Need Some Breastfeeding Advice!

Updated on June 14, 2017
J.P. asks from Colorado Springs, CO
10 answers

At my son's 4 month appt, he dropped from the 50th percentile to the 25th. He is now in the 15th percentile (5.5 months).

He doesn't eat a lot at once. He "snacks" pretty much all day long regardless whether from breast or bottle. From bottle, he will only take a 1/2 oz or 1 oz at a time. There is no schedule. We constantly offer all the time trying to get him to take more milk. He wakes twice a night to feed.

His ped is convinced BFing is the issue. I have over 300oz of milk in the freezer. She thinks my milk either isn't fatty enough, or he's not getting enough from me on the days and times that I'm at home. I do offer from both sides at each feeding to increase production, and I express for a bit to make sure he's getting hindmilk. I don't see any mucous or anything in his stool to make me think he's not getting hindmilk. I am dairy free and soy free and have been since before he was born (because my older child had MSPI issues as an infant). I'm also gluten free because of my own gluten intolerance. She's having us bring in stool samples this week to test in case there is a malabsorption issue. She said the only reasons for not gaining enough weight would be a heart defect (which he does not have), malabsorption, or not enough calories. She is using the WHO charts and is supportive of BFing.

I tried exclusively pumping for a day and offering him pumped milk. He ate 30 oz that day (24 hour period). I asked if she would recommend we do formula (I'm open to whatever will help him gain weight), and she said no. At the same time, though, she said it's common in her breastfed babies. I don't want to put him at risk of failure to thrive. Right now, we're trying exclusively pumping for the next week. Do you have any other advice on either getting him to take more in a feeding, or...I don't know? Making my milk better?

I have an older child who successfully breastfed for 18 months. No issues with weight.

I'm also worried because we're considering daycare (ILs are watching him now), and the daycares we've looked at say that once they warm a bottle, they have to dump it after ONE HOUR if it's not eaten. We'd end up either dumping half of what we bring, or bringing in 20 one-ounce bottles every day!

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So What Happened?

Hello! Thank you all so much for weighing in. After 2 weeks of exclusive pumping, we determined a few things. First, supply was not the issue. I was almost perfectly matched to his intake. Second, he is getting enough volume (between 28-35 oz per day).

After the first week, his weight didn't go up and one of the three stool samples contained blood. On the second week, I found some small things I was eating that could be an issue (things that could have dairy or soy from cross contamination). I also cut out coffee, which I probably should have done a long time ago. In just 4 days, he gained 2 oz every day. The doctor said he was meeting the growth rate she expects for his age. She wants to continue monitoring for the next 2 weeks to make sure this wasn't just a random growth spurt. I'll update in 2 weeks!

Also just wanted to clear up some misconceptions. Daycares are not required to dump milk after an hour to be licensed. That is something many corporate daycares do to ensure their employees don't forget. Also, the rule that all bottles must be premade is set by daycares to cut down on the cost of changing gloves (which they have to wear if they prepare bottles). We found a family owned daycare that is very accommodating to BFing mom's, as was the one we took our daughter to when she was a baby.

Also, the snacking. One huge benefit to exclusive pumping is that he has started eating more at once. All in all, things are heading in the right direction!

More Answers



answers from Portland on

First, you mentioned that he ate a lot with the bottle, so to me that suggests it's easier for him to get the milk out. So, if it were me, I'd pump and use that milk to feed him.

One thing which will happen in daycare is that your son will likely start to get on some sort of feeding schedule instead of 'demand' feeding. I've worked as a nanny and at daycare; it's impossible to feed 8 infants with three caregivers all on 'demand'... we just don't have that many arms! :) Daycare workers are also going to let your little one fuss a bit, not out of neglect, but because A. we aren't the bio mom and don't have that physical pull to sate a fussy baby right away (it's true, as I've experienced this as a mom and as a caregiver) and B. we are constantly having to prioritize which most necessary task comes first.

