On 2/26/2014 3:30 PM, Laura Spitzfaden wrote:
> My question is are the risks of formula greater than the risks of not catching up on the weight gain when the baby is developing normally in every other way, meeting milestones and content? My gut feeling is that supplementation would be best until he is back on the charts but I don't know if this is correct. Maybe starting solids early would be best?

Laura,
Supplementing with the artificial milks would not hurt this kid - 
remember, first and foremost we have to feed the kid. The dyad is used 
to the supplementer, so that would work well.
At the same time, by 5 mo of age she most probably can safely start 
supplementing the kid with the family foods, paying attention to the 
adequate protein intake and to not introducing juices and other drinks.

As an adoption pediatrician, I can assure you that at that age the 
appropriate growth is extremely important. "Normal" milestones is a 
veeery stretchable definition. How would you know that the kid is not 
delayed 2-3 weeks from what he was supposed to do? I am usually saying 
in this situation: "normal" is a setting on your washer.

This mom deserves all the praise and support we can give her, and no 
matter what decision she will make (to supplement or to introduce foods) 
she is doing the best for her baby.
Failure (to thrive) is definitely not an option here.

Alla

-- 
Alla Gordina, MD, IBCLC, FAAP
General Pediatrics
Breastfeeding Medicine
Adoption and Foster Care Medicine

Global Pediatrics and Family Medicine
NJ Breastfeeding Medicine Educational Initiative

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