EASY for baby with weight issues :(

[J+M]

Also, it's 5pm today and she has not taken a single nap.  This has been so hard.  I'm trying to do shh/pat and PU/PD but she just isn't responding to it like she used to.  They used to work great.  The most I can get is her from crying to calm in the crib, talking and grunting and calling for me.  Sometimes quiet and looking around, kicking her legs, but not for long and at most 20 min.  I just don't know what to do.

Also, she is really eating more solids.  About 2-4 tablespoons per meal.  So could that also hinder my milk production because I'm trying to make more but also filling her up on solids so she is still going to need less to nurse from me.  Seems like that's what's happening.

I just feel like trying to get her to eat so much more frequently and solids to help with her weight is just throwing a wrench in our EASY that used to work so well.  Now it's just a mess and especially bad if she won't nap in the day.

By the way, I try for naps when she starts rubbing her eyes...which is usually on cue with her having been up 1 hr 40 m to 2 hours.  So I'm trying to read her cues and they seem to WANT to time with the routine I'm trying to do.  I just hate that it's not working.

Also, all the night feedings and I"m worried I'm making a snacker out of her, but if she needs to eat, I just don't know what else to do but feed her.  I'm trying to feed her as much as I can during the day, but most of the time she still wakes frequently to eat at night.

[~*Nicole*~]

Hi. I can't believe the lactation consultant said following BW caused you supply/demand problems. BW always advocates BFing and feeding at night IF your lo wants to and not rushing to wean, etc. etc. I don't think she's ever read one of the books!

Anyway, I am so sorry that you are still having such a rough time. It really sounds like you are trying all that you can. Solids is a good way to get the calories in. Any milk that you pump can be added as well...to the cereals etc.

About her not napping. I am wondering if her activity level is higher now that she is becoming more mobile and since her calorie intake is still lower and she is probably burning off a lot...she may be more tired than usual. Can you shorten her A times a bit. Sounds like all the waking and eating and everything might have caught up with her as the exhaustion is catching up with you and she may be overtired. See how reducing her A time helps her settle for naps. If that works she should be able to catch up a bit.

Other than that, my only other suggestion for you at this point is to AP for naps. Since she is having such trouble with weight gain etc. and you are waiting to see if the meds will help....I would do what you have to do in order to get her back to sleeping again. Car-ride, walk in the stroller, wearing her in a sling, rocking, whatever. Once you sort out the feeding/weight gain/milk supply/possibly reflux issues.....THEN we can worry about breaking any sleep habits. You know? Sort of like...pick your battles right now. Do what you need to do to survive kind of thing. I know we usually say, start as you mean to go on....but I think you have a tough situation going on and like you said, lack of sleep is not helping your body have what it needs to up your supply etc.

I really hope things start to settle down for you both soon.

[J+M]

Yeah, I'm going bak and forth between feeling guilt for having my baby sleep through the night because of what she said, and thinking that she was ready to wean out those nursing sessions or it wouldn't have been so easy to do it (only took 2 nights).

I'm going to look at the routine and try to shorten A like you suggested.

Yes, it does feel like I'm trying to tackle so much at one time.  I just feel overwhelmed with it all, and also like I'm throwing all the hard work I did down the drain by going against the habits I help train.  I will go ahead and just do what ever it takes to get her to sleep.  If I can only focus on one thing, then you are right, the medical issues have to come first.  Its just so hard because yet again, I nursed her at 5:00pm and since she has yet to sleep all day she feel asleep while nursing.  So I put her in her crib (until this week she would just continue to sleep in her crib) but she woke right up crying again.  Instantly.  This is just not like her but she has become less and less independent as each day goes by.  I just don't think I can hold her constantly for every nap and at night.  How do I get her to stay asleep?  She used to fall asleep during her walks in the stroller, but now she doesn't. I'm wondering if she's thinking "I know I get to eat after this" so she's staying awake for the meal. 

Well, I'll just focus on A times and see if that helps from there.

