5 Month Old Losing Ground on Weight - Breastfed. Ideas?

If he's happy and sleeping through the night, I wouldn't worry about it. Those are good signs he's getting enough. I never really worried about my kids if that was the case. The percentile thing is all relative I think, some kids are just smaller. But, you know I have learned everyone will have advice for you and it may all be different, so I don't want you to feel like I am saying my opinion is the last word. I just don't want you to stess too much, because I know as a mother myself that will happen often.

Hi M.,
I breastfed exclusively until at 6 months my pediatrician noticed my daughter's weight level out, he said I needed to start feeding her cereal mixed with breastmilk. The following month she was back "on track".
That was my experience, less to do with my diet than how much she was able to get at a time + frequency feeding.
Good job mommin'!

My daughter is also exclusively breastfed. I don't know if this will work since you already pump for his mid morning meal, but I pump after my daughters first meal becasue I am the most full in the morning and give it to her at night after she breastfeeds for her last meal. I don't seem to have enough at night most nights so I am supplementing with my own breastmilk:)

My sons did the same thing around the same age, one was breastfed exclusively & one was formula fed. There is no problem with your child if he went down in percentile on the scale used by a doctor's office. That scale is based off of formula fed children. Your child is or should be becoming more active and that can cause less of if any weight gain for a short time (sometimes even weight loss). After experiencing e=weight gain fluctuations in my 4 children, I don't see anything wrong with what your child is doing. NO need to supplement as your supply is fine and your child is feeding when he wants and stops when full.

Have a GREAT day!

S.

I would say the same thing as Shawnasie. All three of my children did the same thing around the same age.

My 17 year old was never on the charts. Now he is almost 6' tall and a very healthy weight.

I can totally relate to your concerns. Our problems started a little later. My son, who was born at 7 lbs 13 oz (over 50th %) began a decline in weight gain around 6 months. He dropped to 40% at 6 mos, then at 9 mos he was at 30% and by 12 months had fallen into the 5th %. Then he went through an unfortunate series of consecutive illnesses throughout this winter and completely fell off the chart. We spent a lot of time and money to make sure there was no underlying condition and at 17 months he is healthy and gaining but still relatively small. It has been very worrisome, agonizing at times! My husband and I are by no means petite and he is my second child so I thought I had the feeding thing all figured out. I was able to breastfeed my first child until 16 mos and although she was around 25% at 1 year, she was very tall, healthy and hitting milestones early. I do believe that breastfed babies are not as plump as formula fed and most of the growth charts are based on formula fed children.
I think our problems began with distraction and devolved into a sort of aversion to anything but the breast and most of the feeding was done at night in half-sleep, so I was completely sleep deprived in addition to anxious and pre-occupied with his daytime feedings or lack thereof.
We eventually had a consultation with Nutritional services at Children's Hospital in Denver and they characterized him as one of those kids who was nursing just enough to take the edge off the hunger but not enough to fuel his growth. the recommendation to wean was made and I did that at 13 months. He did start to get more interested in solid food at that time but it has taken months to really get him eating all the right, high caloric foods. Everything has to have extra calories in it and because he doesn't have a huge appetite, we almost completely forego the fruit and veggies for now, which troubles me but I'll deal with it when he's gained a healthy amount of weight.
If I could back to when he was six months, I wish that someone had recommended supplementation to us. I still would have breastfed but at least get him acquainted with the taste of formula. Although it wasn't what I did, I wish I had gotten him to take at least one bottle of formula from Daddy each day. Focus on eating environment, make sure there is always plenty of time for him to get his fill. Since he sleeps through the night, try offering the breast at least one or two times more throughout the day. Before my son was one year, I feared my supply was starting to dwindle and by this time, he had no interest in formula, completely rejected it. I wanted to wean then but it was too early to wean to dairy so I was in a tough place and didn't want to take anything away at that point.
To make a very long story short, I think dropping to 30th, even 25th & is not alone cause for worry. but do keep weighing him to make sure he's not loosing. You're almost ready to start cereals and if he really takes to them then you could be on your way to a growth spurt. But if he's not so keen and you don't feel you're gaining any ground at 6 months, then talk to your doctor or get a second opinion and consider some supplementation. I introduced rice cereal mixed with breastmilk at 5 mos with both my kiddos, then veggie purees with rice/breastmilk around 7 mos. It can take a couple of weeks for them to get the hang of it, so starting with the rice now may be the ticket to having him eating a couple of cereal meals a day by 6 mos. Be conscientious but not obsessive and don't get to where we did because it was no fun. But I think I can assure you that perfectly healthy children do have these issues and some day, when he is a starter on his high school football team, you will look back at this time and shake your head!

