Not so good 2 month appointment :( (x-post)

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DunyaWolf's picture
Joined: 07/25/08
Posts: 223
Not so good 2 month appointment :( (x-post)

So, Rowan had his 2 month appointment yesterday, and it wasn't so good. Mainly, because he hasn't gained very much weight :/ He weighs 9 lb 2 oz and is 22 1/4 inch long, and that's up from 8 lbs 4 oz and 21 1/4 inches 1 month ago. He was 6 lbs 13 oz and 19 inches when he was born- so he started off gaining well, but for some reason in the last month its dropped off. He dropped to the 4th percentile. He's been EBF on demand, so of course I feel like a failure. I'm doing everything the same as I did with Kieran, but Kieran grew like a weed as a baby so I don't know what is going on with Rowan. Part of it might just be that Rowan is going to be smaller than Kieran- Kieran was bigger at birth and has always been in higher percentiles for everything and I think he gets that from his dad because DH is tall. I am petite and Rowan seems to have gotten more traits from me. But, I'm still worried about his slow weight gain and the doctor was concerned too. I'm thinking supply issues right now- I started worrying about my milk supply when he started sleeping longer stretches at night- he sometimes goes 6-8 hours. He's only done 8 hours a handful of times though and usually wakes up at least once. I have always read/been told that it is fine to let them sleep long stretches as long as they are gaining well, and as of a month ago he was. But I think maybe my milk supply can't handle it, so I'm doing all I can now to help increase it including getting into contact with an LC.

In addition to finding out about his weight, the doctor we got was a total **** bag!! He was not the doctor we usually see at this practice; I think he's new, I've never seen him there before. I don't know why we didn't get our usual doc because she was there. Anyway, everything about this guy creeped me out. From the moment he walked in the room my hair stood on end, I can't explain it and I might be overreacting, but he really gave me chills and I did not want him touching my baby. He was also an asshole. The first thing he does when he walks into the room is question/lecture me for at least 5 minutes about delaying the hep b vaccine. His whole tone of voice was very condescending and patronizing. He told me that I had to sign a form because we're not getting it yet and that it creates unnecessary paperwork for him, in addition he told me to not listen to "kooky websites." We didn't get the hep b vax at birth because they don't do it at the birth center, and then I just decided to hold off on it because it would be one less thing to put into his system right now, and he's really not at high risk for it or anything. I didn't feel like explaining myself to this guy though so I just nodded. I've also already talked to "our" doctor about it and she said it was fine and that we could even do a delayed vax schedule if we wanted. Then the whole time he kept making little snide comments, regarding Rowan's weight he said that I should have been waking him up every 4 hours at night and that they should have told me that in the hospital... etc etc. ALSO, he came dangerously close to pulling back Rowan's foreskin (he is not circ'd)! I don't even know why he was poking around in there, and I had my mouth open to say something but he stopped so thankfully he didn't try to actually pull it back (it didn't bother Rowan either) but OMG. I am making sure to request from now on to only see our regular doc!!

marymoonu's picture
Joined: 03/15/08
Posts: 2183

Ick... What a nightmare. Does Rowan seem satisfied as far as hunger goes? I'm assuming he's not feeling hunger if he's sleeping those long stretches...? I would just assume if you were having supply issues, he'd be fussy during and after feedings and wanting to eat more frequently. I'd give it 2-4 weeks and have him weighed again to see what his rate of growth is. He won't let himself starve... If he's hungry, he'll let you know!

In the meantime, don't see that doc again ever. Your mama radar went off for a reason!

April777's picture
Joined: 10/01/08
Posts: 579

How far did he drop in %iles from birth, out of curiosity?

If it were me, I'd think I'd speak first with a LC to see what she suggests. I hate the idea of waking him but if he's dropping a lot in %iles it may be a good idea.

From someone who has had a small baby, it's scary and frustrating. But he may just be petite. i think following up with your regular doctor is probably a good idea. I'd avoid that new doctor if at all possible.

The general rule of thumb from my doctor is that small babies are just fine. You want to look for drastic reductions in %iles. But she did say that %iles will often times go up and down within a 10%ile range for BF babies.

Good luck hon. Don't despair. I'm sure things are ok.

babyJtime's picture
Joined: 05/23/05
Posts: 682

I commented lots of FB but wanted to let you know here that the doctor was not at all appropriate. I'm sure that if you saw the other doctor, she would have said the same thing but in a good way and you wouldn't be feeling so bad!

I agree with April, see if you can see a LC and see if they have any suggestions for you!

And yep, there are just smaller babies out there too. I have two small babies. Jeena started out at 7 lbs 8 oz and now at 5 years old is 32 lbs. That's just how it happened, nothing that I did or didn't do could have changed that! Smile

Hugs Mama, you're doing a good job!

