Breast-feeding Issue

M

mavislohsp

Registered User
Hi all,

My lil one are 4 1/2 months old. Nowadays he seems to spend lesser time on my breast, between 5-10 mins on each breast. Compared to last time he used to spend 15-20mins. I tried to squeeze on my breast after he finished and it is very easy to get the milk out, i.e. He didn't empty the breast. I am just worried he might not get enough milk. He weight 6.36kgs when he is 4 months old, is his weight ok for his age? Though doctor said is alright, just Want to hear some others opinion. Besides, lately he seems to have constipation issue. Yesterday he past motion of his 8 days old poo poo, and before that was 5 days poo once, but all after he took the lactose fr doctor. Today I tried give him the formula and he took 4 1/2 oz. am just wonder is this a sign that he wanted to wean from breast milk? Any suggestion are most appreciated.
 
i found that with both my sons, the older they got the more efficient they were with the breast so they are on it for less time. I bfed/expressed my first for 5 months and then my 2nd for 6 months. you can check your baby's weight on the WHO website: http://www.who.int/childgrowth/en/ but remember it's just a guideline. I never took it too seriously. As long as your baby is happy and healthy, then the are getting what they need. My 2nd son weight through a bit of constipation and my pediatrician in singapore said some pass stool every 14 days....i tried to eat foods that helped - lentils, prunes etc...Can you express milk and see if he drinks the same amount?
 
Hi
Babies get efficient at taking what they need as they get a bit older and often you'll find they pause less when drinking, so it seems much shorter. A lot go through stages at 4-6 months where they are interested in what's happening on around them and this can distract them from drinking efficiently. Try goining into a darkened, quiet room. If you have only recently introduced formula this will be affecting your milk supply. Both my girls fed efficiently (in under 10 minutes) at this age.

The growth charts, are as southside suggested, estimates on a population group only. The WHO isbased more on breast fed babies where as the CDC, formula fed babies so they can differ quite a bit understandably. You will also need to consider your LO birth weight and his/her genetics (build from parents). As long as he/she hasnt dropped two percentiles in a short space of time it is regarded as normal development by most.

The changes in his poo could be due to the formula or the other supplement you were given? Have solids been introduced early? This aways plays havoc with digestion. 6 months is the WHO official view on the introduction of solids as this is when the babies digestive tract is the most equipped at breaking down foods. My second igot quite constiipated with the introduction of solids, so I've introduced a tsp of flax seed oil now into her diet to help with this and it's made a big difference. Also check the formula you have. The iron levels can be too high and result in costipation also.

If you haven't done so already, introduce water to your LO now. It's so hot and they can get dehyrated in this heat so easily. Avoid juice.

Good luck.
 
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Hi there, babies get much more efficient at breastfeeding the older they get, if you allow unrestricted feeding he will take as much as he needs. At around 4 months, a breastfed baby's growth starts to gently taper off, this is normal! If he continued to grow at the same rate forever, he'd be a giant! Studies using ultrasound equipment show that babies usually only take around 75% of the milk available in the breast at a big feeding, so it is normal to be able to express milk out after a feed. Topping up with formula is almost never necessary, and will cause your supply to drop and lead to premature weaning. Babies will often accept a bottle of formula after feeding, not because they are still hungry but because it is delivered from the bottle teat so easily. It is very easy to overfeed a baby this way. Babies who are fed on demand and not offered other sources of milk, will generally not self-wean until closer to 2yo. As for weight gain, this depends somewhat on his genetic makeup as well. You can look at the WHO growth charts, as these are compiled from exclusively breastfed babies. At 4 months old, it is very normal not to poop every day. Some babies at this age will only poop every week or two! Its normal, and not a sign of constipation. If your baby is exclusively breastfed, it is not advised to offer water. Breastmilk composition changes with the temperature, so in the heat your baby will likely take in more foremilk and not be at risk of dehydration. So long as he is allowed to feed on demand, there is no need to offer him water (unless he is having formula, which is a different situation as formula is the same consistency). Feel free to PM me if you'd like any help/info. Cheers! Lali :)
 
