Six month old weight gain pattern - formula supplementation necessary?

[beachgirl]

Hi!

I need information. My six month old is showing a strange weight gain pattern. I have a good baby scale at home. Every morning I weigh him first thing when he wakes up. I also weigh him at the end of the day before he goes to bed. By the evening weight-taking he is around 6-7 ounces LESS than he was at the beginning of the day. So, despite frequent nursing, he is losing weight during the day.

I am nursing very frequently during the day, at least every two hours. It sounds like he is swallowing more or less the whole time. I can't figure out what's going on. 
 

I am just starting solids, only chicken broth right now. (I am following the GAPS baby solids plan). He doesn't eat much of it. It just doesn't seem like he is getting adequate nutrition from my breastmilk. I eat plenty, take nettle infusion every day, drink water, etc.

Does anyone know what the problem could be? And does this mean that I may have to supplement with formula to get him to gain weight? At this age I know he should be gaining about 1/2 ounce/day. I am very concerned.

[crunchy_mommy]

Why are you weighing him twice a day? Does he have a medical condition or other concerns?

When are his bowel movements? How often does he pee? I suppose if you are weighing him before his morning pee & before he's had a bowel movement, he will weigh more than later in the day.

What is his overall weight pattern? How much is his gaining (or losing) each week or each month?

Do you weigh him before & after feeding to see about how much he's getting through nursing?

[D_McG]

he is losing 6oz day?  So at the every week he is 42oz less?  (6oz/day * 7 days)

or are you saying that his weight fluctuates 6oz every day but there is an overall trend upwards?.  Beause that is totally normal.  Maybe you feed him before you weigh him and then he's just pee at night.

I guess I echo why you're weighing him so much?  

[Marissamom]

and the next morning is his weight back up? because it's completely normal for weight to fluctuate throughout the day, that's why they are supposed to do weight checks at the same time of day. 

[beachgirl]

Thanks everyone. Sorry, I should have clarified - he regains the same weight by the morning and re-loses it by each evening. I wouldn't be worried about the fluctuation except that there is NOT an overall trend upward; he's losing and gaining the same 6 or so ounces each day. For a baby his age (six months) this is not normal or healthy, based on my understanding. He should definitely be gaining at his age, if only 1/2 an ounce a day or so. 

I previously only weighed him once a month (we live overseas so I don't go to any traditional well-baby visits; want to make sure my kids are growing OK). When I weighed him I noticed he had gained almost no weight from 5 to 6 months. That is what triggered me weighing him each morning and evening. 

Is it possible that my milk supply is super low during the day, so he's not replenishing what he's burning off/peeing out? I hardly have to change any daytime diapers on him anymore. They are super-dry compared to how they used to be. I am still nursing a ton; possibly more than I did previously. 

Any advice or thoughts are most welcome!! Thank you!

[Megan73]

If he's not gaining overall, I can see why you're concerned. Kellymom.com has some great resources on normal infant growth and how to get more milk into your older baby.
If he's nursing more than ever but isn't having wet diapers, I'd wonder - has your cycle returned? Have you started some kind of hormonal birth control?
Do you have access to an IBCLC who could help you troubleshoot? Do you have a good family doctor to help you rule out a medical problem with your babe?
Supplementation with formula may well be appropriate but I'd want to check those things first. If he's six months, sitting alone and showing interest in food, you could also consider high-calorie solids like full-fat Greek yogurt, avocado, minced meat or fish etc.

[katelove]

What is  his  weight  doing week  by week?  Is it  trending  upwards,  even slightly?  If  his  nappies are normal  and he is alert when awake  and sleeping  well   then   I  would  suggest  that  you  stop   the  twice   daily weighs  and start weighing  him  once  a week,  naked,  at about the same  time  each day.

What  are  his  feeding   patterns  like?  My   LO  was  feeding  less  during  the  day  at that  age  because  she was  so  much  more  active. I  started offering  hourly feeds  even  if she  only  had  a few sucks.

What  is his mobility like?  It is pretty   common  for  babies  to  slow their  weight  gain or even  lose  weight when  they  first start crawling or standing or  walking.

I'm  not  familiar  with the GAPS  plan  but,  in the  circumstances   you  describe I  would be a bit  worries  about  the  chicken  broth.  It seems to me  that it could  be pretty  filling without offering much  in the way of calories.  I think I  would be inclined  to either offer higher  fat solids as PPs have suggested  or stop solids altogether for the moment and offer more frequent breastfeeds.

*If* he seemed  generally well then I'd probably do  all  of the above for 2  weeks if he was actually losing weight, and a month if  he was staying the same or  gaining at all. 

In fact that is almost exactly what I did do when my LO lost 30g one month, except for the solids because we hadn't started them at the time. I changed from monthly to weekly weighs, increased my offering of feeds and observed  her general health. During that month she had an overall pattern of slow weight gain  even though the weekly weights varied.

All  the best.

[crunchy_mommy]

Well the drier diapers is a bit concerning -- although fewer diaper changes is normal, he should still be having a good number of wet diapers each day. Is he still having regular bowel movements?
And it's not unusual to have a weight gain plateau but if it's lasting more than a month or two, I'd be worried. Is he just gaining a very small amount, or not at all?

One thing you might try is weighing him right before & right after nursing. The difference in ounces should give you an approximate of how much breastmilk he's taking in and whether your supply is low. There are things you can do to up your supply -- fenugreek, oatmeal, beer, etc. (I never had low supply so someone can chime in on that more if that seems to be the problem). So no, you don't necessarily need formula, although of course it's an option if you prefer that route.

If he weight keeps steady or drops and you still have an adequate milk supply, I would see a doctor to rule out any underlying metabolic issues.

I have no idea what the GAPS baby plan is but I don't know that chicken broth is a route I would take (I'm a bit biased though, we don't eat meat)... There are higher-calorie, more nutrient dense foods you can introduce that might help with his weight... things like avocado, sweet potatoes with oil (or butter), hummus, fruits, etc. When did you start introducing foods/liquids besides breastmilk? Was it by any chance around the same time he stopped gaining weight?

[beachgirl]

Thanks so much for all the thoughtful replies. He is indeed starting to crawl and becoming very mobile and wiggly. Also, he is distracted during feedings during the day - he has such a hard time focusing on nursing unless he is REALLY hungry. I am going to start weighing him weekly instead of daily as was suggested, thank you. I am also starting some more nutrient dense solids - started egg yolks yesterday. However, it is such a small quantity at the beginning that I can't see it really adding to his weight gain by much. Also I heard that for the first year babies are supposed to get the majority of their nutrients from bm or solids, but I don't really understand how. I don't take hormonal birth control but I feel that my cycle may be trying to start up again and perhaps affecting my milk supply adversely? 

Also, to supplement my concern, I was reflecting on how he was born big (9lb2oz; 4150g) and stayed in the top percentiles in weight for the first month or two, then began declining in percentiles each month and as of his six month check, was in the 60th percentile. Just wondering if this is normal.

Thanks again to all for your help and thoughts!

[katelove]

It is pretty normal for babies to move around their percentiles. The article I've linked below is from the Australian Breastfeeding Association (our equivalent to LLL). It talks about percentile movement and when it is something to be concerned about.

http://www.breastfeeding.asn.au/bfinfo/weightgains.html

[beachgirl]

What a great resource, Katelove! Thank you so much! That was very helpful.