Okay, I think doctors are absolutely great in crisis situations, but I have to say it has been our experience that they can also create crisis when our babies are growing in a normal and healthful way. This "must" or "should" be in the 50% crap is crazy!!! What are they robots who need to be slammed into a mold...no they are individuals who are unique, grow at different rates, have slow periods, spurts, walk and talk at different times and in their own unique ways...why on earth would we look to someone who doesn't even know our kids to tell us how big he is "suppose" to be! How much is enough? Is the child healthy, growing, developing, happy, eating well, stooling well... if yes then I think they are playing a control game and a second opinion from a/your pediatrician or family practitioner may help you determine if she is having a "normal" growth curve<b> for her</b>.
Babies who are premature or have slow starts aren't going to jump to the 80%...that wouldn't even be considered healthy by most pediatricians (our pediatrician told us they look for a nice consistent curve with no major jumps below or above percentiles, even for kids with very rough starts). At one point during his RSV at 9 months old he dropped from 15lbs to 12lbs because he couldn't eat...we asked to place him on the NG tube again to avoid a hospital stay. He ended up admitted again since he couldn't keep anything down and to have anitbiotics in case of secondary infection. Once he was better he put it back on quickly with a combo of NG and breast until he was stable. But I will tell you, we never felt the NG formula feeds helped much to get his weight up more quickly. It just helped get him back on track after diagnosis when he had been without enzymes for 14 weeks and when he was unable to eat orally. Once we saw an evening out of weight gain and my supply came back, he gained at the same rate as he did on NG with formula or better. In fact, after the inital little spurt, the more formula he got the more frequent his stools became and he required 3x more enzymes. Once we weaned him of formula and back to breast only he continued to gain well and steady. It took a year but went from 3% to 50% with only breast milk and food. He has never had dairy (still can't) and we have found other ways to give him calories as he fully weaned from the breast. A pound per month is quite good for breast fed babies and is considered normal.
I feel you have to put your foot down sometimes and develop realistic goals with them as they tend to microfocus on weight, especially when they are healthy. I wouldn't also wonder if they aren't a little concerned about the breastfeeding factor since they can't measure that...have they been supportive? They were very unsupportive of us and I had to stick to it without their support. They used alot of fear tactics about G tubes and overnight feeds until I stopped mentioning breastfeeding and brought up that my pediatrician and I are pleased with his weight and growth chart and they needn't worry as I continued to go for weight checks 2x a month. Then they dropped it and backed off.
Regardless of what you decide, I think you have to grow comfortable with asserting yourself, using information/research and other professionals to back you up if need be, and ultimately doing what feels right for your baby. If you really feel she is well and growing as she should, arm yourself and make an alternative plan with your pediatrician that they can't refuse (consistent gain, plus weekly/biweekly weight checks, and a promise to call if she dips below a percentile; other than that you are sticking to what you're currently doing as it is proving consistent gain). This will allow you to get what you want while protecting yourself from unnecessary threats that you aren't doing enough for your child. This will also ensure that you have a record of all the things your are doing to ensure appropriate weight is being gained and you are being seen by an "authority". It is a bit of a game but so far we have just had to play a few until they settled down about stuff and realized how dedicated we are to his health and well-being.
If Ben seriously dropped in weight or we felt he wasn't doing well, we would call them right away to see what we could do. If for a short time he had to be on a tube or have to add power shakes or other things, we would absoultely do it. But when things are flowin' they need to just celebrate with us and realize it is okay to have a quick follow-up appt with nothing much to discuss!!
Sorry this is long...just some fresh memories I just. It can be frustrating the first year for sure. Let know what you decide...feel free to email me.
Warmly,
Jody jody@meta4tech.com