Skim milk

by DaniGirl on March 27, 2008 · 28 comments

in Baby days, Lucas, Mothering without a licence

We’re sitting in the pediatrician’s waiting room, each admiring the others’ babies as they rest at our feet, each snuggled into their own baby bucket carrier. Hers is dressed in pink and is fleshy and plump and noticeably larger than Lucas.

“He’s beautiful,” she tells me, admiring Lucas. I beam, and return the compliment.

“It goes by so fast, doesn’t it?” I respond, thinking her baby is at least a few weeks older than Lucas. “When was she born?” I ask, expecting her to say some time around the end of December or early January.

“February 12,” she answers. “And how old is your little guy?”

“He was born February 8,” I say, trying not to sound defensive, even though I suddenly don’t feel like chatting with this woman.

“Oh, he’s so tiny! Was he a preemie?” she asks, unaware.

“No,” I answer rather abruptly. I consider elaborating, but can’t find the words to do so. I want to tell her that he was over 10 lbs, but is having trouble gaining weight, that he’s healthy and hearty in all other ways, but just doesn’t seem to be able to accrue the weight he is supposed to be gaining. I want to justify, to explain, to rationalize, but my words are stuck like lumps of undiluted formula in my throat; I’ve just for the first time realized that maybe Lucas’s weight gain issues are more serious than I have let myself believe. The difference in size between the two children is unmistakable, and I wonder how we’ve gone from “oh my god, what a big boy” to “oh, he’s so tiny!” How has this happened?

I haven’t blogged much about Lucas’s ongoing weight-gain struggles because like the infernal optimist that I am, I kept expecting things would be fine any day now. “Well,” I’d tell myself, “this has just been a really chaotic week and maybe I haven’t been nursing often enough. I’m sure it will be better next week.” Or, “I was sick and off my own food and drink, so of course my milk was thin.” Or, “He was spitting up an awful lot because I forgot to give him his medication one day, so of course he didn’t gain enough.” But as I controlled for one variable after another, week after week there has been one constant: Lucas simply isn’t gaining enough weight. He will be seven weeks old on Friday, and he has only gained a little more than 8 oz over his birth weight. He should have gained three or four pounds by now. It’s not as dire as it would have been if he wasn’t born a hefty 10 lbs, but I can no longer ignore the fact that the trend is clear week after week… my milk is simply not good enough this time around.

Time to face the reality: I need to supplement, and I need to supplement more. The 4 oz a day bottle isn’t cutting it. I have to crank it up to 6 oz twice a day, and I suspect that at those levels, it may have an effect on my milk supply. I want to nurse Lucas as long as I nursed Simon (to 16 months) or beyond, but I can no longer rely on my milk to provide the calories he needs to grow. I don’t know why the milk that four years ago was more than enough to sustain Simon is no longer good enough, but apparently my milk has a shelf life and beyond 38 years it begins to thin out. Or something like that. I’ll keep offering it to him as long as he keeps taking it, but I need to top him up nutritionally for now. I’m offering the bottles in addition to regular nursing as opposed to substituting, so hopefully that will help.

I don’t really know why my milk is thin. I don’t think it’s a supply issue… he’s satisfied at the end of a feed, and making plenty (and I mean PLENTY!) of wet diapers. He’s otherwise healthy and happy and generally content — except during the arsenic hours of 3 to 9 pm, which are still challenging but improving. (Best colic solution ever = running faucets. What we saved with the high-efficiency washer we’ve lost down the drain as running the tap in the kitchen is sometimes the only thing I can do to settle him!)

The reflux is still an occasional issue even with medication, but for the most part (80% of the time) it’s just normal baby spit-up amounts. I can feel the letdown and my breasts still leak even with regular feedings, so there is milk there — it’s just not fatty enough, I guess.

