Body, Mind & Spirit

Hi Lauren,

I don’t know if you remember me, but I ran into you Friday night at the Ronald McDonald House charity fundraiser.  And most importantly- you were our doula who helped me deliver my baby last year!!  Here’s my situation:

My son Julian will be one on 4/19.  We were just informed he is below 0% on the CDC growth chart for weight (weighing 17 lbs 2 oz on 3/27).  The pediatrician recommended continuing to breastfeed while we increase his proteins (baby food meats, lentils, beans) and also supplement with whole milk.  Given his ongoing dairy allergy, we are planning to try adding in soy milk or goat’s milk.  I am hoping his recent slow weight gain (really just since 9 mos) is due to his activity levels and perhaps a high metabolism.  Also, to note- he is in the lower percentages (but still on the chart) of the World Health Organization’s weight/age chart, which is based on the norm weights of breastfed infants.   

 But here is my issue- we were ‘on our way’ to weaning since he has been sleeping all night and eating more solids for the last two months.  I currently nurse Julian first thing when he wakes up and last thing before he goes to bed; these are both relatively long sessions, maybe 15-20 minutes each.  During the work week, I pump twice a day.  And that’s all.  The output from pumping has dwindled to just 3 oz per pumping session : (  Now I need to jumpstart my milk supply. 

Here’s what I’ve started since last week:
1.  Taking "More Milk Plus" supplement.  Today I pumped 4 oz my first session.
2.  Increased my daily fluid intake by 16 oz/day.

Here’s what I’m planning to start this week:
1.  No more pacifier for Julian.
2.  Adding a third short pumping session at work.
3.  Adding a pumping session in the middle of the night.  No sense in interrupting his sleep schedule, right?
4.  Increase my own nutrition with more fresh fruit, veggies, etc.
5.  Let Julian end each session and limit distractions.
6.  Make sure he finishes one breast before switching to get the most of the hindmilk.  I admit, I had gotten lax on that one.

Are there any other suggestions you have to increasing my milk supply?  My daycare provider has suggested supplementing with formula, but I am not interested since I know how beneficial the breastmilk is for him.  Also, do you recommend adding in another form of milk, or does that lessen his interest in breastmilk?  Any additional ideas you have are appreciated!

 Thanks so much!
Stefanie Bryant
forcesofgood@live.com
(505) 417-1700

 P.S.  It was great to see you at Girls Night Out!!

Stefanie,

    It was lovely to see you, as well!  What a fantastic fundraiser.

 There are several approaches to your situation I might suggest you consider.  First, let’s address ways we can increase your milk supply and Julian’s weight gain.

    Stopping the pacifier use might show some very fast results.  Many children who use pacifiers will skip or delay meals, whether breastfeeding or on solid foods, because the sucking act releases hormonal signals in their bodies that make them feel as if they aren’t as hungry or hungry at all.  You may see that Julian’s appetite spikes suddenly without pacifier use.

    As far as increasing your supply goes–the supply and demand rule will have the greatest impact.  Taking more milk out and taking it out more frequently will signal to your breasts to make more milk more often.  Using the herbal supplements are a good boost to begin with.  Be sure you back up this initial increase with the increased pumping you were talking about so that you maintain the increased supply well.  Also, adding in more nursing sessions, even one a day or so, will significantly impact your supply.

    As far as nutrition and supply are concerned, as long as you are maintaining a varied and balanced diet, your milk supply probably won’t see much difference for adding more fruits and vegetables in.  While I’m reluctant to discourage *any* mom from fruits and vegetables, it might be good to change as few things as possible in your life at this point because more change might be required later–if stress yourself out over every little thing that might possibly impact your milk supply you’re going to find your supply suffering even more.  Drink to thirst (try not to get too thirsty), eat when you’re hungry and make sensible, healthy choices in your meals–this will support your lactation quite well.

But beyond breastfeeding solutions you might start thinking about some other things:

Is Julian meeting developmental milestones appropriately?  Does he have any other symptoms of potential problems other than low weight gain?

How well does Julian eat when he’s away from you?  Does he have nutritive, high-calorie choices at daycare?  Is he the type of child who eats better when eating with others or when eating alone?