Hi southside852 n sea princess,

I have not introduce solid to my baby yet, and He is solely breast feed. Yesterday I am just trying to see how much he can take in a meal, and I have problem pump my milk out therefore no choice have to use formula. I tried drinking prune juice but it doesn't seems to work for him, I did start giving him water when he is 4 months old, probably the amount was not enough, I shall try give him more. He is really a curious baby, n I always nurse him in a dark room. My doctor asked me to introduce solid to him now saying that the fiber in the solid might be helpful, but I always heard solid will make baby more constipated, don't know if I should do that. I didn't know baby can hold the poo poo for up to 14 days! 10 days is the max that I heard of! Anyway he did letting out gas a lot of times everyday and is very smelly. Thanks for the link and advices, I 'll try your suggestion, cheers!
 
Mavislohsp, I just checked my baby's health record and she was 6.16 kg at 4 months of age (3.55 kg when she was born).
As the others have mentioned, babies do get more efficient on the breast as they get older. As long as your baby is healthy, happy and is putting on weight, I'm sure there's nothing to worry about.
 
mavislohsp said:
Hi all,

My lil one are 4 1/2 months old. Nowadays he seems to spend lesser time on my breast, between 5-10 mins on each breast. Compared to last time he used to spend 15-20mins. I tried to squeeze on my breast after he finished and it is very easy to get the milk out, i.e. He didn't empty the breast. I am just worried he might not get enough milk. He weight 6.36kgs when he is 4 months old, is his weight ok for his age? Though doctor said is alright, just Want to hear some others opinion. Besides, lately he seems to have constipation issue. Yesterday he past motion of his 8 days old poo poo, and before that was 5 days poo once, but all after he took the lactose fr doctor. Today I tried give him the formula and he took 4 1/2 oz. am just wonder is this a sign that he wanted to wean from breast milk? Any suggestion are most appreciated.
Click to expand...

I'm sure that Sarah Hung will have some good tips on this if she reads it.

First of all, it is important to note what your baby's birth weight was. My baby was 8 pounds, 6 ounces at birth (3.8 kilograms). Babies are supposed to double their weight by 8 weeks after birth. So my baby (who reached this weight goal long before 8 weeks) should have been 7.6 kilos by the time she was 8 weeks old. So, for my baby to be only 6.36 kilos at 18 weeks (4.5 months) would mean something was wrong. But....your baby was likely a lot smaller than mine when he was born.

Second, breastfed babies learn the skill of breastfeeding over time. The reason why your baby took 20 minutes to finish a feed in the beginning is that he was not as good at breastfeeding as he is now. My daughter also would feed for like 30-45 minutes when she was 1-3 months-old but now that she's already almost 6-months-old her feedings last an average of 10 minutes--sometimes a little less and sometimes a little more. She's getting just as much milk (or more) but she is more efficient at getting it out. Also, my milk supply is more established so my let-down happens faster and the milk flow is faster. These are things you can't really observe but that's probably what's happening. Breastfed babies eat until they are full--not until they've reached a certain measurement--totally different than formula feeding. If you are really worried about your baby getting enough breastmilk, I suggest that you feed and then pump afterward to increase your milk supply.

Third, there isn't really any need for you to supplement with formula. By supplementing with formula you are already starting the weaning-from-breast process. Babies at 4.5 months will not wean themselves--they will not refuse breastmilk. The more formula you use, the less breastmilk your baby will drink and the less you will produce--which becomes a cycle that is hard to reverse. If you still want to keep breastfeeding I would seriously think about cutting out the formula entirely. Also, beware of local doctors who will say that the baby is not getting enough breastmilk and needs formula. Talk to a La Leche League consultant and get some advise about breastfeeding. Most local doctors don't know much or anything about the reality of breastfeeding.

