11 Month old not gaining well. Help please :(

[Jaspersmommy]

Hello,

I've read a lot of previous threads but I feel my situation is a little different so I'm posting...

Yesterday I took my 10.5 month old daughter to a well-baby check.  My doctor (who is usually very good and pro-bf) is quite concerned about her lack of growth. She's only gained a pound in the past 4 months and nothing in height.  Her birthweight was 6 pounds and she's now 16 pounds, 15 ounces.  She gained well in the first 6 months but seems to have dropped off considerably since then.  The doc said he wants to see her in a month and if she hasn't gained well in that time, he wants me to supplement and I'll be referred to a pediatrician.

I know that all babies have their own rate of growth but I can't help but be troubled by this.  All the information (including Dr. Sears) says she should be gaining a pound a month at this age.  The doc even said 1/2 pound would be less alarming.  He actually said she's "flatlined on the charts" and isn't growing :(.  I'm not sure whether he's using the WHO charts or not and I'm not sure it matters since his issue isn't with percentiles but the basic fact that she's only gained a pound in 4 months.  I'm not convinced about the height measurement since I know that isn't always the most accurate but that's alarming as well.

I just don't know what to do.  She nurses an absolute ton!  We cosleep and she nurses all night long and tons throughout the day as well.  She doesn't really eat solids...she might nibble on a piece of pepper or avocado but I don't spoon feed her.  I'm going to try offering her both breasts at every nurse and just try to generally encourage her to nurse more.

I'm worried :(

Anyone btdt and have any stress reducing advice for me?  Thanks mamas

[Bokonon]

It's actually really normal for a breastfed baby to level off after 6 months - they get more active and burn more calories!  And your doc may have caught your baby between growth spurts.  Has she grown in length and head circumference?  Meeting milestones?  If so, then there is little reason to be alarmed.

Have you seen this?  "Watch the baby, not the scale"

http://drjaygordon.com/pediatricks/newborns/scales.html

[Jaspersmommy]

Well that's the thing too, she's completely dropped off the charts in length/height.  She's grown 2 cms in 4 months but went from being in the 50th percentile for height to way below the chart.  My doc used the term flatlined.  Sigh.  That being said, both my husband and I are short people.  I'm 5'3 and he's about 5'4.  

I know that genetics play a key role in height but she's completely dropped off the chart.  I could understand if she's thinning out from all the mobility but it seems that she isn't growing well :(

Thanks for the article.  I hadn't read it.  Perhaps I'll bring it to my next appointment...

[MichelleZB]

Also, maybe she might be interested in stepping up the eating a little bit? Like, see if you can get some spoonfuls of solids in there? Worth a try. She is of the age where she could be eating a few more solid foods. I'd try that before supplementing with formula, certainly.

[krobin123]

My nine month old gained no weight in the last three months. My doctor noted that he appears to be doing great developmentally and the increased mobility is causing him to level off. I wouldn't be too concerned. Also last week at playgroup two other mothers were in the exact same situation with their little ones with the same info from their doctor.

[PatioGardener]

Before really worrying, I'd make sure that the scales are accurate (and the same one that baby was weighed on before) as sometimes they can be waaay off. I'd also plot baby's weights from birth on the WHO chart : http://www.dietitians.ca/Downloadable-Content/Public/LFA-WFA_Birth-24_GIRLS_EN_bw.aspx

If baby is not maintaining her curve, and especially if she is not maintaining both her length and weight curves, I'd be looking for reasons. But first I would want to re-measure and make sure that the weight and length are correct! It is so easy to get an incorrect length on a squirmy baby, and scales can be off by as much as a pound!

From looking at the WHO curve, a 6 lb at birth baby is on the 15th percentile curve, and a 16 pound 15 oz (say 17 lb) baby at 10.5 months is getting pretty close to the 3rd percentile, but has not gone below it yet.

If weight gain was a real issue, the first thing I would look into is milk transfer/amount of milk baby is actually getting. Sometimes when older babies nurse a ton, they could be needing to nurse more often to get enough milk. Things to consider that impact milk transfer: latch, tongue-tie, maternal milk supply.

If it turns out that your baby isn't growing at a typical rate, do you have access to a good lactation consultant? If finances are an issue, you may find one at your local public health unit.