Animal milks are not an essential component of good nutrition for young children.  You might consider other high-calorie snacks that are more nutritionally sound.  Nuts and nut butters (other than peanuts and only if there are no nut allergies in the family) could be a good choice for Julian.  Dried fruits are densely caloric while still having high vitamin content.  Yoghurts and cheeses may have better protein bioavailability for a one-year-old than straight milk.  There are soy varieties and varieties from goat’s milk as well depending on your preferences and potential allergy risks. 

You might also talk to Julian’s pediatrician about what his concerns for Julian are.  Some kids are just smaller than others–what does Julian’s pediatrician think might be problematic about Julian’s weight?  How did Julian’s weight gain progress over the last year?  Was he on a expected curve and then deviate from the pediatrician’s expectations suddenly?  If so, were there any significant changes in Julian’s life that might help us understand why?

I’ll keep an eye on this thread and let’s see if we can’t get some suggestions that will be useful for you.  I’d like to welcome other people to chime in with their experiences as well.

Cheers,

Lauren Morgan-Smith 

I am definitely not the expert Lauren is, but my first thought was, "is that small?"  Not yet 1 and 17 pounds?  I thought around 20 pounds was "average," meaning lots of kids are less.  If you don’t feel there’s a problem with his development, perhaps there’s no problem here at all?

 I also just wanted to suggest you do further research about soy milk and soy intake at all.  Many folks are now cautioning us about soy’s digestability, allergy potential and phyto-estrogen effects.
http://westonaprice.org/soy/index.html

 Local Albuquerquean Kaayla Daniels has written a well researched and well respected book on the nutritional effects of soy called The Whole Soy Story which strongly cautions against modern soy products:
http://www.thewholesoystory.com/

Traditional, fermented soy products in moderation are a different story, but modern soy milk is highly processed and often made with GMO soy.  There are many facets to this topic and only you can decide what’s best for your family. I only urge you to do your own research. Good luck!

SecretlyStern said:

Animal milks are not an essential component of good nutrition for young children.  You might consider other high-calorie snacks that are more nutritionally sound.

I guess I half agree with this.  I agree that commercial milk is not the best source of nutrition.  But if you could get FRESH goat milk from a goat that is raised well, that is a true whole food and so good for kids.  Also, fresh goat’s milk tastes nothing like what we buy in stores!  Obviously, though, some kids just cannot have milk, so I suppose it’s not "essential," as Lauren says!  Though it is at our house!

Thank you all for the great insights!  I will definitely take that list of questions with me to his one-year well-baby check.  The only thing that really started the decline toward weaning was the fact that he started sleeping through the night (the WHOLE night from 7pm to 6am!) at about 10 months.  And right around that time, he started teething and really took to the pacifier, though prior to then he never really used one.  Soo- add a lengthy time daily of not expressing along with a soother to fool him into thinking he’s not as hungry…  You might be on to something! 

Also- where can I get fresh-raised goat’s milk in case we’d like to try it?  Julian’s dad & I are big milk drinkers, so we’d like to include him in our "tradition" if he is able.  Who knows- maybe we’ll all switch to healthier milk!

 : ) Stefanie

By the way, YES- Julian is completely age-appropriate with his development- mobility, verbalization, recognition, cooperation (and sometime not!)  So I think it is just the weight that concerned the nurse; I don’t know if Dr. Han is concerned or not.  I won’t see him until 4/21/08. 

Julian was born in the 10% range and maintained that through 9 mos; then he dropped to the 3-5% (around the time teething started & the pacifier was introduced).  Now he is below the 0% mark on the CDC Infant Boy Chart.  For comparison purposes, I researched infant weight charts, and found the World Health Organization (WHO) chart that bases their percentiles on the "norm" of breastfed infants.  I believe the CDC is just all U.S. children, breastfed and formula/other food-fed.  And Julian is on the WHO chart in the 2nd lowest bracket; but he’s ON the chart : )  So perhaps he is just a smaller child of breastfed-baby normal!

storianne said:

Also- where can I get fresh-raised goat’s milk in case we’d like to try it?  Julian’s dad & I are big milk drinkers, so we’d like to include him in our "tradition" if he is able.  Who knows- maybe we’ll all switch to healthier milk!

 : ) Stefanie

I highly recommend fresh milk. It’s how milk is supposed to be consumed!  Many folks who have problems with store bought (even organic) milk do not have the same issues when switching over.  Email/pm me here and I’ll get you two numbers of potential milk sources.  amylee at bodymindandspiritabq dot com.