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Date: | Sat, 7 Oct 2006 11:52:42 -0600 |
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>I had a mother call me this week who I am seeing on Monday who just had
>
>her 6 month check and the baby only gained 1 pound since then. In spekain
>g
>with her, she feeds him only 4 times per day because he naps for long
>stretches and sleeps through the night. He began cereal 2 weeks ago and
>
>Emily Lindsey, BSPsy, CLE
>Private Practice
>Merced, CA
I think you can definitely make a case for increasing the
breastfeeding here! Four feedings per day is not enough for a 4-6
month old (I assume the previous well-baby check was at 4 months).
Does the baby use a pacifier as well? The mother must have a fairly
large storage capacity for the 4 feedings/day to have resulted in
even 1 lb of weight gain. Perhaps there is an oversupply/OAMER issue
that discouraged this couplet from more frequent feedings.
A mother I know stopped breastfeeding at 6.5 months after her baby
(fifth child, all breastfed) did not gain *any* weight from 4 to 6
months. At the 6-month checkup the mother was devastated to learn
she had been underfeeding her baby. The MD recommended that the
mother drink a gallon of water per day and eat more (mom was slender
& had been dieting) but did not suggest increasing the breastfeeding.
SIGH. I didn't hear about all this until after weaning was complete
so it was too late to offer my observations -- which were that the
mother often ignored feeding cues, held the baby off with a pacifier,
and was nursing only about 4 times in 24 hours. This baby spent a
lot of time in a carseat/carrier, swing, exersaucer, etc -- not being
held or carried. The mother was simply very busy with the activities
of the older children and the baby had a complacent personality. So
this fifth child of a successful breastfeeding mother ended up having
the shortest period of breastfeeding.
Perhaps you can suggest working intensively on the breastfeeding and
returning for a weight check in two weeks. The AAP statement
recommends about 8 feedings per 24 hours for babies past the newborn
stage. In my observation & experience, 6-8 nursings/day is pretty
average after the baby is eating complementary foods. The AAP also
notes, "Introduction of complementary feedings before 6 months of age
generally does not increase total caloric intake or rate of growth
and only substitutes foods that lack the protective components of
human milk." This is a good argument for working on the
breastfeeding instead of just feeding more solids (even though this
baby is now older than 6 months, breastmilk is still more nutritious
than solids).
Margaret
LLLL
Longmont, CO
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