What more can I do?!?! | ExpatWoman.com
 

What more can I do?!?!

522
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EW GURU
Latest post on 17 January 2011 - 13:18

What would you consider to be adequete weight gain for a preemie baby on a week-by-week basis?

We've just had our check-up with the pediatrician and he didn't think my LO's weight gain in the last 6 days was adequete...he put on 130g in 6 days. The Dr wants him to put on 200+ grams per week.

I breastfeed J and offer low birth weight formula top-ups following a full breastfeed. I feed him every 3 hours and wake him for 6 out of 8 of those feeds in a 24 hour period...

I'm wondering what more I can do to encourage weight gain!?!?! I do not want to stop breastfeeding... Is there a distinct lack of enthusiasm in the UAE for breastfeeding? Am I being silly/ over-sensitive? What more can I do to encourage weight gain - should I lock myself in the house and not let anyone handle him???

I feel rather inadequete myself...
<em>edited by meals on 17/01/2011</em>

671
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EW GURU
Latest post on 18 January 2011 - 13:08
continue ur milk and give DAILY olive oil massage followed by a bath after 40 min approx..you will see the difference There is in fact a lot of evidence demonstrating that massage (in a NICU context) can increase weight gain. <em>edited by BFC on 18/01/2011</em>
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EW NEWBIE
Latest post on 18 January 2011 - 12:30
continue ur milk and give DAILY olive oil massage followed by a bath after 40 min approx..you will see the difference
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EW NEWBIE
Latest post on 18 January 2011 - 12:18
Keep b-feeding. Millions of babies term and pre-mature throughout history have thrived on b-milk alone. With all my children, people have been very quick to tell me my milk wasn't enough, I should supplement with formula, blah blah blah. I just ignore them and my babes have grown up just fine. As long as your baby is gaining weight, you are doing wonderfully.
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EW NEWBIE
Latest post on 18 January 2011 - 10:06
MEALS!!!!! There is nothing to worry.. My Preemie was born at 33 weeks and her birthweight was only 1100 gms. She was born the size of a 28 week old fetus literally- this was due to my high BP and low fluid etcetc. ( IUGR) However she gained an average of 20 gms a day which is normal. at 130gms a week your lil J is going just fine!! I had a fantastic pediatrician who is a neo natal specialist ( dr nisha Soares at Al zahra polyclinic dubai) She was so calm and so great! She always encouraged me to breastfeed as much as i could btu never fussed about it either. Because DD didnt BF from birth as she was in the incubator for a good month she got used to the tiny hospital teats and the bottle and i had to express milk every 2-3 hours for 7 months 24-7! The doc did mention that 50% breast milk out of the total intake is enough for the baby to develop required immunity so i was always encouraged to mix B-milk and formula milk 50-50 and bottle feed. My breast milk just didnt have enough calories to fatten my baby! DD was born at Al Wasl -the neo natologits are great there and this was their advice seconded by DD's pediatrician later. With all this she gained about 500 gms i the first couple of months and then went on to gain a kilo every month after the fourth month. Take another opinion- im sure your doctor is good but it never hurts to consult another especially if they will make you feel a lot more positively about yourself. The key is....as long as the baby is gaining weight...Pooing and Peeing as much as she /he should...ALL IS WELL.
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EW GURU
Latest post on 18 January 2011 - 09:13
Awwww Fuzz - you made my cry, thanks love... we'll organise a playdate soon! And thank you for all the support. I guess to some extent I was amazed (although I did have some idea) of the lack of support and dedication and understanding of the benefits of bf-ing here in the UAE. In Oz there is a distinct level of discimination towards those who don't bf! Almost come full circle. After all you support and knowledge and help ladies - this is my plan... I'm going to continue to breastfeed. I will continue to offer formula top ups in the short term (I'll reassess when he's full-term and discuss with a pediatrician). I will weigh him weekly to ensure he's still putting on weight and I'm not going to question my choices... I'm chosing to do what's best for my baby and I know it (thanks in part to all of you!). Breastmilk IS best... and both I and my LO love it :D
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EW NEWBIE
Latest post on 17 January 2011 - 22:57