What will happen, though, is that a good daycare will document those feedings, when they happen, how much was consumed, BM/diaper changes, etc, and you will likely start to see a pattern developing. I encourage parents to begin to adapt their own at-home routines to what the child is experiencing at daycare, so that on the weekends/days off, they are fed consistently. This will also help with your son getting more food.

if it turns out that your milk isn't producing enough fats and carbs, then supplementing with some formula would be ideal. If there's an issue with how he is digesting/processing the milk, that's another category. But you do want to move away from the 'snacking' feeding and toward fewer, larger feedings. (when my son was wee tiny, he'd nod off every time he nursed. We had to take off his socks and tickle his feet to keep him awake long enough! So I understand your concern. Hang in there!)

3 moms found this helpful


answers from Pittsburgh on

Hmm, if he is really snacking all day, it's possible that he's mostly getting foremilk and not as much hind milk. This might be counter-intuitive, since you want him to gain weight, but when he starts to fuss for food, can you make him wait just a little bit (I'm thinking 10 minutes, not more) so that he's really hungry when he eats? Then maybe he will take more at each feeding and over time he'll start to go longer between feedings - but eat better at each one.

Also, since he doesn't nurse for long, no need to offer both sides at every feeding. Think of it in 3-4 hour blocks. Nurse on 1 side only for 3 hours. Then switch to the other side for the next 3 hours. To make sure you keep supply up you should pump the side he's not nursing from at least once during that 3 hour block. **If the baby gets fussy nursing on the same side, like he's not getting enough milk, THEN by all means switch sides even if it hasn't been 3 hours. But the point is to make sure he's really emptying one breast before moving to the other.

Yes, the daycare policy is pretty standard. I used to send in a bunch of 2 oz bottles.

3 moms found this helpful


answers from Miami on

Nervy Girl is giving you great advice. And like other posters also say, no more snacking all day.

I'm not sure that your baby really IS getting the hind milk the way he is eating. When breastfeeding, he would have to empty your entire breast to get to the hindmilk. And if he's just snacking on the bottle, there's not enough there either.

It will be hard, but putting him on a 3 hour schedule (3 hours from the start of a breastfeeding session to the start of another one) is what you need to do. That gets him hungry enough to actually eat. With a true schedule, he will actually experience the hunger and want to do something about it. And you'll have to do this for daycare anyway.

If you are nursing instead of feeding from the bottle, offer only one breast at a time. Put a safety pin on the side of your shirt that you will feed him with the next time when you're nursing him. That way, he'll be more likely to get that hind milk.

OR, just use the bottle and establish the schedule. I know it will be hard. But daycare simply will not feed him every 20 minutes...

2 moms found this helpful


answers from Springfield on

I think you've gotten some great advice! I must admit it's difficult for me to remember the details, as my kids are 8 & almost 11, but I don't remember offering both breasts unless he was really, really hungry. I usually just switched sides at each feeding.

Try to relax. I know it isn't easy. Consider the advice, work with your doctor and try not to worry. I'm so glad you are open to formula. Your son is more than 4 months old, so he's already gotten 4 months of benefits from breast milk. Plus the 300 oz in your freezer. Wow! That is really great!

My youngest had to be switched to formula at 4 months due to some health issues. I didn't love the idea, but it was what was best for all of us. He's a very healthy 8 year old today, so no regrets.

2 moms found this helpful


answers from Portland on

Personally, I would not allow him to snack all day. I was told not to do that. I was told that you emptied both sides (as much as you could) at each feed to make sure they got the fatty stuff. I didn't pump and give pumped bottles - I only did if I was engorged and had to get rid of some, or was leaving a bottle for someone. Even then, by 4-5 months, I just made up a bottle of formula. I think I also may have supplemented a bit at that age (for my youngest), I'd give it right before bed and it helped her to sleep through - because my milk at end of day was not at peak production time, and it wasn't enough to keep her full. My doctor OK'd that and recommended it.

But ya, no to the snacking. That would be the first thing I'd try. My sister let hers snack because she didn't offer pacifiers, and her kids were all very small babies. Weren't at birth, but were pretty teeny. My good friend did the same - her baby would not accept a pacifier, so she basically was the baby's soother. Her baby was failure to thrive. Fine now, but it meant she worried a lot during her first year.

