BFing, underweight, & Schedule

Ok, so DD is 13 1/2 months old and only weighs 18 lbs, putting her in the 2nd %ile for weight on the WHO charts. She's seeing a nutritionist once a month and at this point I'm supposed to not let her graze (so that she will get hungry between feedings so she can get full), offer a full avocado or banana alternating days (she usually eats about half a day), and add sunbutter or margarine, or oil into her foods (like on toast or in veggies). I'm also supposed to offer 5-6 feedings a day. She has tree & peanut, dairy, and egg allergies. My biggest problem is getting in more than 4 solid meals a day. Below is her average schedule.

7 AM: wake & nurse
8: Offer breakfast (usually coconut yogurt w/ fruit or oatmeal), but she usually only eats a few bites if anything
9:30: nurse and nap
11:30: lunch (veggies, a protein, and grain or dairy substitute)
12:15: bath and then do something for the day (get errands done, get out of the house, etc)
2: snack (usually a fruit granola bar and/or fresh/canned fruit and a grain)
3-3:30: nurse and nap
6: dinner (veggies, protein, grain, and sometimes a soy milk fruit protein mix)
8: nurse and bed
Then recently she has been waking once at night to nurse

Any advice or suggestions are greatly appreciated. Sorry it's so long!

At 13m my son weighed 18lb 2oz (1% on some chart). Our doctor wasn’t too concerned at the time because I think the highest he had ever been percentile was 40ish. It’s funny my son had an egg and dairy allergy as well. The allergies make it so much harder to find high calorie (non-junk food) foods. We later worked with different specialists and I have heard both ways on grazing (some say they eat more that way some say less).

Has her weight dropped significantly in percentiles? Is her activity level normal? Are you and your husband thin? Is her length growing on target?

That being said as moms we always worry. From your schedule it looks like the only place you may be able to add would either after her afternoon nap, or maybe a before bed snack. 13/14m is so little still to be eating very many solids. I know my kids were not eating very many solids at that age and my oldest weighed more at her 12m than my second did at his 2yr.

Could you add another nursing session after breakfast/before 1st nap and after dinner/before bed? Those are the only openings I see considering the no grazing rule. I've personally never seen nursing affect my son's appetite for solids. Hhe can eat a pretty hearty meal right after a long nurse. I keep nutritious snacks within his reach most of the day as well. I have the same questions as the PP. Is this a sudden change in weight gain causing concern? Someone has to be in the lowest percentiles. If she's gaining I'm not sure I'd worry. There's no prize for having a big baby.

I fail to see how infrequent meals will encourage more (healthy) eating. Your LO's ingrained energy needs are a fixed factor. By eating less frequently than she would self-select, she will simply perceive hunger more intensely.

Just a thought, in case you'd like some higher calorie snack options. Some other relatively easy snacks that are high fat or carbs you could include are things like: baked beans (not canned), baked sweet potato wedges with olive oil, tofu, mini meatballs, whole wheat pita and hummus, roasted root veggies in olive oil (eg beets, carrots, turnip, yams, yucca, plantains). With the baked veggies, toss in olive oil and roast in coarse pieces at 400F for 45 mins. Rotating your oils through flax, olive, avocado, and coconut gives nice subtle variety to simple snacks.

It sounds like you have a great handle on things!

Quote:

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Originally Posted by @llli*zaynethepain

There's no prize for having a big baby.

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Well put.

Thanks ladies. The reason the pedi is concerned about her weight is because not only did she drop from the 10th to the 2nd on the weight charts, but also dropped from the 65th to the 45th on the height charts. In the last month she only gained 1 oz, but grew back to around the 50th percent on the height charts, so the pedi isn't AS concerned (the drop in percentile at the 12 month check up is beginning to look like an unimportant blip on the charts), except for the 1 oz weight gain in a month (same scale, totally naked both times). She has a very high activity level, and DH was thin as a child.

zaynethepain: DD would probably eat right after nursing if I didn't still have a substantial supply, but she stills gets genuinely full (won't even drink water, which she loves) after most of her nursings, especially the 1st morning nursing.

alphawoman: Thank you for the suggestions for food. I've been running out of ideas of new high-fat foods to offer. I'll have to try the pita and hummus idea for sure!

Anytime! We're dealing with multiple food sensitivities too, so I can appreciate how you feel (I say sensitivities because I hope they'll be outgrown, as my son is still under 1).

Another big hit at our house is a mixed lentil, bean, or quinoa salad tossed with olive oil.

LMK if you want to share more ideas. I can always start a thread under allergies with meal/snack ideas!

If you want a lot of healthy fat packed into a little package try olives. My son loves them.

my DD was 16.5 lbs at a year. She fell from the 25% to below the charts. The docs were alaremd. She was always tiny, small in height too. She was followed by a gastro and a dietician and was deemed to be eating enough calories per day. I was also instructed to add fat and oil, butter, etc... to all her meals. She cought up back to the bottom of the charts by age 2. Now at 3 1/2 she is still tiny for her age, but she is on the charts at least!

She also has multiple food alergies, so I feel your pain!

hang in there momma! AS long as she is developing otherwise normal, try not to panic!

DD2 was FTT from 9-19 mths of age, and she was quite large. Our ped GI, who we selected after seeing 3 others that were terrible, said that he would rather have a baby on the bottom of the chart who gained slowly according to their curve, than a fat baby like ours who tanked out and didn't gain for almost 10 mths. She was 22 lbs at 9 mths and just stayed there. He emphasized that we were seeing a plateau in height as well and that this prolonged period with no weight gain at all could affect brain growth. She just never at very much at all and would barely nurse and would never drink anything but pumped breastmilk. Even then, she would drink an ounce here or there. We killed ourselves and fed her the highest calorie greek yogurt in front of the TV and it worked, she finally gained. She is still difficult to feed at almost age 3. Perhaps a soy yogurt might help, you could always stir in some flax oil to give it more fat, soy is the same as 2 % milk. I love Spectrum brand flax with DHA added. I put it in my older daughters cereal and my little ones soup. Its a very healthy additive.

Hi! First time posting on here. My daughter is exactly the same. At 12 months she was diagnosed with a dairy allergy. She was 15 lbs 9 oz. now she is 14 months and since going dairy free she weighs 18 pounds. Her symptom of dairy allergy was slower weight gainand now without dairy she is naturally gaining more steadily. I have found that instead of increasing the amounts of food, I just increased the calories so she can "catch up" in her weight.coconut milk mixed in with her soy milk for a treat is great!! It has 10 grams of fat in 1/4 cup. Lara bars are all natural and also have 10 grams of fat. I also give her bananas and a good variety of veggies with soy butter for meals. Hope this is helpful!