Breastmilk, formula or cows' milk?

[frogs]

I'd really appreciate some input from the feeding experts here -- mears and tiktok, are you around?

My 8-month old dd2 is very small for her age (below 9th centile). This is despite being 9lb 5oz at birth, and having two 6-foot parents (and two older siblings who followed the 90th centile all the way up, like good little porkers).

I'm not overly worried, as she seems fine and isn't particularly skinny, but the paediatricians are getting a little bit twitchy, and sending her off for blood tests to exclude serious problems. In the meantime we are obviously trying to make sure that she takes in as many calories as she can.

For food like weetabix, rice pudding, ready brek etc, is it best to use full-fat cows' milk, or formula? And in terms of topping her up with extra milk feeds during the day, is there a likely to be an advantage to reintroducing extra breastfeeds, or would a bottle of formula do as well/better? I'm still doing three bfeeds a day, and I'm not thrilled at the idea of going back to doing more, but I would if it was likely to make a big difference.

She's not a very big eater, but she gets through a reasonable range of solid foods spread over three meals a day, and can cope with lumps and finger foods too.

TIA

There is very little calorie difference between breastmilk and formula (formula is made to be as similar to breastmilk as possible) If anything breastmilk has slightly more calories but it's very marginal. I would give formula to a small 8month old rather than cows milk as it is more nutritious. I'm no expert but from what you say she seems to be eating fine and getting enough calories, but is just small, as opposed to thin. It must be a worrying time for you though and I'm sorry. Hope you get good results from the blood tests.

I bet she's fine, too, frogs....but having said that, if you don't want to give her more breastmilk (which is a handy way of getting more calories into her with no preparation from you!), then she can have more calorie-dense solids. You can think about avocado, banana, adding a dollop of butter or cream to whatever she is having (though not everyone would think that is a good idea, I know, but as a temporary measure in a non-allergic baby, I can't see the problem myself). Formula and breastmilk and cows milk are more or less the same in terms of calories, but you do get more iron in formula than cows milk, so this might influence your decision on what to put on cereal.

It's good she can cope with finger foods. It means she can have extra snacks like crusts or rice cakes.

Had really interesting conversation with a 'fat' scentist on tuesday. (He studies fat and is acutally quite slim). Apparently breast milk contains a much higher fat content than cows. So boobies are still best in terms of fatness. My dd also dropped a few percentiles and it is hard not to worry but she also looks totally fine. Hope this helps.

And cake! And ice-cream! These are very good for putting on weight, as I know to my cost. Fat is very good for babies, as our brains are made of fat. Agree with Tiktok about butter and cream on food too.

I'd say that boobies are best too, but if you don't want to give her extra bf would you be prepared to express some milk to use on her cereals, rice puddings and so on?

Pesme, your boffin pal is correct - fat in formula is 3.6g per 100 ml (this is just one brand but most are about the same) and breastmilk is 4.2g per 100 ml (though calorie wise they are more or less the same). That's about 20 per cent higher, yes?

I had to look this up, by the way. I didn't know it in my head!

Don't get too het up about percentiles, Frogs. Forget the family & siblings' history & ask yourself, "Is this a happy growing fine contented baby"?

I have 2 kids below 9th %tile for weight, worse, one is around 2%tile for height. Meanwhile, I am 5'8" and DH and all the near male relatives are close to or over 6'. Then I have a baby who is 50th percentile for weight, & 99th percentile for length!

Frogs, I had a discussion with ds's (dairy intolerant) dietician regarding how to get a baby to gain weight. In dairy allergic babies the recommendation is to add a teaspoon of olive oil or any oil to every savoury meal and use lots of it in cooking and to eat lots of avocados, bananas, mangoes, houmus type things. She said that for non-allergic babies they recommend adding cream and/or butter to every savoury or appropriate meal and using these in cooking and consuming plenty of cheese and yoghurts, full-fat versions. She also said that babies don't have the same issues as adults with regard to fat intake and cholesterol etc so no problems are stored up for the future. Another thing that is done, though only under the guidance of a dietician, is to increase the concentration of formula so more scoops per oz of water. If your dd is OK with dairy then I would give lots of yoghurts, cheese sauce that kind of thing in addition to what you are already doing. My ds loves avocado and banana mashed together. HTH

Before the grammar police say anything it is ds who is dairy intolerant not his dietician

Thanks, guys!

I've decided to use formula in her solids instead of ordinary milk, at least until the blood test results confirm (as I'm sure they will) that she's not anaemic. I know I could be expressing, but at nearly 9 months I've used up all the frozen EBM stores, and feel that my days in the milking parlour are over.

I'm gently upping the calorie content of her solid foods, but she's small overall, with dinky little hands and feet, rather than just skinny, so I'm not going overboard. We're aiming for overall growth rather than turning her into a diddy little butterball.

Since I'm a formula virgin, I'd be grateful to hear whether people feel that organic formula is worth the extra cost.

Hello frogs. I gave ds formula from 6 months. I tried Hipp organic (the only organic one that was available then, 2 years ago) & it really didn't agree with him, made him quite sick. The same thing happened to a number of other babies we know. I ended up using Aptamil very succesfully. I think it was slightly more expensive, but only a matter of a few pence.

Oh, and having seen your dd2 last week, she is entirely adorable (as are the others).

Just wanted to add that I wish I had been mn'ing when my ds was sinking to below 5th centile at 6 months, (from 8lb 14oz at birth) as it was stressful! As with your dd frogs, I always felt he was fine, as he was always happy and energetic, but he was v skinny.

It's lovely to see such supportive advice... We had a few tests too (they wrote down the reason on his notes as 'failure to thrive' - made me think 'failure as a bf mum' more like) but found nothing wrong. I think he was never really a milky baby... he's nearly 4 now and growing fine

But some of the advice on this thread would have helped back then - keep it up, and I hope your dd enjoys her yummy extra cals frogs!