[..Penelope..]

For those who asked me to update on Logan's 2 week pediatrician appointment, I'm just going to x post what I posted on the Breastfeeding forum...

Logan had his two week pediatrician appointment today. It went so horribly

When he was weighed at around 1 week, he had lost 8% of his birth weight. He was born at 8 lbs 4 oz, so that put him at 7 lbs, 8 oz. Today he was 7 lbs 14 oz. The pediatrician told us that he wasn't gaining fast enough. He said that our best option was to supplement with formula, and said that if Logan is not up to his birth weight by 3 weeks, then that is 'failure to thrive.'

Logan also still has jaundice...not only in his face, but also in his chest So then the pediatrician suggested that his liver might not be working properly. Apparently when the nurse took Logan's blood for the newborn screening tests, she got an 'insufficient sample' even though she took a ton of blood and neglected to put a bandage on him, so he bled all over the place. We took him to the lab and had blood drawn again, and they are also testing his jaundice level.

Last...the pedi noticed the tongue tie and said that Logan might not be getting enough to eat because of it. The nurse who visited us when he was 2 days old didn't seem concerned by it because it was 'so minor'. The pedi said that instead of supplementing with formula, I could pump breast milk and give it to Logan in a bottle. He also mentioned cutting the tongue tie. I do NOT want have anyone cut my baby!

I can't believe that all of these things are wrong I don't understand, either...Logan is making more then the recommended amount of wet and dirty diapers every 24 hours, and the poo is the right color and consistency, and his pees are pretty big. If he is not getting enough to eat, how does he have so much output? But I feel like I can't trust my own opinion on this I don't want to starve my son.

Logan is still VERY sleepy at the breast. He was very awake at the breast yesterday, and he cluster fed for the first time from about 5 am to 1 pm, with 2 hours of short breaks scattered throughout. But today, he is back to eating for 10-15 minutes, falls asleep, I wake him up, he eats for another 10-15 minutes, falls asleep. I keep him on the same breast for both 10 minute feedings because I want him to get fatty hind milk. Also, I keep him in only a diaper and socks and do skin to skin. Sometimes I can wake him and put him to the other breast, but after we got home, J told me to stop and let him sleep because I was stressing out so badly and Logan was out so hard.

At this point, we are considering using a bottle with breast milk starting tomorrow. We wake him every 2-3 hours to eat.

ETA: I forgot to mention, Logan grew an inch since they measured him at 1 week.

Any advice on any of this would be REALLY appreciated!

[~*sierra*~]

*hugs* i wish i had some advice for you hun, i just know someone will be here soon with some great btdt advice. sounds like you are an awesome mom to me though!!

[sara~b]

I think your pedi is an idiot. He gained 6 oz in a week. That's a LOT! Seek a second opinion from another pedi and another lactation consultant before you switch to exclusively pumping or formula. Unless his bloodwork shows something is not right then it sounds like he is doing wonderfully to me, especially considering he did lose quite a bit!

[Resi]

I agree with Sara. He seems to be doing okay. He did gain some weight back and if he is making a lot of pees and poops that is a great sign. I'd try to find a good LC or even go to a LLC meeting with other nursing moms for some support. Maybe he tongue tie is minor like you were told. I don't know much about that. If you really don't want to supplement with formula then don't jump the gun on it. You could always try to supplement with some pumped milk as you plan on doing. I just hope he doesn't get confused between nipple and bottle. Keep offering him the breast often. Try not to stress. It sounds like you are doing great and trying really hard!

[Oriyan]

I too agree your ped is an idiot. I would find another one, fast.

You've only been BFing for 2 weeks. Your ped obviously is not BFing friendly. Some babies who are EBF gain weight at a slower rate at the beginning while the hind milk fore milk sorts itself out.

And I believe that this young, they can not classify a child as failure to thrive. I forgot, but one of the other ladies here had the same issue with their son..... i forget who it was......

Maybe Nikki can chime in. I believe she had BFing issues and weight issues as well and she found a LC who was awesome.

To help out the jaundice, some indirect sunlight for 10-20 minutes here and there is good (like a bouncy seat in the sun coming through a window while in a onesie). Or you can bring him outside if its warm enough.

[..Penelope..]

Thank you guys so much!! You have made me feel so much better!

[Chelnae6]

I agree with supplementing with pumped milk. I think maybe the doc wanted to see him back at his birth weight at least since it has been 2 weeks. idk about the recommended weight gain for newborns though so I'm just guessing.

Do you have one of those lights for him?

