Need help with no weight gain. Starting to get worried.

[maryjane]

DD is 8.5 months. She has basically been the same weight - 16 lbs - for almost 3 months. At first her doctor (family physician) said "let's keep an eye on it," but after my bringing her in today for an unscheduled weight check and she is still stagnating, he wants to set up an appointment next week.

Here are a few things that may or may not be related:

• she has been congested on and off (mostly on) since around 5 months
• from 5-7 months she was spitting up full feeds at least once a day (gag reflex, from coughing dt the congestion)... she hasn't spit up in over a month
• she is tongue tied -- had it clipped around 8 weeks, but it wasn't complete and she still has thrust issues. I've worked with a cranio-sacral therapist who was able to loosen it a bit. I do wonder about milk transfer?
• she gained quickly the first few months (double birth weight of 6 lbs 13 ounces) by 3 months... same pattern my older two boys followed, but they kept gaining and she's stopped
• I'm not sure what her height is, we didn't check it today
• She doesn't look "skinny" but she is definitely much less plump than she was a few months
• she's meeting milestones -- started army crawling last week and this week is taking a few paces up on her knees; babbling consonants on occasion; very social and engaged
• DS2 (her older brother) had undiagnosed dairy/soy allergies (doctor never thought so, but his green, bloody poos ended after I cut out d/s) -- she has never reacted to food, so I am currently eating everything
• we're doing blw with her, but she doesn't eat all that much. she likes the experience, but doesn't seem to get too much in.

I am going to see the doctor next week and was going to try to find an LC to do a weight check before and after nursing. I am also thinking that I should switch to spoon feeding and focus on more calorie-dense foods. I'll really appreciate any feedback you have.

[askew]

My DS gained one lb from 6-9 and 1lb from 9-12. He was moving and burning more calories. My Dr was not concerned, but he was bigger at the time. 22 or 23 by 6 months. I know it is normal for them to not gain much the second six months. I wouldn't be too too concerned.

[PrincessAnika]

my dd is only 6mos but we have had slow weight gain issues, and i have been researching when i can. what i have learned:
~ weight gain slows around 6mos naturally
~ babies thin out when they become mobile
~ if baby is growing other ways (head circumfirence, length esp), having good output, and meeting developmental milestones, there should not be a reason to be concerned.
~ illness will cause slowdown in growth since the body is focused on getting better, not growing.
~ breastmilk is far higher in caloric content and fat content than any solids you can get into them, as they can't eat enough to make up for it. you should not replace any nursings or bottles with solids. food before one is for fun. nurse first, then offer solids.
~ as far as which solids to give, avocados and sweet potatoes are great in full of healthy fats etc. can drizzle olive oil over if necessary to add some extra good fats.
http://www.kellymom.com/babyconcerns...ight-gain.html
http://www.kellymom.com/babyconcerns..._increase.html

HTH, and GL!

[maryjane]

Thank you both for your quick responses! As I was reading them, I was thinking, "That's exactly what I'd say to someone else." But after 3 months of no gain (well, she gained 2 ounces from 6-7 mos, lost 3 ounces from 7-8 months and has gained 3 ounces in the last 17 days), I am becoming a bit distrustful of my own instincts. I just talked to DH and said that I really want to work on increasing her nursing. She nurses right now about 5 times a day, with mostly no nursing at night (she wakes around 4 a.m. usually and comes into bed with us, at which point she nurses on and off until we get up at 6:30.) I told him my plan is to nurse one dream feed before I go to bed around midnight, and before and after each nap, rather than just before.

Right now she is eating solids once, maybe twice a day. As I said, it's mostly just the experience, which if she was gaining normally, I wouldn't think twice about. But given that she's not, I want to be sure I'm doing the maximum with solids, too. So, in addition to nursing more, I thought I'd make a more concentrated effort to give her solids (protein/calorie-rich solids) twice or three times a day. What do you think of giving her an egg yolk for breakfast? I'll also buy some turkey breast and roast that up for her. We don't usually buy red meat, but I would be willing to for her, if people think it's worth it. Of course, all solids will be offered after she's nursed, not before or instead of.

My goal is to really focus on (a) nursing and (b) solid feeding over the next week, so that when we go in to the appointment next Friday, I can know for sure that it's not from lack of feeding her enough, yk? In this link it says that 1/3rd to 1/2 of all FTT diagnoses are dt insufficient caloric intake. I just want to be sure for myself that we're not "causing" this.

