6 months and 13 pounds, maybe I should be worried?

[whoami]

My son just turned 6 months and he is just barely 13 pounds. He was born tongue tied and got it clipped and the only challenges we've really had is him gaining. I just pulled up the WHO charts and it doesn't look like he's even on that chart.

I really haven't been worried because he's met all his milestones and started scooting/crawling last week. I don't know what to do, what suppliments if any I should take. My supply seems good, I fill up, I hear him gulping. The only thing though is he's been a spitter upper but not so much lately. Our doctor is booked out until August for his wbv but I can get in for a lactation consult next week so I'm jumping on that. I feel like I am feeding him constantly.

Any words appreciated.

[PatioGardener]

If that were my son, I'd plot all his weights on the WHO chart and look for a trend. Is he following the curve or has there been a drop in percentiles with time?

For example, my guy was born at 8 lb, and lost a pound at birth. He was up to 8 pounds again at 2 weeks. At 6 months he was 17 pounds - right on his WHO curve.

If he had 'fallen off' his curve, then I would get the help of a good IBCLC as soon as possible (tomorrow or the next day at the latest). Together we'd likely do daily weights to measure intake, before and after feeding weights, and I'd get her to take a really good look in his mouth to make sure he didn't have a posterior tongue-tie (did you have an anterior one clipped?)

I'd also get his latch evaluated.

And I would start pumping after feeds to increase my supply, I'd look into herbs and or domperidone if supply was an issue, and if he was in need I'd supplement with pumped or donor milk at the breast, or with a cup.

Different babies grow at different rates. I'd want to make sure that my DS was growing to his potential and was not limited by milk intake. If increasing his intake didn't result in faster weight gain, and he was healthy (that is, no metabolic illness, heart issues etc) then I'd relax and know that he was growing at the rate that was right for him. But I'd check everything else out first.

Hope that gives you some ideas.

[whoami]

Thanks patiogardener for taking he time to reply.

There was a dip down on the curve but I don't have all his weigh in information with me. I know he was born 7.13 and was discarhed at 7.5. At his 1 month visit he was 9.2 and in the 50%, then fast forward to 4.5 months he was 11.14 and below 3rd%. Because of the change in trend they were concerned. He was born with a scar on his abdomen so he went in for an u.s last month and everything came back normal.

His brother was below the 5th percentile for height and weight and didn't get over 25% for either until 15 months. At 6 months he was 13.9 and only 23" so they are not that far off. However, baby is taller so far at 26".

Our ped is also a IBCLC and she keeps saying the latch looks good. I don't think it's a supply issue but what herbs are good? I got squeezed in for a consult Thursday. I'll try pumping again but he won't take a bottle at all.

[PatioGardener]

No time right now just want to say pumping is good - keeps your supply full even if baby won't take the extra milk.

Will write more when my baby is sleeping!

[flower97]

My daughter is a week away from being 7 months and is only at the 13 lb. mark or so.  But for us, I feel a lot of it is her health. She was born with hydrocephalus and has spent the last 3 months in the hospital in and out of surgeries. I have been pumping, she takes my BM from a bottle if I am not around, she is emptying my breasts as I have started hand massages after nursing. But she has always been one to nurse on one side only and for a short time then be good for a few hours... Any suggestions would be great. 

[homemademom]

Motherlove Special Blend supplement REALLY helped me increase and maintain my supply (it's still not adequate, but it's the best it's been), as much or more than Domperidone.  I let the LCs talk me into using the herbal supp from a local store for months instead of Motherlove and it was really a mistake. The stuff is working for me.

My baby was also tongue tied and we're going back for a revision because they didn't laser enough of it before (it's a posterior tongue tie and it wasn't as obvious when he was 1 month old as it is now that he's 5 mths). I feel like he tires from nursing and would be better at transferring milk if his tongue was more free.  He does his best, but side-lying is difficult for him to get a good latch, and night time is when he gets his best/most milk and no supplements so I want to improve it as much as possible. Good luck!

[PatioGardener]

Dropping of the curve from 50% to below 3% would really worry me. As your ped is an IBCLC I would think she is using the WHO growth curves?

How long does she spend with you and baby during a visit? Does she watch an entire feed? I ask this because IBCLC or not, if you are seeing her as a ped then she likely does not have the time to fully assess breastfeeding as you would expect from an IBCLC visit. Can you see an IBCLC for breastfeeding assessment? You don't just need a latch assessment but a milk transfer assessment, and if I were you, hands on advice for at the breast supplementation of expressed milk.

[whoami]

Quote:

Originally Posted by flower97 

My daughter is a week away from being 7 months and is only at the 13 lb. mark or so.  But for us, I feel a lot of it is her health. She was born with hydrocephalus and has spent the last 3 months in the hospital in and out of surgeries. I have been pumping, she takes my BM from a bottle if I am not around, she is emptying my breasts as I have started hand massages after nursing. But she has always been one to nurse on one side only and for a short time then be good for a few hours... Any suggestions would be great. 

I am sorry to hear about your daughter. That must be so hard on you both. No suggestions, but .

