UPDATED Baby not gaining - ped wanting to supplement

[kbins]

My EBF DD went for her 4 month checkup Monday. The ped was concerned because she has dropped down to 10th percentile for weight but still 60th for height. (12lbs 9oz weight, 24" length) My boys were all between 15 and 17 lbs at this age, and 2 of the 3 were also EBF (though were getting bottles at this point because I had returned to work).

I know the growth charts are not as relevant for BF babies. My ped is super supportive of BF, delaying solids, delayed vax's etc. But she wants to see us in 2 weeks and if DD isn't gaining (she didn't set a goal), she said she may want to discuss supplementing. I really don't want to go there just yet, but obviously I'm concerned.

Is there anything I should be doing to help her gain a bit of weight, or should I be looking at other issues (like food allergy) that might be underlying? Her latch isn't great (she clicks) but an ENT ruled out tongue tie. I have an easy letdown and good supply, so she doesn't have to work hard for her meals. She started sleeping through (7pm to 5am) about 3 weeks ago, and my boys didn't at this age, so that may also be factor here. She's fed on demand, all day long.

Thanks in advance.

UPDATED 1/29: We gained enough weight, just on mom's milk. See bottom post.

[Bokonon]

What was her lowest weight? Was this weight taken on the exact same scale as the last one, in the same state of undress?

How many nursing sessions does she have per day? Is she having at least 5 very wet diapers a day? Happy, healthy, meeting milestones? Since she is staying on the same length curve, I wouldn't jump to thinking there is a problem. Try not to worry yet - we'll figure this out.

[kbins]

She was 7lbs11oz at birth. up to 7lbs 13 oz at 2 week check and 11lbs exactly at her 2 month check. Same scale, same nurse.

She has plenty of wet diapers, and a couple of dirty ones a day. Definitely happy, healthy and on track for milestones. (I have an autistic son so we're especially aware of development targets). She doesn't appear underfed. She has creases and such.

I honestly don't watch the clock on nursing. We did that with our older boys (my DH was really into scheduling, and since I worked, I let him set the pace) and it made me neurotic. I've been very relaxed about her schedule but now worried I've done something wrong.

I nursed DS#3 for 10 months and really want to make it a year with DD.

[Bokonon]

It doesn't sound to me like you've done anything wrong at all! What goes in must come out - she wouldn't be producing wet and dirty diapers if she wasn't eating enough.

It really, honestly sounds to me like she is just settling into her own growth curve. Your ped. may be breastfeeding-friendly, but that doesn't necessarily mean that she's breastfeeding knowledgeable, and I would hate to see you pushed into supplementing a healthy, growing, thriving baby.

And according to the WHO breastfed babies growth chart, 12 lbs. 9 oz. is right between the 25th and 50th percentiles for 4 months of age, if I'm reading it correctly.

http://www.who.int/childgrowth/stand...irls_z_0_6.pdf

[boobs4milk]

http://www.kellymom.com/babyconcerns...wthcharts.html

this is good info.

[kbins]

I saw a serious supply dip for almost 2 weeks due to cycles returning, which was even more frustrating given the slow weight gain. I went through our entire freezer stash and had to give 2 3oz bottles of formula during that time. I started pumping daily after feeds, and took fenugreek. I did get my supply back, and DD started nursing like crazy after the ear infection was healed. Unfortunately for me that meant she was eating every 2-3 hours overnight. But the good news is at today's checkup, she's 14lbs 6 oz, and I am SO happy. The ped said "Yay breastmilk!" (meaning she gained all that weight on just momma's milk!) No more talk about formula supplements.

[Bokonon]

That's a wonderful update! WTG Mama!

[PatioGardener]

Well done!

[Rose-Roget]

I'm so happy for you! I've been going through a similar scare recently and am still working on it, so I completely understand your fears and frustrations, and I'm really glad it all worked out for you. Congrats!

[StrongFeather]

Great update!