Slow weight gain

[@llli*christiandanielle]

I need advice/support. My pediatrician is making me stressed and really upset. She's convinced that my babe is underweight. He is 4 months and 11.5 lbs. He is exclusively breastfed and I intend to keep it that way. She wants me to start feeding him rice cereal and my instinct tells me he is not ready. Plus, why would I replace a feeding with cereal? I don't know what to do because she tells me she will want to hospitalize him to check for kidney and liver problems. He is otherwise happy and nurses often. Does anyone have the same problem with their breastfed baby?

[@llli*andy]

Welcome! I would think that if she was worried about him not gaining enough, then she'd recommend you supplement with breast milk or formula. I don't think rice cereal would add many calories. What was your baby's birthweight?

[@llli*mommal]

Welcome! I agree with the PP that a complete weight history would be helpful. Also, can you tell us about your baby's general growth and developement? Is he meeting his milestones, growing in length, seeming generally happy and healthy? Was he born around his due date, or was he born early? Are you and your baby's dad smaller people, larger people, or about average?

Having a small baby can be tough on parents. Pediatricians sometimes have difficulty separating the naturally small and healthy babies from the babies who are small because they have health problems or because they aren't being fed enough. As long as your baby is consistently growing in weight, length, and head circumference, is meeting developmental milestones at a normal pace, and is producing an adequate output of wet and poopy diapers, I don't see much reason for concern. Your baby is at the smaller end of the weight-for-age charts (see http://www.kellymom.com/babyconcerns/growth/chart2.html for a chart for breastfed baby boys) but he's still on the charts, and healthy babies come in all shapes and sizes!

[@llli*christiandanielle]

He was 7+6 when he was born. He was a little over a week late and they induced me. I checked out my charts (that my mom recorded) from when I was a baby and they are practically identical. My mom said I was a small baby and I was exclusively breastfed also. My boyfriend and I are average sized. He is meeting all his milestones too. The only thing is for the past week and a half he has only pooped every other day. I read that it can happen with breastfed babies.
I just feel like I'm fighting an uphill battle because I want to breastfeed my baby. I don't want to subject him to a bunch of unnecessary testing just because he's smaller than most babies. I feel like the pediatrician wants me to feed him formula because she thinks its what's normal.

[@llli*lovebug0411]

Yes! I have struggled with my son's weight his entire 8 months. Like your son, mine is on the small side. He was 11 lbs 9 oz at 4 months. At his 4 month check up, the pediatrician wanted us to start him on rice cereal to help him gain weight. This didn't seem right to me. He didn't seem ready for solids, and from what I'd read, breast milk has more calories than cereal, anyway. As mommal mentioned, it's been hard (on me) to have a small baby. I always thought breastfed babies were supposed to be round. My guy is long and lean, though.

For lots of reasons, I looked around for another pediatrician after my son's 6 month check up (at which point he only weighed 13 lbs, by the way). The new one understands that my son just isn't a big baby. He is meeting all the milestones and is generally very happy. Is it possible for you to find another pediatrician? I wish you luck and peace of mind. The ladies here have been wonderfully supportive of me each time I've worried again about my son's size. I'm sure you'll encounter the same support.

[@llli*christiandanielle]

That makes me feel better already. Thank you so much. And I am going to find a new pediatrician. I feel like telling her that all the stress she is causing me is not good for my supply!

[@llli*yoginimama]

If you were induced, you were probably given lots of IV fluids. Those IV fluids can cause you to gain a lot of water weight - and they also cause your baby to gain a lot of water weight. So their birth weight can be artificially high. Then it makes them look like they have lost a ton of weight and are thus "slow gainers" and may "need to be supplemented." I'm guessing IV fluids may have set the numbers off. Ask me how I know? BTDT and have the T-shirt! I had a terrible time with the doctors. I would keep an eye on wet and dirty diapers.

I agree with your gut. If you wanted to gain weight would you eat a bowl of rice or drink a milkshake? I'm going with the latter on this one.

ETA: why does the doctor think there are kidney or liver problems??? Are there symptoms?

[@llli*gamom]

Ugh, I so feel your pain!! DD2 (seven pounds at birth) now 6 months and weighs 13 pounds. Tiny hands, tiny feet. I am very petite and hubby is small too. We have had a few issues different than your own, so some of her slow weight gain will not correlate to your situation. However, I had the same issue of them wanting to start her on cereal and she WAS NOT ready at all. Major tongue thrust, etc. She has just now started to accept foods. So you aren't alone. And I agree...breastmilk, from my understanding, is the better choice of the two! BY FAR!

If you feel she is needing the extra calories, here is what my IBCLC instructed me to do. One: increase feedings (this may not apply to you) so that my breasts were drained more often. Seemed like moving the feedings closer together really helped us (also, at five weeks she was sleeping through the entire night, like, eight hours, so I had to set my alarm clock to get up and wake her for nighttime feedings!) This helps with more hind milk being taken in when sessions are moved in closer. Two: pump after every nursing session and save any milk I got. This could be another supplemental feeding later. Sometimes, even after she has finished I am still pumping off a total of an ounce (and it's nice and creamy). For some reason both my kiddos started sleeping early throughout the night, and just didn't wake me up to eat! I am still doing the alarm thing.

Anyway, I hoped that helped and alleviated some of your stress...it's not fun when they guilt you so badly. Good luck...I am sure things will get better!

[@llli*greatestjoy]

1. Adding or worse, substituting with, cereal does not make sense as mentioned by others, due to lack of calories
2. At birth your child was between 25 - 50 percentile and now is below the 5th percentile. This may or more likely, may not, be cause for concern. Do you have a weight for any other time between birth and 4.5 months? This will be very helpful.
3. Yes IV fluids can contribute to falsely elevated birth weights. This was the case for us, and it was a hellish nightmare convincing our ped that my son did not need formula on day 2 of life (he had a greater than 10% weight drop after birth, I told them to kiss my ***). Pediatricians need to learn to treat the child not the numbers.
4. Along that same line of thinking, is he a happy baby? This is very important. Is he fussy all day, how long are his stretches of sleep?
5. His poop frequency is not an issue. Up to 14 days (ridiculous huh) is considered normal.
6. I cannot see your baby in front of me, so my advice is limited, but I do feel your pain as I have been there in tears just fighting for my baby and his right to the milk that was created for him.

[@llli*christiandanielle]

I decided the best thing to do was make an appointment with a lactation nurse. She is going to do an intake weight check and see how much he is eating in one feeding. I have been a stay at home mom and I am starting to wonder if maybe I should try a feeding/sleeping schedule. I originally thought that it would be ok to just kinda "go with the flow" and let my babe set the pace for the day. Maybe being on a schedule will help?

When we were in the hospital we had our babe circumcised and the nurses gave him tylenol and sugar water. Well that made him so drowsy that he wouldn't nurse bc he was knocked out. The nurses persuaded me to give him 1 mL of formula. They practically forced me to do it. Now looking back it makes me sad to think that the only time in his life he has had anything other than breast milk was at the one place where you should get the most support for your decision to breastfeed.

I have a very happy baby and everyone always comments about how mellow he is and how much he laughs. I feel like if he was starving or something was terribly wrong he would let me know. Hopefully the lactation nurse will help