3 month old not gaining

[TX Mama]

I have a 3 month old that went in today for a shot and wellness check. I learned he is about 3 lbs underweight. I EBF and don't plan on changing that. The ped said I should start supplimenting 3-4 bottles of formula a day. I said ok but just didn't feel like arguing it. What can I do to bulk up my little man? He gets unrestricted feedings morning, noon, and night. He eats about every 3 hours or more if he wants. I am a very trim person myself. I got back to prepregnancy weight 2 months after. It just happened, no diet. I'm vegetarian so I don't get a lot of fat. I also suspect he has a dairy intolerance so I cut out dairy too. I'mreally upset about it and welcome all ideas.

[2boyzmama]

HUGS mama! Stressing about your little one is scary!

Need more info though...

Birth weight?
Any weight checks since birth, give the date, his age, and the exact weight and length.

What is his development like? Is he smiling/interacting with you? Is he holding his head up well? Is he rolling in one direction yet? Does he have clear awake/alert periods? Is he sleeping in a semi-regular predictive pattern yet?

How's his output? Go to your trash can or diaper pail right now and count how many diapers from today. Or start counting now, and keep track in a 24hr period. How many wet diapers? How many dirty diapers? What does his stool look like? What color, what consistency?

Infant growth and development is rarely textbook. A thorough dr will consider the entire baby, not just the weight on the scale. For a baby to "thrive", they should be not only gaining weight, but also growing in length, head circumference, hitting developmental milestones, and should overall *look* healthy. A baby shouldn't be termed "failure to thrive" based solely on one part of that complex equation.

SO...that's a lot of questions. Answer those, and then we can help you figure out if there's a problem, and how to go about fixing it.

[PatioGardener]

when was the last weight check? how much did baby weigh then? and now? have all the weights been on the same scale? was baby doing well the first 2 months?

not gaining is usually from not getting enough milk. reasons include poor milk transfer (tongue-tie is one of the common reasons) and not enough milk.

i strongly suggest you see a good ibclc. you guys need a plan! for now, can you pump? would you consider supplementing your baby at the breast with your milk? if it is true, 3 lb below expected weight is a lot for a 3 month old and i would work quickly to see why he isn't gaining and get some more milk into him.

eta cross posted with 2boyzmama - totally agree with what she said too.

nak

[TX Mama]

His birth weight was 7 15 and today was 9 14. Honestly I don't remember the weight in between. The doc didn't seem concerned at that time though. We did a month long road trip and even though we stopped every 3 hours to nurse maybe that threw off his schedule.

His development (aside from weight) is on track. Smiles, babbles, stands assisted for a minute or more, rolls on his side, we "talk" all the time and he's very alert. He doesn't have a set sleep pattern due to the traveling but we are working on that.

What would be the difference between supplementing with my milk and actual feeding from the breast? I guess in a bottle I can see actual oz amount? Do I run the risk of him not wanting the breast? I don't think he is tongue tied as I have seen a LC and she ruled that out. I had a hell of a time early on BF and had to get help. So much pain I feel like I have a good supply. They feel full and then less after feeding. Not sure what else to go by.

His output is on track. I change prob 6-10 wet diapers a day. Some days no BM but I have read that is not all that uncommon. When they do come they are that mustard color but have been a little foamy sounding and mucus like. I thought it was a dairy intolerance and have cut it out of my diet. That has only been a week though and haven't really seen a change. He doesn't seem to be in pain or trying hard to pass it.

[PatioGardener]

Well, looking at the who chart he has gone from ~40% at 2 weeks (estimating back to birth weight at 2 weeks old) to well below the 3rd %. Not even on the charts at 3 months. (If my math is right). You expect at least 5 oz / week for the first 3 months, which would be a gain of 55 oz in 11 weeks, and your little one has gained only 31. http://www.who.int/childgrowth/stand...boys_p_0_6.pdf

If you pump and feed that milk at the breast while baby is nursing he gets the bonus milk without bottle preference, while breastfeeding. See http://www.nbci.ca/index.php?option=...lips&Itemid=13

Are you cosleeping? How often do you feed at night? With slow weight gain many mamas find they need to offer the breast more often (say every 90 min - 2 hours) to get more feeds in a day. Also, a visit with a good IBCLC to recheck the milk transfer (see: http://www.nbci.ca/index.php?option=...lips&Itemid=13) would be a good idea.

Things that may cause low milk supply: birth control, cold medicine, poor latch, tongue-tie, poor milk transfer, not feeding enough at night when prolactin is highest, scheduled feeds, parsley, sage, mint and some other herbs.

There are also many ways to increase milk supply, if that is an issue.

Also, a rented scale at home can be useful to see how baby is doing. Once a plan for more milk is in place, it is then easy to see if baby is gaining ~1 oz/day.

Also you may want to consider a new pediatrician. yours is obviously not pro breastfeeding! (http://www.nbci.ca/index.php?option=...tion&Itemid=17)

[Bellabaz]

I didn't read all the other posts. But I had a similar situation with my dd2. She was fine until about 3 months of age then didn't gain anything for 3 months. She was growing/developing fine otherwise. She was very fussy,nursed every 45 minutes. Her poops were super stinky and weird and she had purple around her eyes. It ended up being dairy sensitivity and for awhile gluten would mess up her sleep. I did an elimination diet and got the stuff out of my system and now she is fine. She can have goat and sheep milk based stuff but no cow's milk. And now she is fine with gluten too.