[sara~b]

According to the BREASTFEEDING ANSWER BOOK, "Average weight gain for the first three to four months is about six ounces (170 grams) per week" (Mohrbacher and Stock 2003).

HTH! Obviously, Logan lost the first week but gained the recommended amount the second. As long as he keeps gaining you guys are right on track!

Another site that backs up my 'Logan is healthy' theory:
WEIGHT GAIN (GROWTH PATTERNS)

Print these out and show them to your pedi when you tell him to shove his 'failure to thrive'!

[faith*hope*love]

I also want to add that my nephew had the tongue tie and they clipped it and he had no problems at all, he didn't even act painful, and I believe he was between 1-2 weeks old when they did it.

[~*sierra*~]

Jack Newman's Guide to Breastfeeding says in it that all the growth charts used these days are based on formula fed babies. that is a great book if u have time to read it, but its long, its like a text book.

[momof6lopez]

P, I saw your post here and hope you dont mind me chiming in......

My second son is "tongue tied", enough that they put it on his birth certificate as a birth defect. I waited until he was 2 to make any decisions about being "cut" and was told his speech was just fine, and he did not need the operation.

I also breast feed him, and he gained wait appropiately, but had a very hard time latching on.....I just never gave up, like you, and kept waking him up and basically enforcing the bf'ing. He was also very jaundice, had to have him tested every week until he was about 6wks, and finally all was better.

I will tell you that eventually I had to stop the bf'ing with him due to how many breast infections I was getting (due to the latching problems) at age 7mo. He took the bottle so much better. It was very hard for me to give it up, as all my kids were bf'd until 1+yrs.....but I was loosing too much weight myself, due to how sick I was getting from the infections.

I agree with a second opinion on his weight, and "failure to not thrive" diagnoses. He has gained, he is wetting/pooping plenty. Maybe once his liver catches up, you will see a big leap in his progress. And sometimes it takes a little while for the liver to catch up, I know my son's did. He was born 10lbs, and still was very jaundice even though he was gaining weight.

Dont stress yourself out, sounds like your doing everything right, IMO.

[fromGirltoMommy]

Dont let them push you into formula. He IS gaining. Some babies gain slower than all the others! If you supplement the only thing your going to hurt is your supply. Which is no good. Maybe do a nurse-a-thon weekend?

[SandKmommy]

I want to offer

Kieran had bad weight issues if anyone remembers....
Kieran was born at 6lbs 13oz and dropped down to 5lbs 9oz. And I was told to supplement with formula but ended up supplementing with pumped milk instead. She didn't gain back to her birth weight till 1mo and they never classified as failure to thrive but we were going for weight checks every few days and some days she wouldn't gain any others she'd gain some. And even at 1yr old now she is still a tiny baby at only the 12% for her age.

Do not let them pressure into formula, alot of doctors will right away.
I also want to add that it is normal for a baby to loose upto 10% of its body weight.
kellymom.com :: Average Weight Gain for Breastfed Babies

[..Penelope..]

Thanks, ladies!

At this point, we have decided to just continue what we are doing - feeding him as much as possible and waking him every 2-3 hours during the day as necessary (he wakes on that schedule by himself at night). We are not going to go to the health centre on Monday, we'll just return to the pedi's office on the 26th.

I forgot to add, the reason why the nurse said that his tongue tie was minor was because he could get his tongue out past his gums (and it actually extends past his lower lip). The tie doesn't extend all the way to the end of his tongue, and our latch is not painful 95% of the time. The other 5% is usually at night when I'm exhausted and Logan slips, but then if I pop him off, he closes his mouth and won't continue nursing. It's just not worth it for him to fall asleep, refuse to wake up, and then be up again an hour later wanting to eat again.

Resi - I don't want to supplement with pumped milk, either, because I don't want to risk nipple confusion. We were planning on occasionally giving him a bottle around 3 or 4 weeks so J could give me a break from one feeding during the night.

I am definitely going to look for a different pedi.

Sara - Thanks so much for the quote and the link! I can't wait to show the patterns to the pedi!

Lori - I don't mind you chiming in at all! Wow, you had such a tough time! About the jaundice...my sister said that my nephew had jaundice for a month.

Nikki - Hurting my supply was something that popped into my head as soon as he started recommending supplementing with formula. I feel like every day is a nurse-a-thon! But as long as that means that Logan is getting what he needs, and that he is growing, then it's worth it.

At this point, Logan is in the 97th percentile for length, 50th percentile for weight, and 25th percentile for head circumference.

[SandKmommy]

Thats a good schedule to keep. Kieran wouldnt' wake up at night at all and we had to force her(which ended with both of us in tears.)

