Gaining 3 oz/wk from 2 to 4 months? Scratch that... half an ounce a week. :(

[Harmony96]

Is that ok? He was born at 8 lbs 12 oz, and was 12 lbs 2 oz at his 2-month visit and now is 13 lbs 9 oz at his 4-month visit. I know that a BF baby's weight is supposed to slow down but I thought it wasn't until after 6 months. DD was a slender infant, too, but I think at this time that she was gaining at least 4 oz/week.

ETA 2/19: So I was looking at my blog for other reasons, and I had weighed him on my scale at home on 1/12, and he was 13 lbs 13 oz THEN. I weighed him again on it just now, and he's 14 lbs even. : Then I looked at the Kellymom calculator and put in his birth weight and 2-month weight and 3-month weight and 4-month weight. For his first 3 months, he was gaining 6 to 6.5 oz/week. But then in this fourth month, he has only gained half an ounce a week. Half an OUNCE, not half a pound. I would be happy with half a pound. I'm not happy w/ half an ounce. Even with DD, when she was gaining her slowest in her first six months, it was never THIS slow. I would try to feed him more, but he already is so spitty w/ what he has... I don't want to overload him and just have him spit up even more. I guess I'm just making water instead of milk.

ETA 3/8: I just now weighed him again, on the same scale as the 2/19 weighing, and he's still 14 lbs even.

[PatioGardener]

Especially from 2-3 months only 3 oz a week seems quite low to me - lower than the low end of normal.

Have you plotted baby's weights on the WHO growth chart? http://www.who.int/childgrowth/stand...boys_p_0_6.pdf You'll have to convert pounds to kilograms, but it is worth it to see if baby is staying on his grwoth curve or dropping off.

The other thing you have to remember is that weights vary by scales. Was baby weighed on the same scale each time? If you are concerned about weight gain it may be worth seeing an LC about milk transfer and she can get accurate weights before and after a week which will tell you more than weights on your ped's scale may.

How often is baby nursing now? Can you squeeze another feed in?

Good luck!

[Harmony96]

I wonder if reflux might make him not gain like he's supposed to?

I plotted the 3 weights I know on that WHO chart, and he's dropping in percentiles there, too. Just over the 50th at 2 months and then just under the 15th at 4 months.

I can try feeding him more, but when I've tried to do that in the past, if he's not interested then he's not interested.

[PatioGardener]

The drop from 50-15% on the WHO chart would worry me. Worth investigating for sure.

I think you are on the right track to think about other causes, like reflux, if he's not keen on nursing more. The other thing to investigate is a tongue-tie, which makes nursing more difficult so babies often tire out without taking on enough milk.

Reflux can affect nursing and weight gain. Does he have any symptoms that make you think reflux?

I hope you figure it out quickly!

[Harmony96]

I'm pretty sure that it's not tongue-tie b/c 1) we would have seen more issues by now and 2) he doesn't have any of the symptoms of tongue-tie (he can stick his tongue all the way out, and it's just tongue-shaped instead of heart-shaped when he cries, etc.).

He is growing fine in length and in head circ. I think I read somewhere, can't remember where, that the calories an infant takes in are allocated first to brain growth, then to length, then to weight.

Even w/ the reflux "idea" I'm not sure that it might be that, b/c the only things leading me to that is that he seems to be slightly fussier overall than DD was, and he seems to spit up slightly more often than she did. And it's like ninja spit-up... it doesn't come w/ a burp, but comes stealthily in between burps, surprising me until I hear it land on the floor, lol.

Here's a picture I took of him about 7-10 days ago, and he looks pretty much the same now. So just to LOOK at him, he's fine, ya know? It's just those blasted numbers popping up and making me worry, lol.
http://i27.photobucket.com/albums/c1...96/bonbblp.jpg

[Harmony96]

bump... any more input?

[PatioGardener]

He's such a cutie!!!

You're right - head (brain) growth is preserved first, and then height, and then weight - so it's great that baby is growing well in length and head circumference.

I'd still recommend a visit with a good IBCLC to check out posterior tongue-tie or milk transfer issues, as well as getting a good accurate weight check. Hopefully some other Mamas can give you input too.

[Harmony96]

Update in first post.

[PatioGardener]

Have you seen a good LC? If you post your location you may get some good recommendations. You need to get this figured out!

ETA: Has anything changed in the last month? Started birth control?

[Harmony96]

Originally Posted by PatioGardener

Have you seen a good LC? If you post your location you may get some good recommendations. You need to get this figured out!

ETA: Has anything changed in the last month? Started birth control?

I actually saw one yesterday, at the BFing support group that my pedi's office group is starting up. Didn't get to talk to her a whole lot b/c there was a mama there due in a month w/ her first and she was all nervous and had a million questions, lol. But the LC did recommend to me that I compress the breast while he's eating, to increase the fat.

