Breastfeeding low weight gain?

by Kristie
(Willimantic, CT)

My daughter is 15 weeks old today. She has a doctor's appointment at week from today, her 16 week/4month checkup.

Here are her weights so far:

Birth: 7lbs 12oz, 20"
1week: 7lbs 6oz
2week: 7lbs 10oz
4week: 8lbs 10oz, 22"
8week: 9lbs 8oz, 22.5"

Today at 15 weeks she weighs 11lbz even and is 24"

I'm afraid that her pediatrician is going to tell me that she hasn't gained enough weight and that I should supplement. My husband and I have given her bottles of breastmilk before on day trips and she prefers the bottle (even with the slowest nipple flow nipples) and then has a rough time transitioning back to the breast. I refuse to formula feed her. I'm also afraid that the pediatrician will tell me to start her with baby cereal and I have also decided to wait until 6 months before introducing solids, and we have decided to skip cereal altogether.

What would you tell the pediatrician if you were in my situation? I don't want to sound disrespectful, but I also don't want anyone telling me what I need to do with my child! I just want to make sure she's on the right track and i'm doing the right thing. If you have any ideas for things I could try i'd be more than happy to try them!

Thank you so much!
Kristie

Answer from the lactation consultant
Her weight gain is a tad below "average" for a breastfed girl but not much. She is still well within the parameters. Are you plotting her on the breastfeeding chart? Here is a link to it if not,WHO breastfeeding growth chart for girls

Just as important as her weight gain is the neccesity of her meeting her developmental milestones AND her feeding patterns.
My daughter was always in the 10% for growth on the standard growth charts which are geared toward formula feeders. So be sure to print off the growth chart to take with you.

If for some reason the doctor is insistent that you start supplementing, tell him that you will consult with a lactation consultant first on how to increase feeds. Then do it, plan an in person visit with a local LC.
Just to cover some basics about feeds: your baby should be eating 8-12 times a day or every 2-3 hours. She should be having at least 6 saturated wet diapers and one poopy diaper. When you feed her (now this is VERY important for babies who are not gaining weight well) you must EMPTY a breast before switching her. NOT 10/10 routine. Nurse her for 10 minutes or so, take her off burp her and put her back on the same breast until it is empty. Then, if she is still hungry, offer her the other breast to top off. If you switch breasts without emptying, the baby never accesses the fatty hindmilk and thus getting the watery foremilk. This results in slower weight gain, more frequent feeds, and very watery (sometimes foamy) green stools.
I would also like to address your diet. Are you eating a minimum of 1800-2000 calories a day? Are you taking your prenatal vitamins? Are you drinking plenty of fluids and getting plenty of rest? These are all very important steps to take to make adequate breastmilk.

I do not feel it would be wise for me to recommend an herb to increase your supply at this point not knowing your feeding schedule or her output (diapers).
If you have further questions, I would request you schedule a phone consultation at this point so we can resolve your situation that way. The phone consultation button is on the left navigation bar.

Liz Pevytoe, RN, IBCLC