When my boys hit 3 1/2 months old, they had growth spurt and nursed and nursed and nursed every hour, and never seemed full. They would nurse, then come off and cry (because I was out of milk) I was trying so hard to follow doctor's recommendations (which 5 and 3 years ago was to start solids at 4 months, not 6) but my first son actually lost weight in those two weeks.

And it's not like I didn't have a plentiful milk supply up until then. I had so much I'd wake up in the morning rock-hard and have to pump before the baby woke up. I had a freezer full of milk, and was so excited that I actually called up the breastmilk bank to find out about donating. But I suddenly had to use that milk to feed my ravenous son. He used it all up in the two weeks before I started solids.

Then with my second son, I started on the minipill. A few weeks later, he was crying all the time. I took him to his 4 month check up. He's a BIG kid, so the doctor didn't seem concerned that he hadn't gained any weight in the last month. That's stupid. Babies ALWAYS gain weight. I didn't listen to my doctor about not worrying. I stopped taking the minipill and my son stopped crying so much, slept more, and SUDDENLY shot right out of the clothing size he'd been wearing.

See, I was unintentionally starving my children, and my doctors weren't worried.

So do what your gut tells you to do. If you think your baby needs more food to be full, happy, and GROWING, he's definitely not too young to start on solids. In fact, don't they say that babies that wait until 6 months to start solids are less open to new flavors? I've kept up on the recent recommendations, and they say BETWEEN 4 and 6 months, not WAIT UNTIL 6 months.

From my experiences, I'd tell you start solids right away. But that's a decision only you can make.

Hi-
I didn't read everything, but I didn't see anyone note that breastfed babies are always smaller than bottle fed babies, so that throws the weight chart off. My son started in the 50th, and by one year was down to the 3rd percentile. He stayed on the same track, and now at four is back up to the 25%. Breast fed babies tend to gain a lot quickly and then taper off significantly because they can control how much they eat. Bottle fed babies tend to eat more because the parent can see how much they are getting and try to push them to finish the bottle, so they don't self-regulate as well until they are in the toddler years and refuse to eat more. Not to say Mom's who bottle feed are doing anything wrong. However, this is why you see a difference. you might want to look up a growth chart for solely breastfed babies--you will see than it is different than the chart for all babies. In other words, I wouldn't worry. I think your little one is doing just fine.
J.

I wouldn't worry too much about the percentile. My son only gained like an ounce between the 2 and 4 month checks. I was really concerned about my milk production, so I set up a weigh before and after appointment (weigh the baby, feed, weigh again - don't change diapers or anything between the two weighs). It turned out that my supply was down. I started taking Fenugreek 4 capsules 3 times a day, and went up and down on the dose as my milk needed it (I think at one point I was taking 6 pills 3 times a day).
The evenings are naturally the least productive. I also started pumping at night after putting my son down. Another thing I always did was to make sure that he finished completely on one side. I pretty much wrung out my breast as he was eating to make sure that he got all the good fatty hindmilk. I do this while pumping too. You can also pump both at the same time.
When I took my son in at 5 months, he had gained a pound! His percentiles are still all over the place, but I still usually get the comment that he is "well fed" with his little budda belly.
I would definitely work on the breastmilk, as using formula could make the demand for milk less, and therefore your supply could decrease again. This is not to say starve your child, but give it a good try for about a week or two, with weight checks at the doctor to make sure that you are progressing. If there still isn't progress and you and your doctor agree that formula is the way to go, then don't feel guilty at all. It is what is best for your baby. I just don't want you to miss out on what has been an amazing year for me.