I kept it really simple. I just switched the breast I offered first each feed - I would have stretched it to 3 - 4 hours by this point. Are you introducing solids? I can't remember when you do, it seemed to change every baby I had. I wouldn't until the paediatrician OKs that or suggests it.

I drank a ton of water when breastfeeding and had almost excess milk. I also burped my babies half way through - got a huge one out of them. If they are not burped in between breasts, then they are full on air. That was a really good trick I was given.

1 mom found this helpful


answers from Jacksonville on

I'm certainly no expert, but I would suggest you consider that the "snacking" might be the problem. Does he snack b/c he falls asleep early in the feeding? If so, you need to wake him up. I would also try to use a schedule rather than just randomly feeding. Will he go 3 hours between feedings? If you can have him wait just a few minutes from the time you think he might be hungry, he might eat better for you.

I know these with mine own children, I changed their order of activity... Eat, awake sleep. Eat, awake, sleep. NOT: Eat, sleep, awake. When they eat first, then are awake for a bit and begin to fuss most people would offer them to eat again and they'll fall asleep soon after a little snack. If you just put them to sleep (without offering the feeding that turns into just a snack), they wake up ready to eat a FULL MEAL. And then are content and happy for a while before getting tired/sleepy again.

Just a thought you might consider.

Oh, and I never offered the 2nd breast during the same feeding (well, rarely, maybe during a huge growth spurt a couple of times only). Baby got full from one breast, but it was completely emptied. If I tried to remove baby after 10 minutes to switch sides, he was uninterested and ended the session himself. I just let him feed until he was done. Then for the next feeding, I started on the other breast. Same thing. Let him feed until he was done. If he eventually fussed b/c he'd emptied it, I'd offer the other side, but that was rare. And he was a very healthy boy, no weight problems whatsoever.


answers from Springfield on

both of my children started at 50% for weight at birth. both were light weights. and both had droped to the single digits in weight percentages by a year.
why consider daycare do your ILs not want to watch the baby? and have you consulted a lactation consultant to check babys latch and to make sure you are producing well? i suggest talking to them or the la leche league or even kelly mom .com for info on whats going to help your baby out.
my childs dr also said i could if i wanted to add oatmeal and mashed avocado and other simple stuff to my childs diet after they hit 5 months, has your childs dr said anything about adding solids for the purpose of weight gain?


answers from Norfolk on

He's still growing - just not at the rate everyone thought he would.
I think he'll hit some important growth spurts in the next 8 months.
Breast milk is fine - and even if he's late to take to solids (our son was about a year old) breast milk is still best for him.
If your supply starts drying up then formula is fine too.
Maybe bring lots of small bottles of breast milk to day care.
That way they only dump small amounts at one time if he won't eat.



answers from Los Angeles on

Your pediatrician said what's common in BF babies? That it's common in BF babies to go down in percentiles by that much? I find that hard to believe. I BF both my kids and they were both able to maintain their birth percentiles until 6 months of age. It wasn't until solids were introduced that they began dropping in percentiles.

I suggest formula. I'm in the "fed is best" camp. I think making sure your son gets fed what he needs to thrive is the most important thing. If he's snacking all day, he might not be getting the hindmilk; formula can make up for that. Going with formula will also make things sooo much easier when he starts daycare. Good luck!


answers from Santa Fe on

I never produced enough breast milk even after 5 months of breastfeeding. They finally came to the conclusion that I'm one of those rare people who do not produce enough. It is something to do with my breast tissue. It is rare but it happens. I don't think this is you...I think you have a different issue but it's something to keep in mind. How much milk can you pump out at a time? Anyway....It sounds to me like he is not taking in enough ounces at one time. And snacking throughout the day also sounds like it might be a problem. I would have the same worry as you with the daycare...are they willing to feed him on this snacking schedule? Have you tried feeding him right after he wakes up instead of before he gets sleepy? And have you tried pumping your milk and only feeding him with a bottle for a couple weeks so you can see how much he takes and one time and try to get him to take more? Not just one day...give it longer to see if you can change this habit of his. It has been a long time, but I seem to remember my son taking about 6 ounces at a time at this age.

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