Hi Hun, I just wanted to say that I'm really sorry that doctors are making you doubt yourself. You are a fantastic mum! Jackson is absolutely gorgeous and really looks like he's doing so well and you should be proud of yourself! I can't imagine what a rollercoaster the last month must have been for you. But I truly believe that a mothers instincts go a lot further than any doctor trying to make your baby's health fit on a chart they use for every baby that comes through the door.  The 2 paeds I've come across out here we're so anti-formula, it was a little scary! So if you are still worried, do take him to another paed, so they can at least put your mind at ease if we can't! I believe that a mother always knows in her heart of hearts if her baby is doing well or not. It's the way we're made and you should trust this natural instinct and don't let anyone make you doubt yourself.  I know you and I know that you'll be doing fantastic by Jackson and as long as he's gaining weight I really don't think you should be worried. Every baby is different and what rate they gain weight will vary baby by baby, you can't predict it and you can't standardise it. He's really lucky to have such an amazing mum and I will remind him of that when he's older! I really admire you, your strength, your resolve really is inspiring. I miss you so much. The girls and i are dying to see Jackson, so let me know when you're settled at home and it's a good time for us to come and visit please! xxxxxxx
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EW EXPLORER
Latest post on 17 January 2011 - 22:11
I salute you, lady! ... and yes, there does seem to be a propensity amongst medical staff to dismiss breastfeeding. Ask your Dr if he's using the WHO weight gain charts based on breastfeeding babies? Here's a [url=http://www.rcpch.ac.uk/Research/UK-WHO-Growth-Charts'>link[/url'> to them... might be worth printing them off! Thanks HK :) According to the charts he's in about the same percentile that he was when he was born (according to birth weight) - nothing wrong with that for his gestation by my thought processes... Grrrrrrrr!!! I'm sick of second-guessing myself and my choices! Same thing here meals. DD maintained the same growth curve that she was born with when we weighed her at the doctor's office, although it was a low percentile (I think 25% or even less), and the doctor was happy with that. He said that might as well be her potential and there's not much we can do to try to rush them beyond their potential. I believe the same applies to your LO.
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EW EXPERT
Latest post on 17 January 2011 - 21:17
Dr Shola although nice wasn't very helpful with me and BF. I went to dr Keith nichol and Rachel the nurse there is fantastic. 043941000
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EW GURU
Latest post on 17 January 2011 - 20:46
Thanks LD. I think to start with I might take him to see the pediatrician that I take my older two boys to - Dr Shola at DLC. She's always been great with my older two rascals. I will be in touch if I don't feel she is a bf-ing advocate tho - thanks. The more any Dr's talk about changing to formula the more I dig my heels in and become adament that I want to bf for as long as possible... why is it so difficult to do what's best for our LO's here!!!
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EW NEWBIE
Latest post on 17 January 2011 - 20:41
Hi Meals, babies aren't born to fit charts and statistics. Your baby may have a sudden weightgain next week, who knows. Breastmilk is the best for any baby, it's certainly the easiest to digest for a premature one. Good luck.
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EW EXPLORER
Latest post on 17 January 2011 - 20:39
Meals, what your paed said is ridiculous! Anything between 15 g and 30 g per day is within the recommended weight gain guidelines for preemies. This by the way is what I've been told by healthcare professionals at Al Wasl, by DD's paed as well as Cecile De Scaly (lactation consultant). 21 grams per day is within the upper range of that norm so is quite an achievement! Stick to what you're doing now... it's obviously working and bringing results. LD - THANK YOU!!! How can a pediatrician that I was referred to by the neonatologists at the hospital not be aware of the guidelines??? He has made me question myself all day (and I do enough of that already without someone else chipping in!)... It's difficult enough to feel comfortable that I'm doing the best for my LO without contradictory reports from Dr's who are supposed to know and advise accordingly. Meals, I assure you Jumana has managed to gain 30 grams per day or more on breast milk alone. It may have been EBM in a bottle, but trust me the volumes she used to drink in the early days at home were not much more than the top Jackson has of the low birth weight formula. In time once he's stronger and bigger he'll drink more and gain more. Also once your supply has stablised to his needs; he'll get a larger proportion of the creamier hind milk. Also, IMO then the first thing you need to do is find a team of healthcare professionals who are there to support your decision and make it work rather than second guess you all the time. Let me know if you would like to get the details of my DD's paed - he has been a tremendous support in getting me to continue what I'm doing, and he really does see beyond the growth charts.