Oh, and if you aren't comfortable with the doctor, change...you can do the immunization schedule anywhere.

People always think breastfeeding solely is not enough and supplimenting formula is the answer...it's not always!!! I am with Jodi P...my son was the sme way...at 50% at birth and by 2 months was to 10% and then stayed at 3% or below...he's now 18 months and still at 3% or below...while he doesn't have any extra fat, he still looks healthy (not gaunt or anything), meets ALL his milestones early or at least on time, is growing in height and always EATS A TON!!! At 12 months, the Dr did do some blood tests in order to check for malnutrition and to check for disorders that can make a child small and everything came back clean, so I'm not worried about him at all! If you want to "suppliment" with something, try starting him on some cereal or applesauce or little puffs or something like that (that's what I did with my son...even though it didn't seem to make any difference with his weight gain...in fact, I even was told by a different MD- my MD was gone and the new MD feaked with his weight- to suppliment with formula for a week and come back in for a weight check and even THAT did nothing...so I quit it as I figured out myself and through the support of my normal MD that breastfed babies are just smaller in general and that as long as he was hitting milestones, he was healthy and fine)!

Use your gut...if you don't want to suppliment with anything and he is hitting milestones like he is supposed to and is sleeping through the night and seems content and you have the support of your MD, keep doing what you are doing! Sounds like he is doing just fine! BTW, the breastfed baby chart is HARD to find, but with a little time and effort, you can find it...it does make a difference (my son is at about the 10% or so on it...so I'm not worried...oh, I might mention that I write this as my son is finishing his THIRD kiddy bowl of dry cereal...!!!)...also look at you and your hubby...mine is small and skinny and I was a small baby too, so it makes our MD look at things a little differently (helps that he was both my hubby's and my MD when we were little too!!!)! You are doing great! Keep it up!

I would be sure you're nursing long enough on each side to get pleanty of hind-milk, the rich, fatty milk. I, personally, don't like my babies to sleep all through the night because I want them to nurse once so as to be sure they're eating enough and I'm keeping my supply up.

Now, from what I read, you're a working mom. That puts a lot of extra stress on your body's demands. I know, I know, lots of people do it, but that doesn't change this simple fact. So, you may want to increase your food volume and also continue taking a HIGH quality suppliment system to assist your body in producing the milk you need while sustaining the extra lengths you have to your marathon. I like Shaklee: https://www.shaklee.net/anbwr

Another thing to remember is that as your baby gets more active s/he will be using more calories. So a baby that eats 1000 calories with little to no movement will be packing on the weight, while baby who is moving around burning through those calories will not be hanging out in the heavy group. ALSO, remember those charts are based on formula fed babies. The food is different and metabolizes differently than breastmilk. Try not to freak out that your baby isn't following a chart that isn't based on his eating habits anyway.

Now if you don't feel comfortable with your Doctor...I'd be sure to have a pointed discussion with her to give her a chance to explain where she was coming from and to see if that sits will with you. If it doesn't, move on over to the next Dr. There's no reason you have to employ a less than stellar medical professional to help you in making health decisions for your children, or yourself.

All of that said. Trust yourself. If you sense something needs to be done, STUDY it out and take action.