DunyaWolf's picture
Joined: 07/25/08
Posts: 223

Thank you. To clarify, the reason I think the doc is a jerk wasn't because he was concerned about Rowan's weigh gain- because I was too and would have asked him about it anyway. It was just the way he came across, the lecturing about the hep b, everything else. I spoke to a lactation consultant who didn't think his weight gain was necessarily a problem; she is going to come weigh him next week so maybe we can get an idea of how he is doing. But I am really pretty sure it is a supply problem Sad Yesterday evening he was really fussy; I had fed him recently and just pumped (I've been trying to pump in between feedings... can't always get to it, but dammit I'm making it a priority!). I had 4 oz in the fridge that I had managed to pump that day and decided to give it to him... well he sucked it down :/ I've been attributing his fussiness to other things like gas, possible reflux, dairy sensitivities but now I wonder how much of it is because my milk supply is low Sad I feel terrible not thinking of this sooner. I've started taking fenugreek, I'm pumping as often as I can in between feedings, and making sure he nurses at night (he has only slept through completely a handful of times and usually wakes up at least once; last night it was twice).

But I'm really frustrated with this. Today I broke down and gave him a bottle of formula. I had pumped recently and knew I didn't have enough for him, but he was really crying and I didn't want to listen to him be hungry anymore. He sucked that right down to, then promptly fell asleep.

April777's picture
Joined: 10/01/08
Posts: 579

Jessica, don't be hard on yourself. Supply issues are a total b!tch to deal with. I've dealt with them a lot! The fenugreek will help a bunch. Try eating a bowl or two of oatmeal every day too, that will also help. You're doing all the right things. Your supply will probably rebound. Try to hang in there. You're doing a great job!

AimeeLynne's picture
Joined: 09/29/08
Posts: 572

Don't get down on yourself, you're doing a great job with him. :bigarmhug: The whole pumping in between feedings was so hard for me too! If your supply is low, a bottle of formula a day is still okay. Also I heard a beer helps with supply issues!! Miles was a tiny baby (5lb10oz), still is (only 21lbs). He would go all night w/o waking up and my doc said its fine because he is slowly gaining weight, and healthy! He's still in like the 10% for weight. We call him a lolly pop (skinny body with a big ole head).

Oh and next time make sure they don't schedule you with that A**Hat! When I read that on FB I wanted to punch him in the face! Biggrin

harmonybear's picture
Joined: 06/06/07
Posts: 639

I wanted to add that if it is a supply problem (and it sounds like you think it is), assuming Rowan doesn't have a bad latch you really should be having him nurse to increase supply rather than pumping. If he has tongue-tie or something like that, he won't be able to get milk well and giving him a bottle of pumped milk should help in the short term, but if his latch is good you will get the best stimulation (which increases supply) from baby.

I'm a huge fan of SNSs for women with low supplies - baby nurses at the breast, but receives either pumped BM or formula when your milk runs dry. This way baby is getting enough food AND your nipples are being stimulated to produce more milk. Rather than giving him a bottle and using an inferior pump to 1) extract less milk than you actually have and 2) not stimulate you to produce as much as the baby would.

I'm not saying don't pump. Pumping while he's sleeping would help, and it would give you milk to feed him when you're using the SNS (if you can find one). But here's what happens when you use the pump *instead* of nursing Rowan when he's awake: the pump empties maybe 50-75% of the milk that a normal infant would. That tells your body that Rowan only needed 50-75% of the milk he would have swallowed at that session, so next time your body makes less. That works against your supply rather than with it.

And if you knew all of this before and are already using the pump in a beneficial way, just ignore all of this. You're doing a good job, it'll all be fixed eventually!

JackieJ1's picture
Joined: 02/18/09
Posts: 24

:bigarmhug: Jess

I pumped and towards the end when my supply was fading I added whatever breastmilk I had to the formula. She got at least some of the nutrients breastmilk provided until she was on formula full-time.

Don't beat yourself up Jess. You're a great mom and you're doing everything you can!

As far as the Doctor, I said it on facebook and I'll say it again RateYourMD.com! Let everyone know how he made you feel. I know my doctor goes on that site to check out what people are saying about him or his staff so maybe ****bag will too and give himself an attitude adjustment!

ekcanada's picture
Joined: 05/06/09
Posts: 1707

I have been delaying responding to this because it upsets me. And my response today will seem all over the place...

The fact that Rowan is gaining (albit slowly) doesn't mean he is not doing well. I think as nursing mothers we always are worried about our supply (and I do trust in Mom's instinct so if you are feeling you have supply issues, good for you for seeking the help of an LC - I did and it helped). I also think of how tiny you are. Do you remember if you gained quickly at birth?

The stupid doctor was just adding to your worries which also bothers me. You have struggled with Rowan from the beginning (he is a fussy baby right?). I hope you complain about the douche bag!

