WWYD: Supplementing an older baby

[noodleoo]

I kind of need to talk this out. DD had her 9 month checkup yesterday. She's doing great aside from having a stomach bug, no concerns with her development or anything. She's always been a very tall baby, consistently at 97th percentile on the growth curve. She started out pretty high for weight as well, I think 75th percentile for the first few months. At her 6 month visit she had dropped to like 60th percentile and yesterday she dropped to 49th percentile. My dr was a little concerned that she's dropping on the growth curve. I'm exclusively BFing and I have no concept of how much milk she's taking. I do feel like she's a fast feeder and she only does 5 nursing sessions a day. She eats a lot of solids, but dr said that doesn't really give her a lot of calories. 

Anyway, dr said I should try to get her take more milk. I'm so over breastfeeding. I don't hate it, but I don't love it either. It has been a rough journey for us and honestly, I don't think I'm up for putting any more effort into it. I know that sounds bad, but it is what it is. The idea of trying to nurse her more or longer just makes me feel exhausted. Dr said I could also just give her an extra bottle of formula. I kind of figured I'd just do that, but when I got home with formula samples, it just doesn't feel right either. 

The thing is, DD seems fine to me. She's tall and skinny, which is not surprising as her dad is a the same and I was too as a kid. And she has stomach flu! But even if she didn't, I kind of think she's fine. I've read that growth curves aren't very accurate for BF babies because the way they gain weight is different than formula fed babies and they tend to level out around this point. 

So, WWYD? Do the supplementation? We have another weight check scheduled in a month. How concerned would you be?

[nachos]

Honestly, I'd take it with a grain of salt and KOKO.

With DS1, the nurses at the BFing clinic had me so paranoid because he was a tall and slim baby that I ended up supplementing and wrecking my supply. With DD, I EPed, so I saw what she was drinking - avoided the clinics - and she grew much the same as her brother. This baby? Same thing. Tall and slender.

If she's happy and meeting milestones you're both doing just fine.

Sometimes I think that numbers and charts have taken the place of common sense.

[nessness]

DD was 90th percentile and dropped to 55th by 9 months. Her pedi wasn't concerned at all.

ETA: if she is gaining weight and seems happy I wouldn't be worried.

[anna7602]

Hmmm, is she crawling/very active? Babies definitely do thin out at some point, although I'm not a doctor so can't say how much of a percentage that should account for. If your mommy gut is telling you nothing is wrong, I think I'd be inclined to go with that. Although your doctor is right that food won't replace BM (or formula) for the time being. Did you cut nursing sessions when she started solids?

[VillainV]

My kid dropped from 75th to like 30th percentile over the same time period and the pedi didn't bat an eyelash.

A lot of active babies gain slower over that period, and sometimes kiddos have a growth spurt which changes where they fall on height/weight scales.
Also, if they aren't consistent about weight (clothes and diaper on or off, same scale) or your kid just ate or had a diaper change, the weight can be off a little.

[starburst604]

I feel like doctors in general can be so focused on charts, BMI, etc and don't pay enough attention to body type and genetics. I don't think I would be concerned about this.

[sh10]

I wouldn't worry about it, my DS was and still is tall and skinny, just like DH. At her age, I wouldn't bother adding in a bottle of formula. Mostly because I am lazy, but also because she's not far from getting cow's milk at one. And for some kids, the "food before one is just for fun" isn't true, my DS liked to eat. Since she likes to eat, I would try full fat yogurt, avocado, and other higher fat foods.

[countthestars]

I woi do KOKO but if you want to wean or supplement and drop a nurse my session def do that instead. Don't feel bad that you don't love it.

[tealblue]

I wouldn't supplement because she's falling off a curve. You can if you are over breastfeeding but I don't personally think you need too. About your Dd's age, our dr suggested adding calories in his solids like adding butter and oil, and I can't remember what else. I didn't follow it. I'm thin, DH isn't large and DS was small but healthy. About 15 months our pedi said "I can see you are both not large people so I'm ok with his weight." Well, thanks for the handout several months ago about how to add calories and wanting him to do some toddler boost drink.

[aprilsails]

If you're happy with the status quo right now I would stick with it. DD just had her 6 month appointment and is 95th percentile for height and now down to 30th for weight but she's had a nasty stomach bug and has spent the past two days pooping and puking so the pedi didn't really care. DD has always been tall and skinny though so that's just her growth curve. She's hit 50% weight at best. My Mom says I was the same.

