9 months - supply reducing

[NewChoos]

I think my supply has gone down, I have offered DS formula a few times after bf's to make sure he is getting enough milk but it's hit and miss if he will take it. I am concerned as his weight is only 17lbs. He is taking good amounts of solids. he was gaining weight ok (although has always been on the slimmer side) but it has tailed off in the last couple of months.
I have tried pumping to try and get an idea of volume but I hardly get anything :( although I was never great at pumping.....
Any ideas please? I was hoping to bf until 1 year. Also, I am feeling awful in case my supply has been less for a while and DS hasn't been getting enough milk. I haven't felt as 'full' for a couple of months.
DS has just had a bf (5mins) I have offered him a bottle but he has refused. He did take 120mls formula earlier, which is unusual for him.

Ok a couple of thing's

It's normal to not feel so full/ stop leaquking ect when you have a well estabished BF relationship. These are absolutly no indicator of supply at all.

Seconed him taking milk in a bottle after a feed is also no indication of suppy either. BF baby's will often take more form a bottle due to the faster flow/novalty factor.

As you know pumping is no indicator of supply either. Some women can't pump, others find hand expressing more sucessfull rather then using a pump.

Appart from his slowing weight gain is there any other reasion why you think your supply has droped? Has he been ill recently this can effect weight gain even if just a cold.

From everything you've siad so far everything sounds normal and no need to worry.

In addition to what MigGril has said - feeling full means you have excess milk not no milk, if you don't feel like you did in the early weeks that's because your breasts have adjusted to baby's needs and aren't making lots more 'just in case'.

If you keep offering formula though, you may end up with lowered supply as you are telling your breasts to make less than before.

As said above pumping is only an indication of how much you can pump not how much milk you have (some pumps work better than others - for me one type of hospital grade electric only produces 1 drop of milk for about 28 sucks, using another type directly afterwards I got about 50mls [i think it was a while ago!]).

Weight gain does slow down, and it's considered normal and not worthy of investigating for a baby to go up or down 2 centile lines (e.g. 50th%ile from 91st%ile), more than 2 may be normal but needs investigating to rule out illness/issue. If he isn't actively losing weight or plunging down the centiles or sickly then it may be he's just finding his new line. Also, babies can't keep gaining 6-8oz a week or they would be seriously overweight at a year (if a 7lb 8oz baby put on 8oz a week for 50 weeks they would be 32lbs 8oz at the end of their first year - the size of a 3y/o!).

Thanks very much for the replies. He has only gained 800g in 3 months (we are under hospital care for a health concern which does not require intervention at the moment but slow weight gain could be seen as him now coping as well). He has been following a centile but I have been advised I need to get him up to the next one.
Regarding production, although I appreciate I won't feel the same as in the first few weeks, for the some reason I can't shake of a feeling/concern I am not producing enough (not scientific I know!). Past few days I have felt he seemed more hungry and so the milk and solids aren't enough? He is taking good amounts of solids though and I offer until he is clearly not interested ie will offer cereal for bfast, toast & fruit.

As long as he's still have plenty of wet nappy's a day though he's still getting enough milk. If he still seem's hungery there is no reasion why you can't offer more milk. Offer first side then seconed and then back to the third again, just like you would do with a newborn.

Are you offering milk before solids?
Milk is the most important part of there diet at this age and he shouldn't be reducing his milk feeds much at this age. Milk is still there main source of nutrition untill at lest 12months and most solid foods don't contain as much calleries as BM so if he's replacing to much milk for food it could be a possible explination for the slowing weight gain.

At home I pretty much offer milk when I think he wants some (bit grizzly/tired/several hours since last milk feed). He has just started nursery 1/2 days and so they offer milk while there, if he hasn't had any, I give him a bottle on the way home.
I keep getting conflicting advise! HV says solids should be main part of diet and to cut down bf's. Dr said offer formula as bf supply likely to be less now and I'd probably be weaning soon anyway!!!

Its hard to trust your supply when breasts always feel a bit deflated! FWIW a month ago I used to have to pump at work or my breasts were in agony at the end of the day. Now DD is 9mo, I no longer needed to pump and they are even full feeling at the end of a work day . I don't know what has changed given I still demand feed the weekend. I do sometimes doubt if there is enough milk but I just keep offering the breast and DD doesn't seem to complain.

