Test results only revealed one abnormal value, the one which indicates nutritional status. It looks as though her nutrition level isn't what it ought to be. This doesn't tell us a whole lot really. The basic plan of action is to increase calories and see if she gains.
Why is that so depressing to me?
1. The most calorie-dense, readily-absorbed source of nutrients is breastmilk. I can't physically feed her any more often than I do now. Since last week, I have begun to encourage her to eat longer, which puts a single feeding at well over 30 minutes, often much longer. She eats 9x/day. I'm exhausted.
2. I have not had success with pumping, ever, and hand expression, even though I'm probably slightly better than average at it, yields very little after an extremely long nursing session. I don't know how, at this point, to introduce any more breastmilk.
3. I didn't have a breastfeeding goal when we started. For months, I just said I had no specific end date in mind, that my breasts didn't expire, etc. Very recently (within the last month?) I decided that my goal was no formula. We made it nine months, what's another three? I didn't have weaning plan set for one year, but if we made it that long we could give her cow's milk, etc. if we needed/wanted to supplement. I have no beef with formula, I just didn't want to buy it if I could make healthy baby milk for free.
4. Which means, essentially, that the milk I'm making is not sufficient. Either the quantity or the quality is not enough. I'm feeding her an effing ton, and she's not gaining. So it's me. My milk. My fault. (yeah, I know what I'd say to me if I were you, but I still feel like this. Telling me it's silly will not help.) Once again, my body has failed at something. The doctor kept saying over and over that it was no reflection on me, that I didn't do anything wrong, that we've gone longer than most, blah, blah, blah, but really? It couldn't be any more personal. I've been starving my baby. And I didn't notice.
(and yes, I know that 5oz isn't really obvious. but I didn't pick up on a lack of growth either. maybe I couldn't have seen it. maybe no one would have. but the bottom line is that I'm her mother and magical powers or not, I didn't. so I feel like crap.)
5. I have to supplement with something. It can be bottled (sippy cup) breastmilk, formula, solid foods, or a combination. For the time being, I've chosen to increase breastfeeds and increase solids. It's possible that this alone will help.
6. I hate, HATE that this will prove the MILs, the grandmas of the world right. ("you need to feed that baby" "when are you going to stop nursing and feed her real food?" etc, blah.) From what I understand, this isn't a normal outcome, but that's not what they'll hear. I know it doesn't matter what anyone else thinks, but I can't exactly ignore it either. It's hard enough being the pioneer in the family in the first place.
7. There is a teeny tiny chance that she is getting everything she needs and is still not gaining for some reason. This is not very likely. If so, it would (obviously) be bad. If she has not gained in one month, we'll have earned a trip to the hospital. I don't want to think about this. I'd much rather the problem be me than her.
So, the plan, for now at least, is to stop crying about it, increase time spent at the breast, and be consistent with giving Birdie three additional meals per day of table food. I know the ped wanted me to give her an extra (cup) feed of milk/formula, but I want to try this first (I think. I'm still digesting a little.) which is why I asked for a two-week weight check in addition to the one-month. If she hasn't gained in two weeks, I can re-evaluate and try something else before we get to the hospital point.
Also, sincere apologies if I've been short with you via email. I'm worried (and there are other things going on now too) and feeling generally defensive, so I know it's coming out where I don't mean it to. I truly appreciate all your support, even if it doesn't sound like it.