How bad is half an ounce gained per day really?

[Lirazel]

DS is gaining about half an ounce per day. My midwife was fine with that, but we started going to his ped who says he needs to gain a full ounce or we should talk supplementation. I just brought him in to be weighed and he's still at half an ounce.

DS is happy, alert, sleeping well and developing appropriately. He wets 11 cloth diapers per day and has 2-3 good poops.

I have had supply issues and currently take 6 capsules each of fenugreek and blessed thistle as well as 3 cups of tea of the same herbs daily. I can't tell for sure if my supply is the problem or if he's just a slow gainer.

I really don't want to use formula, but I don't want my pride to get in the way of my son's needs. The ped says the full ounce would ensure he's getting enough fats for good brain development, so I certainly don't want to deprive him, but he also already seems to be developing fine.

Opinions?

[PatioGardener]

Baby is 11 weeks old now? Have you tried plotting his growth on the WHO chart to see if he is maintaining a curve? http://www.who.int/childgrowth/stand...boys_p_0_6.pdf

If he isn't holding his own on a WHO curve (50% or 3% - doesn't matter as long as they stay on it) then I would look into milk transfer issues. Any ped who goes straight for formula is NOT breastfeeding friendly.

Have you seen an LC? Someone who can look for a tongue-tie? Latch and milk transfer issues? That's where I would start - and if you do decide to supplement I'd go with breastmilk! There are medical options to increase milk (domperidone) as well as pumping, supplementing at the breast etc.

Good luck!

[mambera]

I second the advice to check his curve.

I've thought a lot about this bc different sources will give you different 'minimal acceptable' rates for weight gain. I've heard anywhere from 5 to 7 oz/week. My LO was gaining 5 oz/week in her first month and both my ped and LC advised me to supplement at that time. I'm still not sure if that was the right decision but there it is. A small supplement (2-4 oz/day) jetted her from 5 oz/week to 10 oz in 1 week and she caught right up to her curve.

I actually would be concerned about a weight gain of 3-4 oz/week consistently, though. Nutritional deprivation early in life can have long-reaching consequences. A baby has to be REALLY undernourished before you see obvious behavioral differences; I wouldn't use that as your yardstick.

Check the WHO curve, and if he looks as if he's fallen off his, then I would get help pronto. Appointment with an IBCLC and check milk transfer issues. And if you have an issue that can't be fixed quickly (or can't find the issue quickly), honestly I really would supplement at the breast (with bm if available obviously - but 'not enough food' is far, far worse than any percentage of formula necessary). (Or, depending on the issue, if you pump after feeds you may be able to make up the supplement from your own bm.)

If you supplement at the breast you should be able to take whatever time you need to fix the issue while maintaining your supply and making sure baby gets what he needs. HTH

[Bokonon]

Average weight gain from 0-4 months is 5-8.5 oz/week.
http://www.kellymom.com/babyconcerns...ight-gain.html

Half an ounce a day is below the average, but not necessarily a problem if, like PatioGardener said, baby is following his own curve.

[ElliesMomma]

it's nice to be at a full ounce... but at four months, their rate of growth slows, and you are only about five weeks away from that.

how often are you feeding him? if you're not already nursing overnight (cosleeping), try that to give him additional calories AND boost your supply.

my son was a slow gainer, especially so due to reflux. does your LO spit up a lot? if so you can look at your diet to help limit reflux (no tomatoes, coffee, caffiene, citrus fruits, etc.)

[marcib28]

I'm dealing with the same situation, except that my lo is only 3w3d. Quick related question though for you mamas-as long as my baby is ON the scale somewhere, should I worry? He started just over the 87%ile (8lb14oz), but is now down to about the 50%ile (8lb11oz)... It's been a lot of ups and downs and I've had to supplement for little bouts of time to get him back up. Should he be following the 85% curve?

[PatioGardener]

Originally Posted by marcib28

I'm dealing with the same situation, except that my lo is only 3w3d. Quick related question though for you mamas-as long as my baby is ON the scale somewhere, should I worry? He started just over the 87%ile (8lb14oz), but is now down to about the 50%ile (8lb11oz)... It's been a lot of ups and downs and I've had to supplement for little bouts of time to get him back up. Should he be following the 85% curve?

The WHO charts show typical growth for babies. The % is not important, staying on the curve is - so dropping curves is a 'red flag' that something may be wrong. The growth chart is just a screening tool - something to alert parents and doctors to growth that doesn't follow a typical pattern. Then you try to find out why.

The general thoughts about weight gain for a newborn is 5-7 oz a week is normal. Less than that and you worry about milk transfer, milk supply, other issues. So if baby was up to his birth weight at 2 weeks, then you would expect him to have gained to be about 8-10 oz above birthweight by 3 weeks 3 days.

Sometimes babies have high birth weights because their Mamas had lots of IV fluids at birth. This needs to be taken into consideration.

Also, weights really need to be taken on the same, reliable scale each time to be accurate.

Have you seen an IBCLC to make sure that your milk supply and baby's latch and milk transfer are optimal?

[mambera]

Originally Posted by marcib28

I'm dealing with the same situation, except that my lo is only 3w3d. Quick related question though for you mamas-as long as my baby is ON the scale somewhere, should I worry? He started just over the 87%ile (8lb14oz), but is now down to about the 50%ile (8lb11oz)... It's been a lot of ups and downs and I've had to supplement for little bouts of time to get him back up. Should he be following the 85% curve?

I don't really think it makes sense to expect babies to follow precisely the curve that starts at their birth weight. Birth weights are dependent on gestational age, size of the mother, fluid status, and other factors that don't affect the child's genetically programmed optimal size.

Also real babies do wiggle up and down the curves a little bit bc they are individuals, not averages.

But it does make sense to use a curve drop-off as a warning signal.