somewhat URGENT, baby not gaining weight...

[chrstene]

I am actually writing for a friend who has a 10 month old DS. She has been nursing/pumping (she works ft). This is the first child she has nursed and I've tried to support her along the way. I don't know all the details of her schedule, nursing patterns, etc. I do know that he goes to daycare and she sends bottles. He sleeps in a crib. She nurses him before bed, when she gets home from work, in the morning.....and other times get the bottles of expressed bm.

BUT, she was at a wbv today and her ped threw out the terms "growth retardation" .... he has only gained 1 oz in the past 3 months and hasn't grown any taller. He has suggested she supplement with formula. She would like to keep him ebf until at least a year. I"m not sure if he eats solids yet...should I suggest that? Or if he is, should I suggest she stop since bm has more calories usually.

Any ideas, thoughts or suggestions? Is this as serious as it sounds?

She is really awaiting a response and I wanted to throw this out there to you ladies before I get back in touch with her.

Thanks.

[PatioGardener]

Thoughts: if the weight issue is real (often scales are to blame - different scales can vary by up to 1 lb) then my next step would be to plot all weights on the WHO chart: weight: http://www.who.int/childgrowth/stand...boys_p_0_2.pdf (and height: http://www.who.int/childgrowth/stand...boys_p_0_2.pdf)

If baby has fallen off his curve, then yes, it is an issue. I would try to increase breastmilk supply/transfer (with herbs, medication, more frequent nursing, more pumping, check for tongue-tie etc.), and I would focus on high calorie nutritious foods, like sweet potato, avocado etc. (see http://kellymom.com/nutrition/vitami...dcalories.html)

Formula supplementation would not be my first choice. If immediate supplementation was needed, mother's own milk or donor milk would be preferable to formula.

ETA: Also important to know if he is eating solids, which solids, or if he hasn't been offered them, why.

[ShwarmaQueen]

Its somewhat normal for weight gain to slow around 1 year (baby's moving more, burning lots of calories, is uninterested in slowing down to drink milk, and usually not that great yet at consuming solids). I wouldnt supplement formula, I would try nursing more frequently and offering more calorically-rich solids (egg yolk, acocado, cheese, full-fat yogurt, etc).

[curiouscanadian]

I know you don't know what the baby's getting for solids, but it's possible too that he's getting too many solids. DS had issues around 9/10 mo. which in retrospect stemmed from me pushing solids to the detriment of nursing. In trying to get him to "eat more" I was actually filling him up and depriving him of the more calorie-loaded BM.

[chrstene]

I never really used bottles...so I can't help her here. How many ounces should the bottles be at this age?

She nurses once in the morning, then at 6 p.m., 9 p.m and 2 a.m. The 8 hrs he is at daycare during the day are the bottles, so how many ounces???

I did talk to her about the food intake and she is definitely going to make some changes there.

I really think she can do this wthout formula...he is a healthy kid and still in the 50th percentile despite this "slowdown".

you ladies are great. thanks for helping me to help her a bit !

[basje]

hmmmm.

My LO is eight weeks and honestly it's been the last three that she has been nursing like crazy and I've given a lot of thought about how this would have been affected had I left at 6 weeks to go back to work.

I co-sleep and she's now taken to cluster-feeding for a few hours at a time while sleeping at night. It's not a very aggressive suck, but she is getting *something* and it lasts for a few hours some nights. I'm feeding her much more than if I was only nursing on some type of demand like fussing or crying. Because she's in bed with me I can offer her a breast any time that I see that her mouth starts moving or she starts to fidget. In a crib or even a pull up to the bed co-sleeper I wouldn't be doing this.

From talking to other mothers at LLL meeting who are working many have found that co-sleeping allows them to "catch up" on nursing sessions that they would be doing during the day. Although they note that they loose more sleep and are more tired at work many of them find the benefit worth it. It's an option to consider.

[Shellie]

I also would be inclined to think the scale and/or measuring could be off. I started weighing and measuring my dd at home myself when she had growth issues (she has ulcerative colitis so we knew the cause...still I wanted accurate #s).

I would also be interested in knowing how much and of what he gets at daycare. I do know that my EBF babies needed to eat a LOT more often than you're describing.

[chrstene]

I do agree about the night nursing. at this age, my kids were cosleeping and nursing all night, and I"m a SAHM - so I would imagine that it is that much more important if you WOHM. But I can only suggest it.

As far as the milk at work, Shellie - how many ounces/bottles during that time do you think he needs while at daycare??? She ff her first child, so perhaps she is not sending enough milk....if she is comparing it to when she used to send formula.

Thanks so much ladies, you guys are great!

[HappyMommy2]

I don't know about this child, but I can tell you about my experiences. As soon as both of my kids started crawling, they stopped gaining weight since they were so active.

My DD is now 2.5 and still breastfeeding. She was initially in the 75 percentile for everything. But around 10 months went down to 25 percentile. She was busy! And she totally thinned out. The nurses were concerned at first, but I knew she was fine and thriving, so I didn't worry. After a few visits at the 25% the doc told the nurses that she wasn't worried; that 25% was her new normal.

In this situation, I would offer nutricious (sp?) snacky finger food like avocados and bananas to beef up the kid! Also, yogurt works great. (whole milk yogurt) I used to mix yogurt with a little juice in a sippy cup for a drinkable shake.

Does the baby cluster feed all evening? I know mine did when I was working.