Hi, M.-- Good for you for being such a responsive, intuitive mom.
Here are my short answers to your list of direct questions: I would not be worried if my child were otherwise reaching milestones and urine/stool output was appropriate; offering artifical baby milk will only further decrease your supply and prbably add to your worries; and there is evidence that babies in the NICU who receive human milk fortification to gain weight are more succeptible to colitis and other gut infections, so even though your baby is not a premie in the NICU I would exercise extreme caution-- fortifying is rarely, rarely necessary and is appropriate only when the benefits truly outweigh the risks. And yes, I think it's reasonable for you to want to find a more responsive pediatrician. Your pediatrician is hired to be your consultant, after all, and someone who won't consult can't be very helpful.
Here are a few things to consider:
The American Academy of Pediatrics updated their infant feeding recommendations about five years ago to say that babies should be exclusively breastfed until they are at least six months of age and continue until Baby is at least one year of age. This was not an arbitrary recommendation; it is based sound research that links the early start of solid food to the development of food and environmental allergies. You are following the most current, evidence-based guidelines as you continue to breastfeed your baby.
You should know that breastfed babies are usually leaner than their artifically-fed counterparts, and the weight percentile charts most pediatricians use are based on artifically-fed babies. So, while I think it's appropriate to be alert because you've seen a drop in weight, it's important to remember there are a lot of factors at work here besides your milk supply. Five months is typically when babies become more active and therefore burn calories more with rocking, kicking, and learning to sit up, etc.
I just went to a seminar last weekend taught by Dr. Jay Gordon, a pediatrician in Southern California, and he joked with the audience about how often he is consulted about babies and children who are considered to be underweight or too small. He said the latest protocol for pediatric residents involves running lots of tests of the child--blood samples, MRI, etc.--even before anyone looks at the child's parents! He says it's his personal protocol to study the parents' appearances and gague the child's smallness based on that, assuming the child is otherwise healthy and active and hitting developmental milestones. So, consider your baby might be settling into the body type determined by genetics as much as meals--assuming you and your husband are not NFL linebackers, of course. ;)
Milk production is all supply and demand, but it typically takes your body 24 to 48 hours to increase or decrease supply according to baby's needs. If you are pumping, it's important not to evaluate you supply based on how much you can pump, since your baby will always be more effective than your pump at getting milk! Watch for a happy, satisfied, generally cheery baby who has at least five really wet (the weight of three tablespoons of water) diapers in a 24 hour cycle and has yellow stools regularly. It's in the range of normal for a baby to "save up" stool for a couple of days and then have a big one. Anything the size of a U.S. quarter counts as "a stool," so if he saves up and gives you $1.50 worth every few days, that's OK. ;)
Also, since breastmilk changes consistency during a feeding, it's important to let Baby finish the first breast first so he receives all the creamy, high-fat hindmilk available. Offering the same breast again if the initial nursing was brief can be a way to ensure he gets more hindmilk.
You might like the new book "The Breastfeeding Mother's Guide to Making More Milk" by Linda Marasco IBCLC. You could probably borrow it from your local La Leche League group. You might also like the book "Working Without Weaning," which addresses some of your pumping/timing questions. You can find your local group at www.llli.org.
Sorry to be so long-winded--I hope this is somewhat reassuring. Best wishes!

pump, and put powdered formula in your breastmilk. thats what i did with my son and he gained weight right away!

I had the same thing happen with my son at 3.5 months of age. When I called my pediatrician and a lactation consultant, they both said it's very common for mothers to not have enough milk for exclusive breastfeeding when their babies get older/bigger (but it appears many women don't know this). My relatives in Europe were completely shocked that American woman are expected to not give anything but breastmilk for 6 months. While it's true you don't need to be frantic about the percentiles, I do think that a baby who doesn't gain any weight in a month could probably use a little more to eat and supplementing with either formula or cereal won't hurt him, or, if you're able to pump in the morning like you said, give him the extra milk you pumped later in the day when your supply is lower. If he eats a lot after you've already breastfed him, you'll know he's still hungry (note, if he only eats a half ounce or an ounce, it might just be because the bottle is an easy way to get milk, but if he's eating two or three ounces, you know he didn't get as much as he wanted).

