Help! My BFing 15-mo old nurses a TON but losing weight. What's going on?

[Mimma]

Hi! Until now I've been happy reading everyone's posts and getting great ideas, but this time I need some advice... I took my 15-month old son in for his regular checkup and found out he has gone from 17.8 lbs to 17.1 in a few months. His doctor wants me to look into my milk supply. I told him that my DS has been nursing like a newborn and while his appetite for solids fluctuates a lot, he seems to eat at least the minimum amount that he needs. He doesn't love cow's milk but i can get him to drink anywhere from 1 to 8 ounces per day.

My question is, if DS has been nursing very frequently day AND night (sometimes hourly), why isn't he gaining weight?  I think i still have enough milk.  He does seem to get satisfied though sometimes he cuts a session short due to some distraction then wants to nurse again minutes after.

I haven't pumped since he was 3 months and I'm afraid that I won't respond well to a pump if I rent one. DS is healthy and very active, and is hitting all his milestones. Can his frequent nursing be his attempt to get as much milk from me if my supply is low? Can a hospital grade pump give an accurate measure of one feeding? 

Any advice is appreciated.

[TiredX2]

I do not like to consider myself an alarmist, but that would concern me.

My daughter lost one ounce from 10 to 15 months.  During that time, she continued growing in height, in head circumfrence and she went from crawling to running.  She also had her first illness and a poor introduction to cow's milk.  No weight gain in those months is not uncommon---- with increased mobility comes both decreased food intake and increased calorie usage. 

With your son's weight, though, my concern would be that he was already under the 5th percentile  (if his 17lb 8oz weight was at 12 months).  He is now significantly below the 2nd percentile:

http://www.cdc.gov/growthcharts/data/who/GrChrt_Boys_24LW_100611.pdf

How much this would concern me would depend on a variety of other factors:

1) Has his head increased in size

2) Has he gotten taller

3) Is he meeting developmental milestones (walking, begining to talk, etc...)

4) Does he have other indications of good health (good skin tone, shiny hair, strong finger nails...)?

In your situation, assuming he is perfectly healthy and happy *other than his very low weight* I would recommend a limited wait and see approach.  Can you have him weighed again in a month and see what happens?  Was he weighed on the same scale both times with similar clothing/nakedness and at the same time of day.  The one time that my midwife was concerned (we did a well baby clinic with the midwifery) was when it appeared that my DD had *lost* about 1/2 lb-1  lb.  In the end, the scale was actually incorrect! 

Lastly, does this growth pattern make sense in your family?  Are you or your DP particularily small?  Are you non-white (some ethnicities have different average sizes/growth patterns that can cause concerns when compared to a mostly white (often formula fed) population)?

Good luck!