Has your doctor been watching you carefully? I am wondering if you are experiencing a bit more than baby blues...

Take care girl!

DunyaWolf's picture
Joined: 07/25/08
Posts: 223

April- I realized I didn't answer your question. I just found the paper they wrote it on last time... it looks like at 1 month when he was 8 lbs 4 oz, he was in the 15th percentile... and now he is in the 4th Sad Seems like a pretty big drop to me..

Harmony- I know the number one thing I should be doing is nursing him as often as possible, and I have been, I just was thinking it would help to pump in between both to tell my body to make even more and to have some to supplement with if needed. I don't MIND giving him formula, but I just feel like if I'm making it I should try to use that. But, thanks for the reminder that nursing is best and pumps are second. I really HATE pumping, lol. I hated it with Kieran and I hate it even more now, when its even harder to squeeze it in because I have to make sure the baby is asleep or at least content being put down, AND I have to hope I'm not pumping too close to the time he will want to eat again. Its just hard to coordinate all around. Maybe I will lay off the pump a bit unless he is sleeping and just focus on nursing, nursing, nursing.

Erin- the midwives were really good about asking how I have been doing at all my appointments. The truth is I probably would benefit from some kind of counseling or therapy and I would look into it for sure. But, I'm really stuck when it comes to that. For one, I am not sure I have insurance. I was on medical assistance when I had Rowan, but they only cover you for the "post partum period" which is something like 2 months after you have the baby. So knowing I wouldn't have insurance for long, I felt like it was useless to pursue that knowing I'd only be able to get it for a short time, and I certainly can't pay out of pocket. The other issue is finding someone to watch the kids when I have appointments. My only options are my mom, my sister and MIL. My mom is too busy and too unreliable (I love her, but she's a serious flake when it comes to committing to things, and she works and takes care of my younger bro and sis too). My sister has her own baby and it would probably be too much for her to watch all three of them, at least while Rowan is a newborn. MIL is both reliable and will willingly watch them, but I don't want to have to explain to her what I am doing. She's a good hearted person, but she is also very judgmental and gossipy. I can't tell you how many times she's told me stories about another family member or a friend that involves what was probably supposed to be confidential information. I think she is also one of those kinds of people who doesn't "believe in" mental illness and I'm just more comfortable not going there with her.

woelfelyojo6's picture
Joined: 01/15/09
Posts: 52

"DunyaWolf" wrote:

Thank you. To clarify, the reason I think the doc is a jerk wasn't because he was concerned about Rowan's weigh gain- because I was too and would have asked him about it anyway. It was just the way he came across, the lecturing about the hep b, everything else. I spoke to a lactation consultant who didn't think his weight gain was necessarily a problem; she is going to come weigh him next week so maybe we can get an idea of how he is doing. But I am really pretty sure it is a supply problem Sad Yesterday evening he was really fussy; I had fed him recently and just pumped (I've been trying to pump in between feedings... can't always get to it, but dammit I'm making it a priority!). I had 4 oz in the fridge that I had managed to pump that day and decided to give it to him... well he sucked it down :/ I've been attributing his fussiness to other things like gas, possible reflux, dairy sensitivities but now I wonder how much of it is because my milk supply is low Sad I feel terrible not thinking of this sooner. I've started taking fenugreek, I'm pumping as often as I can in between feedings, and making sure he nurses at night (he has only slept through completely a handful of times and usually wakes up at least once; last night it was twice). But I'm really frustrated with this. Today I broke down and gave him a bottle of formula. I had pumped recently and knew I didn't have enough for him, but he was really crying and I didn't want to listen to him be hungry anymore. He sucked that right down to, then promptly fell asleep.

During the first 3 weeks of BFing Eloise I would have to supplement with a 2oz or 4 oz bottle b/c of supply issues once every other night or so. She would cluster feed and fuss and fuss in the evenings. I thought it was colic until DH made her a bottle one night to let me rest and she sucked it down after eating for almost 2 hrs straight. To be honest, a couple of times I did it b/c I was so sore I could not stand to latch her on again. She has not had formula in 2 weeks because it seems to have worked out - but I did not feel guilty for giving her formula. It did not confuse her, it satisfied her and in the whole scope of things its really not a big deal (I threw up the first time I had to give Liam formula b/c I was so upset about it - thank God the 2nd time around is more laid back)

You are doing everything right! Go with your instincts and hopefully Rowan keeps on growing for you. It sounds like he is just going to be petite like you. They made a huge deal about my niece and my SIL did both BFing and formula for 3 months-right around 2.5 months to help her daughter gain weight per the doctors request, she eventually went straight over to formula...now that Morgan is 2 the doctor said, "oh well, I guess she is going to be petite like your husband"...my SIL was SO angry...they upset her to the end of the Earth and back and made her feel useless b/c of her supply and her daughter being so small...

anyway...I am exhaustion babbling!