Personally, I think we've gone too far the other direction and lay too much expectation and guilt around mothers with breastfeeding. It's terrific if you can do it, I support it, I did it as much as I could, but you shouldn't let a baby go hungry (IF that's what's happening) or beat yourself up or make yourself crazy if you need to supplement.

Why not offer 2-4 oz of formula after he breastfeeds in the evening? Try your last breastfeeding of the night a little earlier so he won't fall asleep and then do a "bedtime" bottle of formula. I breastfed my baby for a year and supplemented with formula as needed and he did just fine. Of course every baby is different. Good luck.

What you are describing with your milk supply is completely normal. Milk production is highest at night due to the hormone production working best then. It sounds like your baby is satisfied and isn't really losing weight. Babies and children don't necessarily grow on the nice little curve on the chart, and they don't necessarily demand food on that curve either. It is almost time to begin adding solid foods to the breastmilk, but I would definitely stay away from adding formula to the diet. Breastmilk is sufficient for your baby's needs at this time and when he begins looking at what you are eating with interest, then give him little tastes of your food.
-L. (mother of nine and midwife)

If you're worried about how much milk he gets, you can weight him before and after feeding. Our son did the same thing. By 6 months, he was off the weight charts. At 10 months he had still not gained anything. What I later learned is that around 4-6 months, a baby can learn to nurse without taking in any milk. That's what our son did. We got in with a feeding therapist and they were able to confirm it. Our doctor was not concerned, either. We later found out he had undiagnosed reflux. He never spit up because it was going into his lungs, so we never knew. If you have concerns, follow up on them. You could see if he's interested in a bottle after nursing. Maybe your husband can give it to him while you pump to increase milk. Or you can get a thing you tape on that gives formula while he nurses so you still get his stimulation. (Our daughter thought that was the dumbest idea!) Maybe your son would go for it. :) I'd love to talk more, if I can be of any help. I know it's a frustrating, scary time. I hope he starts to gain soon!

I don't worry about the percentile stuff. If the doctor's not concerned, I don't worry. My kids did the same thing. I feel it's mainly because my kids are so active and work off so much of their calories. I noticed that they usually fell from the 60th percentile in weight to around the 25th around 6 months. That's also when they all learned to crawl. He's not underweight, TRUST me the doctor would tell you if he was. My 2nd didn't gain much at all between her 6 month and 1 year appointment and the doctor said she wasn't unhealthy, but asked me point blank if I was feeding her. The girl was downing 2 FULL jars of baby food at every feeding. 5-6 times a day. I have no idea where she put it all. If your doctor and nurse are not concerned, don't worry. And, I'm with you on not being comfortable with your current doctor. My last pediatrician would leave the room mid-question, so I switched and love our new doc.

Hi M.,
As far as your concerns go you need to go with your gut feelings you are the mommy and you know your little guy the best. It is definately not going to hurt him to give him formula and he is old enough now maybe you can start introducing him to rice cereal. As far as changing doctors if you don't feel comfortable with this doc then find one that you do you are paying them to be there for you when you need them so find one you are confident in. Good luck

Yes, I agree with Dita--thank goodness for formula, for w/o it, my son would probably not be here, either (he was a preemie and I had no milk for a couple of weeks!). Great job on the bfing, by the way. You've done great! I don't see the problem w/ at least offering a formula bottle as a supplement to your last night feeding. Just even for your own piece of mind. What's the harm in trying it? When I pumped, I got way less at night than in the a.m. Normal! And I never had "extra". Babies tend to eat a little less at night, anyway; however, there's a difference b/w "less" and "none". Good luck!

You can start him on rice cereal now. A bit of cereal mixed with breastmilk, formula, or water. (Introduce juice separately, then you can use it, although using the juice makes cereal sweeter and may teach him to like sweet things.)

