Our culture is supremely concerned with weight. Overweight men and women are made to believe they are ugly, weak and good-for-nothing. I had a taste of the other side of the coin, when Shira's pediatrician decided that since she isn't gaining weight at the expected rate, we must supplement with formula.
Shira, indeed, has been gaining weight very slowly after her first month. However, we didn't see anything unusual in her behavior, and she was definitely growing in length and outgrowing all her clothes so I thought we're fine.
I always breastfed on demand and never gave any bottles and/or pacifiers. Thinking back, I probably had a dip in my milk supply after Shira started sleeping through the night at 2 months. We never pushed sleeping through the night by methods such as letting her cry, introducing a pacifier when she wanted to nurse, or any other way, but we let it be. Now I think it was way too early for her to night-wean, but I was so tired back then that I just took every bit of sleep I could have. Setting the alarm clock and waking up in the dead of night while my baby was sleeping peacefully and I could be sleeping too was simply too much for me at the time.
Another concern of mine was that I've read a breastfeeding mother must keep on at least a small, minimal "cushion" of extra weight in order to maintain an abundant milk supply. As much as I tried, I just kept losing weight. I was living the dream: when Shira was two months old, I had lost all my baby weight and had a little one who was sleeping through the night. But I would gladly go a size up and be awake five times a night, if necessary, to ensure my baby's well-being.
I asked the pediatrician if night weaning was what might have caused a dip in my milk supply but it was obvious she couldn't care less. She told me that she was only able to nurse her son for 10 weeks and that was it - for some women, milk "just dries up" and we're endangering our child if we won't supplement with formula. Of course, from numerous examples I saw, I knew that supplementing can very soon become a substitute for breastfeeding. Shira is so young and I so hoped to nurse for at least a year!
The pediatrician classified Shira as FTT, which made me feel terrible. I, as you know, was firmly set on exclusive breastfeeding and decided to give it my best - and perhaps last - shot. I started offering the breast even when Shira wasn't showing signs of hunger. I nursed her for comfort and nursed her to sleep. I tried breast compression. I started taking fenugreek. I tried pumping between feedings but it was so slow and frustrating that I thought it makes more sense to just nurse often, especially since Shira has no problem to nurse.
Other than her weight, Shira always seemed to be a happy baby - she's calm, alert, active, playful, smiley, giggly and is developing very well for her age. She has never been ill so far. She makes plenty of wet diapers. She grabs things, plays with toys and started rolling over freely at 4 months. Her blood work and urine came back just fine. Everyone who has been around her notices what a very sociable, communicative, company-loving baby she is.
I nursed and nursed and nursed, nearly all day, for as long as she would take the breast and at our next appointment the pediatrician was pretty happy with her weight gain, but then we had a "control feeding" (weighed her before and after feeding) and she gained only 20 gr (less than an ounce). I did feel she just nibbled through that feeding, but the pediatrician told us we must supplement with formula and to come back every day to check Shira's weight. They wanted to give her a bottle of formula right then and there, to make sure I know how to do that, but thankfully, they had no samples on hand.
After that appointment I went home and cried my eyes out, and then called the local La Leche League hotline. The lady who answered my call told me that I don't need to be worried about that one unsuccessful feeding, because breasts aren't bottles that refill at exactly the same rate at all times, and perhaps my baby takes just a few big meals during the day and the rest is "snacks" and it's normal. She also told me that since both my husband and I are tall and lean, it's natural that our baby tends to have the same constitution, and that we have to remember breastfed babies don't grow as fast as formula-fed at this age, and also that it's pointless to check baby's weight every day because it just leads to fretfulness. She told us that even early introduction of solids doesn't undermine breastfeeding like supplementing with formula and so we should avoid it if at all possible. And that I should just keep doing what I have been doing - nurse, nurse and nurse.
I also asked counsel from a couple of friends who are/were breastfeeding mothers, and am so grateful for them sharing their experience, specifically with slow weight gain which later resulted in perfectly healthy, normal children (without having to switch to, or supplement with formula). I also read several breastfeeding stories such as this one, which confirmed my belief that it's possible for babies to be misfits concerning growth charts, and still be following their own version of normal. Yes, it's very cute when a baby has big round cheeks and chubby legs, but it doesn't mean that lean babies cannot be just as healthy and well-developed.
My mother instinct told me my baby is fine and healthy, but we were under so much pressure. Everyone in the family told us how thin Shira looks. My mother kept comparing her to her friend's grandbaby (who is formula fed and doubled his weight by 2 months). Of course we weren't going to give her formula because of what others think, but we were seriously concerned. I've been feeling so terrible about Shira's poor weight gain, almost as though I'm a failure as a mother, to the point of not wanting to see anyone because I'm afraid people will ask me about her weight or point out how small for her age she is.
We decided to forgo obsessive weight check-ups, trust the Lord (while closely observing our daughter for any signs of distress, malnutrition, or dehydration), and simply nurse often. A couple of days later, I rejoiced when Shira woke up to nurse earlier in the morning than she was used to. Every other day, she started waking in the middle of the night to nurse, too. Some parenting books might have warned me about messing up good, convenient sleeping and feeding patterns, but I couldn't care less. I didn't care about sleep deprivation, not getting things done around the house, or not having enough "me" time. All I wanted was to give my baby the best possible nutrition. I trusted my body. I knew I could make milk, and therefore, even if there's a problem it can probably be resolved. I didn't believe what the pediatrician said - that I simply cannot make enough milk and I should just give up. Over the next days, both my husband and I prayed that my milk would be enough and plenty to provide for all Shira's nutritional needs.
I don't want it to sound as though we dismissed the pediatrician's concerns, but I must say I wasn't impressed by her attitude towards breastfeeding. Milk production is a bodily function like any other, not some sort of mystical phenomenon - and when something seems to be wrong, it should be checked, not dismissed. Offering formula as an immediate choice is not a solution, it's a bypass.
Frequent nursing (such as every hour or so), coupled with drinking plenty and a supplement of fenugreek - and lots and lots of prayer - seems to be the answer for us so far. I don't know exactly how much weight Shira gained lately, but her growth is noticeable, even though she is not (and probably won't be) chubby. Last week, my heart rejoiced when my mother-in-law picked her up and commented on how much she seems to have grown, and asked whether I've been supplementing. She was very surprised when my answer was a happy negative.
Our breastfeeding story isn't by any means near the end, but I still thought I would share it because it might be encouraging to another mother who is perhaps struggling with the very same issue. I hope to write a happy follow-up as time passes.
I think it's also important to say that my last intention would be to cause any hurt feelings by writing this, specifically to mothers who for some reason didn't breastfeed or stopped breastfeeding early. Perhaps you were in a similar situation and made different choices. I know how terrible it feels when your very best is labeled as not good enough, and I wouldn't want to do it to any other mother. My purpose is only to offer encouragement and support, which I generously got from fellow mothers.