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EW NEWBIE
Latest post on 17 January 2011 - 20:39
would you mind sharing which hospital? government or private?
522
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EW GURU
Latest post on 17 January 2011 - 20:23
Meals, what your paed said is ridiculous! Anything between 15 g and 30 g per day is within the recommended weight gain guidelines for preemies. This by the way is what I've been told by healthcare professionals at Al Wasl, by DD's paed as well as Cecile De Scaly (lactation consultant). 21 grams per day is within the upper range of that norm so is quite an achievement! Stick to what you're doing now... it's obviously working and bringing results. LD - THANK YOU!!! How can a pediatrician that I was referred to by the neonatologists at the hospital not be aware of the guidelines??? He has made me question myself all day (and I do enough of that already without someone else chipping in!)... It's difficult enough to feel comfortable that I'm doing the best for my LO without contradictory reports from Dr's who are supposed to know and advise accordingly.
522
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EW GURU
Latest post on 17 January 2011 - 20:16
I salute you, lady! ... and yes, there does seem to be a propensity amongst medical staff to dismiss breastfeeding. Ask your Dr if he's using the WHO weight gain charts based on breastfeeding babies? Here's a [url=http://www.rcpch.ac.uk/Research/UK-WHO-Growth-Charts'>link[/url'> to them... might be worth printing them off! Thanks HK :) According to the charts he's in about the same percentile that he was when he was born (according to birth weight) - nothing wrong with that for his gestation by my thought processes... Grrrrrrrr!!! I'm sick of second-guessing myself and my choices!
378
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EW EXPLORER
Latest post on 17 January 2011 - 20:12
Meals, what your paed said is ridiculous! Anything between 15 g and 30 g per day is within the recommended weight gain guidelines for preemies. This by the way is what I've been told by healthcare professionals at Al Wasl, by DD's paed as well as Cecile De Scaly (lactation consultant). 21 grams per day is within the upper range of that norm so is quite an achievement! Stick to what you're doing now... it's obviously working and bringing results.
522
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EW GURU
Latest post on 17 January 2011 - 20:10
Thanks ladies! :) It's lovely to recieve such support... Honestly, I felt like he was trying to tell me that my milk wasn't of a very good quality (something I am paranoid about, and try to overcome by eating well and drinking loads of water). He indicated I should be stimlulating him to take more milk, pushing him to take more... This isn't my first time on the merry-go-round - I bf my first two LO's and I know what I'm doing (or like to think I do!). I know it's not an issue with regards to volume - I have plenty of supply. Muzza1 you're right, this is our first week home and he is recieving more stimluation with regards to big brothers and visitors. He is just settling in (and so am I). I just feel that regardless - there is always something his Dr's seem to find to knock me down. Would be lovely to get a gold star from them with regards to his development. 200g aim for weight gain just seems enormous - considering his current weight, that's quite a large percentage of his body weight they want him to gain each week. It's difficult for me to just stay home and keep little J tucked up tight in bed all day for sleeps and quiet controlled environments for feeds - I have two other LO's who adore and want to smother him (and yell the house down), I have school runs, lovely friends who visit and cuddle... surely if the right enviroment for him was a quiet, temperature controlled, minimal movement situation they would have kept him in NICU - and perhaps that's why in other countries they do keep them in NICU longer than here... Just frustrating - esp when the messages as contradictory. I will msg BFC and ask her to read and see what she has to say too. FYI - he feeds for 30-40mins bf-ing, I offer the other side but he rarely takes it (there's still plenty of milk on the side he feeds - slight issue with oversupply to start with and my supply is just sorting itself out. I don't want to only offer each side for a short time each as I want to encourage him to take as much hind milk as possible). I also offer 35ml low birth weight formula after each bf until he's done sucking to maximise weight gain. He'll take between 10-25mls of this. I went in today expecting top marks for J - his cheeks are filling out, he's no longer feeling "hollow" and he's looking healthy (I think)... way to shoot a mummy down! :(
