me when I say you will most likely do all this worrying and work and he will turn out just the same, big/small, but mainly just right :hug: The wonderous thing about nursing is he can take just how much he needs, so let him and try to let nature work its magic.

 

Don't dump the foremilk! Pump after one of your feedings and mix the hindmilk with your foremilk. You can get a good balance that way. Don't waste liquid gold!

 

QUOTE(Fletchie @ Dec 11 2008, 12:12 PM) [snapback]1107051[/snapback]
Don't dump the foremilk! Pump after one of your feedings and mix the hindmilk with your foremilk. You can get a good balance that way. Don't waste liquid gold!


I had been mixing the foremilk with what I pump at work, and the pedi told me not to....I wish I had time during the week to pump after a feeding, but I don't. I hit the ground running from the time I get home to the time I go to bed. I've still been mixing, but just not as much.

 

A few thoughts...it's probably just his size or that he's active now. My DD1 didn't gain for 3 months from 12mo. to 15mo. She started walking (very active) and didn't gain. The doctor was concerned, but I wasn't. I knew how active she was and how well she ate. She's perfectly fine.

Although, I'm reminded of a friend who had a daughter with very poor weight gain. They found out when she was a few years old that her daughter had a high allergy to dairy. Her daughter is now a very healthy 8 yrs old, so no worries. I've heard that poor weight gain can be a classic symptom of a food allergy/intolerance like wheat/glutton (celiac) or dairy in children. Now, it probably won't be the case for Will, but its something to keep in mind.
:hug:

 

My DD also had low weight gain from 6 months to 9 months. The ped told me that at 9 months, the weight gain should come from increase in solids and told me not to worry about milk supply. She suggested feeding her avocado, yogurt, cheese, or anything else that is high in fat content. So I've stepped up her solid feeding to 3 times a day and have fed her lots of these fatty foods. I just had her 10 month visit and she had gained enough weight in the last month that the ped is not concerned anymore. Good luck!