>
> Do we ever see slow gain in bottle-fed / formula-fed babies when offered
> ample milk? Or is it a phenomenon related to breastfeeding? Has anyone
> ever studied low gain babies to see how much milk they are actually
> transferring? I've always wondered if it is genetic in growth rate, a
> function of milk intake (including limits in available milk), or a
> function
> of infant self-regulation. The latter also brings up questions of reasons
> babies self-regulate at low levels; an example of a pathologic situation
> might be discomfort with feeding experience (reflux, pain, association
> with
> painful experiences, etc)
>
> ~Lisa Marasco
Well, just last year I was working with a mother who was breastfeeding her
baby. He was born at 9 lbs. 6 oz. but gained weight slowly - around 4 ounces
a week. Doctor was concerned. We tried various things to increase milk
intake and supply, including giving the mother domperidone. By four months,
after trying various things including supplementing to no avail, the doctor
convinced the mother to wean to formula. On formula, he gained at almost
exactly the same rate. The mother said he would never finish the bottle -
would stop and actually push the bottle away. Of course, now the baby was on
formula, the doctor stopped worrying about the weight gain and decided it
must just be his natural pattern.
I also have a sister who was bottlefed (the rest of us were breastfed) who
gained slowly on formula. My mother commented as well that she would never
finish the bottle.
With my daughter, I felt it helped that my doctor commented at birth that
she was going to be tiny. Even though she weighed 8 pounds, she clearly had
fine bones, small hands and feet and a "petite build." Today, at age 26, she
wears a size 0. She's not thin-looking, either, but nicely rounded - just
tiny, as she was meant to be.
I certainly had plenty of milk and she had free access to the breast 24/7 -
but I believe she self-regulated to meet her own needs. My doctor reminded
me that weight at birth has no correlation to adult size, but weight at one
year does. So babies like Lisa who may be born larger than average need to
"grow down the chart" to be the appropriate size at one year.
We now are seeing research that shows excessive weight gain in the first few
weeks and months is a significant risk factor for later obesity. If we take
these babies who are meant to gain 4 ounces a week and supplement them so
they gain 6 ounces a week, have we benefitted them? Or have we harmed them,
both by giving them formula with all those inherent risks, and by increasing
their weight gain to a possibly unhealthy (for them) level?
Teresa Pitman
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