Part of me wants to go back to the EASY that was working, with the A times that worked.  Now that she's eating more solids I'm hoping that will give her the extra calories she needs, even on the old (age appropriate) schedule.  I don't know, is that just a horrible idea?

I just feel like in one way, I'm meeting her feeding needs, but in another way I'm not meeting her mental needs for what a 6 month old should be doing right now.  I feel like I nurse and feed solids and before I know it its time to walk in her stroller and nurse her again.  So much of her A time is feeding, there is not a lot of A time left for her to actually play and experience things around her like she needs to develop skills.  I'm wondering if that is also another possible reason for the not napping?

I don't mean to over think this but it's all I do all day.  Plus with not sleeping at night I'm on a 24 hour "mommy" shift 7 days a week and I just can't help but think about what I'm doing, if it's working, or should I be doing something else.

Thanks for your response.  I'll start with the A adjustment for now unless I hear any other thoughts or ideas.  I'll write back and let you know how it goes.

[~*Nicole*~]

If she is OT..which you'll find out after trying the shorter A time a bit....she shouldn't need to stay at the shorter A time. Once she is caught up you can go back to her normal routine. And once she is not as OT she may not be as dependent on you for sleeping. You can get her on a good routine and then work on going back to independent sleeps. Like you said....it's better to focus on the medical stuff and then worry about the rest once that is settled. Doing everything at once is going to end up exhausting and overwhelming you more than you already are. Don't feel guilty. You are doing a wonderful job! Once her routine is going well you can try to get her to do one sleep every day independently...then two....then eventually all of them. It might be a slow road but it will probably keep you saner than trying to do it all at the same time.

If it turns out the sleep issues do not seem to be OT related...then hopefully the nexium will help as the sleep issues could be discomfort related. It's all a bit of trial and error.

*hugs*

[J+M]

OK...so it's 10:30am and here's how it went so far.

I tried a shorter A time.  I started her walk early (10 min early) even though she was talking and fully awake, showing no signs of being tired.  We did the walk (15 min) and when I got back we read a story and then I tried putting her in her crib.  She started crying and just seemed wide awake still so I pulled her out of the crib and we looked at another book.  I read it at first, then just quietly looked at the pages.  Its a black and white book so minimal stimulation.  She was talking, sucking on her feet, playing with her dress.  I mean, just awake and alert.  After awhile we're past the point of A time she used to get tired at when she was on her old EASY.  So then another 5 min after that (or a little more) she started getting upset and trying to suck on my shirt.  So at this point, I'm thinking, she's tired but expecting to eat.  She ate and went to sleep.  I held her for 5 min, then tried putting her in her crib.  She woke right up crying before I even finished putting her down.  I held her again, 5 min, then tried again, same thing.  I did it a 3rd time, same thing.  This time, she's awake but upset so I nurse her again on the other side and she falls asleep.  I hold her asleep in my arms just so she can finally sleep, and after 10 minutes she wakes on her own, wide awake, smiling at me and touching my face and talking.  Just wide awake! 

I don't know why she won't sleep.  I really don't think 10 min counts as a nap, do you?  What do you think is going on?  We had a great meal at 8am and then followed with 2 tablespoons of bananas afterwards.  So I think I'm meeting her food needs first and foremost.  Then the shorter A.  But if that's not it, what else could it be?  What else could I try?

I've continued with her Nexium and Ranitidine for the reflux but honestly, she doesn't seem like she has that.  Because she'll sleep fine laying down if I'm holding her on the pillow.  So there is no change in position where she is suddenly uncomfortable because she's changed from upright to on her back.  It's the exact same position, just moved to her crib.  As each day goes by and we don't have any reflux outbursts of crying or spitting up like we used to, I'm thinking this is less and less of an issue. 

I don't know what to do or try next,...what do you think?

