Cecilia had her 4 month check-up. She got two vaccines, Rotavirus (oral) and DTap (shot). She was upset about the shot for a minute or so, but quickly recovered and had no apparant side effects that night. Yeah! She's back on the Dr. Sear's alternative schedule for vaccines, so we'll go in again next month for the Pneumaccocal and HipB.
I don't have the charts right now, but her measurements were
height - 26" (96.29%)
weight - 15 lb 12.8 oz. (90.33%)
head circumference - 41cm (51.97%)
It appears her weight is now catching up with her length and she's in the 90+ percentile for both! She seems to have a smaller head, though :).
Other notable points from the visit:
- Leah (our doc) was impressed her belly button was an inny already because most babies don't have strong enough abdominal muscles to pull it in. That may not happen until 2 years in many cases.
- She is hitting all of her milestones and is even a little ahead on some things (I forget what they are at the moment - I guess this is "Mom brain").
- Although she could get a flu shot at 6 months, we have decided that since she is a breastfed baby who does not go to daycare and is not in a risk group due to a medical condition we will not get her a flu shot.
- We have been assured that her infrequent stooling is completely normal for a breastfed baby and she is definitely growing well.
- We will not schedule visits for 10 am again since it is before her current "wake up" time and she was very sleepy in the doctor's office.
Overall, we are reassured that Celia is growing well and developing well. Here is a quick update on her feeding. Celia has been breastfeeding less and less, now more for comfort than for nutrients. I offer all day, but she usually refuses. I have hope that she may decide to breastfeed more often again, but we've come to accept that our baby gets most of her nutrients from pumped milk. So far, I've been able to maintain my supply and I plan to do so until Celia no longer needs to nurse at all. I have visions of her choosing to nurse sometimes as an older baby and establishing a routine of nursing at bedtime at least. The most success we have with breastfeeding now is at middle of the night wakings and at naptime - all while lying in bed. If I can catch her as she's waking she'll usually nurse for at least a few minutes. While this is not what I had hoped for, we have learned a lot and hope to breastfeed more successfully if we are ever blessed with more children. We are proud that we were able to teach her to breastfeed and every day we can continue to give her breastmilk instead of formula is a small victory.
I was surprised that the information included in the after-visit summary they gave us after her check-up said that she should be eating 6-7 ounces every 4-5 hours. This implies that she should be eating 30-42 ounces a day. We feed on demand and always have milk available to her, and she eats around 25 ounces a day - sometimes less! Obviously she is growing well, so she's getting more than enough calories to thrive. I am inclined to think that some babies might eat more because they eat so much faster with bottles than with breastfeeding and still need to suck (aka the pacifier) so that parents who bottle feed tend to regulate how much the child gets instead of the child regulating the intake. I may be way off-base since I haven't studied any research, but it seems to me that we don't have a really accurate idea of how much a breastfed baby eats (I've heard up to 30 ounces at 6 months, but I don't know). The bottles we use do require suction and compression and require her to suck more than a normal bottle to eat. I wonder if the increased sucking means she's eating more slowly (we know it can take her 15-20 minutes to eat a bottle) than if we used another bottle so she is regulating her calorie intake more closely to the way a baby does when they eat exclusively from the breast. She also usually gets milk pumped within a few days unless we're freshening our frozen supply. I've also heard that the composition of breastmilk changes as the child ages, so it may be that the calorie content of milk changes to meet the needs of the baby. Also, breastmilk is metabolized better than formula, so I wonder if the baby just gets better at metabolizing the nutrients and doesn't need as increased an amount of milk to meet her needs. These are just my thoughts since Celia eats far less than what they are telling us she should and is definitely not having any problems with growth or development. An interesting discussion. Any thoughts?
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