Adding a feed without messing up our 4hr EASY

[gcnieminen]

Hi,

Our son is 19wks and we transitioned him to 4hr EASY by 4months, no problem.  However, when we went in for his 4month checkup (albeit a few weeks late), the pediatrician was concerned because he dropped down a few notches in weight.  He didn't lose weight, but he didn't gain as much as he "should" have from 2-4months.  She advised us to not let him go longer than 3 hours between feeds during the day.  Of course, that would be setting us back to a 3hour EASY and possibly cause the problems that you avoid by going to a 4hour routine.     We are trying to add a feed somewhere to simply get more calories into him but don't know exactly where to do it.  We are looking for suggestions or others' experiences.  He is a very happy kid and quite adaptable.  Breastfed (~15 min) and takes a bottle for the DF.

Current routine is pretty "textbook":
7am E
9am S
11am E
1pm S
3pm E
5pm S
6:30 E
Bed at 7ish
DF at 10:30 5oz

Any suggestions would be appreciated! 

-Greg, Christa, and Baby Anders, Washington State

[Deb_in_oz]

not to second guess your ped, but where does your lo fall on the weight charts and did her stay on the same %ile? in australia that is what they look at - a steady line rather than a big drop or gain in weight - so it is not a big deal to be 90% or 40% as long s youy don;t suddenly jump from one to the other.

anyway- if your lo is a reasonable weight, has wet nappies through the day and is feeding welli woudl not stress too much about 3 or 4 hr feeds because at this age most lo woudl probably end up with a similar TOTAL feed amount for the day (ie for a bottle fed baby on 3 hourly mighttake 4-5oz, but on 4hrly might take 5-7oz per feed KWIM)

with your current routine if he is not giving hungry cues earlier than 4 hrs then the 1 place i woudl add food woudl be before bed - i have always done a split feed with my girls - offer one side (or 1/2 bottle) before a bath or massage/stories etc (if no bath in the evenings) then get ready for bed and offer the second breast(or a full bottle) they always tanked up this way and for Olivia who is 1 yo she takes a HUGE amount at bedtime and if we don't offer the extr she actually will cry for it. it  is like she knows to top herself up to last the night.  If he gets hungry before 4hrs you can have some cycles that are 3.5hrs and the last cycle can even be 3hr + top up HTH

[Deb_in_oz]

not to second guess your ped, but where does your lo fall on the weight charts and did her stay on the same %ile? in australia that is what they look at - a steady line rather than a big drop or gain in weight - so it is not a big deal to be 90% or 40% as long s youy don;t suddenly jump from one to the other.

anyway- if your lo is a reasonable weight, has wet nappies through the day and is feeding welli woudl not stress too much about 3 or 4 hr feeds because at this age most lo woudl probably end up with a similar TOTAL feed amount for the day (ie for a bottle fed baby on 3 hourly mighttake 4-5oz, but on 4hrly might take 5-7oz per feed KWIM)

with your current routine if he is not giving hungry cues earlier than 4 hrs then the 1 place i woudl add food woudl be before bed - i have always done a split feed with my girls - offer one side (or 1/2 bottle) before a bath or massage/stories etc (if no bath in the evenings) then get ready for bed and offer the second breast(or a full bottle) they always tanked up this way and for Olivia who is 1 yo she takes a HUGE amount at bedtime and if we don't offer the extr she actually will cry for it. it  is like she knows to top herself up to last the night.  If he gets hungry before 4hrs you can have some cycles that are 3.5hrs and the last cycle can even be 3hr + top up HTH

[gcnieminen]

Thank you for your response, and suggestion.  Anders was in the 30th % at his 2 month checkup and was in the 5th % at his 4 month checkup.  That is what caused our pediatrician's concern.  Anders has not been giving us any hungry cues earlier than 4 hours, though.  This is why we assumed he was getting all the calories he needed and are now a bit confused.  We will try your suggestion and give him an additional feed before his bath tomorrow and see how that goes.

Thanks again!

Greg, Christa and Anders

[Deb_in_oz]

HI

I can see the red flag as this is what i was referring to - wondering if there was a drop in %, so from 30% to 5% you woudl definitely be looking to increase total daily intake.  you could try dropping back to 3.5hrs (earlier or later depending on times he wakes from naps). you can also adopt a semi-split system for feeds if he woudl take some extra at feeds after a little break (ie feed, 10 min break, re-offer and see if he actively feeds) apart from adding in a night feed or reverting fully to 3hrs those woudl be my suggestions. i suggest you also seek some advic eon the BF board since you said you were breastfeeding.  just as some babies (like my Liv) don't give tired cues very clearly, maybe your lo is just rather blase about eating and needs the food schedule set for him rather than waiting for him to ask - if he needs to increase his milk intake the first step is to try to increase intake at each feed and secondary step would then to increase frequency if little progress is made on the amounts. HTH

[LucyA]

Hi, also not wanting to second guess your doctor, but just wanted to mention that here (UK) the growth charts are based on formula fed babies, who tend to have a different growth pattern from breast fed babies. I think the same applies to the charts used in the US. My ds went from 91% at 10 weeks, to just over 50% at 17 weeks, and my health visitor and GP said not to worry, it was extremely common for breast fed babies. If your ds is otherwise well, energetic, wetting nappies etc I wouldn't worry too much.

Having said that, I agree with Debra's suggestions, also, do you feed on both sides? I single side fed for the first few months, but in the last few weeks have been double sided feeding, and ds is growing more quickly again. Also, you could try and increase your supply by pumping after each feed for a few days.

HTH