I too had a ped give me ridiculous advice-I went there when dd2 was 6 months since she hadn't gained. I told her i suspected a food issue, particularly dairy. So she told me to give her a bunch of food (we hadn't really started solids at that point) and cow's milk to fatten her up. I didn't go back and I didn't follow her advice.

For fat for you, I am not a vegetarian, but try olive oil, nuts, avocados, coconut milk and oil, cook with butter.

Good luck mamma. Its scary, but I don't think you need to go right to formula supplementation.


ETA:-Mucusy poops were another big problem for dd2 when I was on dairy. Another common sign of an intolerance. It can take 3 weeks for dairy to be totally out of your system and also watch out for hidden dairy. Check out the allergy forum.

[TX Mama]

We do cosleep and he keeps his regular "schedule" of about every 3 hours. I do suspect low supply. We took a month long road trip but still fed every 3 hours or so. It was a little stressful. Then we came home and hubby went back to work and we won't see him for 2 months. So I am home with a newborn alone which increased the stress.

I have started taking fenugreek along with a tonic my LC suggested. We are also nursing more often to try to stimulate more production.

Is it possible some kids are just small? Neither me nor hubby are large. I would also think that if he were hungry he would cry more or be fussy. That's not the case. He's very alert and smiles all the time. That's not to say we don't have our moments.

I also suspect a dairy issue and have cut it out of my diet. That's only been about a week and I have seen little change. I'm hopeful all of the things I'm doing will kick in soon and we start to see a change.

[PatioGardener]

Originally Posted by TX Mama

I would also think that if he were hungry he would cry more or be fussy. That's not the case. He's very alert and smiles all the time.

This is most almost always the case: hunger = fussy baby. Unfortunately there are a few babies who are "happy to starve", and those are the ones who scare their mamas! These babies will truck along taking in not enough milk to grow and still be happy little guys. Fortunately we catch them by measuring weights every so often.

I'm so glad you are getting help with this from an LC. Has anyone talked about supplementing with your milk to give him a boost until your supply kicks back in? 24 oz below where the smallest you'd expect him to be is a lot to make up, it may be worth considering giving him some help before your supply ramps back up.

Good luck with it all, Mama. I hope he's back up to typical weight gain soon.

[TX Mama]

It was mentioned earlier but am wondering if he will take both breast and bottle?

It was kind of weird when I called my LC. I told her he was pretty underweight and suspected a low supply. Asked if I could come in to discuss options and she said she could save me the trip (it's a 45 min drive) and just tell me over the phone how to increase. She suggested the herbs, tincture, and 2 meds. I'm not big on meds so I am going with the herbs. I got off the phone a little unfulfilled. I would have thought she would want us to come in, weigh, feed, then weigh to see what we are dealing with. Discuss using my own milk to supplement, etc. I live in an area that does not have a lot of options. At least they are not easily found. Should I get back in touch with her and ask something else? Sometimes I feel like I'm walking in the dark.

[spughy]

At 3 months he will be totally fine with breast and bottle. Just make sure you pace the bottle feeding (ie, don't just hold it there and let him suck it down, make sure he's feeding in a similar pattern to the breast - suck for 10 seconds, rest, suck for 10 seconds, rest, etc.) Give the bottle *after* you nurse, then pump whenever you can.

However, before you try that, I would suggest you take the fenugreek and (probably?) blessed thistle your LC recommended - fenugreek as much as you can stuff down. You need to start smelling like maple syrup. (It's odd, but not unpleasant.)

And - most importantly - nurse more frequently!!! It doesn't matter if your baby isn't giving hunger signals. He seems to be accustomed to feeling hungry and you need to help him "relearn" how much and how often to eat. Nurse him every 2 hours, minimum (stay with his regular schedule at night though). Nurse him every hour, if you can do it. Your body will get the signal to increase supply, and his tummy will get used to not going long stretches without enough in it.

I have also noticed in my practice the odd mama - usually vegetarian, but vegetarianism isn't a problem per se, it's just easier to not eat enough as a vegetarian especially if you go off dairy - who loses too much weight too quickly post-partum and has a difficulty getting enough calories. This CAN affect milk supply. It doesn't always, different women will respond differently and some will lose unhealthy amounts and still produce more than enough milk - but you are probably not one of those "lucky" ones. Try to eat more. If you can't eat more fat, eat more carbohydrates. Oatmeal is good and has lactogenic properties - peanut-butter sandwiches are great, peanut-butter sandwiches on croissants are even better. Get those calories into you in any way you can (except maybe via refined sugar). Eat lots of eggs, nuts, avocados, lentils, hummous, etc. And make sure you're drinking enough water - it's easy to notice that you're thirsty, make a plan to go get a drink and then find that it's 2 hours later and you still haven't made it to the tap. If you don't have one already, get a water bottle, keep it by your side, and refill it at least 2 or 3 times a day.

HTH! Keep us posted!

[Bellabaz]

Hi again,
you aer getting some good suggeswtions here. Sorry that you didn't feel your LC was being very thorough but its good you are in touch with one. MAybe try what she says for a few days and if you are still not happy call back and request an appt. I also had supply issues with dd1 and dd2. I drank fennel tea, ate oatmeal ( with dd1 this was my #1 thing that worked), tried fenugreek, pumped extra and nursed on demand (we always nod though). If it is something you like, you can also have half a beer, which helps too. It might take a few days but your supply should respond. And make sure you yourself are eating well, drinking and resting enough. Stress can mess you up too. I know, know easier said than done =)

Good luck!