Drop in Weight Percentile

[Evandy]

My EBF 4-mo-old DS dropped from 51st percentile at his 2 mo well baby visit to 27th at 4 mo visit. The 27th percentile doesn't worry me--DD has always been between 5th and 15th percentile. The drastic drop is a little concerning. He is perfectly happy and healthy in every way I can tell--he smiles, laughs, makes eye contact, is developmentally on track, nurses every 3 hours or so. I wouldn't worry if this happened when he was learning to crawl or walk, when babies usually tend to slim down.

 Instinct tells me he is fine. I just worry when my very very pro bf ped looks at me and says,"You could go ahead and start solids." My response was, "Oh, we're going to wait at least 2 more months." Her:"Well, yes, normally, but..." Me:"His weight?" Her:"We just don't want to see him any thinner." I was thinking "what's the big deal, his percentile has dropped a little," but this was before I saw it was down to 27 (was thinking maybe 40-ish).

Clearly, at 4 mo, I just don't feel he's ready for solids. I'd like him to at least be able to sit independently before we go there.

So, I'm thinking I'll just offer the breast more often, like every 2 hours whether or not he seems hungry. I'll check his weight in a couple weeks and see how we're doing. Does this make sense? Or am I taking the situation too lightly?

[mra]

Was your ped using the correct growth chart - the one for breastfed babies?

[mrskingred]

I think you need to go with your mama instincts. Then again my EBF DS dropped from 97% at 2 months to 50% at 4 months then down to halfway between 25% and 50% at 6 months which is when he started on solids (grabbed a plum from DH). He maintained this for his 9 month visit but dropped to between 10 and 25% for his 12 and 15 month visits. DS could sit independently at 4 months, but didn't crawl until 6 months. I was concerned at his weight loss before 6 months but the ped and BF counsellor were not.

I did try to nurse more often but DS refused - too busy watching everything going on.

[poorlittlefish]

I am a worrier, so take this advice with that in mind.

I would be worried.  I wouldn't start solids yet though...MAYBE in a month but I would probably offer more often, and/or pump after a few feedings per day to increase my supply.  I would do formula before solids at this age. 

[tabrizia]

I won't be worried.  DD's percentiles changed a lot between each appointment till we hit 9 months and she started moving to the percentile she was suppose to be at, ie dropping from 45th at 6 months to 15th at 9 month and under 5th where she has happily stayed since.

That being said she jumped a lot each appointment at 2 months she was in the 50th then at 4 months she was down to 35th and then back to 50th at 6 months.  Remember a not a lot of weight can make a huge difference at this stage.  As long as your DS is growing and meeting milestones I won't be too worried about it.

[Evandy]

Thanks for all the encouraging words, mamas! Good to know I'm not that others have been in the same situation.

Originally Posted by poorlittlefish 

I am a worrier, so take this advice with that in mind.

I would be worried.  I wouldn't start solids yet though...MAYBE in a month but I would probably offer more often, and/or pump after a few feedings per day to increase my supply.  I would do formula before solids at this age. 

Forgot to mention that I have no supply problems. Oversupply if anything! And I will be offering more frequently. Although I wonder if frequent snacking will not alow him enough hindmilk.

[PatioGardener]

I agree with the PP who asked which growth chart you are using. Try this one out - it is from the WHO and show how typical, healthy term babies should grow, not like the CDC chart which is a reflection of how some (mostly white, formula fed babies from mid-Western USA) do grow.

http://www.dietitians.ca/Downloadable-Content/Public/LFA-WFA_Birth-24_BOYS_EN.aspx

[Evandy]

This is interesting. CDC now recommends using the WHO growth chart for babies 24mo. and younger. But my ped's software has the growth charts from 2000. I went to this site (too lazy to plot on a graph), and got the correct percentiles. For weight he went from 57th at birth, to 50th at 3 weeks, to 34th at 2 mo, to 15th at 4 mo. Height went 87th, 70th, 60th, 39th. So, a general downward trend. Kelleymom has guidelines for how much (in oz) a breastfed baby should gain weekly, and he was behind for the last few weeks. But, I have been encouraging more frequent feeding, and he's been receptive, so hopefully I can get him back on track.

