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Should I start solids or increase milk supply?

This month my 4 month old baby gained only 390 gr. and the doctor said to supplement 3 times a day with cereal, yogurt and fruit. She weighs 6100 gr. in total.

I don't want to start the solids, so I am supplementing her with my stored milk from freezer three times a day about 2 oz. each. My milk supply when I express is about 2, 5-3 oz. from both breasts 3 hours after feeding the baby. I think it is very low.

Rita Madden | Other Provider

Rita Madden

I understand your concern with what to supplement and how. I hope I can help with your situation based on what you have written.  Let these three breastfeeding "rules" help you:

Rule 1:  Feed the baby.

Rule 2:  Protect the milk supply.

Rule 3:  Fix the breastfeeding.

"Feed the baby."  You say your 4 month old baby gained only 390 grams. Is that since her 2 month visit? Is that since last month? On average, babies should gain 4-7 ounces in a week or 120-210 grams in a week. If she gained 390 grams in the past month, then her weight gain sounds slow, but steady and supplementing with your pumped milk sounds appropriate provided you recheck her weight in 1 week with the pediatrician's office. 

"Protect the milk supply.  Fix the breastfeeding."  If the flow is fast from the bottle to the point that she doesn't have the patience to nurse well and completely, your supply might dwindle. You have a few options that your lactation consultant can help with.

1. Supplement at the breast using a supplemental nursing system. This way she gets her supplement and nurses with you all at the same time. It will increase breast stimulation, increase effective breastfeeding and increase your supply. This is the best option and will only be necessary until she nurses more effectively and you can wean her from the supplement while she still gains weight. Use the teamwork of your pediatrician and lactation consultant.

2. Pace the bottle feedings. This option is okay but does nothing to improve breastfeeding.

3. Elicit your let-down before she latches so your milk is flowing immediately when she latches. This option is okay, but may not help her gain weight as fast as you and your doctor would like.

Pumping 2.5 to 3 ounces every 3 hours is on the low side of normal, but not "very, very low."  Starting solids this soon with breastfeeding going fairly well will "feed the baby" but not help with the other two "rules" at all. I encourage you to get in contact with your lactation consultant for help with setting up the at-breast supplementer.

Your desire to give your baby the very best nutrition is encouraging.  I am rooting for you!!

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