[~*Nicole*~]

Well I guess my possible OT theory is unlikely. Sounds like she may have been UT and then got herself OT refusing to lay in her crib. So that's likely why she took such a short nap. NOW she probably needs a shorter A before her next nap since she took such a short and therefore not restorative sleep this morning. It also sounds like she really does not want to be placed into her crib and would much rather sleep on you at this point. Do you think she could be teething? DD does this often when she is teething or has a cold, etc. She gets HYSTERICAL when I try to lay her down in her crib even though she has been able to do so and go to sleep independently for months. Not sure if you can check out her gums and see if you notice anything. If that is the case you can try some pain meds about 30/45 minutes prior to her nap to see if that helps.

I am reluctant to advise you to try weaning her from using you as a sleep prop at the moment until her reflux and other issues are resolved.

[Peek-a-boo]

{{{Hugs}}} Sounds like you're dealing with a lot right now.    How long are her breast feeding sessions taking at these days?

I would caution you to be reserved about solids at this point for a couple of reasons.  One, most of the solids we offer at first (fruit, veggies, rice) are totally carbohydrates--no fat and protein like milk.  So they take up space in the tummy, but digest very quickly and don't contain the nutrients she really needs to grow.  They are more about experimentation at this point and not about calories.  If she was already being a "happy hungry" baby, then filling up her tummy with carbohydrates may exacerbate the problem.  Secondly, some solids can disrupt sleep in their own right (rice cereal is notorious for this as it can cause constipation and also be a bit tough to digest), so you may be adding an additional variable to already cloudy situation.  She is at an age where starting solids is appropriate, but I guess I just wouldn't be looking to them as a major part of your solution right now.  
  
I gave my DD two breastfeeds during each A time at this age, so maybe I can help you figure out a bit of a routine.    

[Peek-a-boo]

One more question--this 15 minute walk . . . is this sort of part of her wind down?  Does she get drowsy during this?  How long prior to nap do you do this? 

[A pair of Charlies]

Hi there 

I am so sorry that you're still having such a rough time right now. I think Nicole is right; focus on the most important things first and APOP (accidental parenting on purpose) to get some sleep for both of you, if you can.

One thing that I found helped us with naps was a short winddown of 5 mins. Literally a walk to the bedroom, change nappy, look out of window to say bye bye to sky, clouds, sun while closing blind & curtain, put music on (DS has music playing throughout nap) and into bed. That's it. We used to books and a song etc but going down for naps was a 'mare so I cut it right down.

Can I ask, for your supply are you taking fenugreek or any supplements? Are you drinking a large glass of water per feed you give her (in addition to drinks for you throughout the day) and eating plenty - EXTRA? Are you feeding from both breasts per feed? Sorry so many questions, just want to understand what you've tried so far 

Hugs sweetie. 

[~*Nicole*~]

A Pair of Charlies and Peekaboo-I am happy you've jumped in. I don't really know how else to advise with the feeding issues. J + M posted an update a few back and she has been doing a TON to increase her supply. Feeding more often, eating oatmeal, taking fenugreek, double pumping after feeds when she can....etc. etc. I throw my hat off to her! But alas, I stopped BFing around 4 months and don't know much about it as I had plenty at the time. So glad you are here with more information/advice.

[~*Nicole*~]

A Pair of Charlies and Peekaboo-I am happy you've jumped in. I don't really know how else to advise with the feeding issues. J + M posted an update a few back and she has been doing a TON to increase her supply. Feeding more often, eating oatmeal, taking fenugreek, double pumping after feeds when she can....etc. etc. I throw my hat off to her! But alas, I stopped BFing around 4 months and don't know much about it as I had plenty at the time. So glad you are here with more information/advice.

[~ Vik ~]

More (((hugs))) for you   You must be so exhausted!

You've gotten great advice so far, I just wanted to pop on for support. 

I completely agree with Bethany, and I would try to limit solids a bit if you can.  For example, an oz of breastmilk contains about 20 calories and is full of protein, fat, and all the nutrients your lo needs.  An oz of carrot only contains about 5 calories and is pure carbs.  That's a big difference to a tiny tummy!  I would still offer solids at her usual times, but limit the amount.  Also, any pumped breastmilk that you can hide in her solids (ie, using it to make her cereal, adding it to her fruits and veggies, etc.) would be helpful too!