I’d like to rationalize and say I’ve done everything I possibly can to make exclusively nursing work, but that’s not quite true. I’ve done a lot, endured the bleeding and the nighttime alarm-setting and what seems like all-day feeding sessions and even a blocked milk duct, and we’ve worked through all of it. I could pump, I could try some sort of herbal supplement, I could pay for a few more hours with the lactation consultant. But I have two other boys and a busy house, and I’ve more or less dedicated the last month to trying to make this work and it still isn’t working out well enough. Next month we’ll be giving up our nanny, too, and there just isn’t enough of me for everyone as it is. There is always more I could do to nurse exclusively, but I think I may have reached the limits of what I’m willing to do. Now I have to make my peace with it.

***

I wrote the first half of this post this morning, and have since been to see my darling midwives as well. Despite his paltry weight gain, Lucas has grown an impressive 7 cm (2 1/2 inches) in length, and his head circumference has increased by 3 cm since birth, so he’s obviously growing well. He is meeting all of his developmental milestones, including and especially the social ones — he flirted shamelessly with the midwives and anyone else with whom he made eye contact.

I’m still disappointed and frustrated with the lack of weight gain, but deeply reassured that he is otherwise well. And speaking of social, he is currently sitting patiently in his bouncy chair where he has awoken from a brief nap, waiting for me to stop with the tap-tap-tapping and get back to gazing lovingly into his eyes, something I seem to spend a large preponderance of my time (happily) doing these days.

Sorry, bloggy peeps. Much as I love all of you, you really can’t compete with him for my attention these days…


{ 27 comments… read them below or add one }

1 Holly March 27, 2008 at 5:05 pm

You need to choose what is right for you and your child – no matter what everyone else says. But, I’m sure you know that already. He IS growing and IS happy so that is bonus! ๐Ÿ™‚

2 Holly Star March 27, 2008 at 5:35 pm

Big hugs to you! Max is also a small little dude (3rd percentile at our last visit) and as much as I try to laugh it off, it still stings most of the time so I can definitely relate and empathize, especially to your recounting of the scene in the ped’s office. Max keeps getting mistaken for three or four months next to all the other sumo babies. I think you have made a hugely valiant effort these last few weeks and there should be absolutely no shame on your part in terms of supplementing. You are a rocking mama and don’t let anyone make you feel any different!!!!

3 Veronica Mitchell March 27, 2008 at 6:10 pm

Oy. Breastfeeding can be so frustrating. I had supply issues with all three of my kids, and saw them get skinnier. I have two friends who also had teh skim milk problem, and both switched to formula early. You make the best choices for your family, and you don’t let the ideologues on either side get to you. You’re doing great.

4 Mac and Cheese March 27, 2008 at 6:45 pm

I think in the scheme of things, you’ve gone above and beyond the call.

5 rowena March 27, 2008 at 7:14 pm

I had similar issues with my daughter. 8lbs 10 oz at birth, she was a big girl, and then just didn’t get bigger… well she got bigger, but she slowed down in her growth rate. I ended up supplementing when she stopped gaining for two weeks… and you know what? I just weaned her when she turned one. I could have kept going. I’m sure it affected my milk production, but it didn’t affect the feedings I gave her. And I think the reduction in stress actually improved my production. And I actually felt more freedom with her than I did with my exclusively breast fed son. In the end, they both grew and got what they needed.

You do what you have to do. Guilt isn’t a productive (ahem) emotion.

6 cinnamon gurl March 27, 2008 at 7:31 pm

Oh, Dani.

My sister had to supplement around 6-8 weeks, but eventually she was able to breastfeed exclusively — and she kept breastfeeding for more than three years (obviously not exclusively), so supplementing doesn’t necessarily mean you won’t eventually be able to breastfeed exclusively later.

Is it possible that you could have any retained placenta? My sister found out (like eight months postpartum) that she had a small piece of placenta stuck in her uterus, AND that retained placenta interferes with milk supply.

Anyways… lots of hugs, you’re doing a kick-ass job!