Also, count his diapers. IIR, breastfed babies who are getting enough milk should have 8+ wet diapers a day.

Maybe try pumping at night. A woman's body generally makes enough milk to keep up with what is used, so if you pump right after he eats, there is extra stimulation and you may start producing more in the evening.

If he starts loosing weight, then I would definitely have him checked again. Babies shouldn't loose weight. Sometimes they will go through a stage where they don't gain much, and then they'll have a growth spurt and gain a bunch at once. But trust your instincts, too.

Like everyone else I agree find a pediatrician you can talk to, they should still follow the immunization schedule you want.

Kai is 19 months now. He is in the second percentile, and has been for at least a year. He was in the 50% when he was born. He just slowly went down to the second percentile and has stayed there. He is very active and has always eaten well. Being a normal eater he goes from eating like I do not feed him to eating next to nothing. I just keep offering healthy choices and let him decide what to eat.

I would not supplement with formula. Hold out till next month and cereal will supplement. Also if you pump first ting in the morning then let him eat he will get more out than the pump after he has eaten, and he will get more of the richer hind milk, then use that milk you pumped later in the evening.

Enjoy your little guy.

S.
mother to Kai
www.HomeWithKai.com

I would cut dairy from my diet because it is hard for babies to digest. If you see white pieces that look like cottage cheese in his stools, that is milk protein that has not been digested. You mentioned immunizations and that concerns me too. My husband passed out after receiving his immunizations as a baby and the nurse scooped him up and told his mom he would be fine. He had symptoms of Crohn's disease at age 7, and he also had a brother who was otherwise fine and died soon after his immunizations. I'm sure you weren't expecting this information but it is definitely something to think about. Meanwhile I have a friend who talks to a doctor who went back to school to become a nutritionist. He has really helped her out, so if you want his information let me know and I will call and get his number.

Each kid is running their own race. The percentiles are averages of tons of kids. It's not a report card, it's just a statistic. You don't have a "failing" child just because they aren't fat. If he's happy and eating fine, then don't stress it. Tell everyone he's your little string bean/feather weight/easiest baby to carry around. He's a kid, not a merit badge. ;D

Just a few thoughts. . . re: immunization schedule. A good pediatrician will let you set your own immunization schedule, so don't worry about that if you decide to switch doctors.

I wouldn't be worried but I would be concerned. I think most babies start to slow down on the growth around this time but they shouldn't stop. I would start him on high calorie solids such as whole milk yougurt. I would also start including some formula. This is just my opinion but I will tell you that it helped both of my boys who were exclusively breast fed. Good luck!

It's probably not anything to be concerned about. I breastfeed my babies until they are 2. The more the baby eats the more your body makes milk. So, maybe try pumping RIGHT after you lay him down for the night? Even if nothing comes out, make sure you do it for at least 10 minutes on each side. Then in 3 days you should get milk out the whole time, or at least produce enough that he would eat longer (if that is the problem of why he stops?).

If he's sleeping through the night he is probably getting enough. If he wasn't, then I would suggest to supplement with formula. Has he started crawling? Mine was an expert at 6 months. Maybe he's just more active? I'm assuming he drinks from a bottle since you work P/T? So after you start pumping milk at night, try feeding it to him after he's done nursing to see if he'll drink anymore?? If he doesn't seem to want it, try having your husband feed him the bottle because sometimes babies won't take a bottle if he knows you're around.

Also, there is a tea you can drink that is supposed to help your supply. I forget the name, but just ask the person at your local health food store. You could drink that at night (instead of ice cream).

As far as diet goes, it sounds like you are doing good, but I would try to eat about 100 grams of protein a day, and don't ever eat less than 1400 calories a day (1100 is the minimum you eat no matter how much you weigh, plus when you breast feed you are supposed to eat 300 more calories). You can still lose weight if you eat the "right" foods. Eat a protein, color carb (fruit/vege), and a carb with each meal and stick to 1400 calories (more if you weigh more -- take your weight and times it by 8 and that's what you should eat to lose weight + 300 more if you breast feed). I know this for a fact because I won a weight loss contest doing this. It's changing your lifestyle and eating healthier, not dieting.