You are working so hard to increase your supply!  Keep it up, you are doing a fantastic job   Try to get as much rest as you can - taking care of yourself will help your supply too.  Fenugreek can work wonders, as can eating oatmeal.  Kellymom.com is a great online breastfeeding resource, here is the link to their page on increasing low supply for some more ideas:  http://www.kellymom.com/bf/supply/low-supply.html

More big hugs, we are here to help in any way we can

[First Time Mom]

I just wanted to jump in to say I was in the same boat with my dd years ago at that age! It's hard and frustrating so hang in there, you're doing a great job with your lo.

My dd was always on the chart at 10% or less, had some months where she really didn't gain any weight though was a happy baby and reached all milestones. Weighed 12 pounds at 6 months. I went through 2 doctors before I stumbled upon the Ped that we stuck with. I was told all the same- increase solids, feed during the night as she should NOT sleep through, stop bfing and switch to formula, etc., etc., etc!

My Ped said "no" to increasing solids- weight gain in the first year should be from breast milk or formula but not from solids. Actually solids can play a negative role in bfing as if we give them too much they will cut down on bfing and the higher cals/fats. If a lo needs to gain weight after one year then it should be from solids (as proteins, etc., are in the diet at that point). Prior to a year the gains should be from bfing or formula.

To get my dd to nurse longer and to increase my supply I would offer 3 sides- meaning offer one, then the other, then I would go back to the first side again. I did cluster feeding in the late afternoon and early evening and df at night. DD did not wake in the night to feed after she was 4 months old (unless it was during a GS). I never refused a feed and offered a bf if she was fussy even though it might not have been from hunger as I never wanted to make an error and not feed in case it was hunger. This changed my supply slightly. Are you by chance slim? Is your husband slim? Both myself and dh are tall and slim and that's another thing to keep in mind if you are, your lo will not be a huge and chunky baby. My Ped also said my milk probably was not very fatty and this I couldn't really change as I was on a limited diet (dd had a milk protein allergy until she was 18 months).

It sounds like you are doing everything you can to increase your supply but I think maybe you're stressed out over this and the stress will not help your supply. Try to be easier on yourself, get rest, and drink lots of water.

[J+M]

Hi ladies.  THANK YOU SO MUCH FOR YOUR POSTS!  They have such great comments.  My baby is being especially needy right now and cries for me whenever I put her down. So it's been hard to step away to the computer to read these posts and type.  

I want to respond to all of your posts, because I think putting all of what you say together is going to help.

Regarding teething:  Every person I take her to see suggests this, but upon looking at her gums says teething is not happening right now. This all started about a month and a half ago and still not a single tooth.  So I don't think teething is a factor right now.  I kinda wish it were because it would have come and gone by now (its been 6 weeks at least of this!)

Regarding solids:  Yes my pediatrician is pushing me to feed more solids.  I was doing Baby Lead Weaning before so she was tasting and playing with her food but I really couldn't monitor how much of it she was eating.  She would poop out some of it, but not a lot.  So I went to purees and spoon fed her.  At first she only ate a table spoon and my pediatrician told me to feed her much more then that and also supplement with formula (FIRST TIME MOM, this sounds like your post!), so I'm trying to do that.  Especially because my husband gave me the whole "we tried it your way at it's not working (breastfeeding only and BLW) and now we need to follow the Dr.s advice!)  We got into a bit of an argument over it and in addition my husband felt like no ones opinion mattered but mine so I agreed to follow the new orders except switching to mostly formula.  I still really want to make breastfeeding work.  Now she's eating nearly 4 tblspoons of solids.  Her poos are solid now.  But she is farting a lot and night and it is waking her up.  I feed her solids AFTER nursing, hoping it won't prevent her from drinking from me first.  What goal should I have with solids?  