[Janeen]

You think that's bad, mine dropped WEIGHT between two and four months. Talk about FREAKED! I can't remember what her percentile was but she was 11 lbs and 7 oz at 2 months and she dropped to 10 lbs and 12 oz at just past 4 months. The ped sent me home with almost 100 bottles of formula and talked me into having her be given a bottle at the appointment (especially since I was there with both girls for their appointment). He was also saying that if we didn't get her weight up, she may have to go in to the hospital. I immediately picked up some Blessed Thistle and Fenugeek and started nursing around the clock. I did not use the formula and I did not give her any solids (though that was a thought before giving her formula). She did gain weight and has been gaining weight but ever since, she's been down at the 2nd percentile. It bothers me because my older daughter for weight has always been well above average (at 5, she's around the 74th percentile for weight). I try to remember that my youngest probably takes after her daddy and my older daughter takes after me but it's hard when she still has 0-3 months clothes that are too big for her (she's 8 months old now).

I think part of it was depression that had me not as focused on her (and stress from my husband and older daughter returning home from South Korea and a bunch of other issues that all hit at once) and part of it was genetics taking over but it was really worrisome considering prior to that, she had gained over three pounds between day 6 and 2 months of age (and she had gotten back to her birth weight and then some by her 6 day appointment).

Janeen

[Janeen]

Oh ouch, according to that chart, my daughter went from 51st percentile down to below 1 percentile! Yikes! She's just NOW up to past the 2nd percentile as of her six months appointment when she was at 12 lbs and 11 oz. I haven't been keeping up with height as much though but I know she's like an inch behind where her sister was at 6 months.
 

Originally Posted by Evandy 

This is interesting. CDC now recommends using the WHO growth chart for babies 24mo. and younger. But my ped's software has the growth charts from 2000. I went to this site (too lazy to plot on a graph), and got the correct percentiles. For weight he went from 57th at birth, to 50th at 3 weeks, to 34th at 2 mo, to 15th at 4 mo. Height went 87th, 70th, 60th, 39th. So, a general downward trend. Kelleymom has guidelines for how much (in oz) a breastfed baby should gain weekly, and he was behind for the last few weeks. But, I have been encouraging more frequent feeding, and he's been receptive, so hopefully I can get him back on track.

[leigh09]

It is concerning that your baby is dropping so much in weight.  I have had all small babies, my doctors & lc all said it doesn't matter what the percentile is, as long as it's consistent.

One thing that has helped my babies is a tip from the book "Mother food for Breastfeeding Moms".  Eating more healthy fats ... olive oil, sesame oil, eggs, butter, and the like ... can increase the fat content of your milk.  The book has a specific strategy for boosting the fat in your milk.

Another thought, if you are concerned that baby isn't getting enough hindmilk kellymom.com has great info on helping your baby get more of the hindmilk.

Sending you hugs.  I have had many worries about my baby's weights, I know it's hard.

[katelove]

I wouldn't be too worried about what you've described. The Australian Breastfeeding Association (our equivalent of LLL) has a good discussion of weight gain here

http://www.breastfeeding.asn.au/bfinfo/weightgains.html and your LO falls within  their acceptable limits.

To maximise his hindmilk consumption you could try feeding from the same breast several times before swapping sides, depending how often he feeds and for how long.

[SilverFish]

i personally would be concerned. i have had a low percentile baby from the beginning (approx 10-15th) but she always stayed on her curve. i would worry about a baby dropping percentiles. i wouldn't offer solids, probably, as i really don't think many solids that a baby could easily eat at that point would be high enough in calories to be a benefit over breastmilk. if your ped was going to recommend cereal and other typical first baby foods (applesauce etc), those are mostly bulk... they would just be taking up space in her gut.

i would be taking a good look at my own diet though, and very much up the fat and protein intake. actually, i did anyway, as i was starting to feel run down from nursing when my dd was about 6months. i started liberally drenching everything i ate in olive oil, coconut oil and milk, lots of nut and seed butters, lots of vegetable protein etc. it really helped my own sense of well-being and she has gained very well despite not really being into solids until a couple months ago (now 13 months).

i don't have much knowledge about oversupply, but i have heard that foremilk is less high in fat than hindmilk, so i would try a little block feeding, as well as just nursing a LOT. your baby is old enough that maybe he's getting distracted by sights and sounds around him and not nursing as fully as he should be? dark, quiet room, skin to skin, staying in bed together in the evening or morning, lots and lots of offering, those should all help him take in more milk.

after all that, not all babies are going to grow the same way, despite the charts. if you think he looks healthy, happy and alert, then he is probably fine and will either catch up or has found his new curve. but i would still want to watch his and your own intake a bit more carefully for a few weeks until you know whether he is going to stay stable or continue to fall on the charts.