About bowel movements (going poo). Another interesting thing about breastmilk is that the baby's body can really use almost 100% of the milk so sometimes breastfed only babies go a long time between poos. Now, if you're also giving formula, the constipation is from the formula--because formula is difficult for babies to digest as cow's milk is not easy on their tummies. I gave my daughter formula (good, gentle, organic type) when she was about 8 weeks old and she got terrible sick from it--she was constipated for three days and screamed and cried in pain. After she passed the formula out of her system she was fine and happy again. I never gave her formula after that. I suggest that if you want to keep giving formula, give goat's milk formula (Karihome) as it's easier to digest than cow's milk formula.
 
thanka2 said:
Babies are supposed to double their weight by 8 weeks after birth.
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What???? That's the first time I've ever heard that! Are you sure? My baby only doubled her birth weight when she was 6 months. She was born at 3.55 kg and was exactly 7.0 kg at her 6 months check-up. My pediatrician NEVER mentioned that there was anything wrong with her weight. I'm really surprised to hear that.
 
KeHK said:
What???? That's the first time I've ever heard that! Are you sure? My baby only doubled her birth weight when she was 6 months. She was born at 3.55 kg and was exactly 7.0 kg at her 6 months check-up. My pediatrician NEVER mentioned that there was anything wrong with her weight. I'm really surprised to hear that.
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Thanka2 is definitely incorrect on this - her statement is quite misleading. There are many growth charts/centiles kicking around. They are only a guide at best, and none of the ones I have seen have babies doubling in weight after 8 weeks.

At example is here, at the World Health Organisation.

http://www.who.int/childgrowth/standards/weight_for_age/en/index.html

You can look at all the percentile ranks for both boys and girls - none is expected to double after 8 weeks - regardless of whether your baby is very light, average or very heavy at birth.

-- edit: miran beat me to it!
 
KeHK said:
What???? That's the first time I've ever heard that! Are you sure? My baby only doubled her birth weight when she was 6 months. She was born at 3.55 kg and was exactly 7.0 kg at her 6 months check-up. My pediatrician NEVER mentioned that there was anything wrong with her weight. I'm really surprised to hear that.
Click to expand...

Sorry! I really typed that wrong! Sorry. Babies get back to their birth weight by 2 weeks. The general rule is that a baby doubles his/her birth weight by FOUR months, not TWO! Sorry! Frazzled brain. Thanks for catching that! :) And my daughter reached that stage earlier than four months. But, this is a general rule. From what I understand, it only becomes an issue if the baby is "failure to thrive" or having serious weight issues.
 
2010-NewDad said:
Thanka2 is definitely incorrect on this - her statement is quite misleading. There are many growth charts/centiles kicking around. They are only a guide at best, and none of the ones I have seen have babies doubling in weight after 8 weeks.

At example is here, at the World Health Organisation.

http://www.who.int/childgrowth/standards/weight_for_age/en/index.html

You can look at all the percentile ranks for both boys and girls - none is expected to double after 8 weeks - regardless of whether your baby is very light, average or very heavy at birth.

-- edit: miran beat me to it!
Click to expand...

And thanks for keenly catching that mistake. Posters on this board never miss a beat! What I read and was told my my son's doctor in the States is that babies generally double their weight around four months. And there certainly are no cut-and-dried rules about weight, height and size of children. Against the Chinese weight and height charts that my "mixed" children are measured they are "giants"--97% for height for my son, 99% for my daughter and; 70% for weight for my son, 90% for my daughter. In the States, they would be in a more "average" range.

I think it's really an issue if your baby is not faring well in other ways or is extremely thin and unwell--which is something you should be in contact with your doctor about.
 
miran said:
on an average - double in 5 months. triple by 1st year. never heard of 8 weeks ! :)
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Thanks for catching that mistake, miran. The details of whether it's 4, 5 or 6 months are unclear. It depends on where you're looking but yes, the general range is between 4-6 months to double weight. Babies should regain their birth weight by 2 weeks.