You sound worried - having a chat with an IBCLC who can assess your baby, latch and milk transfer may put your mind at ease.

Good luck!

[Altair]

Can you try upping the solids (especially good fats and proteins)?  Most babies don't need purees, but some mashed avocado for a baby not growing well can't hurt.  I'd also try soft egg yolks, scrambled eggs, (better to be pastured to make the most nutritional bang), plain full fat yogurt with a little fruit pureed in, letting her suck on big pieces of grass-fed meat/marrow, roasted sweet potato "fries," and getting a bit of olive oil/coconut oil in her food.  And continue to let her nurse as much as she wants. 

I would add organic nutritionally dense whole foods in long before using formula at this age. 

[Rrrrrachel]

My ten month old has gained maybe half a pound in four months. She totally stalled out/leveled off at six months. She's a little chunker, though, or as the doc out it "she has some to give" after she'd actually lost a it at her last appt (she had been sick.)

I second pushing more solids over supplementing with formula as well as not being convinced anything is really wrong. What does the mommy gut say? If anything I would try to work in more fats like others have said, avocado, coconut oil, olive oil, nut butters, etc. around here were a full fat dairy family, but I know not everyone does dairy.

[parsley]

Both my kids have been really slow growers.  When DD1 was an 6+ months old (not sure exact age, but once she was actually enjoying solids) I decided to start lacing her solids with fats to try and force her to gain more quickly.  I just added a T of olive oil to her solids when she ate them or mashed avocado into everything-- bananas and avocado, potato with olive oil, apple with avocado, etc...  She ate an avocado a day from 9 months to 2 years and she'll still gobble one down when we have them around. 

In retrospect, I don't think I did any harm to her but I don't think it was necessary either.  I'm now weathering another round of "she's so tiny" comments about DD2.  I don't know if I'll try the fat lacing plan again or not once she is eating solids. 

If you are actually worried, I would try the fat lacing plan.  But, at first glance, it doesn't seem to me that there's anything to be worried about here if you babe is active, alert, engaged, learning and developmentally on track. 

Hugs, mama.

[fruitfulmomma]

The fact that she has gained nothing in height would be more concerning to me than the weight issue, though I would guess it could still be within the normal range. I have one girl who just tends toward being small and is very close in size to her sister who is 2.5 years younger. We never did wbv with her so I don't know where she was on the charts but she was tiny and is in fine health.

Babies do tend to slim out one they start moving around a lot which could explain no weight gain.

Have you ruled out other health issues? Food allergies for example. Not absorbing nutrients properly could contribute to slow growth.

Along with what the others said, keep breastfeeding as much as she will and use solids rather than formula. As long as she is breastfeeding well she really can get any additional nutrition she needs from real, whole food sources which are nutrient dense...avocadoes, coconut oil, butter, whole milk yogurt and cheese, eggs, etc... 

[Jaspersmommy]

Thanks to everyone for all the responses!!

I have been trying to nurse her more frequently and making sure I offer both breasts as well.  I think she's getting more intake as her bowel movements have increased in size and frequency.  I'm not sure that her intake could really be an issue if her output is good.  She's has a ton of wet diapers (10+) each day and she usually has a bm daily also.  Could she still not be getting enough?

I'm trying to increase her solid food intake also with a heavy emphasis on fats and proteins.  Unfortunately it seems she's just not that interested.  

Quite honestly I think the doc is most concerned about her height which was measured @ 66cms. I've plotted her growth on the WHO charts and for length, she's completely dropped off the chart. :(

With that being said, my mommy instincts tell me that genetics are at play.  I'm 5'3 and my husbands only 5'5.  He comes from a *really* short family. His father is about 5'3, sister is under 5 feet and many uncles and aunts are under 5 feet as well.  I told the doctor this but I'm not sure he really listened or cared.  I'm wondering if the pediatrician will take more interest to the genetic component. 

The doc told me that she hadn't grown in length at all since Jan however when I called to get all the specific numbers so I could plot them myself, I found out that she had grown 2 cms.  While not a huge change I was very happy to hear that there was growth.  Maybe she's just a peanut who is growing slowly?  Of course I can't help but be worried but she's happy, developmentally right where she should be and generally looks healthy.

My son was a complete tank (different father) so this is all new for me.  And stressful.  Sigh.

Thanks again to all you wonderful mama's for your great advice and support!