Not Enough Fat In Milk.

[Anonymous]

Anonymous wrote:OP, are you feeding the baby frequently? Every 2-3 hours? If he's super sleepy you may have to wake him to eat.

Have you tried eating other things, like different cuisines, different preparations of your favorite foods? I agree your diet isn't varied enough. There is so much good food in the world -- try branching out for a week.

Op here. He eats every 2-3 hours. I am very picky with what I eat. We eat out 1-2 times a week, ans we switch up dinners. I am fine eating the same thing off breakfast, lunch, and snacks.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op here. Thanks for all of the helpful suggestions. I am going to comment on one post instead of commenting individually.

For the pp who commented on the LC. We have not had a weighted feed. When we had a babysitter, I set-up a phone appointment to ask how much to put in bottle for him. The LC said he is likely getting 2-3 ounces each feed.

Diapers - He is having mostly wet diapers. Sometimes it isn't that wet, but sometimes it's very full.

Pumping - I didn't realize you were not supposed to pump. Almost everything I read said to pump after each feed to increase supply. I will stop or try to decrease to maybe one pump. I feel too engorged if I don't.

Feeding: I have been offering both breasts. Is offering one breast called block feeding? I read that it's used to decrease supply. We don't use nipple shields because he hates them. He is doing well with latching but does take about 45 minutes to eat. He will often latch and relatch multiple times. I have flat nipples which I think makes it more difficult.

BMI - I am just under 5'2 and my current weight is 132lbs. My pre-baby weight is 120. That's a BMI of 21/22 which is normal.

Eating: I feel like I eat a lot. I eat large amounts of the food I listed. I will start swapping out and eating more carbs, but fruit is carbs, so that doesn't make much sense to me. I never track food but I did to see what it will say. With what I eat, I am getting 1700 calories, 43g of fat, and 58g of protein. I've read that's a good amount. I do eat large amounts of my food - oatmeal is 2 cups, large bowls for fruits and salad, 1.5 - cups of veggies and potatoes ( made with olive oil) at dinner. I also am always thirsty and drink about 100oz a day.

I will try some of the suggest for feeding and start adding in more fats like more avocado, coconut yogurt, cashew milk, etc. I do want to point out I eat fruit because I need the potassium. I have a medical condition which causes low potassium, so I need to eat a good amount of bananas, kiwi, berries, etc., to keep my potassium at a normal level.

OP here. I forgot to add that I am starting to think it has more to do with his not getting enough, and less about what I am eating. He sleeps almost all of the time expect for waking to eat. I noticed he was sucking and sucking his hands while sleeping every time. I thought that meant he wanted a pacifier. I thought he just wanted the comfort of sucking. I noticed since feeding him formula at almost every feed, he doesn't do it. He will only do it after I don't feed him formula. I am starting to think he is getting enough just nursing. He is fussy in his sleep, but I chalked that up to wanting to be held or comforted.

NP here. If he's sucking while he's sleeping, you're right, he's probably hungry. In the end, it doesn't really matter if he can't nurse enough or if the milk isn't fatty enough- it's he's gaining too little, you need to fix it. My first was EBF and never had a drop of formula and was huge (97th percentile). My second never gained weight off my breastmilk and he gets a mix of BM and formula, but has still not recovered fully from the months we struggled to find something he could tolerate and grow from (we ended up with Alimentum Ready to Feed). But adding the formula took him from 0.02 percentile to 30th.

My advice is that if you think your breastmilk isn't fatty enough, then to continue the formula as long as your baby is thriving. 1700 calories seems like too small an amount to eat while nursing, by the way. https://kellymom.com/nutrition/mothers-diet/mom-calories-fluids/

[Anonymous]

Anonymous wrote:Eggs are not dairy.

+1000

[Anonymous]

1700 is way too few calories. You need at add at least 500 more because you are breastfeeding. You also need more starchy carbs. You can do sweet potatoes or squash, it doesn't need to be bread. Also, sucking on hands is a hunger signal. Are you walking to feed overnight? If baby isn't gaining you should be. Has your pediatrician rolled out jaundice if the baby isn't waking unless you wake them? Had baby been evaluated for lip and or tongue ties?

Please, please also get in to see an ICBLC lactation consultant. You have a lot of misconceptions about breastfeeding and would benefit from a qualified person. Can you get into the Breastfeeding Center in DC?

[Anonymous]

Anonymous wrote:1700 is way too few calories. You need at add at least 500 more because you are breastfeeding. You also need more starchy carbs. You can do sweet potatoes or squash, it doesn't need to be bread. Also, sucking on hands is a hunger signal. Are you walking to feed overnight? If baby isn't gaining you should be. Has your pediatrician rolled out jaundice if the baby isn't waking unless you wake them? Had baby been evaluated for lip and or tongue ties?

Please, please also get in to see an ICBLC lactation consultant. You have a lot of misconceptions about breastfeeding and would benefit from a qualified person. Can you get into the Breastfeeding Center in DC?

*Waking to feed

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP, are you feeding the baby frequently? Every 2-3 hours? If he's super sleepy you may have to wake him to eat.

Have you tried eating other things, like different cuisines, different preparations of your favorite foods? I agree your diet isn't varied enough. There is so much good food in the world -- try branching out for a week.

Op here. He eats every 2-3 hours. I am very picky with what I eat. We eat out 1-2 times a week, ans we switch up dinners. I am fine eating the same thing off breakfast, lunch, and snacks.

Try not being so picky in the interest of helping your baby gain weight. Do you eat beans? You could eat channa masala and rice, black beans and rice, bean burritos, chili, etc. How about tofu? You can make coconut curry, pan fry tofu and eat with veggies over rice. Lots of options that will add more calories to your diet.