My kids had tongue issues too. Kieran could only bring her tongue to her gum line and then would "swallow" it back when we tried to nurse(hence why I had to use the shield again with her to help bring her tongue forward.)

I would do what you want to do and if the is EBFing keep going! He sounds like he's gaining the normal amount! For the janudice... do you have a chair you can sit in to nurse by a window? I was told to nurse Kirsty in natural light (Feb is too cold outside here lol!), I used to nurse at a window - if your house is warm enough, strip him down or open his sleepsuit down the middle so the natural light (not sunlight though) gets onto his chest & face.

If you can, let him nap in natural light as well, again by a window but not in direct sunlight. if it's nice enough with you, try to get outdoors as much as you can.

Daylight & fluids are the best way to get rid of the jaundice. Kirsty had it still at his age so it's not uncommon, I wasn't offered blood tests for her, nor was I advised to supplement or anything.

Some babies gain really fast to begin with then slow right down and often don't gain for ages around the 8/9month mark - Kirsty did this. Others are slower to begin with. I bet when he hits the 4wk growth spurt he'll nurse like mad and it'll help all this.

Are you able to contact an LC or similar in your area to get support & more BFing geared expert advice? I know Nikki has had great support from hers with Kennedi

p.s. have you stopped by the BFing board here on JMs?

[**jessie**]

Definitely get the hyperbilirubinemia (jaundice) under control. The high bilirubin causes babies to be really sleepy and not feed well. Jaxon had to spend 3 whole days under the bili lights at 7-9 days old. It made a huge difference.

[szczepanski]

Penny you've gotten some fantastic advice so I just wanted to tell you that you are doing an AMAZING job nursing Logan - 6 ounces in a week is what they are supposed to be gaining! So he is doing wonderfully!

Go with your gut....keep nursing him and keep doing what you are doing. Once he gets over the jaundice he will be wide awake and you wont know what to do.

Your pedi doesn't sound very pro-breastfeeding, have you thought about finding a new one?? You don't need any stress, especially any NOT needed stress!!!

[**Jenn**]

I know you've already gotten tons of responses here but I wanted to let you know that I went through the same exact thing with Liam. He was born at 7lbs 5oz and dropped down to 6lbs 7oz by his first pedi appt. He was a little over 4 weeks old before he was back up to his birth weight. He also was jaundiced and pretty sleepy. I was scared into supplementing him with formula and that is the absolute worse thing I did. He had plenty of wet and poopy diapers but I was pretty much told that if we didn't supplement he'd end up really sick and back in the hospital--not what a new Mom wants to hear and I unfortunately believed them. All supplementing did was completely ruin my supply and cause awful stomach problems for Liam. And you know what? The formula didn't help him gain any faster and at his one month appt. a different pedi said he's just a slow gainer and not to worry. By that time we were too far gone and had to use more and more formula because my supply kept going. And his tummy problems kept getting worse and worse because his body couldn't process the formula (and we tried several different kinds in hopes to find one that he could tolerate). It wasn't until he was close to 5 months old that I had had enough and had to get a prescription for domperidone in hopes of basically relactating to get him off formula. It took about a month but we were able to get rid of it altogether! It was an awful road to go down and completely unnecessary and I really don't want to see you have to go through all that. Go with your gut and maybe find a new pedi.

[ScottishBrit]

I never heard any of that when I was going through those problems with Cambria. We BF Exclusively and I brought her to the Peid when she was 3 months ( a little earlier then her regular appt ) cause everyone kept commenting on how small she was. Since she would Literary eat Every hour for an hour I was concerned. I found out she only gained 6OZ's in 3 months! She was 7lb's 2 Oz's when she was born and had dropped to 6lb's 10oz after birth. I tried everything I could to make more milk and I really just think my supply SUCKS!!! My sister had problems too. I started pumping for 10-20 mins after she nursed and I'd be lucky to get an Oz. I would give her that extra bottle before bed ( I think we started that at 4 months ). She still wasn't gaining a ton. My supply started decreasing A LOT so I had to start Supplementing around 6 months. We stopped BFing at 9 months and I dried up. I was sad and I feel like a Failure but I know I tried as much as I could. Cambria Is still Petite, she only weigh's 23 Lb's. And that was before she got sick and lost a little cause she didn't eat for a week! So who know's what she's at now. ALL the girls in my family are Petite though and my Peid is really nice and think's thats just how she's gonna be to. Maybe you can Pump and give him that or even give him a Oz a day of Formula If that would make you feel better?