Growth charts are, however, frequently interpreted poorly. A baby who follows the 10th percentile is growing normally and as he should. Too many people, and surprisingly even some physicians, believe that only babies on the 50th percentile and above are growing normally. This couldn't be more false. Growth charts were developed on information gathered on normal babies. Somebody has to be smaller than 90% of all other babies (on the 10th percentile) -- somebody normal.
9. Lactation aid. If it is decided that supplementing is necessary, the best way to do it, even if you are supplementing with breastmilk, is with a lactation aid at the breast. Our lactation aid is made with a #5 French, 36 inch or 93 cm long feeding tube leading from a bottle of supplement and it is used once the baby has fed only after doing steps #3 and #4 above and the baby has fed on at least both sides. Why is a lactation aid better than a bottle, cup, syringe, or spoon?
10. Solids. If the baby is older than about 3 or 4 months and supplementation appears to be necessary, formula is not necessary and extra calories can be given to the baby as solid foods. Yes, you can give solids to a baby of 3 or 4 months of age. The statement by Health Canada, the Canadian Paediatric Society, the American Academy of Pediatrics, UNICEF, the World Health Organization, and almost all paediatric societies around the world encourage exclusive breastfeeding to about 6 months.
This means that if the baby needs extra calories and is also getting formula he is still not exclusively breastfed. Formula is basically a liquefied solid. But it's not the formula that is the biggest problem. It's the bottle. If the baby gets bottles when the milk flow from the breast has slowed because of a decreased supply, he will figure out pretty quickly where the food comes from and start rejecting the breast.
Bonding is important, but hunger comes first. So formula can be given, but mixed with the baby's solids. This works fine. First solids can include mashed banana, mashed avocado, mashed potato or sweet potato, etc -- as much as the baby will take without forcing.
Note however, that giving the baby solids at 3 or 4 months of age when everything is going well and the baby is gaining well is not recommended. Solids should normally be started when the baby is showing a definite interest in eating solids (usually around 6 months of age, but not always, sometimes this occurs before six months and sometimes after). See the information sheet Starting Solid Foods.
11. Late onset slow weight gain. If your baby was gaining weight well for a few months and no longer is, see the information sheet Slow Weight Gain After Early Good Weight Gain. Reasons for a decreased milk supply are listed there. Fix what interfering factors fit your situation and follow this Protocol
Questions? Get Dr. Jack Newman's book The Ultimate Breastfeeding Book of Answers.
Jack Newman graduated from the University of Toronto medical school as a pediatrician in 1970. He started the first hospital-based breastfeeding clinic in Canada in 1984 at Toronto's Hospital for Sick Children. He has been a consultant with UNICEF for the Baby Friendly Hospital Initiative in Africa, and has published articles on the subject of breastfeeding in Scientific American and several medical journals. Dr. Newman has practiced as a physician in Canada, New Zealand, and South Africa.