Daniel had his four-month check up on Tuesday, and his percentile for weight has dropped. He has gained weight since his last visit, but the rate at which he is gaining has significantly decreased.
Our pediatrician thinks it's because I'm only feeding Daniel on one breast per nursing session. After three months, the regulation of milk production changes from hormonally controlled to being controlled by a supply and demand system. Because of this, his primary theory for the fall in weight percentile is that I'm basically starving my kid by not offering the second breast.
I disagree with him.
Here's why: There hasn't been any appreciable decrease in Daniel's output, nor have I noticed a change in my supply (less fullness or leaking, less yield when I pump each morning). I have noticed that his nursing sessions have gotten shorter, but he also seems to be getting much more efficient at removing milk at a faster rate. The reason I was feeding him on one side only was twofold: to avoid more painful engorgement and to make sure Daniel was getting enough fatty hindmilk. I've been feeding "on demand" since he was born, never refusing to nurse or putting him on a schedule, because nursing on cue has worked great for us, and it's the method that's most widely recommended. (I recently read someone call this feeding philosophy "breast on request" and I think that's more accurate—and much kinder language—than calling it "demand". It also acknowledges the two-way relationship of breastfeeding, as the mother can also request that her baby feeds to relieve discomfort or because she may be leaving for a while.) Another thing is, Daniel has learned to do a lot of new things this month, and learning new things expends extra calories.
Nevertheless, since the doctor suggested this reason for the slower weight gain, I've been offering the second breast at each feeding and offering to nurse more frequently throughout the day (and night). I have not, however, been following his advice on how to do this: switch to the second breast after five minutes on the first, and switch back again after five minutes. I know that's a great way for Daniel to fill up on watery foremilk. I also know that "emptying" a breast completely gives better feedback to the brain to make more milk than does leaving milk behind in each breast by switching back and forth. The more milk is removed at each feeding, the better. What I have been doing is this: I wait until Daniel is finished on the first side, I give him a chance to burp if he needs to and provide a short reprieve from eating, then I offer the second side.
The results thus far: lots of spitting up, and a child who closes his mouth tightly—lips pursed—when he frustratedly refuses to nurse on the second side. There has also been a lot of popping off frequently to look up at me when he's just not that interested in nursing, while the milk sprays everywhere. I've found myself trying to coerce him to nurse, when I know full well that breastfed babies will not eat if they aren't hungry (or thirsty).
When I was talking to my mom about all this yesterday, she reminded me that (of course) I will do anything for this baby. For me, that includes seeking a second opinion and not following advice from a doctor (about feeding for five minutes on each side) when it goes against my better judgment to do so. I have to live with the decisions I make, and I have to live with whatever consequences those decisions have on my child. I wouldn't be able to live with myself if I listened to him when I think he's wrong and it adversely affected Daniel. That's just not something I'm willing to do.
We're going to see a lactation consultant today to get her take on the whole situation. I'm hoping that she can help to educate our pediatrician more about breastfeeding so he can give better advice to other parents. I'm hoping I'll learn some new things, too! I'm hoping that she'll find nothing wrong with my little one. And I'm hoping that my milk really is enough—because I truly believe it is.
I suspect that what's going on here is that Daniel comes from long lines of tall, skinny people on both sides of his family, and he's merely beginning to benefit from these genes at a very early age. I'm the shortest person in my entire extended family on my mom's side (at 5'6") with even my aunts being at least 6' tall. Jaymz is 6'5", and skinny enough that he was denied for the best rate on our life insurance because his BMI is too low.
All I'm sayin' is, odds are in this kid's favor that he's going to be tall and thin, and I really hope that's all this is. Please let me be right about this one.
Any encouragement, words of wisdom, or good vibes you can send our way today would be much appreciated. Thanks.