[Anonymous]

OP, wake up the baby if necessary to feed and feed every 1.5-2 hours instead of every 2-3. Start with Breastfeeding and top off with formula. You can try other formula's too - the best one is the one your child likes and drinks the most of. I would do a sensitive formula given your allergies. I had a low weight baby and we basically offered formula (didn't BF) frequently to get the weight up vs. waiting for a hunger cry.

[Anonymous]

1) you need to work with an IBCLC if your baby is having weight issues. A weighted feed is when an IBCLC, with a special scale (nothing you can afford to buy at home), weighs the baby before and after you feed. It shows how much the baby is actually transferring at the breast.

2) Has baby been evaluated by someone with extensive training for a tongue tie or other suck dysfunction? Is baby pooping on and off the breast? Clicking while nursing?

3) Is baby draining your breast when baby feeds? If not I would continue pumping while you sort this all out. I would also make sure to finish the first breast first and offer the 2nd just as “dessert”

4) Also, the least of your focus should be your diet. Unless you are malnourished, your body will make sufficient milk.

Susan Howard with Arlington Lactation is an expert and has helped me immensely. She leads the free weekly groups at Virginia Hospital Center and also had a private practice.

[Anonymous]

Anonymous wrote:1) you need to work with an IBCLC if your baby is having weight issues. A weighted feed is when an IBCLC, with a special scale (nothing you can afford to buy at home), weighs the baby before and after you feed. It shows how much the baby is actually transferring at the breast.

2) Has baby been evaluated by someone with extensive training for a tongue tie or other suck dysfunction? Is baby pooping on and off the breast? Clicking while nursing?

3) Is baby draining your breast when baby feeds? If not I would continue pumping while you sort this all out. I would also make sure to finish the first breast first and offer the 2nd just as “dessert”

4) Also, the least of your focus should be your diet. Unless you are malnourished, your body will make sufficient milk.

Susan Howard with Arlington Lactation is an expert and has helped me immensely. She leads the free weekly groups at Virginia Hospital Center and also had a private practice.

I’m the PP- re #4 I mean sufficient in composition

[Anonymous]

Op here. I will address everything one large post again.

Feeding: He eats around the clock every 2-3 hours. We let him wake up to eat. We have been using a European formula which he seems to like. The pediatrian said feed every 3 hours by breast, and then offer 2 ounces of milk. His poop is yellow which I read means he is getting a good amount of fat.
He doesn't have jaundice, and doesn't have a tongue tie. He does have a weak suck and always pops off the breast while eating. I am seriously considering just eping if it's his latching that's the problem. It's easier and he seems to take the bottle better.

Eating: I will try to increase my calories. I eat a blend diet because I have severe acid reflux that acts up badly when I eat anything too acidic, spicy, or with caffine. I can't eat the things suggested like curry. My acid reflux is so severe it's called Gerd. I have achy chest pains and my chest feels like a weight is weighing me down when it gets very bad. I can't risk trying new things.

[Anonymous]

When i was breast feeding I was constantly hungry and I actually got tired of eating! I started adding a couple spoons over my food just so i would get more calories and feel full longer. Maybe try that?

In the morning add coconut oil to your oatmeal - it'll taste delicious!

lunch and dinner - drizzle olive oil over your food

[Anonymous]

Anonymous wrote:Op here. I will address everything one large post again.

Feeding: He eats around the clock every 2-3 hours. We let him wake up to eat. We have been using a European formula which he seems to like. The pediatrian said feed every 3 hours by breast, and then offer 2 ounces of milk. His poop is yellow which I read means he is getting a good amount of fat.
He doesn't have jaundice, and doesn't have a tongue tie. He does have a weak suck and always pops off the breast while eating. I am seriously considering just eping if it's his latching that's the problem. It's easier and he seems to take the bottle better.

Eating: I will try to increase my calories. I eat a blend diet because I have severe acid reflux that acts up badly when I eat anything too acidic, spicy, or with caffine. I can't eat the things suggested like curry. My acid reflux is so severe it's called Gerd. I have achy chest pains and my chest feels like a weight is weighing me down when it gets very bad. I can't risk trying new things.

PP - I had GERD during pregnancy so I understand eating bland. At one point I couldn't eat bread. I'm the one who suggested sweet potatoes. My concern about your calories is less for the baby (because your body will take your nutrients for the baby), it's for you. At 1700 calories while breastfeeding you are effectively only eating 1200 (or less depending on your supply). Before I was pregnant, I ate about 1600 calories to not gain. I make at least twice the average supply and and eat closer to 3000 calories. I still lost over 60 pounds from my highest pregnancy weight and over 30 from my pre-pregnancy weight.

EPing is certainly a valid option. You can also ask about an SNS which allows you to supplement at the breast and/or suck training with an OT to address the underlying cause of his weak suck.

I know it probably feels like you have received a lot of criticism, I want to say well done for working to figure out how to help you baby thrive.

[Anonymous]

For starters, I would increase your 1/4 avocado to half (even more if you can) and add in a protein to your lunch. (Chicken, turkey...) and add in a protein shake (with fat) to your daily food consumption- maybe when you are feeding in the middle of the night.

[Anonymous]

I think you've got it op. See an LC to discuss latch and try to get a weighted feed. You seem happy with the rormula and so does baby, so freeze that extra milk, but you could consider using it in the follow up bottles too. His latch could still improve. Good luck!

[Anonymous]

Take your baby to a doctor, do a weighted feed, whatever you need. Stop guessing. Your baby is hungry!