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EWmums

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ewmoda

How to fatten my LO up?

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522

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EW GURU

Latest post on 09 June 2011 - 16:59

As for the disclaimer, what can I say... I've been working in investment banking for way too long! ;) edited by lemondrops on 09/06/2011 Lol :D Sounds like a good plan! Will have a chat with the pead about that. Ta :)

378

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EW EXPLORER

Latest post on 09 June 2011 - 16:56

Thanks LD - they're some great ideas. I love your little disclaimer at the end ;) The idea of putting a little formula in his milk is a great idea. Any recommendations on which one? As you're looking for weight gain, I would go with the low birth weight formulas. You already know that J tolerates the low birth weight s-26, so I would stick with that. As for the disclaimer, what can I say... I've been working in investment banking for way too long! ;) <em>edited by lemondrops on 09/06/2011</em>

522

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EW GURU

Latest post on 09 June 2011 - 16:56

Thanks very true! I know I wouldn't have been as sucessful with breastfeeding my LO's if I didn't have the wonderful help and support of a fabulous midwife who took so much time with me when my eldest DS was born. I'd never hold back on a feed or try to stretch him. I'm actually far more relaxed with J than the other two and if he throws an extra feed in during the day, then so be it! No concerns there. As for sitting for 20 min feeds 8 times a day - my couch has an imprint of my derriere well embedded! ;)

kiwispiers15400

2782

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EW EXPERT

Latest post on 09 June 2011 - 16:47

Yeah I wouldn't encourage it ;), I had to as he got super-active (early crawler) and wouldn't keep still for longer than 5 minutes at a time to feed so it was either ram milk into him whenever I could (daytime only of course although sadly he still takes his best feed at around 3am) or stop breastfeeding. I mostly just feed him everytime he wakes from a nap and everytime I put him down so its not too bad and I'm not sure I could go back to having to sit still for a 20+ minute feed anymore. I think so long as you feed your baby sooner than scheduled if he seems hungry you're fine. Thanks for the invite to stickybeak away, I think we all need to talk about our breast-feeding experiences as much as possible, since we don't grow up physically seeing as much breast-feeding as we should, we need to at least share the knowledge we gain before it becomes a completely lost art, there are so many websites with info about latching at the start but here is so much else you have to deal with along the way especially if you breastfeed for longer than the first few months.

522

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EW GURU

Latest post on 09 June 2011 - 16:45

Thanks LD - they're some great ideas. I love your little disclaimer at the end ;) The idea of putting a little formula in his milk is a great idea. Any recommendations on which one?

378

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EW EXPLORER

Latest post on 09 June 2011 - 16:27

Hi meals, a few tips if you do want to try fattening him up, if he still takes the 10 pm bottle with his vitamins; you can add an extra half scoop of formula to every 120/150 ml - this bumps up the caloric content to 24/27 per ml. You can also try adding a tablespoon of vegetable oil. I think coconut oil is highly recommended. I plan to add a tablespoon of flaxseed oil to one of DD's bottle once she turns 6 months adjusted as it's very high in Omega 3/6, which is excellent for brain development. Also if you've got loads of EBM stored in the fridge and prefer to avoid formula altogether, you can basically scoop up the fatty hindmilk that sits on top of the milk and add that to J's regular bottle. That should also help bump up the caloric content. FYI, whilst there are all recommended practices of increasing the caloric content of infants' feedings, including that of preemies, you may want to pass these ideas along to J's pediatrician before implementing them.

522

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EW GURU

Latest post on 09 June 2011 - 15:55

Please don't stop sticky beaking! Not that I think that's what you're doing! :) It's great to get different views and opinions! Not sure about the 1-2 hourly feeding tho!!! I guess I'll let him tell me more what he's after :)

kiwispiers15400

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EW EXPERT

Latest post on 09 June 2011 - 15:48

well really he is only 4 months old, and you know, if he hadn't been prem, he might have come 2 weeks after due date so yeah, stick with 3 1/2. I doubt the Ped will tell you to introduce solids, sounds like your baby is feeding well, he is only little, and only has a little tummy so he can only grow so much at a time. Forgetting about his weight, from a developmental point of view I found that DS starting solids later, is a much better eater than his peers who started sooner. Also if you start when he is older you'll able able to go straight to things like meat which have far more nutritional value than something like baby rice. Final thought (and then I'll do my best to stop sticky beaking :), DS's weight gain going up a centile also co-incided with forgetting about 3 hourly feeding and going for 1'1'2 hourly ish feeds, not that that was really my choice but his reflux stopped when he started doing that so again, the wee critters do sometimes know better than we do :)

