Q.
Today my 5-month-old son's doctor told me I need to start supplementing
with formula because my son is just not gaining weight. He was 7
pounds, 14 ounces at birth and now is only 13 pounds, 2 ounces.
The doctor had me pump while I was there and I could only get three
ounces. He says I'm just not producing enough. He said formula is
just as good, and I can do both. Is this true? A.
Let's start at the end: No, infant formula, also referred
to as ABM (artificial baby milk), is not as good as breastmilk.
I guess you probably knew that already because mothers often have
better instincts than doctors.
There are basically
three different types of formula: soy-based, cow's milk-based
and protein "fragment" formulas which have been promoted
as easier to digest when babies are allergic to soy or milk.
It doesn't take
much scientific training to decide that cow's milk could be as
different from human milk as cow's are from people. The type of
protein is completely different and there are a lot of people
who are sensitive or allergic to this milk.
Soy products have
become quite controversial lately and the facts will sort themselves
out with further study. Doctors and other scientists disagree
about soy's potential for adverse effects as a part of a varied
diet. There is much less disagreement about the potential for
problems when an infant's entire intake comes from soy based food.
When babies are
unable to digest either soy or cow's milk formula, the "predigested"
formulas are used. I have seen only limited success with these
and they certainly differ from breastmilk in hundreds of ways.
Babies gain at
different rates and growth charts are really not very valuable
tools in assessing adequate growth or development. A skilled and
caring doctor will form a partnership with loving, observant parents
and discuss growth and development at each hospital (newborn care)
or office visit. I have never helped a baby by looking at a growth
chart. Never.
Weight increase
is a small part in the assessment of your son's health. If your
baby is eating well, smiling, peeing, pooping and meeting
most of the "textbook" milestones for his age,
he is almost definitely healthy and getting enough food in spite
of not sticking to any particular curve or line on the growth
chart. If the opposite is occurring, it really doesn't matter
how big he's getting or how much weight he's gaining.
Increase in head
circumference and height might actually be more important numbers
than weight. Neither, however, play as big a role in assessment
as the underlined "measurements" in the preceding paragraph.
Many moms cannot
pump three ounces of milk. Especially in a doctor's office under
pressure. That is a very nice amount to have pumped. In addition
to that, a pump is not an accurate assessment of a milk supply.
A pump uses suction to extract breastmilk. A baby uses suction
in addition to jaw movement, tongue movement and kneading. A healthy
baby will always be more efficient at extracting milk than a pump.
The bottom line
is that if your baby is happy and meeting milestones, you do not
need to add formula to his diet. Conversely, if your baby doesn't
look good to you, you need more answers than to supplement with
formula.
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