I don't have the dilemma with solids because DD is in nursery full time and she has dropped all the bottles herself during the day. I don't see why I need to give formula now at nearly 10mo. I'm quite determined to move her onto cows milk directly. As for weight, DD is quite small, weighed 7.95kg last week. (I checked it's basically the same weight as your DS). She was on the 50th centile until she got bronchiolitis in November. Shes now stuck at just above 25th. Obviously I don't know your medical situation so I can't comment why they need your DS to climb a centile.

I mean they aren't full after a whole work day. That's 10 hours!

I post this everywhere as it really does cut through the confusion about solids vs. BM

6-8m need 130 kcals of complementary foods and 485 kcals from milk (approx 650ml of bm at 75kcals per 100ml) total 615 kcals a day

9-11m need 310 kcals of complementary foods and 376 kcals from milk (approx 500ml of bm at 75kcals per 100ml) total 686 kcals a day.

12-23m need 580 kcals of complementary foods and 314 kcals from milk (approx 420ml of bm at 75kcals per 100ml) total 894 kcals a day.

Full detailshere on page 18. Pleae note that there is different values for industrialised/developed countries and developing countries. I have listed the industrialised/developed countries figures.

Your supply is only going to be lower if you don't feed as much (i.e. swap bf for ff), that's absolutely fine if you want to stop bfing at some point soonish to offer formula but if you want to carry on (WHO guidance is 2y minimum) then why would you not have enough milk?

Have they given a reason why he needs to be overweight? Because if he is normally following a particular line and they want him to be on the next one up that's what they are asking - a bit like you being 9st and your Dr saying 'We like all our asthma patients to be at least 10st if they are your height' even if 9st is a healthy weight for you and your height.

How does your son's weight percentile compare to his height percentile? Are they comparable (i.e. he's not 9th for weight and 91st for height but 25th for weight and 50th for height or what have you...)

Keep going with the expressing, I have a 16w DD and am currently going through a slow weight gain period with her, she has dropped into third percentile. BF counsellor advised me to feed feed feed, and express after she has gone to bed, during her naps etc to increase supply (and give baby an extra feed via bottle). I can only express 1 or 2oz at a time so I feel your stress, but last night I managed 2.5oz so was well chuffed! I find breast/nipple massage before I pump helps, it usually makes my milk 'come in' and I can get a bit off both sides then. But once it stops, leave it for 20 mins or so, then try massage and re-pump. I have an Avent pump, it's the best out of 3 manual pumps I've tried.

I should say they may want him to carry extra weight as it provides a safety net if he is ill and can't eat, or he needs to be at Xkg to have an operation (clutching at straws!).

He has a cardiac problem and so they see slow weight gain as a sign he of struggling with breathing & feeding (sorry not explaining very well).
Thank you for posting about the calories - it was very helpful.
He is on the 9th centile for weight and 75th for height.

Ah, DD3 had bronchiolitis 10 times in her first year (obv. not in the same league as a heart condition) and dropped from 91st at birth to 2nd at about 4m and everyone was fine about the plateau'd weight gain as they said she was burning up extra calories with high heart rate/struggling to breathe. She's 50th for weight and height at 2y though so has sort of regained things

I can sort of understand why they are pushing extra weight gain if there is a bit of discrepancy between height/weight AND he has a heart condition, but surely the best way is to maximise the calories he is getting (assuming he's not on a low fat diet) by giving calorie dense food (BM is one of them) over just extra solids?

Have they referred you to a dietitian for help getting the most out of his food? We didn't get referred and DD3 just went on the Double Cream Diet (at least 600mls a week but more usually 1200mls!) she had double cream porridge with fruit, double cream cheese sauce on her veggies/pasta/rice, double cream/butter/cheese mashed potatoes, greek yogurt with double cream and fruit, etc, etc. It did increase her weight gain between 6m-12m but not more than a centile or so (was surprised given how much fat she had!)

Thanks so much for your advice and support. No referral to dietician but was advised to give cream, cheese etc! I''ll persevere with bf and calorie rich solids, perhaps weigh again in 2 months as I don't have to see the Dr for 3 months.
Glad to see your DD is doing well now.