Slow weight gain low milk supply?

[snhill]

I'm worried to death about my milk supply. I KNOW that this is probably hurting it more but I can't stop worrying about it. I need advice.  I have a couple of things that could be the real culprit so I really just want feedback and possible solutions!

My LO gained weight beautifully for the first 3 months. I had been told to stop eating milk and eggs because she had reflux (though she was NEVER uncomfortable during the episdoes) so I stopped after the first 2 weeks but it never helped. Doctor put her on a medicine which didn't help either and when we went back to her 3 month appt it had disapeared. The day before I ate a piece of lemon creme pie and it didn't affect her at all. So I assumed my problem was OVER supply.

Fastforward.

LO is 7 months. At her 6 month appointment she ALMOST weight 13 pounds. She can STILL wear 3 month clothes. Shes tiny.Ped sent us to give her at least 5 breastfeeds and 3 solids meals but 2 snacks.
Honestly there isn't enough hours in the day to keep feeding her. And I WOULD think she would be gaining but she still hasn’t grown out of those yet. She’s really active, meeting milestones, alert, and sleeping through the night. I don’t understand how she could be malnourished!

Another issue…I pump once in the morning and once and night before I go to sleep. I used to get 1-2 ounces but now I get half an ounce. I have NO idea why it went down.

Here are what I think they good be… but please let me know if you think there is something I’m missing.

1. Maybe she really did have a lactose intolerance and now that I've been eating it she isn't gaining weight because her body is absorbing the nutrients right   - stop drinking/eating dairy. No big thing but what if that’s not it. I go to doc she has gained weight and I’m not eating/drinking it because I think that was it. I mean I’ll do it for her if that’s what she needs… but if not… well I love cheese : )

2. I have a low supply –  which I  wouldn’t understand because she should be eating what she needs, right? And I never tell her NO. Wait. Even if she wakes up in the night I wouldn’t but she doesn’t.

3. My pump is not working anymore making me think I have a low supply but don't and she is gaining just fine according to HER… just not what doc wants.

What do you all think??

[*Ali*]

Wow, that is an awful lot of solids for a 6mo! I'm not surprised you can't fit it all in. Most 6mo are on one meal a day at that age. In the UK the recs are to not move to 3 meals a day until around 8mo and snacks normally come closer to 12mo when LO starts dropping milk feeds.

Most early weaning foods have many less calories per ounce than breast milk so normally the advice would be to increase breast feeds rather than solids at this age. Too many solids can actually fill up their tummies at this age and mean they eat less milk and therefore lose overall calories.

Have you tried any measures to increase supply like taking fenugreek capsules or eating oats? Dr can also prescribe domperidome for apply in some countries.  "I'm worried I may have a low milk supply"

Or do you feel you still have oversupply? In which case have a look at this FAQ.
Oversupply and Overactive (Forceful) Let-Down

It is common to be ale to pump less milk at this age simply because of the way the milk is produced now. There is some great info on this site http://kellymom.com/pregnancy/bf-prep/milkproduction/

Does she still have any symptoms of reflux or intolerances? Here are some links to help you decide Reflux 101 - General reflux information
Does my LO have food intolerances?

Is your DD actually dropping down the centile lines on the WHO growth charts? From where to where?

Is your DD much more active now? It can be normal for growth to slow around this age as LOs start being awake longer, rolling, sitting, crawling and also eating solids.

[snhill]

Thank you so much for responding!

To answer your questions...

Have you tried any measures to increase supply like taking fenugreek capsules or eating oats? Dr can also prescribe domperidome for apply in some countries.  "I'm worried I may have a low milk supply".....  I started eating oats yesterday because I read that was a good way to boost it naturally. I am going to try to find fenugreek capsules but I live in Ecuador and have no idea what they would be called or where they would sell them

Does she still have any symptoms of reflux or intolerances? Not that I can tell. She spits up some but never alot (which is what she did when she was younger) and when she does it just sort of dribbles out of her mouth. Her poo has never been frothy and only for a while was it green (but I suspect that was due to foremilk/hindmilk imbalance) but maybe 3 times in her life. Usually after vaccines... No idea why that is.

Is your DD actually dropping down the pecentile lines on the WHO growth charts? From where to where?  This I'm not actually sure. I'm not quite sure which growth chart my ped is looking at but I THINK so. This is her weight gain
BIRTH: 6lbs3
2 WEEKS: 6lbs3
1 Month: 7lbs11oz
2 Month: 9lbs11oz
3 Month: 11lbs
Here is where it goes downhill...
4 Month: 11lbs12oz
5 Month: 12lbs2oz
6 Month: 12lbs12oz
7 Month: Haven't been to the doc but 7month since the 23rd

Is your DD much more active now? It can be normal for growth to slow around this age as LOs start being awake longer, rolling, sitting, crawling and also eating solids.  She's a VERY active child, always has been. She was an early sitter and she is crawling. Has been for about 2 weeks now.

