Expert: Sally Wendkos Olds - 11/3/2010

Question
QUESTION: I HAVE A BABY BOY WHO IS ALMOST 7 MONTHS OLD. HE WAS BORN 2 WEEKS EARLY AND WAS 6 LBS 13 OZ. HE IS ALWAYS HIT HIS DEVELOPMENTAL MARKS AND NEVER BEEN BEHIND IF ANYTHING HE HITS THEM EARLY. HE HAS BEEN BREASTFED ONLY UNTIL 4 MONTHS OLD WHEN WE STARTED CEREAL. HE HAS NEVER HAD FORMULA.
AT HIS 6 MONTH OLD CHECK UP HE HAS HAD A GROWTH SPURT AND IS 28 INCHES LONG BUT ONLY WEIGHTS 16.6 LBS. SO HIS WEIGHT HAS SLOWED DOWN SINCE WE STARTED SOLID. HE HAS ALWAYS BEEN IN THE  70% FOR HIS WEIGHT AND IS NOW IN THE 50%. THE DOCTOR SAID TO GO TO STAGE 2 FOOD WITH HIGH CALORIES. HE IS NOW 2 DAYS AWAY FROM BEING 7 MONTHS AND IS NOT GAIN WEIGHT. HE IS NOW TEETHING AND IS VERY FUSSY FOR FEEDINGS AND SOMETIMES I CAN ONLY GET HIM TO NURSE FOR 5 MIN BUT HE WANT TO EAT EVER 2 HOURS AND STILL WAKES UP EVERY 4 HOUR AT NIGHT TO EAT. HE HAS A LOT OF WET DIAPERS DURING THE DAY AND NIGHT.
WHAT CAN I EAT OR DO DIFFERENT TO GET HIM TO EAT MORE BREAST-MILK AND GAIN WEIGHT??? IS IT NORMAL FOR A TEETHING BABY TO NOT WANT TO NURSE MUCH??? DO I NEED TO CUT OUT THE REAL FOOD TO GET HIM BACK TO NURSING WELL???

ANSWER: Dear Tasha,

First, congratulations for giving your son the best start in life by breastfeeding him!

Now, to your current question: There are many causes that can make a baby have a decreased appetite.  Teething babies often refuse breastfeeding.  Babies also become more efficient at nursing as they get older and decrease their amount of time at the breast.  It's hard to know from what you wrote -- and from a distance -- to be able to tell whether your baby is actually failing to thrive. To get a sense of that you need to ask your pediatrician.

Also, it's not clear to me if you have already started to feed your baby the Stage 2, high-calorie food your doctor recommended and if he is still not gaining enough weight. If you haven't started this yet, try it for a week or so and see whether your baby starts to gain. If you have been feeding this and the baby is still not gaining, ask your doctor what she/he thinks the problem is and how you should address it.  At your baby's age he shouldn't need to nurse every two hours during the day and every four hours at night, so you need to change his feeding plan in some way. One other possibility might be to supplement the breast milk with formula,  maybe in a cup if he is not used to drinking from a bottle.

Good luck!

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Olds & Marks, 4th edition, September 2010, published by Workman Publishing, and soon available in most public libraries, bookstores & La Leche League chapters.





---------- FOLLOW-UP ----------

QUESTION: THANK YOU SALLY FOR YOUR QUICK RESPONSE.
TO FOLLOW UP A LITTLE AND GET A LITTLE MORE INFORMATION FOR YOU I AM WRITING  YOU BACK.
MY BABY BOY HAS ALWAYS BEEN A GREAT NURSER. HE STARTING NURSING WHEN HE WAS 30 MIN OLD WITH NO PROBLEM AND WHEN FROM 6.13 LBS AT BIRTH TO 15.4 LBS AT 4 MONTHS OLD.BUT AT HIS 6 MONTH CHECK UP HE WAS 16.6 LBS. THE DOCTOR HAS NOT SAID HE IS FAILING TO THRIVE BUT HIS WEIGHT IS JUST NOT WHERE IS SHOULD BE FROM WHERE HE WAS.
I FEED HIM 1/4 CUP OF CEREAL TWICE A DAY AND IT IS MIXED WITH BREAST MILK INSTEAD OF WATER SO THAT HE GET EXTRA CALORIES.  WITH THAT HE IS ALSO GETTING STAGE 2 FOOD. HE EAT 2OZ JAR WITH BREAKFAST AND 4 OZ JAR WITH DINNER AND ABOUT 1 OZ OF FRUIT AFTER DINNER AS A DESERT. WHEN HAVE BEEN DOING THIS FOR THE LAST MONTH AND HAVE NOT SEEN THE RESULTS THAT THEY THOUGH.
AS FOR HIM NURSING EVER 2 HOURS JUST STARTED BACK UP SINCE HE STARTED TEETHING. HE WAS EATING EVER 3-4 HOUR DURING THE DAY AND 5-6 HOURS AT NIGHT.
I HAVE TRIED PUMPING AND FEEDING HIM OUT OF A CUP/BOTTLE AND HE WILL NOT TAKE IT. WHEN IT IS FEEDING TIME AND I PUMP I CAN GET 3-4 OZ OUT IN 6 MINUTES AND I KNOW HE CAN GET MORE OUT OF MY BREAST THAN I CAN. SHOULD I STILL BE VERY CONCERNED? I HAVE READ ABOUT BABIES GOING THROUGH NURSING STRIKES IS THIS TRUE? COULD THAT BE HIS PROBLEM?
HE LACHES ON AND IS ON FOR ABOUT A MINUTE AND THEN CRIES AND GOES BACK ON AND REPEATS ONCE THE MILK DROPS HE STAYS ON FOR A MINUTE AND THEN WILL NOT TAKE ANY MORE. THIS GOES ON FOR ABOUT 15 MINUTES ONLY ABOUT 5 MINUTES IS HE ACTUALITY NURSING.
HE IS VERY HAPPY, PLAYFUL, AND LOVABLE. BUT BEING A FIRST TIME PARENT I AM VERY CONCERNED EVEN THOUGH HE HAS ROLLS ON TOP OF ROLLS.
THANKS YOU AGAIN.

Answer
Dear Tasha,

It's good to see that you are such a devoted and concerned mother. From your description of your son's behavior and general attitude it sounds as if he is a fine healthy baby. However, there is no way I -- or anyone else -- can diagnose what is going on with him without seeing him. This is why you need to take your concerns to your baby's doctor. If the doctor examines your son and says he is just going through a phase and not to worry about it, you can carry on with the feeding schedule you are giving him now. However, if the doctor feels you need to do something differently, you will have an expert opinion and you can do what the doctor recommends.

Your son is lucky to have such a caring mom!

Best regards,

Sally
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Sally Wendkos Olds
Author, THE COMPLETE BOOK OF BREASTFEEDING: Olds & Marks, 4th edition, September 2010, published by Workman Publishing, and soon available in most public libraries, bookstores & La Leche League chapters.