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EW GURU
Latest post on 17 January 2011 - 19:06
Oh babe. You are doing great and so is little J. I have no experience re premmies but I do have experience with paeds here and can say yes, very often most of them are happy to encourage formula feeding over bf. With E, I kept getting told he wasn't gaining enough and to put him on formula. And the paed I saw at City for M's first follow up visit told me that formula would be better for Max as u mentioned he seems to have reflux. The only paed I have found to be really knowledgable and supportive of bf is Dr Loubser. I know there are other great ones out there...but just talking from my own experience. I'd do a search on here and take J to see someone who comes highly recommended on this board. Thinking of you.
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EW NEWBIE
Latest post on 17 January 2011 - 18:20
Maybe u shoudl consult BFC on the forum who is a breastfeeding consultant. She is lovely! Most doctors here do promote formula milk, but there are lovely people like BFC and other breastfedding consultants, doulas, etc who are trying to create breastmilk awareness. Def agree with shaf BFC is sooo helpful and will also help you feel less up against it
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EW NEWBIE
Latest post on 17 January 2011 - 18:17
I salute you, lady! ... and yes, there does seem to be a propensity amongst medical staff to dismiss breastfeeding. Ask your Dr if he's using the WHO weight gain charts based on breastfeeding babies? Here's a [url=http://www.rcpch.ac.uk/Research/UK-WHO-Growth-Charts'>link[/url'> to them... might be worth printing them off!
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EW EXPLORER
Latest post on 17 January 2011 - 18:08
Maybe u shoudl consult BFC on the forum who is a breastfeeding consultant. She is lovely! Most doctors here do promote formula milk, but there are lovely people like BFC and other breastfedding consultants, doulas, etc who are trying to create breastmilk awareness.
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EW NEWBIE
Latest post on 17 January 2011 - 17:57
Hey Meals, keep at it. If Jackson is only just home (a week I think?) he is using more energy adjusting to his environment etc. That's the first thing...also I think when they are before their EDD their weight gain at home is slower then speeds. As far as I know the general rule of thumb is on average newborns put on about 23 grams per day (spread over time), so that means really he's doing well at 21g per day as a prem just home from hospital. When Em came home her first weigh in showed about that too (300 grams over two weeks from memory - averages the same as Jackson) and then the next time she put on a good deal more. I think you're doing superbly and I agree they can seem less supportive here - you are not being oversensitive about this. Also my neonatal consultant/ paed was not overly pro BF-ing and has suggested my milk 'doesn't have everything...' etc and tried to give me formula (I note this was supplied to him as a freebie by a pharmaceutical co. - nice lobbying!). I was initially upset and then politely but firmly declined this and now have vitamins and iron to give her (can accept the iron as she was had anaemia in NICU). I think he's given up on me but I am appalled by it - I bet lots of people esp first time Mums wld give up unnecessarily. I think it's way too early for the paed to draw those kind of conclusions - prems are very sleepy when they first come home and it takes a while for them to find their groove. I think for him to quibble over 2 grams less than average is unfair, especially after only one week. Let me know how you go...hang on in there as you are doing a fab job in difficult circumstances. <em>edited by Muzza1 on 17/01/2011</em>
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EW NEWBIE
Latest post on 17 January 2011 - 13:52
Sounds to me like you're doing a fantastic job! I don't know much about preemies, but from what I heard, most doctor's solution for any problem with newborns seems to be put them on formula. That's one of the reasons I picked a German ped for DD, as I was determined to bf exclusively. And very happily did so. To me it seems doctors here are rather obsessed with the whole weight gain issue: first the ask the pregnant woman to gain as little as possible. If there is any chance of the baby weighing more than 3kg at birth the request C-section. Then after birth the drama continues with reverse roles. Since doctors here are not so familiar with bf babies, it might be worth to check with a bf consultant about LO's weight gain. Some babies are just skinny, so if everything else is developing normal, I would try and keep ebf. Good luck!
 
 

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