522

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EW GURU

Latest post on 09 June 2011 - 15:36

Hey meals I had the same with my son. He was always at the bottom of the growth charts and I did fret but then I just stopped looking and relaxed about it. I knew he was eating, was happy and continuing up his own growth curve. I bf until 7 months, solids from 5. He is 3 half now and he is only 11.5 kg!!! I do not worry. He is happy and healthy, he eats well and being lean is just the way he is! I'm am completely happy with how he's growing (apart from the actual numbers). I just know I'm going to have to discuss it with the pead next week and I want to go in armed with the knowledge that what I'm doing is right and there's very little more she can offer in terms of alternatives. I don't want to stop bf-ing, I'm happy to try solids (but really, for the first little while they don't take much do they!). I don't mind if he's a little bit little for a while... HOWEVER, apart from telling everyone when they ask that he's only 4 months old, I'm almost at the point of scaling that back and saying he's 3 1/2! ;) Moonkitty - thanks for sharing, it's nice to know I'm not the only stress-pot! edited by meals on 09/06/2011 <em>edited by meals on 09/06/2011</em>

522

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EW GURU

Latest post on 09 June 2011 - 15:34

I would have thought 120g was enough, but as I charted him on the chart his little curve is slowly trending downwards. Thanks for saying it all seems right tho! As for switching sides, I did think it was best to encourage him to take the most from one side, completely empty, to encourage the fatty hind milk consuption as this is where the calories lie (whereas fore milk is more for hydration). I guess if he thinks he's finished one side and I've tried the football hold and still not interested it won't hurt to give him a shot at the other! Thanks for all your advice... and any more is always appreciated :) I thought that too, but then I read that it wasn't that simple, and also that if you were feeding frequently that the baby would get to the fatty milk quickly regardless. I was advised to do the one sided feeding becose of reflux due to oversupply, to discourage overeating. Anyway maybe let him feed one side until he stops, then whack him on to the next side rather than doing the football hold trick, I think babies have an instinct about what they need. Here is a good link http://thetruthaboutbreastfeeding.com/category/research/forehind-milk/ edited by kiwispiers on 09/06/2011 Thanks for that. Sometimes those little critters know exactly what is right huh! I'll give it a go.

kiwispiers15400

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EW EXPERT

Latest post on 09 June 2011 - 15:31

oh and looking and DS's line is very much a wobbly up and down with the WHO curve kind of fitting in between, they seem to grow in bursts rather than constantly.

kiwispiers15400

2782

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EW EXPERT

Latest post on 09 June 2011 - 15:23

I would have thought 120g was enough, but as I charted him on the chart his little curve is slowly trending downwards. Thanks for saying it all seems right tho! As for switching sides, I did think it was best to encourage him to take the most from one side, completely empty, to encourage the fatty hind milk consuption as this is where the calories lie (whereas fore milk is more for hydration). I guess if he thinks he's finished one side and I've tried the football hold and still not interested it won't hurt to give him a shot at the other! Thanks for all your advice... and any more is always appreciated :) I thought that too, but then I read that it wasn't that simple, and also that if you were feeding frequently that the baby would get to the fatty milk quickly regardless. I was advised to do the one sided feeding becose of reflux due to oversupply, to discourage overeating. Anyway maybe let him feed one side until he stops, then whack him on to the next side rather than doing the football hold trick, I think babies have an instinct about what they need. Here is a good link http://thetruthaboutbreastfeeding.com/category/research/forehind-milk/ <em>edited by kiwispiers on 09/06/2011</em>

82

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EW NEWBIE

Latest post on 09 June 2011 - 15:16

Hey meals I had the same with my son. He was always at the bottom of the growth charts and I did fret but then I just stopped looking and relaxed about it. I knew he was eating, was happy and continuing up his own growth curve. I bf until 7 months, solids from 5. He is 3 half now and he is only 11.5 kg!!! I do not worry. He is happy and healthy, he eats well and being lean is just the way he is!