[PrincessAnika]

try this, might help: http://www.kellymom.com/nutrition/vi...dcalories.html
the concern with pushing solids is that solids do not digest as quickly, whereas BM digests in about 90 mins, so then you have to make sure they are not filling up on solids, and not nursing.
as far as 'thats' what i'd say...' - i do the same thing all the time.
GL!!

[kdtmom2be]

If you should be concerned about anything it would be the weight LOSS from 7-8 months. 3 ounces isn't much, but why was she losing weight?

From your last post it seems that she's had a bit of a gain in the last 3 weeks... I would just keep an eye on it personally, especially if she is meeting all her milestones.

FWIW, my little guy is 9 months, not quite 18 pounds. The doctor is quite concerned but I am not. He's much like your LO, meeting milestones, looks healthy, etc. He IS gaining, just slowly. I know that he is much more laidback than his sister though and I think that when he's hungry he doesn't necessarily let me know, he'll "happily" keep on playing or he might get a bit whiney and be satisfied with being held. I've basically tried to schedule his food intake to a point because I know that if I don't he might not ask for anything! So, he nurses first thing in the morning (comes to bed at 3 or so, nurses at 5, 7 and 9) and then we get up and he has breakfast with me, these days he's on to egg yolks, oatmeal and dry cereal. He'll happily sit and munch on dry cereal ALL morning if I let him but it makes him constipated so we don't do that! Then he nurses before and after naps (two naps a day), has a snack when big sister has lunch and eats dinner, nurses, has another snack and nurses before bed! And with all that he still only gained 8 ounces between 6-8.5 months.

ETA: bolded that statement because in effect we are "causing" his FTT by not being able to read his feeding cues, but that's because he doesn't care! (or so it seems)

[Skrimpy]

I would focus on increasing her nursing and increase the amount and richness of your milk by paying special attention to you eating extremely well.

Then focus on solids - I would say to go with smooth purees, and do what foods you feel comfortable with. But no "empty" foods. Give nutrient dense foods like avocado, egg yolk, and meats if you feel comfortable introducing meats.

My little guy Galen is 15 months old and he was much like your LO. Gained fast initially then slowed down a lot as he got more active. Then he stalled completely and started losing weight (a little later though, around 12 months.)

He has other issues - major sensory issues with his mouth and a big solids aversion. But going to smooth purees for all his solid meals and making sure they were very nutrient dense really made a big difference. I puree his meals together with heavy cream from grass fed cows for extra calories, even, though you may not want to do that since she is under a year.

It depends on your comfort level, but I would recommend you focus on your milk, and if you want to increase the solids go with smooth purees for now. The smooth purees really helped Galen and he is growing strong again. Gain 1lb 9oz in 3 weeks after only 3oz across months!

[Kiwiontheloose]

got no advice but wanted to say Hugs cos it must be worrying, and I hope you find some answers

[PatioGardener]

IS there anyone who can evaluate the partially clipped tongue-tie to see if it affecting milk transfer? I've seen a couple of babies who did OK with a tongue-tie until 6-8 months and then just were not able to transfer milk well (moms had really good let downs and ample supply until then) and didn't grow as expected any more. One mom in question ended up getting the tie clipped (baby wasn't able to deal with solds well either), and the other started on domperidone and pumped and supplemented with a sippy cup.

[maryjane]

Originally Posted by PatioGardener

IS there anyone who can evaluate the partially clipped tongue-tie to see if it affecting milk transfer? I've seen a couple of babies who did OK with a tongue-tie until 6-8 months and then just were not able to transfer milk well (moms had really good let downs and ample supply until then) and didn't grow as expected any more. One mom in question ended up getting the tie clipped (baby wasn't able to deal with solds well either), and the other started on domperidone and pumped and supplemented with a sippy cup.

This and allergies are my two primary concerns. It was so hard to find someone to clip her tongue in the first place and he did a not very good job, in my opinion. I'm not sure where to go to find someone to evaluate it now. Would that be an LC? That's interesting what you wrote about solids, b/c the baby is definitely not doing well with solids. Put stuff in her mouth and enjoys sucking/moving it around, but most food gets spit back out rather than swallowed down. She sees a craniosacral therapist, so I guess I could start by going back to her. Any other ideas?

I know getting my baby growing is the #1 priority. But I will be totally gutted if we can't do that *at* the breast.