Tiny Boy had his 9 month well visit on Friday.
Although I like his pediatrician a good deal (she's GREAT with LG) and although I trust her when it comes to sick kids--when to crack out the amoxicillin, say--it turns out our philosophies don't really track when it comes to infant care. Never really occurred to me to interview her when I was pregnant, as she was already our pediatrician (we lived in a different state when LG was a baby).
That is, we have very different views on how to handle my sleepless--and still very tiny--boy.
It appears that Tiny Boy's growth has slowed down. Although he's gained about 1.5 lbs since his six month well visit, it seems he hasn't gained any weight in the last six weeks or so. I'm not entirely convinced that's the case, as when he was last weighed (at a "sick" visit) he was in a (probably) wet cloth diaper, as opposed to nude. But regardless, it certainly isn't a lot. He weighs 15 lbs 14 oz, which puts him somewhere below the 5th percentile.
She thinks upping his intake of solids (which is already a struggle to get in him) and decreasing the number of times he nurses (to 4 times per day!!) would help. But, from what I know, breastmilk has more calories than those squishy veggies, and certainly more fat and protein. Not to mention the fact that the boy has reflux and if he eats too much at a feeding just vomits everything back up.
So I think I'm going to keep doing what I'm doing and trying to give him some extra solid food "snacks," but this certainly does go a long way to explaining the nurse-a-thons that started basically when he got mobile. The kid is HUNGRY.
And as for sleeping? Well, turns out she's a Ferberizer, too. I'm not really troubled by that, given that I'm already CIO and all. But she doesn't think he should nurse at night, from 10-5 am. And, to accommodate that, she thinks his bedtime should be somewhere around 9:00, instead of 6:30 or 7:00, without even adding a third nap. That might work for some kids, but mine can barely make it as late as he is, and generally sleeps close to 12 hrs. Perhaps that would change if he actually believed in naps, but right now he doesn't.
So. That's where we're at. Mostly better at night (though last night SUCKED and I finally let him sleep with me, as I was getting him out of the crib hourly) and still horrid during the day, at least when it comes to sleep. When he's awake and happy, wow, he's suddenly a little boy, not a baby, and certainly great fun to have around.
Although I like his pediatrician a good deal (she's GREAT with LG) and although I trust her when it comes to sick kids--when to crack out the amoxicillin, say--it turns out our philosophies don't really track when it comes to infant care. Never really occurred to me to interview her when I was pregnant, as she was already our pediatrician (we lived in a different state when LG was a baby).
That is, we have very different views on how to handle my sleepless--and still very tiny--boy.
It appears that Tiny Boy's growth has slowed down. Although he's gained about 1.5 lbs since his six month well visit, it seems he hasn't gained any weight in the last six weeks or so. I'm not entirely convinced that's the case, as when he was last weighed (at a "sick" visit) he was in a (probably) wet cloth diaper, as opposed to nude. But regardless, it certainly isn't a lot. He weighs 15 lbs 14 oz, which puts him somewhere below the 5th percentile.
She thinks upping his intake of solids (which is already a struggle to get in him) and decreasing the number of times he nurses (to 4 times per day!!) would help. But, from what I know, breastmilk has more calories than those squishy veggies, and certainly more fat and protein. Not to mention the fact that the boy has reflux and if he eats too much at a feeding just vomits everything back up.
So I think I'm going to keep doing what I'm doing and trying to give him some extra solid food "snacks," but this certainly does go a long way to explaining the nurse-a-thons that started basically when he got mobile. The kid is HUNGRY.
And as for sleeping? Well, turns out she's a Ferberizer, too. I'm not really troubled by that, given that I'm already CIO and all. But she doesn't think he should nurse at night, from 10-5 am. And, to accommodate that, she thinks his bedtime should be somewhere around 9:00, instead of 6:30 or 7:00, without even adding a third nap. That might work for some kids, but mine can barely make it as late as he is, and generally sleeps close to 12 hrs. Perhaps that would change if he actually believed in naps, but right now he doesn't.
So. That's where we're at. Mostly better at night (though last night SUCKED and I finally let him sleep with me, as I was getting him out of the crib hourly) and still horrid during the day, at least when it comes to sleep. When he's awake and happy, wow, he's suddenly a little boy, not a baby, and certainly great fun to have around.
"She thinks upping his intake of solids (which is already a struggle to get in him) and decreasing the number of times he nurses (to 4 times per day!!) would help. "
ReplyDeleteYes, this is the opposite of correct from everything I've read... and a red flag.
My DC1 was very active and thus pretty low weight percentile. We nursed on demand and kept a little tray of non-chokeable finger foods out for him to snack on as he cruised by. We were also encouraged to set aside time for nursing in a dark and very boring room so DC1 could focus on eating. He was still low %ile, but all muscle and totally healthy. Since he wasn't being denied food nobody was worried. Now that he's older it is amazing how he stops eating when he's no longer hungry, even if he's eating sweets. He really listens to his hunger.