7 Rev Dr Mom March 27, 2008 at 7:44 pm

Lo these many years ago I had the same problem with NSLS…she was the 3rd kid and I was just way stressed out and too busy. I wish now I’d had more time to try nursing more; she was pretty quickly exclusively on formula (by 5 months or so). But you know she turned out just fine ๐Ÿ™‚

I hope that whatever you choose, you will feel okay about it, and that you ALL thrive. Hugs

And the captcha oracle is at it again: concord milk

8 Shauna March 27, 2008 at 7:59 pm

I feel for you. Nursing was so emotionally draining. You have gone above and beyond.

9 Javamom March 27, 2008 at 8:34 pm

Dani,

Ask someone to dig out an old tape recorder of some kind and TAPE the water pouring from the drain. Then, stick the kid in front of the tape recorder.

Or try the kitchen fan, which makes a similar noise (helped both our kids).

Sending positive thoughts!

10 Miche March 27, 2008 at 10:12 pm

*hugs*

“Much as I love all of you, you really canโ€™t compete with him for my attention these daysโ€ฆ”

Exactly as it should be!

11 Sheila March 28, 2008 at 12:08 am

I’m sorry you’ve had so much anxiety and concern with the weight gain issue. I hope the increased supplement will help him, and quickly, so you’ll know it’s working. If you can continue to nurse most of the time, or even part time, Lucas will benefit from your antibodies, the skin to skin contact and eye contact and all that bonding. So great for both of you.
Please don’t let this difficulty feel like a personal defeat – it’s just the way it is, and you are finding the right solution.
Thanks for your beautiful birth story – it was worth the wait (I just got back from a week’s vacation and read from March 18 forward.) You did great that day, and you are a wonderful mom to all your children.
Captcha says “drinks movement”. I think you and Lucas both deserve a nice drink of your favourite!
Best wishes,

12 nomotherearth March 28, 2008 at 2:06 am

We had a lot of issues the first time round, supplemented, tube fed, fenugreek, blessed thistle, domperidone, and on and on. It did eventually work out, so hang in there if that is what you want to do. And Under the Mad Hat just posted about breastfeeding and hypothyroid – you should check it out if you haven’t already.

13 Rebecca March 28, 2008 at 8:14 am

I’m so sorry this part has been so difficult for you!! But you know you’ve done all you can, you plan to keep nursing and just supplementing, and so you’re doing what is best for Lucas. Changing plans according to what’s best for your kids is what makes you a good momma.

14 lini March 28, 2008 at 8:34 am

Hi Dani,
I am sorry this has been so difficult this time around. However, I must question that you believe you milk has changed or is “skim”. Perhaps Lucas has a high metabolism. Perhaps he is not meant to be the classic “gerber baby” with rolls everywhere. Who says that is the right way anyway. Wasn’t the gerber baby drawn whilst formula was introduced and perhaps the babies were bigger in weight (after drinking it)? He is growing in height and circumference and he is gaining weight not losing it, correct? As long as he is gaining he is doing what he is supposed to be doing.
Lexi was born a week early and weighed 8lbs 1oz, after losing weight in the hospital she was still not at her birth weight at 2months. but she was gaining each week. Cadence was 7lbs13oz and was my chunkiest baby her first year out of the 3 of my kids. Jacob was the same birth weight but is pretty slim, not as slim as Lexi but still pretty slim. He is in the 90th percentile height and 20th for weight. But , he gains at each appt. Mabe not the average 1-2 lbs they state is average and he has not one roll on his little body.
I think you are doing great and supplementing after you bf is a great option but don’t be too hard on yourself. Your baby is growing.
Lini

15 MomOnTheGo March 28, 2008 at 9:27 am

Dani,
You are so brave. It helps for mothers to be so but especially for ones who are willing to share their troubles with the world. Keep on keeping on and doing the best you can for Lucas and that will be enough.

