Quoting Love Wedge +2:" So last month we had an appointment with Bub's pedi. He'd only gained 1 lb since the end of November, ... [snip!] ... I want to. I formula fed my daughter right from the start and she's super smart. I don't know why this bothers me so much."
Have you tried getting his nursing up to the 8-12 per day like we talked about before? I know he had been doing as few as 5 feeds a day & that is more in line with the 6 a day outlined in books like Babywise which is linked with failure to thrive & other issues when so few feeds are given. (I am NOT saying YOU are scheduling him at 5, I know you said he isn't cuing more often - I am merely saying that so few feeds a day, has
been shown to contribute to poor weight gain). In most cases feeding on demand/cue is the way to go, but some babies just don't cue often enough & it has to become an issue of offer, offer & then offer again. It won't matter what
he is fed if he doesn't take in enough, formula is not fattier than breastmilk. You can also try pumping between nursing & offer pumped milk instead....you can see a comparison on calories & fat here between breastmilk, formula & other solid foods: http://kellymom.com/nutrition/starting-solids/babyfoodcalories/
Why would she say iron enriched? Ferrous sulfate (formula iron) is far less digestible than lactoferrin (breastmilk iron) so ferrous sulfate gets absorbed at lower rates than breasmtilk iron. But it really is no matter since virtually all
of them are iron enriched these days. I am not aware of any you can get anymore that aren't. Lots of Drs get confused by the concept that breastmilk has lower iron levels (it does) because they fail to factor in how bioavailable that iron is in that form.http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CEgQFjAC&url=http%3A%2F%2Fwww.iupac.org%2Fpublications%2Fpac%2F82%2F2%2F0429%2Fpdf%2F&ei=cUMRUZfSFLG60AHCvYCYDw&usg=AFQjCNGnwWA1l5pw9smUrffwKCOu2-Ex1HPQ&sig2=rmyzNZfl3Bv7Dp0EOM49Sw
That is a very complex study - but it shows special receptors human infants have to be much more receptive to lactoferrin than to ferrous sulfate. in case you are interested.
I am ALLLLLL for getting his weight up - for sure. It would be concerning to me too. I am just wondering why your Dr think formula is the answer. Has she had you run a crematocrit to look at what the fat/calorie concentrations are in the breastmilk? Has she had you do a pre-feed/post feed weight in to see how many ounces per feed he happens to be averaging to know if he is taking in enough feeds per day for that number? Like if he did 5 feeds a day, but took in 5 oz or more, that's fine. If he does 5 a day & takes in 1-2 oz, that is too low. They need in the range of 25 oz per day to do well....some do as little as 19 or go as high as in the low 30's - but most fall around 25 oz. Has she suggested pumping & bottlefeeding with a human milk fortifier added (it's a powder, made from breastmilk that has a super dose of fats & calories sometimes used with preemies with slow weight gain or in term infants with other medical issues).
I only tell you all this because you say you are sad & hoped to EBF...and many times there are just changes you can make in how often a baby is nursed that work...or in pumping & doing some supplemental bottles of breasmtilk if baby needs more encouragement to take more in. A baby doesn't cue less often because you have low supply - far from it - so taking fenugreek & all that wasn't likely to make much difference anyway unless there were more feeds added or at least come pumping. When trying to increase supply the most critical thing is increasing stimulation/number & frequency of feeds...you make as much as you cue the body to make, so if he maxes out at 7 feeds a day, you will only make enough for those 7 feeds. The galactogues are great in conjunction with additional stimulation, but by themselves they work about as good as coffee does to make up for lack of sleep. You may get a small short term boost, but not much & certainly never as much as you'd get from actually sleeping.
By all means though, if you have tried all of that, then you can certainly see if topping him off with formula helps. I just don't know any logical reason why it would...as it isn't higher in calories & the more formula he takes in, the less likely he is to cue to nurse, so it will likely just make you have lower supply. Also - ounce for ounce breasmtilk gets higher & higher in fat & calories as baby ages, and so he'd have to be willing to take in more ounces of formula to get more fats & calories & he seems to be a baby that isn't eager to eat too much or too often. Formula also takes about twice as long to digest, so he'd likely cue less often than he does already. That would be concern as to "why" would formula help with this....