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Sudden poor weight gain, behind in skills at 10 months. Feeling awful :(

1K views 12 replies 9 participants last post by  SarahKatN 
#1 ·
I just took my little one to the ped for her 9mo wbv (a month late because we switched practices) and I'm feeling so sad right now. She dropped from the 60th% for weight to the 20th% and from the 80th% for height to the 25th%. The doctor also noted poor muscle tone and was concerned that she wasn't pushing herself up to sitting (she sits well, but only if I put her there). She

's also not crawling and no where even close to standing. In fact, she hates when we hold her up like that to bear weight on her legs. The doctor thinks that my breastmilk has lost some calories or I'm not making enough and that's the issue.

She doesn't nurse a ton during the day (around 30 min before each nap and before bed, probably one or two other very short nursing sessions during the day because she's so distractable. Then at night she's up 3-4 times and I nurse her each time, but she seems to be doing it out of comfort, not hunger).
By the way, I'm sorry for the odd formatting of this message. My husband's keyboard is very screwed up apparently! Ok, so anyhow, I'm feeling awful at this point. I'm blaming myself completely. I have two older daughters who were always top of the charts for height and weight and still are. I'm wondering if I'm not spending enough time feeding and playing with this babe because I'm so busy with three kids now. Dr wants to bulk up her diet with legumes, yogurt, avocado and other high fat foods, as well as introduce formula. I'm planning to up my water intake and do what I can to increase milk supply, if that's the issue. I don't know. I just feel like I'm letting DD down and not giving her the best start that I gave to my older DDs.
 
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#2 ·
Hugs, Momma!!!

First, give yourself a break. As a mother of 3, I understand being SO busy. If baby isn't asking to nurse, it's easy not to offer when you are being thrown in 3 different directions.

First, I would make a conscious effort to nurse baby MORE often. Find a place in your house that is the least distractable for her, and try to nurse her for longer and more often. Offer both sides. Offer, offer, offer to nurse. I wouldn't offer formula. Can you pump any milk or hand express? I would offer that in a cup/sippy before formula.

For the developmental stuff....again, make a committed time to play with your baby. My dd wasn't rolling over at.all. at her 4 month appt. OR swatting at toys. My pediatrician suspected that I just needed to play with dd2 more often and that she would get it. She was spending a lot of time in arms ( which is NOT bad at all) and I just wasn't playing with her actively like I did with my other two. And viola...she got it. She is now 8 months old, and nowhere near crawling....BUT, she doesn't spend a lot of time on the floor either. How would she learn to do this, if she doesn't et the opportunity to do so, right? Oops. But, someone is always holding her....lucky baby.

Try and slow down ( so hard!!!) and I bet you'll see some advancements in everything!! Good luck!
 
#3 ·
You switched pediatricians right? Are you aware that there are multiple growth charts? It is very possible that the new doc uses a different chart. I would not assume your child dropped from 80 to 20 percentile until you explore that. This is the WHO chart and much more accurate for breastfed babies. http://www.who.int/childgrowth/standards/en/ Here is the CDC one http://www.cdc.gov/growthcharts/clinical_charts.htm The AAP actually now recommends using the WHO chart up to 2 years old.

I am not impressed that the doc's answer is to introduce formula instead of looking at alternatives like increasing your nursing sessions or giving expressed breastmilk as the PP said. I agree - more nursing, even if it means lying in bed nursing multiple times per day. Pumping or hand expressing is a good idea too.

As far as the developmental stuff, from what you are saying I'm not seeing any red flags. Each child develops differently, and there is no magic age where every child does things - there is a window. This is a great resource for seeing if your child is on track. http://www.who.int/childgrowth/standards/motor_milestones/en/index.html

Hugs mama.
 
#4 ·
She looks like she's within the window of normal by the chart the PP provided with regard to meeting milestones.

I wouldn't worry too much about the dip in height/length -- if you switched providers, it's likely they measure differently (did one stretch the baby out and the other not? did one use a measuring tape and one use a stationary ruler on the side of a scale?) 1/4 of an inch makes a big percentile difference, and user error in measuring that happens a lot.