522

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EW GURU

Latest post on 09 June 2011 - 14:52

120g a week is a normal gain isn't it, Im not familiar with the "rules" for prems but that is the gain we had at that age and it was more or less in line with the WHO chart (for non prems). It sounds like you are doing absolutely everything right, I would have thought the gain was more important than the actual weight. When I suggested pumping more milk, I didn't mean you had a supply issue, more that he might take more from a bottle than the breast in one feed (as it would be less tiring) but with a gain like that above I'm not sure you need to bother. We charted DS's growth and at 4 months his weekly gains were 90-120 grams weekly (and he's a big boy), he did drop down a little bit and then went up again from 5 months (we introduced solids a little before 7 months). I think the growth lengthwise is seen as more important isn't it? I would have thought 120g was enough, but as I charted him on the chart his little curve is slowly trending downwards. Thanks for saying it all seems right tho! As for switching sides, I did think it was best to encourage him to take the most from one side, completely empty, to encourage the fatty hind milk consuption as this is where the calories lie (whereas fore milk is more for hydration). I guess if he thinks he's finished one side and I've tried the football hold and still not interested it won't hurt to give him a shot at the other! Thanks for all your advice... and any more is always appreciated :)

522

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EW GURU

Latest post on 09 June 2011 - 14:49

how do u know its really empty? I find that even if my breast is soft, if i squeeze there is still milk... When he's had a good feed and I'm feeling empty, he starts to get a little aggitated and pulling on and off and if I hand express I'm lucky to get a drop of hind milk on my nippl3.

kiwispiers15400

2782

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EW EXPERT

Latest post on 09 June 2011 - 10:34

I should add, although it may not really be relevant, that my sons weight gain increased quite a lot (he went up a centile) when I stopped feeding him from one side only. The foremilk isn't just water, its very sugary (lots of lactose as shaf said, which is milk sugar) and not as filling as the hindmilk, perhaps this encourages them to eat more? Anyway as I said maybe not relevant as the reason I stopped with the one sided feeding was that he was starting to feed for shorter period and I found that switching sides (with the faster milk flow you get initially) kept him interested. Just thought I'd throw that out there as it popped into my head when I was looking at his chart just now.

kiwispiers15400

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EW EXPERT

Latest post on 09 June 2011 - 09:58

120g a week is a normal gain isn't it, Im not familiar with the "rules" for prems but that is the gain we had at that age and it was more or less in line with the WHO chart (for non prems). It sounds like you are doing absolutely everything right, I would have thought the gain was more important than the actual weight. When I suggested pumping more milk, I didn't mean you had a supply issue, more that he might take more from a bottle than the breast in one feed (as it would be less tiring) but with a gain like that above I'm not sure you need to bother. We charted DS's growth and at 4 months his weekly gains were 90-120 grams weekly (and he's a big boy), he did drop down a little bit and then went up again from 5 months (we introduced solids a little before 7 months). I think the growth lengthwise is seen as more important isn't it?

429

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EW EXPLORER

Latest post on 09 June 2011 - 07:15

how do u know its really empty? I find that even if my breast is soft, if i squeeze there is still milk...

522

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EW GURU

Latest post on 09 June 2011 - 06:28

For breastmilk, the foremilk is water and the hind milk is fat, correct? So what you can try is feed him only from one boob during any 3 hrs, so that u make sure he gets all the fatty milk too. Ie, from 5pm-8pm everytime he wants a feed, give him the same boob. So basically, after the first feed at 5pm, every other feed till 8pm, he would be getting fat milk. My DD has lactose overdose and this is what I do for her.. she needs the fatty milk so that it is held down. U could give it a shot, before u move to formula. Good luck! Thanks shaf - yep, don't want to move to formula! Thanks. The only issue with that is that he tends to finish a side at thr 5:30pm feed and as that's the busy, hectic time of night it's not always replenished well by the time he's ready for his bedtime feed and so the other side has enough for him. As for getting enough hind milk - he tends to only feed from one side per feed. Unless he completely empties one side, I don't switch him to encourage him to get that hind milk. And if he's fussy on one side and there's still plenty of milk there I use the football hold to "trick" him into taking more from that side.

