3 month old lack of weight gain and decrease appetitie

[@llli*coolranchdressing]

hello, I have a 3 mo old daughter (first baby) and exclusively BF, no bottles. she was full term, healthy, no issues.

-at birth (nov 7): 5 lbs 13 oz (2.6 kg) 19 3/4" (according to WHO weight for age girls she was in the 10th percentile
-around 1 mo she was 7 lbs 13 oz (4.1 kg); gained about 1 oz/day (7 oz/wk) and sprung up around the 45th percentile
-at 9 wks: 9 lbs 11 oz (4.4kg) 22"; she went down to around 10th %
-at 11 wks: 10 lbs 3 oz (4.6kg) now gaining only 4 oz/week steady at the 10th %
-at 13.5 wks shes only 10 lbs 6.5 oz (4.7kg) dropping around the 5th % and ONLY gained 1 oz/week

I am worried about this weight trend

she is nursing less often; in the beginning of course she nurse for >1 hr; then got proficient and would nurse about 15 min (every 2 hrs) and then nursing now about 5 min per breast every 2 hrs but now not interested that often and only wants to nurse every 3 hrs and sometimes only nurses from one side! I have good milk production and when I try to encourage her to eat more/more often she cries. she will either draw herself off the breast herself or she will get "lazy" and drift off to not doing anything, or she will just mouth around after she's done but sometimes when shes done she cries for 10 sec. She nurses at night but there is no pattern; on avg she wakes up every 5 hrs in the night; other times every 3 hrs and very rarely (5%) she will sleep the full 11 hrs.

she is very active, alert and content otherwise, hitting all the milestones altho this past week she hasnt progressed much--> other than the past 1.5 weeks she will cry inconsolable on + off for 2-6 hrs three times now which is unlike her.

she naps well esp in the mornings.

the only changes in the last 3 weeks: my husband went away for work and comes home on wkends. also at that time we changed her from co-sleeping in the bed w/ me to her own room and crib. the transition was well and I needed this change as I wasnt getting any sleep near the end of our co-sleeping expierence (It was very handy when she was young). I am a very light sleeper. she is also now swaddled in her crib as she cant sleep yet with flying limbs (she wasnt swaddled when we co-slept)

she doesnt seem to be teething; nothing that I can feel. she is drooling. she rarely spits up altho lately she HAS been spitting up a little more. she is a good burper.

her diapers are good, wet and she passes good stool; poops a lot (avg 5 times a day; was always a big pooper).

sometimes after a feeding I'll change her diaper and she MAY cry a bit in the biginning but I'm not too sure if its due to pain of being on her back (i.e. reflux) or just "because". she normally likes being on her back. then after the diaper change I'll sit her up w me for about 10min, then play time on her back, then either tummy time or just go to nap time.

I am worried about GERD. I went to the dr (its a walk in; my family dr is on mat leave) and they didnt care. but then again they havent been charting her or didnt even want to weight her at the last visit; I suggested it. I plan to go to a BF dr this Tues.

thank you

Andrea

[@llli*kevins-mom]

I'm no expert on this, I'm a super worrier...and I have no experience with diagnosed reflex or any other health issues....however...

My son's weight chart looks almost exactly identical to your daughters.
Born full term but small when compared to most babies.
Big leap in percentiles around the 1/2 month mark, and then went back down to less than 4th percentile at every weigh in since.
He is nearing 11 months now, and he is perfectly healthy, just small (16lbs).

Hope this helps!

[@llli*mommal]

As the PP suggested, there's a good possibility that she's just constitutionally small. But the 3 things that really jump out at me from your post as things you might want to change are, first, that your baby can sleep an incredible 11 hours at night, second, that she's sleeping swaddled, third, that she is sleeping in her own room. In some babies, long stretches of sleep can be tied to slow weight gain. A lot of 3 month old babies will nurse every 1-3 hours at night, and that represents a lot of additional milk and extra calories. And at this age, "sleeping through the night" is a single 5 hour stretch of sleep. Your baby is giving you double that amount.

Now, I hate to tell any mom to wake her baby at night- unless there's a concern about weight gain. At the very least, I would either stop swaddling or move baby back into your room. If she wakes a little more often, or you hear her a little more keenly, then she could end up taking a few feedings overnight and that might get her back on a slightly faster weight gain trajectory.

[@llli*coolranchdressing]

thanks for the responses...
last few nights she's waking more frequent and when she doesnt I dream nursed her (once) altho' yes, I agree I don't really want to wake her.
as for swaddling...if I don't she can't sleep (unsure what is wrong w/ swaddling her tho?)
any more input would be greatly appreciated!

[@llli*carm3]

I think the issue with swaddling is that babies tend to sleep longer when they are swaddled, and if you're concerned about weight gain, you don't want her to sleep that long without nursing.

[@llli*mommal]

I think the issue with swaddling is that babies tend to sleep longer when they are swaddled, and if you're concerned about weight gain, you don't want her to sleep that long without nursing.

Exactly.

[@llli*coolranchdressing]

well so far last night I took your suggestion and feed her when I awoke w/ engorged breasts (3 Xs) instead of pumping. I'll continue to do this and see if she has gained any significant weight next week and again next mo. She only nurses from one breast tho' in the night...I try to get her onto the other w/ no success. is this normal? from what I've read here, it seems to be??

[@llli*mommal]

Pretty normal for a baby to sometimes require just one breast. It's great that you nursed in the night- I hope the hard work pays off!

[@llli*coolranchdressing]

just an update:

thanks for all the responses thus far. well I went to a breastfeeding doctor and my LO actually gained 1 lbs in 8 days which is good. They are attributing her lack of appetite to perhaps her feeding more at night (I started to dreamfeed her starting last week). they recommended to no longer dreamfeed her, nurse her on demand (even if its q3hr) and keep a journal of the feedings. They said some babies can get all they need in 3 min feedings. The dr noted that she eats/gulps well. and seems content post feeding. They recommended not to pump unless I do just for comfort (i.e. not empty the entire breast). I will be going back next week for weight-in and recheck.

currently she is 11.11 lbs (5.3 kg) and 3.5 mo. she is holding steady in the 10th percentile (was always around this except for last weight-in at the docrors 3 wks ago when she dropped)

fingers crossed and hope she is ok. the doctor said at this time (after 3 mo) weight gain is about 2-5 oz/week

they didnt think it was an ear infection b/c she gulps well at first until she is full and has no other signs of ear infection.

I will also be going to the pediatrician in 2 weeks time for her vaccines and see what they have to say as well. I will keep all posted!

[@llli*lllmeg]

Sounds like things are back on track, 16 ounces in 8 days-that's 2 ounces a day is very good gain-twice the norm! Weight gain can normally go in fits and starts-but that seems almost too great a difference from before-are all weight checks being done on the same scale, baby naked? Or maybe it was just a ginormous growth spurt?

Great your doctor was able to assess a feeding! No many doctors take the time or know how to do that.* So you were not cue feeding previously? Are they saying nurse on cue even if it means less nursing frequency overall? I am a bit confused on that point. Babies this age typically do require to nurse at least once overnight. I agree very short nursings are often fine at this age but based on the gain it sounds like nursing more often or overnight helped??? What do you think?

*EDIT- Oh duh, I just saw this was a breastfeeding doctor. Is this a doctor who is also an IBCLC? Or a doctor with a breastfeeding clinic? Sorry I am curious, we don't have doctors who specialize in breastfeeding around where I am in California. Unfortunately!