Well, best wishes to you.

Try the simplest things first. Take a look at your diet and see what your caloric intake is. Also, what kind of foods are you eating? Are you trying to lose weight, if so this will affect your breastmilk. A great suggestion that I can give is for you to eat a bowl of regular (NOT non or low-fat) ice cream each night. This will make your hind milk much thicker and stronger for your son. You do need to realize that if you start supplementing with formula, then this will affect your milk supply. The less your son gets from you, the less you will make. It sounds like you're very aware of what's going on with your body. Try a couple of other things first (like the ice cream...I SWEAR it works), and if they don't, then try looking at supplementing.

Also, if you're not comfortable with your doctor, then you should switch. You should be able to ask questions and raise concerns and have them addressed. This is really important, so if you wonder if you should switch, then you probably should.

Good luck!

Sometimes Dr.s like to watch their weight for a period of time before having you make changes, as some fluctuations are normal. I think there is greater concern if there is a trend of dropping percentiles. However, I'm surprised your Dr. didn't at least want to watch it more closely. I know if the trend continues, you may have to do some supplementing. And, of course, that 6 month mark is just around the corner. I'm sure adding those solids will help. But if you have concerns about your child's pediatrician, it might be a good idea to change. There are so many wonderful Dr.s out there, I'm sure you can find one who fits with your philosophies and that you are comfortable with. Good luck, and enjoy that baby!

Formula feeding is a slippery slope. If you start supplementing-you will lnot produce as much milk. Try going to a Laleche meeting.

Also- has your son learned to roll? Become more active? My son was born at 9lb 4oz and is strictly breastfed. At 11 months he is considered "skinny" and no longer in a high percentile for weight. However-he's smart, healthy and happy.

If you do feel that you need to ad more to his diet using formula (which is nowhere near as healthy for your little boy) try using an SNS or putting pumped milk in an SNS.

You can also try cosleeping (safely). Now that my son is more active- he gets most of his food while sleeping with us. He is too distracted when awake.

I had a daughter that was in the 50% and over time dropped below the 5th. Although not at five months, it was around a year. They probably are not too concerned because the weight stayed the same, he didn't loose any. I understand your concern about not producing enough milk. I have four kids and my mother in law is a Lactation Consultant, so I have gotten many a tips from her and just from experience, so here is what I think...
Your body should be regulated by now and just producing what he is taking, but also it seems that around 5-6 months I have to give my supply a little boost and then again around 9 months. There is an herb called fenugreek that I take, any health food store will have it. It smells like maple syrup. Just take two or three pills with each of your meals, you'll notice an increase in about two-three days. You will want to take it for at least a week.
It is good that you are pumping for the time that you are away. It is best if you have a schedule, bodies seem to respond well to consistency. Make sure you are feeding him or pumping at least every three hours for six-seven feedings a day. You can wake him up every three hours if you need to and try to nurse on both sides if you can.
Also try switching from feeding him before he takes a nap to right after he wakes up. Then he wont fall asleep on you. The last feeding of the day it is okay if he falls asleep but try to get him to complete the feeding. You can do this by stroking his cheek, gently pull away from him (not breaking suction)enough that he will start to suck again, make him not so cozy and warm etc...
You could also pump after he is down for the night, and after any feeding that you feel there is not quite enough. It will increase your milk just because you are getting more stimulation to make more, even if you are not getting any milk out.
I breastfeed exclusively for the first 9+ months, so I don't think you need to start him on any thing else, increasing your milk supply will help.
Hope this gives you some good ideas.
E.