429

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EW EXPLORER

Latest post on 08 June 2011 - 22:05

For breastmilk, the foremilk is water and the hind milk is fat, correct? So what you can try is feed him only from one boob during any 3 hrs, so that u make sure he gets all the fatty milk too. Ie, from 5pm-8pm everytime he wants a feed, give him the same boob. So basically, after the first feed at 5pm, every other feed till 8pm, he would be getting fat milk. My DD has lactose overdose and this is what I do for her.. she needs the fatty milk so that it is held down. U could give it a shot, before u move to formula. Good luck!

522

Posts

EW GURU

Latest post on 08 June 2011 - 21:37

just re-read, sound like you are feeding him often already. W with him being prem you'll want to watch his iron. Solids can block the iron in breastmilk (weird things like pear purees can somehow stop it from being absorbed) so you might want to give an iron supplement if you do start giving anything other the boobie-milk. Personally I'd just get as much milk in as possible and keep a close eye on the weight another month at least unless he stops gaining. He's on an iron suppliment already, so that's the iron sorted :) I'm not in any rush to start solids! If it weren't for the numbers I would be completely unconcerned - he's meeting my expectations for growth and milestones!

522

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EW GURU

Latest post on 08 June 2011 - 21:33

BTW I've been weighing him weekly for the last few weeks and his weight gain has been around 120g/ week, which although is a gain, still means he's slowly been dropping down the graph and now is off it completely.

522

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EW GURU

Latest post on 08 June 2011 - 21:24

Thanks humpf - starting solids early was something I thought might be recommended. Kieispiers - I don't believe I have a problem with my milk supply. He's had a few growth spurt periods and my supply has increased accordingly. When I express if a bottle is required there's always plenty there, more than he drinks from the bottle. As for offering extra milk top-ups after a feed via the bottle - as I said, he's just not interested! Once he's had enough, he's done - won't let me get any extra into him Good to know that the calories are the same. I've got plenty of milk in the freezer from our stay in NICU so the one or two times in the last month where I've thought by the end of the day that he's cleared me out, I've offered him a top-up and he'll take it, but that's the only time he's taken it. Not sure when I'd be able to fit solids in then. He feeds pretty regularly during the day with feeds around 6:30am, 9am, 12pm, 3pm, 5:30pm and 7pm with a dream feed at 10pm and a night feed between 2 and 4am. He's a stubborn little man, if he's not hungry, he won't feed or will snack and that ends up being a snacking situation all day - and that's happened ocassionally and ended up with me being fuller at the end of the day (so he's obviously taken less over that period!). Not sure that I can feed him more frequently!

kiwispiers15400

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EW EXPERT

Latest post on 08 June 2011 - 21:22

just re-read, sound like you are feeding him often already. W with him being prem you'll want to watch his iron. Solids can block the iron in breastmilk (weird things like pear purees can somehow stop it from being absorbed) so you might want to give an iron supplement if you do start giving anything other the boobie-milk. Personally I'd just get as much milk in as possible and keep a close eye on the weight another month at least unless he stops gaining.

kiwispiers15400

2782

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EW EXPERT

Latest post on 08 June 2011 - 20:41

If he has a steady weight gain then probably you are fine, next step would be pumping extra milk, can see no reason for formula, the calories are the same. If you add solids early be careful they don't replace any milk feeds, most early solids foods are things you'd eat if you were on a diet, more milk would be the best answer if possible, can you feed him more frequently?

43

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EW NEWBIE

Latest post on 08 June 2011 - 20:31

My friend in Oz had the same thing with her small full term baby boy. She was very worried his small head circumference would lead to learning difficulties. her pediatrician told to start solids at 4 months. When he still didn't fatten up enough from eating solids the pediatrician sent her to a dietician who told her to start adding lots of full fat to his diet. Custards, full fat cream in his fruit, avocado & banana blended, cheese in with his veggie blends. Hope that helps.

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