As for changes in the last month, the only change I did was going off of dairy (to try to help his eczema, but it doesn't seem to be doing much), but I'm making up my calories elsewhere and making sure to stay hydrated. No birth control, no return of cycles.

[ElliesMomma]

Originally Posted by Harmony96

I wonder if reflux might make him not gain like he's supposed to?

I plotted the 3 weights I know on that WHO chart, and he's dropping in percentiles there, too. Just over the 50th at 2 months and then just under the 15th at 4 months.

I can try feeding him more, but when I've tried to do that in the past, if he's not interested then he's not interested.

yes, reflux can be a cause of slow weight gain. does he sleep well? if not, that's another reflux factor. does he seem to be in pain? does his cry seem hoarse? does he spit up often, how often, like 20 x a day?

my son had all of the above factors, which i identified at 2 months old. slow weight gain was the one that really stuck out. we decided to medicate with (non alcohol version) of liquid zantac. it has really helped. he is now 5 months old, sleeping very well, spitting way way less, and gaining fairly well, although still on the skinny side. he is average in height, however.

[monkeyandthebean]

I've had similar issues. DS was born 8lbs8oz and dropped to 7lbs12oz, his lowest weight. He gained 2 - 3oz a week the first three months, then at his 4 month check he had only gained 2oz. He weighed 11lbs at 4 months. My doctor started me on domperidone to help increase supply. It's been a week now and his diapers have been better and he is starting to go a little longer between feeds. Definitely bring up your concerns to your pedi. But in the meantime, nurse, nurse, nurse. Breast compressions while nursing help too. I'm assuming you've had his latch checked and all is well there?

[Harmony96]

Originally Posted by ElliesMomma

yes, reflux can be a cause of slow weight gain. does he sleep well? if not, that's another reflux factor. does he seem to be in pain? does his cry seem hoarse? does he spit up often, how often, like 20 x a day?

He actually sleeps really well. He doesn't really seem to be in pain, and his cry is not hoarse (although he does screech when he's happy, lol). He probably spits up only 10 times/day, but I haven't really counted it. I have to keep washcloths all over the house b/c I never know when it'll happen or how much it'll be.

Originally Posted by monkeyandthebean

I'm assuming you've had his latch checked and all is well there?

Well, I was going to on Thursday, but the lady got there late and DS was hungry and I couldn't wait any longer. Then when she WAS there, he wasn't interested in trying to eat.

[Harmony96]

Originally Posted by Harmony96

He probably spits up only 10 times/day,

I take this back... it probably is closer to 20, b/c we're already up to about 7 or 8 and it's only 10:20 a.m., lol.

[CalaRei]

Sounds like reflux to me, with the number of spit ups a day. My sons are stealthy too. He'll be sitting in his bouncy chair, and I just hear liquidy splash noises, and it comes spilling out of him. Goes through 4-5 outfits a day sometimes. His twin doesn't do any of this.

The unfortunate thing about reflux is that the meds help with the pain and acid that makes them fussy, but the babies just have to outgrow the spitting. So if your babe is spitting up enough to not gain weight, I'm not sure what the next step would be - your ped might want you to pump and fortify the milk with extra calories.

(Mine pushed cereal in formula, euf. This just made his spits thicker and got his nose clogged with rice. Not to mention that breastmilk doesn't thicken with rice, trust me on that.)

[Harmony96]

Two and a half weeks since his last weighing, and he hasn't even gained an ounce. Not "an ounce per week", but he hasn't gained an ounce at all.

Both the LLL meeting and the BFing support meeting at his dr's office (w/ the LC) are this Thursday, so I'll definitely be talking about it w/ them.

He doesn't LOOK hungry or dehydrated or anything, though. And a tooth popped through yesterday, so I know that some growing is happening. And he learned how to roll over both ways, but he has to be in just the right mood to do it.

[Harmony96]

In the past 20 hours or so, he hasn't had any poopy diapers. But he's had 9 wet ones (or pees in the potty). So I guess he's getting something.

[Harmony96]

LLL said he's probably fine. Another mom there (not a leader) said that her DD had a stair-step growth curve instead of a "smooth" curve. One of the leaders said he is probably gaining length more than weight.

The IBCLC said that it would be more of a concern if he was losing, rather than not gaining at all. She said that people could "go crazy" with weighing their babies too often, and I definitely don't want to do that.

So I think for now I'll stop the charting and just do what I've been doing, nursing on demand and keeping an eye on the "overall baby" instead of just a number on the scale.

[Harmony96]

I think I'm going to weigh him again today. I had a dream last night that I weighed him, and the scale said he was just under 10 lbs, which would be a loss of 4 lbs. I sure hope that the dream doesn't turn into a reality.

[Harmony96]

Ok now he's at 14 lbs and 2 oz.