As far as supplementing goes, I'm not sure I'd worry too much about that either (though it's hard! I know!) How's diaper output? Could you get in to an LC to do a before/after weighing to see how much she's taking after a good feed? If you do decide to supplement, can you squeeze in some pumping sessions and supplement with expressed breastmilk? (Personally, I would make a concentrated to offer the boob more and to focus on getting in several good feedings over pumping/supplementing at all, unless it really is necessary.)

Hugs!
 
#5 ·
Thank you all for the feedback. I feel like she is still within normal guidelines, just on the lower side of them, so I think I'm going to do what I can to help her from falling lower. I think you're right, 1sttimemama, I need to slow down and take the time to nurse her enough and play with her more. She is on the go with us a lot and I spend a lot of time holding her. She gets some good floor time each day, but doesn't seem too motivated to stand at this point. She is super close to crawling, though. I feel like that could come any day. She's also doing other things fine, like feeding herself and signing and waving. I'm feeling a bit better today than I was yesterday.

It was just an all around bummer of an appointment. When we weren't talking about her slow growth, we talked about her constipation (she goes days and days without pooping and strains and grunts and cries) and her frequent nightwakings (she goes 1-2 hours between wakings all night long. Meanwhile she slept 10 hr stretches from 2-5 mo!). The dr thinks they're all related and that feeding her more will cause her to poop more and sleep better. I am taking her advice with a grain of salt because she was flat our wrong on one point (insisting that solids had more calories than breastmilk) but that's kind of how I"ve taken the advice of all our previous ped's, as well. We're new to this practice and it has a reputation for being crunchy overall, we just happened to have the least crunchy dr yesterday. So we shall see! Thanks again!
 
#6 ·
From what you're saying, your doctor is right, your daughter needs more fluids (milk) during the day so that she can poop easily and feel fuller at night. If she's not nursing all day really, its not surprising that she's not sleeping because she wants to nurse all night. If you're saying she's only really nursing for comfort, then she might not really be getting a lot of nutritive sucking in and getting in a nice amount of milk.

I second what everyone seems to be saying, she needs to be nursed more. Can you get a babysitter at home to take your other kids out so that you can relax and nurse the baby for a while? Turn the lights off and make things very relaxing. You might try nursing her 2 hours afer she wakes up as that's usually when babies are naturally drowsy, making them more likely to accept "slowing down" to nurse.
 
#7 ·
Our typical day goes like this:

7am wake

Small breakfast (fruit mostly)

8:00 nurse her but she's very distracted. Might only go for 5 min.

9:30 go up for nap, nurse 20-25 min

Lunch (more fruit, bits of bread, etc)

2:00 go up for nap, nurse 20-25 min

Dinner (baby version of whatever we're having)

7:30 go up for bed, nurse 20-25 min

Then overnight she'll wake up on average every 2 hours and nurse for 5-10 min, but it's sleepy comfort nursing.

I fed her constantly yesterday and she actually ended up sleeping in 3 and 4 hour stretches last night! I'll definitely continue this and hope for the best! During the week it's a bit easier since the older girls are in school, but on weekend when we're out and about, she's too interested in watching the world (when nursing in the car or wherever we are) to really focus, so I know she gets less on those days.
 
#8 ·
Quote:
Originally Posted by SarahKatN View Post

Our typical day goes like this:

7am wake

Small breakfast (fruit mostly)

8:00 nurse her but she's very distracted. Might only go for 5 min.

9:30 go up for nap, nurse 20-25 min

Lunch (more fruit, bits of bread, etc)

2:00 go up for nap, nurse 20-25 min

Dinner (baby version of whatever we're having)

7:30 go up for bed, nurse 20-25 min

Then overnight she'll wake up on average every 2 hours and nurse for 5-10 min, but it's sleepy comfort nursing.