Yup.
ReplyDeleteThe boring room idea is a good one, as he's totally distracted when folks are around.
I'm going to pay more attention to his nighwaking to see if it's worse on days he doesn't nurse as much...
I was chided for my obsessive weight checks to estimate volume. But, when you have a slow gainer, damn. I wish I had tips short of blending twinkies, but I got nothing. I can't even get my girl to take down a full feeding from my right boob these days. I would be up all night nursing if she'd do that, but no.
ReplyDeleteNothing like being told you are sorta starving your baby and that to remedy this, you should starve your baby. Nice! I wonder if people think those thoughts through.
Exactly.
ReplyDeleteYeah increasing his solids makes very little sense... Also remember that these growth curves are based on the average of mostly formula fed infants and the growth curve for breastfed babies is different (faster in the beginning and then slower later on). I've read somewhere (but forgot where) that by one year babies should get 25% of their energy intake from solids and still 75% from milk. If he's pooping and peeing and active then I wouldn't worry too much and just slowly introduce more solids after you've breastfed him.
ReplyDeleteErrrr... yeah. Time to ignore her. A friend of mine is a neonatologist and when she had a baby, she told her ped she didn't want any childrearing advice from him at all. She trusts him when it comes to sick kids, but has no interest in hearing about things that are just opinions. Turns out this is much of pediatrics. Outdated, ill-informed, unscientific OPINION.
ReplyDeleteThe pushing solids, nursing less = madness. Oh, and so is the NINE O'CLOCK BEDTIME. Dude, dude, dude.
Do you think you'd be as concerned by his %ile if it weren't for the IUGR? Is there any reason to think he's not healthy? It doesn't sound like it. It sound like he's a small kid. I'm not suggesting you shouldn't worry, but rather hoping that reassurance that he's doing fine (the peeing, pooping, active of above) might allow you to worry less.
Bunny, you know...now that you put it that way, I'm NOT really worried. I nurse on demand (probably in the vicinity of 8-10 times day/total) and offer him three "meals" per day of solids. The IUGR thing...well, that was my body fucking up, as evidenced by the fact that he GREW as expected once delivered.
ReplyDeleteSo, yeah, he's a small but healthy kid. Smaller probably than he "should" be genetically because he was growth restricted in utero but clearly he was never intended to be huge either.
But this tells me that he's nursing at night at least in part for a reason so need to strike a balance between making sure he has access to the boobs and I'm able to get some sleep...
Just curious: what was/would be the doctor's response if you told her exactly what you told us -- that your understanding is that breast milk has more calories/fat than the food that he eats and that he can't keep down large amounts of food anyway?
ReplyDeleteBecause what you're saying seems to make a lot of sense and I'm not seeing why she wouldn't agree.
Not that there's anything wrong with disagreeing with the doctor --I'm just trying to understand what her reasoning is.
Also, probably you're right that TB is just meant to be small.
But, for what it's worth, I thought the doctors were being waaay over-concerned about my IUGR/slow-growing baby.
I'm small, his dad is small. I figured that he was just going to be small.
Turns out there *was* a physical issue (fortunately one that was easy to fix) and, 20 years, later, my below-the-5th-percentile baby is a slightly-above-the-50th-percentile college student.
Niobe, it's weird. I went in to the conversation wanting to talk about actual medical issues (like, should he have a sleep study) and all that got derailed and she ended up giving me a ton of unsolicited advice.
ReplyDeleteWhat's strange, of course, is that I basically told my RE all the time what I wanted to do...
Ugh, pediatricians! We've decided to smile and nod then ignore all sleep and food advice from our ped (who casually told us at 4 months to start CIO at 6 if she wasn't sleeping through the night yet - hahaha!). But it is frustrating to figure this out. Does TB eat dairy? Because Goldie will only eat small amounts of most things we give her but, for some reason, LOVES popsicles (chopped into smaller bits to avoid a full body mess). We freeze whole milk yogurt with banana and berries and it's definitely the most calorie dense thing she eats. She wants every last bite and she once ate two in a day when our babysitter gave her one after she'd had one for breakfast. All other food gets a nibble.
ReplyDeleteBut you're certainly right that breastmilk has more calories than a jar of veggies.
I'm glad sleep is inching towards better.
Just to jump in, from my understanding, the earlier you put a child to bed, the longer he or she will sleep. My LO has always (since 6 months or so) gone down at 7 and slept between 10 and 13 hours....when I was breastfeeding, there would sometimes be wake ups for feeds (until I stopped the night feeds). A later bedtime is not your solution. I have never asked my doctor any child rearing questions. I have mostly followed my own intuition with my LO, or read books and adapted to fit my needs. Good luck!
ReplyDeleteAlso, you could probably start whole yogurt now - 6% by Astro is good - I would put in pureed fruit or mashed banana or even mashed avocado (high calories). The 6% yogurt with the avocado may increase some of the weight without you compensating the way you breastfeed - don't change your feeds!