[Deleted]

I'd KOKO if you're happy, I'd not worry about the charts. That said, I introduced formula around 7 months and stopped pumping at 10 and my quality of life dramatically improved (I HATED pumping). P did fine with it and climbed up the growth charts a bit. She's tall and skinny too, 20% for weight but 60th for height.

[smsm24]

Which growth chart is your doc using? I read a while back that the WHO chart is more representative of EBF babies (the curve flattens earlier in EBF babies) and the CDC for more formula fed babies. I can't find the article right now but if it were me I wouldn't worry and just try to get some calorie dense solids in her (cheese, yogurt avocado etc).

[soozy87]

I think you are fine doing what you are doing. With our first the doctor said we could start cow milk at 9 months. We started at 10 with one bottle and then increased it by one bottle a month until a year. That is another option if you are comfortable with that. Doesn't sound like your kid is starving or lacking for nutrition though.

[Susie]

Feb 25, 2016 22:29:30 GMT -5 smsm24 said:

Which growth chart is your doc using? I read a while back that the WHO chart is more representative of EBF babies (the curve flattens earlier in EBF babies) and the CDC for more formula fed babies. I can't find the article right now but if it were me I wouldn't worry and just try to get some calorie dense solids in her (cheese, yogurt avocado etc).

Yep, our pedi uses the WHO chart or the CDC chart depending on whether a particular baby is BF or FF.  

I agree with most of the pp's - I wouldn't change what I was doing based on this appointment, only if the change was something you wanted apart from it.

[Deleted]

I would just keep doing what you're doing for now and reassess at her next check up. I don't think they should have a had a talk about weight after/during the stomach flu.


Similar thing happened with both my kids. DD was 50th% at birth and first 6ish months then dropped to the 5th% ! Dr was concerned, added fatty foods to diet and nurses more with no change (actually she went many months without gaining at all) so we did a whole array of tests (she did have a few other things going on but nothing serious) and everything came back normal and it was decided she would just be small. She is now almost 4 and still in about the 10th%

Now my DS is 18m and hasn't gained a single pound since he was 10months. He's in 0% for height and 4% for weight now but the dr is waaaaaay less concerned since this seems like a typical growth pattern for my kids

[mswax]

2 of my 3 boys started out "big" (75-95%) and were in the 25-50% by age 1. I think birth weights can be inflated for all sorts of reasons, so I struggle to go by that in the first place. It sounds like all other milestones are being met, and your daughter is still well within the "normal" range. If it were me, I'd KOKO and not even think about it.

[noodleoo]

Thx, everyone. Sorry, I started replying last night and got interrupted and never finished.

I'll definitely have to ask about the growth charts. I personally think it is just genetic, both H and I were super skinny kids. Plus she just started crawling and has been super active, so I'm not surprised she's not gaining much. I think I'm going to just start adding in some fattier solids once she's well again and keep BFing as we are. We'll see what she weighs at the weigh check next month. Thx for the reassurance, I needed that.

[cilantro]

I'd throw some formula in a bottle and give it at night after nursing for ten or so minutes.

I never supplemented with my first. I supplemented starting around 7 months with my second. So liberating. But you got to do you.

[sparkythelawyer]

I wouldn't worry. My kid went from the 90s for weight at birth to like 70something at her 9 month, to 50 something at her 12 month and my doctor gave nary a fuck (though admittedly she was on the tail end of a bug that week that was messing with her intake of calories also). They start moving so much at that age and a bunch of slimming down is not unusual.

And my kid is a super fast nurser also, all she has needed since about 2 or 3 months is about 5-7 minutes per side.

I wouldn't necessarily run to supplementing if you don't want to, I'd focus on making sure she has access to some higher fat foods during the day, and let it ride.

If you do decide to supplement, consider it like a slow progression towards weaning? Maybe that will help?

[busterpup]

Weights on babies are so fickle. Your kid could go up or down by 8oz based on if he/she fed right before being weighed or after (or pooped, or whatever). And 8oz makes a big difference on growth charts at that age. I wouldn't even worry about it, but if you want, I do like the idea of giving full fat yogurt, cheese, avocado, etc.

[osulori]

As long as she's gaining I wouldn't worry. AJ's weights started dropping on the growth curve starting at his 6 month appt due to being more active (he didn't start army crawling until 11 months but was rolling all over the place and more active in general) and was still gaining so our pedi wasn't worried. I wouldn't necessarily worry about supplementaing for that reason.

If you want to start supplementing because you're over breastfeeding and ready to start phasing out nursing sessions, though, have at it. I feel like 9 months was around when I started getting really over pumping (I work FT so was pumping at work)and once I started cutting out pumping sessions and my freezer stash ran out for good the slow transition to formula was so liberating.