If the OP's doctor says the baby is doing well and the OP seeks other opinions and they all say the baby is doing well and she doesn't notice any other problems with the baby's health then weight (especially small differences in weight) shouldn't be a problem.
 
As the others have said as babies grow older most (but not all) shorten their feeding times, sometimes to just five minutes per feed. How long the baby feeds for doesn?t matter it is how he grows on those feeds that does.

It sounds like you baby is doing great on the feeds he is having. 6.4kgs is a good weight for a 4 and a half month old. We are looking for his weight to be between 6.0 kgs and 8.7 kgs. (2006 WHO Growth Standards) But really it is difficult to say anything about a baby from a single weight we really want to look at growth, so need to know his birth weight, his lowest weight and what he?s been doing for the last few months.

As others have said we are looking for a doubling of birth weight by 5 months and a tripling by 12 months although some babies manage this earlier. This was a change with the introduction of the new standard curves in 2006. In developed countries these curves made more babies at 12 months fall into the obese category and in developing countries it made more babies fall into the undernourished category.

The longest I?ve ever heard of an exclusively breastfed baby going without stooling is 13 days. The mother of this baby told me that it was a lot to clean up when the stool eventually came! The important thing about the stool is the consistency not the frequency. If the stool is soft then it is no problem even if the baby only has one stool every two weeks. But if the stool is hard and dehydrated it is a problem even if the baby has one every day.

A word of warning about giving a baby milk (expressed breast milk or formula) in a bottle after a feed. The baby will always take some ? even if he is full. Imagine that you come to dinner at my home. You eat the main course and are full. Will you have some desert? And if you say, ?No thanks, I?m full.? And I say, ?But I make it especially for you and it?s your favourite.? Will you still say no? Because this is the message you are giving your baby by offering the bottle and so babies nearly always say yes ? even though they don?t need it.

If you have successfully breastfed for the last four months then you have enough milk for your baby and don?t need to start giving formula. Remember a one month old baby drinks the same amount in the day as a six month old baby. So if you had enough milk last month you?ll have enough milk this month too.

It is very easy to know if you have enough milk. We are looking for the baby to have six wet nappies each day (24 hours) and weight gain over time. I would expect your baby to still have at least six feeds a day but eight to ten is more common.

I would recommend attending La Leche League meetings. Here you will find other breastfeeding mothers and be able to get answers to all your questions. The English speaking schedule is at http://www.lllhk.org/Meetings.html and the Chinese speaking meetings at http://www.lllhk.org/ChineseMeetings.html. The web page, What is La Leche League, http://www.lllhk.org/WhatisLLL.html explains exactly what the society is all about and the article: Why LLL, http://www.lllhk.org/WhyLLL.html will explain why the meetings may be helpful.

Best wises,
SARAH

Sarah Hung IBCLC
www.lotuslactation.com
 
Hi Sarah and all mothers out there,

Thank you so much for your reply, I really appreciated it. I felt so relief after reading all the advice above. My baby's born weight is 2.8kgs, which means he is doing absolutely fine! I fed him about 7 times a day, and he did wet about 5-6 nappies a day. I shall monitor him closely on his poo poo. The last time he pooed has leak all the way to the floor, but I am happy to clean the mess he created!

Thanks Sarah, I shall try to attend the meeting, I am sure it will be very helpful for me. Thanks everyone! Have a great week!
 
Hi, just to do some update. My lil one just pooed today, I.e 6 days from his last past motion. Hurray! Don't know is it because he did 'more' exercise yesterday :) he went for his little swim or rather floating session in the swimming pool yesterday.
 
Don't top up with formula, you'll just over feed your baby. And don't compare the amount of expressed breast milk with formula your baby take because breast milk changes in composition according to your baby's need and formula can only increase in volume to accommodate that. Breast milk is super easy to digest so it's possible that all of it is digested by baby. If you are really worry about baby's constipation, massage baby's belly in clockwise motion, and give his legs some bicycle movement exercise when baby lays on his back.
 
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