Regarding nursing: She nurses about 30 min total.  15 per side.  I have been doing once a side, I'll try to do it 3 times.  I sometimes weigh her before and after a nursing and my body was making around 2.5 oz total per feed.  Not a lot at all.  Since I pump after nursing I only get a small amount, which I've been using to mix with her oatmeal.  I've given some breastmilk and some formula to her in a bottle.  We're still working on that.  She'll probably only get another ounce in a bottle.  But she doesn't always want it so that's 1 ounce at one sitting, only once in a day because she'll refuse the other times.  I am still taking fenugreek, oatmeal, drinking (but I'm thinking I need to drink even more), and pumping when I can.  I'm resting when I can, but believe me, it's just not enough.  Baby is taking so much of my time and although sleep is getting better at night I'm still up every 2-3.5 hours to nurse her.  She used to sleep 11 hours straight on average so this is a huge adjustment for me all over again.  I'm definitely BEYOND fatigued!

Regarding A time: I think the verdict is in for sure now.  She is UT.  I went out to run errands and had her in my sling.  I wasn't able to get back to the car to nurse her and she drifted off at 3 hour 5min and slept for an hour after that.  This is the first time she's taken anything near a real nap.  So I think that is her new A time.  6 weeks ago it was 2 hour 5 min.  I've been trying to fit 2 feeds into this A time and it just wasn't working.  

Regarding naps: She has been a textbook/touchy baby and therefore she's usually required a long wind down time before going into a nap.  I found a 15-20 min walk was working really well.  She rarely fell asleep during the walk, but would be completely relaxed and when we walked in her nursery and turned the rain sound on. I could hardly read 1 book and she's be closing her eyes and go right into her crib within 2 min or less.  Of course, now that I'm feeding twice during A she gets this second wind after the 2nd nursing and just doesn't nap at all.  And if she does while I'm nursing her and I try to transfer her to the crib....forget it!  She wakes up screaming.  She never used to do this and it's so frustrating.   That's why now I'm just at a loss what to do.

Today I tried to work 2 nursings into a longer A.  I thought this was the final missing piece!  She just fell asleep after the second A but wake instantly if I moved even the slightest bit.  I then tried walking her to continue the wind down with a hopeful transition to nap and she woke RIGHT UP.  Talking and everything while in her stroller and as awake as can be at home.  Its like she's getting her nap while eating during that 2nd nursing.  It's not working for me at all.  Because not only do I not have any free time to wash dishes or other basic things to just make it through the day, but now she's becoming more and more dependent on being with me and I can hardly leave her to play for a second so I can do anything.  Even typing this she's on my lap.  Again, this is so frustrating because she used to be really independent and I could fold laundry and brush my teeth. I used to shower during her naps but now that she doesn't nap...I can't even tell you the last time I showered!   It's awful!  My husband works 12-14 hours a day 6 days a week so I am truly on my own for this and if I don't get a break I really have no relief coming at the end of the day to tag team so I can take care of myself.

OK...so after all of that...I hope I answered your questions...what do you think?  

To sum up:
1)If I'm feeding her too many solids, what should be my goal so I know what to shoot for?  
2)I would love to have her get most of her calories from nursing, I'm just so nervous to try it and hurt her weight again.  Also, it's very hard for me to pump enough since I am on my own and she's becoming so dependent on me.   I try to put her in her high chair to do a little BLW while I pump but she doesn't always sit peacefully and I have to cut my pumping short to feed her the purees.    I don't know how I should be fine tuning this.
3)If she is really under tired but falls asleep during the 2nd, supplemental, nursing during A no mater if it's a longer A or a shorter A, what options do I have left to get a nap in from her?
4)Anything else you see that you want to add?

THANKS AGAIN. I really am taking everything you are suggesting very seriously.  I will get back here as soon as I can.

[Peek-a-boo]

1)If I'm feeding her too many solids, what should be my goal so I know what to shoot for?

