Milk Intake for 6 months and above

iVillage Member
Registered: 12-02-2008
Milk Intake for 6 months and above
5
Mon, 01-11-2010 - 11:48am

Hello


Recently I had my son's 6 month appt w/ his pedicatrician and the doc said LO needs to take 30-36 oz of milk over 5-6 feedimgs over the day. I am assuming that w/ a formula, this would be easy. Right now, he is completely on BM, but for a tiny amoutn of formula that is mixed w/ his cereal (i am not a HVP, while I am at work) and giving him three bottles of 4 oz each while I am gone itself is a big deal for me.


My question is whether the doc's recommendation of 30-36 oz is correct or not? I am panic striken w/ this and plan to exclusively pump for a week to see if his infact does take in so much (if not nursed in my presence at home). he gets solids, 2x a day, with the second solid, consisting of a tablespoon of rice cereal mized w/ milk, hjust before he sleeps. his first solid in the day consists of a sampler of a veggie/fruit plus a tablespoon of oats cereal mixed w/ milk.


I would like ot know how much a baby should drink to be gaining well? My LO is a very slow gainer and only now did he come on the wt chart (just at 5 percentile).


thanks!

iVillage Member
Registered: 09-10-2009
Mon, 01-11-2010 - 5:02pm

It sounds to me as though your dr. is far more familiar with FF babies and FF practices than how to support moms through successful breastfeeding. The 30-36 ounce recommendation would definitely hold true for FF from what I understand. However, that's likely too much for a breastfed baby.


Research shows us that the average bf baby takes in 19-30 ounces of breastmilk per day from 1 month to 6 months. THe number doesn't change during this time period because breastmilk changes and becomes more nutrient-dense as time goes on, whereas formula stays the same. After the 6 month mark when baby is established on solids, we'd expect that number to even go down a smidge.


Also, 5-6 nursing sessions would be the absolute minimum we'd want to see at 6 months. Many babies are still nursing 8 times a day or more at the 6 month mark.


I would not recommend exclusive pumping for a week to measure intake. Exclusive pumping with no direct nursing has the potential to lower your milk supply (pump doesn't stimulate supply as well as baby typically), you have the potential to get baby too used to bottles, besides the fact that pump output is NOT a valid way to measure supply.


Can you tell us a bit more about your weight gain concerns? Can you give us a weight history? How many times per day are you nursing? How is diaper output? Are you on any hormonal birth control? Any health problems that might affect supply (PCOS, thyroid, hormonal issues, breast surgeries)?


I hope that helps. Please take a spin through and let us know what questions you might have.


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iVillage Member
Registered: 12-02-2008
Mon, 01-11-2010 - 8:20pm

Thanks

iVillage Member
Registered: 09-10-2009
Mon, 01-11-2010 - 9:39pm

Doing the math,


weeks 2-6, he gained 5.5 ounces per week,
weeks 6-8, he gained 3 ounces per week,
weeks 8-17, he gained 5 ounces per week, and
weeks 17-26, he gained 4.8 ounces per week.


The average breastfed baby gains 5-7 ounces per week in weeks 1-17 and 4-5 ounces per week in weeks 17-26. Other than the one little blip between weeks 6 and 8, his weight gain looks just great to me.


How are you gauging how much milk he's getting per day? And if he were getting 24-26 ounces per day, that sounds perfect since the average bf baby consumes 19-30 ounces of breastmilk per day. I'm not sure I'm understanding where the concern is.


I'm wondering if your dr. is still using the old charts based on FF babies (based on your dr's formula-centric advice, I'd bet he is) rather than the newer charts available based on BF babies. BF babies have a different growth pattern so it's important to chart on the right charts. Do you have any idea what kind of weight gain your dr. was looking for?


Is there any way to squeeze another nursing session back in there somewhere?


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iVillage Member
Registered: 12-02-2008
Tue, 01-12-2010 - 10:16am

I have no way to guage how much LO is getting, but am basing my decision from pump outputs (which I know is wrong, but i have no other measure).


The concern on weight gain is from the fact that until now he has never been on the chart that his doc has. He had his own curve, but was never on the curve and at one point (during the 4 mth check up), the doc (a lady) told us (me and my DH) that LO is 'failing to thrive'. Those were really tormenting words and taunted us for a while.


I have asked the doc what chart she uses, and she says it is the latest. I feel that she is not willing to reveal more information on this. From our interactions w/ the doc, it seems that she is more concerned about the LO's weight and growth pattern and does not care much as to where the source of milk is coming from - if I cannot provide the number she thinks LO needs, she encourages us to supplement w/ formula (something that we have resisted from day one). I guess the doc is expecting LO to maintain the 50% that he was charted from his birth weight.


I am trying my best to squeeze a nursing session. it appears that LO wants to nurse the moment I come back from work (even if he had his third bottle couple of hours back). i am guessing that, along w/ the night comfort nursing should get him some weight (although, from this point on, his weight gain will be slow - if I understand the litreature on Kelly mom right).


What, at this point, I would like is to see the same pumping output that i used to get couple of months back (3.5 oz in half an hour to 40 minute pump session at work). I just want LO to get the best he can. please help.


iVillage Member
Registered: 05-20-2008
Tue, 01-12-2010 - 12:54pm

Here is some information on the use of growth charts with BF'd babies. It's important to know what growth charts can and cannot tell us. Here is what Kellymom.com has to say about growth charts:



A note about growth charts


A growth chart isn't a test, where you are striving to get your baby into the 100th percentile. The growth charts show us the statistical distribution of weight, height , etc. in a particular set of babies (or children or adults). So if a baby is in the 50th percentile for weight on the CDC charts, it means that half of the babies of the same age in the US are heavier and half are lighter; if a baby is in the 10th percentile for height, then 90% of babies of the same age in the US are taller and 10% are shorter. Healthy babies, just like adults, can come in all shapes and sizes - a baby in the 3rd percentile can be just as healthy and normal as a baby in the 97th percentile. What doctors are generally looking for on a growth chart is that baby stay relatively consistent in their growth pattern (see below for why this may not happen with the current growth charts). Growth charts are only one part of the puzzle, however, and must be evaluated along with other factors, including:

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