As for the food thing... Yes it is a lot... maybe I should supplement with formula instead of so much solids? I don't WANT to do either but she only nurses so much and then is ready to play. I wasn't worried because she slept so long and is honestly NEVER fussy. She's just a happy baby. So honestly I have no idea what the problem is.

I will obviously talk to my ped but she just thinks i should add more solids whereas I think I should BF more. I've returned to BF every 2 hours now though we were doing 3-31/2.  Could that be another problem? ... We are going to ped the 19th of next month and if she doesn't gain as much weight as she *should* by then, ped wants to add a calorie supplement to her food and run some tests.

I'm hoping to avoid this. Next week I'm going to go and weigh her just to see but other than that I have no idea. So any direction would help!

Thanks in advance!

[CCCmom27]

(((hugs)))) It is so worrisome when the doctor tells you your baby isn't gaining weight like they should.  I went through that when G was around 3 or 4 months.  I agree with Ali and wouldn't feed too many solids and try to get more breastmilk in her.

[becj86]

Hon, I had a lot of issues with DS' weight. When he started solids, he lost weight so I offered EBM in a bottle/sippy (usually a bottle because I couldn't bear to see the liquid gold going on the floor) rather than water.

I also found that he gained least weight when I had most milk - again, a foremilk/hindmilk imbalance thing and worse after a growth spurt (or if I ate any milk-increasing foods). Block feeding helped to get it under control and get him back on track with weight gain.

From my brief look at her weight, she's hovering between the 3rd centile and the 15th centile lines since birth - that would indicate to me that she's fine - ideally a baby will follow a curve rather than going up the centiles. Are you/LO's dad smaller than average?  http://www.who.int/childgrowth/standards/chts_wfa_girls_p/en/
http://www.who.int/childgrowth/standards/cht_wfa_girls_p_0_6.pdf

Also, if your baby is more active than others her age, she will be using more energy moving rather than putting it into growing. This was another major cause of lower weight gain for DS.

If she's happy and active, you're probably doing fine.

[snhill]

CCCmom27 and becj86 Thanks for replying!

Bec - Yes. Both of us are on the smaller size. My mom even told me that I was always under weight.... And I really try not to worry because of this and because she honestly never stops moving. If she was really Failure to thrive wouldn't she NOT meet milestones? But she seems to meet them before the "average" so that would tell me she is perfect. But 3 months clothes at 7 months? That's really scary to me.

Also do you know of a website I could put in the information of her weight and it will just give me her growth curve on the WHO chart?

[*Ali*]

I believe Fenugreek is known as fenogreco or alholva in Spanish. Its Latin name is Trigonella foenum-graecum. Here we would buy it in a health food shop like Holland and Barratt. If you do have oversupply though then this is not going to help and may make things worse.

I would just keep BFing 3hrly and offering age appropriate solids and nothing more.

[becj86]

If she was really Failure to thrive wouldn't she NOT meet milestones? But she seems to meet them before the "average" so that would tell me she is perfect. But 3 months clothes at 7 months? That's really scary to me.

Yes, this is the main reason docs worry about small bubs - that they are FTT - but FTT is really characterised by dropping down the centiles on the charts and failure to meet milestones. DS was also meeting milestones early.

I can't find a site where you can put her weight in to compare it, sorry.

On the fenugreek, oats, etc.: If you are dealing with an oversupply issue, these things to make more milk will only make the problem worse. Eating high calorie foods like avocado, coconut oil, etc. would be better, as it should increase the calorie content of your milk. Increasing your supply further is a bit like you drinking more water to gain weight whereas adding caloric value to your milk is more like you drinking cream to gain weight - which would work better?

From what you're saying, it sounds like she's doing fine.

[*Ali*]

Yes just to reiterate I only suggested the measures to increase supply because in the first post snhill you say you are worried you have low supply now. If in fact the opposite is true then of course you would not want to increase supply further.

Apparently diet actually contributes little to determining the amount of calories in breast milk although eating more animal proteins and fats can change the type of fat in breast milk which may be worth looking into. The best way to increase the fat content is breast milk is to do breast compressions (to dislodge the fatty molecules from the sides of the milk ducts) and to feed til empty (so very frequent feedings may not help). Here is a link to this info in more detail http://kellymom.com/nutrition/milk/change-milkfat/

The more you say the more I think there is no problem with your lack of supply or her growth. Someone has to be on the lower lines. My HV said movement between up to 2 centile lines is fine.

[snhill]

Thanks everyone! I do feel better about the whole thing.

Also I guess I didn't make it clear.. I don't think I have an oversupply anymore. Maybe this is why I think I have a LOW supply and really it's just normal because for so long I did have an oversupply... Does that make sense? Either way I've started getting up at 3am to pump just in case.

I just think it is a possibility that it is a low supply... but how am I supposed to know? She acts satisfied. It's so much more complicated now that solids have been added. Before it was just milk milk milk. Now, who knows?

But thanks everyone for the advice. I'll see what the ped says when I go next month. Hopefully she's a little chunk by then!

[*Ali*]

If she seems happy at the breast and is going a reasonable time between feeds then you probably don't need to worry.