Well, I took a peek in the BW book and Tracy recommends starting out with one meal per day and just 1-2 teaspoons of puree.  Then the 2nd week add a second meal, same amount, and then after another week or two add a third meal, same amount.  So, really, she's advocating very tiny "just a taste" kind of portions at the outset of solids introduction.  Not wanting solids to interfere with bf, I would tend in that direction personally.  You might ask the LC her advice regarding solids as a second opinion to your doctor's advice. 

2)I would love to have her get most of her calories from nursing, I'm just so nervous to try it and hurt her weight again.  Also, it's very hard for me to pump enough since I am on my own and she's becoming so dependent on me.   I try to put her in her high chair to do a little BLW while I pump but she doesn't always sit peacefully and I have to cut my pumping short to feed her the purees.  Sad  I don't know how I should be fine tuning this.

If you have a good baby scale, I would take a deep breath, implement all these changes you're planning, and wait a week to weigh her and see what happens.  If she's maintaining, I'd keep it up and check again the next week and give it a few weeks to see if she'll start gaining.  If she's gaining, great.  If she's losing, then I'd maybe give it one more week, then go back to the LC and reevaluate.  If you do a before/after weigh in for a feed, be sure that you are either weighing her naked both times or that she is wearing the same clothes and same diaper both before and after.  Again, as pp mentioned, I think a lot of weighing at this point is probably creating a lot of stress for you.  And doesn't necessarily give you actionable information--at least not a weigh in for every single feed.   

Regarding pumping--it can be a good tool to increase your supply, but actual stimulation from actual baby is always going to better, so I would prioritize actual feeds over pumping.  If you can work in a couple of pumping sessions each day, great, but, to be honest, I wouldn't let that become a source of stress if it's not happening or that not as long as you would like.

3)If she is really under tired but falls asleep during the 2nd, supplemental, nursing during A no mater if it's a longer A or a shorter A, what options do I have left to get a nap in from her?

I agree that her A time has likely increased since 6 weeks ago.  You may end up finding it's not quite to 3 hours, but I think going in the direction is definitely the right track. 

For us, when we did two feeds in an A time, I would try to make the first feed a bit of a sleepy feed.  As soon as DD woke, I would go to her, leave the shade down, snuggle with her in the rocking chair in the nursery and let her have a nice leisurely nursing session.  Sometimes she would even drift back off to sleep, but that's okay because she would still be flutter sucking and giving my breasts some stimulation.  I agree with First Time Mom that offering right, left, then right again is probably a good strategy to maximize the stimulation your breasts are getting. 

Then for the second feed during A time I would time it for 20-30 minutes prior to the end of A time (my DD didn't nurse for as long as yours does, so you may need to do it a little earlier).  This feed I would do in the living room, lots of light, the radio on; if she started to get drowsy at all, I would talk to her, mess with her, absolutely anything to keep her eyes from getting blinky blinky.  Even a minute of sleep at the breast near the end of A time can give a 6 month old the oomph they need to resist a nap.  So, in answer to your question, I just wouldn't let her fall asleep.  Create an environment that's not conducive to sleep and then if she does doze off, actively work to keep her awake.   After she'd fed, if there was A time left, we'd have a little chat and play quietly, then go to the nursery for diaper change and wind down and into the crib. 

I'm wondering about this walk . . . For a while I was taking my DS for a walk before his naps and around 7.5 months I had to stop because I found he was getting blinky, blinky in the stroller and even though he wasn't falling asleep, it was just enough to take the edge off and he would fight his nap.  The analogy I think of is this:  have you ever been watching TV in the evening and getting dozy?  But you can't just pour yourself into bed--you have to change into PJs and brush your teeth and by the time you crawl into bed you're wide awake and can't get back to drowsy?  I think as babies get older they have a similar experience and so the nature of the wind down may need to change too.  Ideally, you really want the whole drowsy/getting sleepy process to be happening in the crib.  That way DD is doing all of it herself (without the aid of the stroller) and it's really independent--if that makes any sense. 

{{{Hugs}}}  {{{{Hugs}}}  You're doing great.    Sending milky vibes your way ~~~~~~~~~~~~~~~~~~~~~~~~