I'll just relate my personal experience. My son didn't feed well at the breast until he was four and a half months old. He has two minor deformities in his mouth that made it difficult for him, until he grew strong enough to overcome the deformities. My milk came in late, and because he didn't nurse well I didn't produce much milk at first. So, I'm saying it may be a combination of things that is leading to your son not gaining weight. I had to supplement my son with formula. He was not called a "well baby" until about four months, he was considered "failure to thrive". We kept at the breast feeding, and eventually he became a champ at it, but the formula kept him alive. Personally, I would advise you to keep him at the breast as much as possible, and think about giving him a supplemental bottle once a day. Some die hard breastfeeding folks might say not to use formula, but I thanked God every day that we live in a time when formula is available because my son would not have survived without it.

As for the pediatrician, you should call her on the carpet for walking away, and you should get her to give you straight forward opinion, advice on your situation. And, if you don't feel more comfortable at the six month check up, definately change. If you're in the north metro area, I really like my son's doctor, Susan Spoerke, M.D. with Mountainland Pediatrics.

They say it takes a village to raise a child.... one example of that is that in the "old days" if a mother wasn't producing enough milk for the baby, another mother would take that baby to her breast.

Good luck, and I'd be interested to know what you decide and how things go.

Hi M., My advice is to listen to your mommy instincts. I wish I would have!! My daughter was born in the 50%, by the 6 month check up she was in the 30%. By her 9 month check up she was in the 3%. When I took her back in at 10 months she wasn't even on the charts. Our daughter was sleeping through the night at 6 months and always seemed satisfied like your son, but she was just not getting enough. I was so concerned about her getting breastmilk and the best possible foods that I was not doing what was best for her in hindsight. We did have some health issues on the side which I know played a part in her weight loss, but I really wish that I would have started supplementing with formula. At ten months we started supplementing with formula and I saw an increase in her weight immediately. She is now 13 months old and I still supplement whole milk with the formula. Babies need all the fat they can get for the growth of their brain.
Also, our doctors office was great with my concerns. I was allowed to stop in whenever I wanted to do a weight check and the nurses would include it in her charts. However, Doctors are always behind, if I wanted to talk about my concerns with my doctor I was expected to make an appointment, which I understand.
Lastly, my daughter was low in vitamin D, which we are now supplementing with drops. I have learned that breast milk can be low in vitamin D.
Hope this helps, sorry about typos, I'm in a hurry but wanted to reply. Go with your gut!

some of us just make fattier milk than others - mine never had more than an inch of cream in 6-8 ounces, my cousin's was all cream (never separated)....her babies were obviously much fatter and heavier than mine. so, some of this is normal and nothing to worry about.
it takes more than water for you to make sufficient breast milk. make sure you're taking in plenty of calories, including fat calories, and good nutrition (whole grains, fruits and veggies, plenty of lean protein). I read somewhere that nursing moms need 500+ extra calories per day - that's more than you needed pregnant!
I had a horrible gastrointestinal illness right before I went back to work after my second. after pump and dump only for 5 days, I was really concerned about milk production, as was the peditrician. She told me a chocolate milkshake (made w/quality ingredients of course) every day for two weeks to make sure I was getting the calories and fat needed to keep my milk supply up. I don't know if that's what did it, but I managed to keep my milk up.
good luck!

I honestly wouldn't worry at this point. It's possible your son grew lengthwise in that month (or right before you had him weighed). It's also possible they'd recently had the scale calibrated or the nurse was a little less accurate at one of those visits. I would worry only if your son is acting hungry after he's emptied your breasts. It is totally normal to have more milk in the morning than the evening...that is how it works. Keep up on pumping at the same times that you would have fed when you are working drink Mother's Milk Herbal Tea if you are overly concerned. Be sure you are not taking Pseudafed, you are getting plenty of rest, and are getting enough calories in your diet (which sounds like you are). The absolute worst thing you can do is supplement with formula...for many many reasons. If your son is happy and content then he is fine.