After an overactive letdown in the early weeks, I began drinking nursing tea when my supply dropped after a day on the min-pill. I usually drink Chamomille and was very impressed with the taste of the nursing tea. I don’t know if it is the fenugreek or blessed thistle but I like it. I quit the pill and kept the tea. The organic section at Loblaws stocks them in the baby section (little brown bags). At Nutrition House, etc. it is sometimes sold as “Nursing Tea” or you might need to look for the fenugreek. Welleda makes a very nice “Nursing Tea”. These will switch into your routine if you are a tea drinker. If you’re not, I imagine the stress of trying to choke them down will counter any benefits that they bring.

Good luck as always. We couldn’t be stood up for a better boy.

16 Mimi and Pipi March 28, 2008 at 10:33 am

Morning Dani, As a mother of three and Mimi to 13 grandbabies! Lucas being the most recent addition, I noticed first hand on Easter weekend that he is looking mighty healthy and is certainly very alert and is even holding his head up (he’s very strong and curious). You are aware that children do not come with instructions, LOL !. Keep on! keeping on!, all is well.Love to you all. and miss you already.

17 Chantal March 28, 2008 at 11:06 am

We worry so hard that we are doing right by our babies don’t we. I know I did, and I know you are. And you are doing right. No matter how things end up. He is happy and loved. What more could a kid ask for.

18 Andrea March 28, 2008 at 11:09 am

I’m sorry.

19 mamatulip March 28, 2008 at 2:13 pm

Ah, the worry…it’s tough to swallow, isn’t it?

Follow your heart; do what is best for your beautiful boy. That’s all you can do.

20 Kerry March 28, 2008 at 6:06 pm

Dani – I just wanted to say that he’s a right cute little bunny. And, he’s squishy enough. And heavy enough! Maybe I was all tense because I wanted to hold him so badly but my arm ached when I let go! And the fact that he had the grace and skill to poop on my hand right when I picked him up… the kids knows how to defecate.

I thought your son was perfect, and so did all the other ladies at work. Even our token guy, for the love of pete. Even all those ladies who didn’t even know who you were :o)

Perfection comes in a lot of different sizes. That’s all I’m saying.

21 Liz March 28, 2008 at 10:01 pm

Hugs and kisses.

Our pediatrician gave us similar angst recently since MM hasn’t gained any weight in over a year…but I pointed out that he’s grown out of three sets of pants and shoes. I wonder if our boys are part helium?

I love your midwives.

22 Jody March 29, 2008 at 1:19 pm

Well, I didn’t know there was such a thing as “skim milk,” and I’d even heard that the foremilk/hindmilk imbalance issue was rarely as crucial an issue as people said, but I also have zero problem with supplements (my kids all got them in spades) and that’s why I’m writing: my kids got supplements in spades, my son went weeks with only one nursing session a day (reflux, competition with the girls) and he ended up being a non-stop nurser until he was three and a half years old. Didn’t drink ANY other liquid from 10 months to 29 months, in fact. Little stubborn baby boy.

So don’t give up hope, if you want to nurse for a good long time, you certainly can.

23 annika March 29, 2008 at 3:02 pm

You are doing a fabulous job, Dani. Keep it up. I had to supplement as well, and you know what? It all works out in the end. You always put your children first, and they will thank you for it when they are our age!

24 kgirl March 29, 2008 at 4:39 pm

If he is healthy, what’s the worry? Every child is different – my 4 month old – striclty breastfed – is almost 16 lbs – the same weight that her big sister was at A YEAR.

Don’t stress it mama.

25 Reluctant Housewife March 30, 2008 at 6:54 pm

Babies are different sizes. Mine were always small too.

26 shortmamaof2 March 31, 2008 at 12:01 pm

great things come in small pkgs…i’m biased as i’m all of 5 feet tall ๐Ÿ™‚

as long as he is healthy and happy, try not to fret too much (easy to say but so hard to do)

hugs to you, you are a fantastic mum

27 Freakazojd March 31, 2008 at 9:06 pm

I don’t know a lot about this, but if he’s healthy and happy in every way and is just not gaining weight, is it really something to worry about? Maybe he just grows up before he grows out. ๐Ÿ™‚ Congratulations on your newest addition!

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