Originally Posted by homemademom 

Motherlove Special Blend supplement REALLY helped me increase and maintain my supply (it's still not adequate, but it's the best it's been), as much or more than Domperidone.  I let the LCs talk me into using the herbal supp from a local store for months instead of Motherlove and it was really a mistake. The stuff is working for me.

My baby was also tongue tied and we're going back for a revision because they didn't laser enough of it before (it's a posterior tongue tie and it wasn't as obvious when he was 1 month old as it is now that he's 5 mths). I feel like he tires from nursing and would be better at transferring milk if his tongue was more free.  He does his best, but side-lying is difficult for him to get a good latch, and night time is when he gets his best/most milk and no supplements so I want to improve it as much as possible. Good luck!

Originally Posted by PatioGardener 

Dropping of the curve from 50% to below 3% would really worry me. As your ped is an IBCLC I would think she is using the WHO growth curves?

How long does she spend with you and baby during a visit? Does she watch an entire feed? I ask this because IBCLC or not, if you are seeing her as a ped then she likely does not have the time to fully assess breastfeeding as you would expect from an IBCLC visit. Can you see an IBCLC for breastfeeding assessment? You don't just need a latch assessment but a milk transfer assessment, and if I were you, hands on advice for at the breast supplementation of expressed milk.

I think my sons tongue tie is anterior, it was underneath the tongue. I wonder if he's tired too because he seems to eat for a minute if that then pop off, the only time he doesn't is if he's super hungry or very tired. He gets very distracted when eating so I usually lay down with him so now I wonder also if maybe that latch isn't good.

The ped doesn't spend much time with us at all which is frustrating and she hasn't watched a whole feed. I have a consult with another ibclc today to see how much he's transferring and she will spend a whole hour with us so I hope it helps. Also go to a bf support group when I can, which is where I got the WHO chart, doc doesn't use it in office. I am flip flopping between being worried and not, I just want to know he's okay, which I feel in my heart he is but i can't figure out why he won't gain. Any bottle recommendations? We have breastflow, drops ins an evenflo glass bottles. Any other herbs to try?

[gemasita]

A posterior tt is under the tongue.  It's just not as obvious as a "regular" tt.

As for bottles, my understanding is the the breastflow and platex encourage a strong suck. If you want to see if he'll take in a lot when he doesn't have to suck hard, I'd try the evenflo glass that you have.  We have some and the slow flow is still pretty fast.  That might tell you what you need to know.

[whoami]

So babe is up to 13.9, right where my other son was at 6 months. Doc wants to run blood tests (lead level, com metabolic panel, and cbc w diff w pit) and is referring to gi specialist. Had blood panel done few months back when he had a cold and came back fine. Asked her to explain more about the tests but she didn't so need to call nurse and ask her. I think I should just switch to my other sons doctor because I feel this one doesn't hear me or care what I have to say. At least at the new doctor they'd be able to pull up my sons chart and compare the two and get another opinion. Doc also recommended giving him a sippy cup with water and start solids. To me, it makes no sense to give him water because then he won't be able to hold down milk, especially when he spits up still.

Also, when I saw the lc she said I only had one let down and so I've started taking lactate support to help increase supply. Part of me just wants to quit bf because I'm just exhausted. I feed him all the time and it takes so long for a feeding because he pops off and takes a while to get settled. I don't know what else to do.

[homemademom]

I'm sorry you're so tired!  We had a horrible first 4 months, so I really feel for you.  Like Gemasita said, the posterior tongue tie is under the tongue, it's just not as obvious. It's not usually a thin stretchy frenulum, but something thicker and more fibrous.  Oftentimes you can't see it well, but it does keep the tongue from being as flexible as it needs to be. Long feeds and frequent feeds along with low weight gain can definitely be a sign of PTT or at least, some problem with transferring milk.  I really recommend finding an IBCLC.

I don't know if you're anywhere near Phoenix, but lowmilksupply.org lists this doctor as a specialist in treating tongue tie. It might be worth an evaluation.

[whoami]

Originally Posted by homemademom 

I'm sorry you're so tired!  We had a horrible first 4 months, so I really feel for you.  Like Gemasita said, the posterior tongue tie is under the tongue, it's just not as obvious. It's not usually a thin stretchy frenulum, but something thicker and more fibrous.  Oftentimes you can't see it well, but it does keep the tongue from being as flexible as it needs to be. Long feeds and frequent feeds along with low weight gain can definitely be a sign of PTT or at least, some problem with transferring milk.  I really recommend finding an IBCLC.

I don't know if you're anywhere near Phoenix, but lowmilksupply.org lists this doctor as a specialist in treating tongue tie. It might be worth an evaluation.

Thanks! I'll call them tomorrow. His current pediatrician clipped his tongue when he was a week old so maybe this doctor can look at it and see if it did the job.

[Marissamom]

it does sound like maybe when his TT was clipped it wasn't clipped all the way, and that big a percentile drop is a concern. it's also possibly a reflux or food intolerance or allergy issue (food sensitivities and allergies can cause lots of spit-up)

[beckington]

Originally Posted by whoami 

So babe is up to 13.9, right where my other son was at 6 months. 

Did your other son drop in percentiles as well, or was his growth more consistent?