I fed her constantly yesterday and she actually ended up sleeping in 3 and 4 hour stretches last night! I'll definitely continue this and hope for the best! During the week it's a bit easier since the older girls are in school, but on weekend when we're out and about, she's too interested in watching the world (when nursing in the car or wherever we are) to really focus, so I know she gets less on those days.
I think that's really normal at this age. My 10 month old literally will only take his bottle in a dark room before sleep. This weekend he actually took 4 oz in a crowded room because he was famished and I had to face him outwards. Have you tried nursing her BEFORE you feed her solids at lunch? That way she's hungry and you can get her belly full of milk before she fills up on solids? My baby also goes from 9:30-2pm without eating, but he seems pretty satisfied (he's also FF), but since your baby isn't seeming satisfied, I'd think that time period is too long of a gap and that she probably needs 2 more feeds a day. I'd think one around lunch time and one around dinner time.

I don't know if you're planning on weaning around a year, but you COULD also go the route your ped suggested, which is to supplement with highly nutritious food at meal times and push extra fluids during the day. This could mean a bottle of breastmilk or breastmilk in a cup or sippy. Does she take a sippy? If you decide to push more solids, I'd be careful to push a few ounces of liquid at every meal to keep her regular.
 
#9 ·
Just wanted to throw in my two cents here that I think the night-nursing may be key to the problem. Around that age DD just plain started sleeping more heavily overall. She's formula fed, but I found she could no longer stay awake long enough to get through even a 4 ounce bottle, so I'd suspect that your LO is saving her nursing for night-time, but then too sleepy to really get what she needs at night - and still hungry so she keeps waking up again. Any possibility of doing smoothies from a sippy cup during the day? I know Tilty makes a special smoothie lid, and it's been the easiest cup for DD to learn to use. Don't know about other brands...
 
#10 ·
Just wanted to give you a little ray of sunshine about the developmental stuff- my dd2 didn't crawl until she was a year old, didn't eat solids until over a year old, didn't walk until she was 15 months (and then broke her leg, so didn't start regularly walking until more like 17 months), didn't push herself up into a sitting position until she was probably 11 months, didn't talk until about 18 months... I often worried about her, but luckily I had a relaxed pediatrician who gave me some hints to help her along but didn't freak out about it. Anyway, she's 8.5 now and is a gifted, athletic, really fun kid! So by all means do stuff to help her develop, like tummy time, active play, etc, but I wouldn't worry at this point. Hang in there, mama!
 
#11 ·
Sarah,
How big is your babe? (lbs).

I really wouldnt worry too much. Its not abnormal for a 10 month old to drop in percentiles. I see no red flags in your babes developmental status. All babies develop at a different rate. My friends baby never crawled, never stood, never sat well until after she was a year old. Then BAM she sat up on her own one week, stood up the next week, and walked the next week. I think "poor muscle tone" is a crapline from a ped. If you are concerned about it, I suggest getting a Johnny Jump Up style thing to show her that she can stand up and she can be upright next to you. Some babies have a harder time with their parents putting weight on their legs because thats not how they want to be held, so if you give them the independence of something like a jumper, they might be more inclined to use it for muscle building. We had one with a tray on it and I just served her breakfast in it while I did the dishes right next to her.

My suggestion to you is to switch to a more breastfeeding positive ped. A ped that suggest formula feeding when there is a problem, is a ped that you will most likely differ with on so many issues as your child continues to grow.
 
#12 ·
I'd check with a lactation consultant first and foremost ...

I'm finding that the percentages they give us for height/weight are always whacky because they'll compare him to an age that he is not! LOL. He was 7 months when we went for his 6 month appointment, and they put him at 75% in height and weight ... where he had been at 50% before ... that was because they compared him to 6-month olds, not 7-month-olds.

KellyMom.com has some good calculators and charts for checking growth in realistic breastfed terms.

The developmental stuff is more concerning. Try not to look backward too much at what you could have done, and look forward to what you can do now. We all can find fault with our past parenting.

I would second the recommendation to offer food much more often. My son only nurses for about 5 minutes at once; he has been this way since he was born (11 months plus now). So we nurse many, many times a day.

The nursing sessions are great not just for food, but for the interaction that helps with development.

A checkup for you might help too! Taking care of your LO starts with taking care of you.
 
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