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Thread: Slow weight gain and breastfeeding paranoia

  1. #1
    Join Date
    May 2013
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    Utah
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    Default Slow weight gain and breastfeeding paranoia

    My 2-month-old daughter was diagnosed last week (Friday) with reflux. At that appointment the doctor was also concerned about her weight, which was in the 26th percentile (she weighed 10 lbs 10 oz). She theorized the reflux might be impacting it. I'm trying some changes and we have an appointment this Friday to see how things are going and if we want to consider medicine.

    Well... I went out and bought a baby scale and weighed her today. She has only gained an ounce, and I can't help but be a little scared.

    My biggest fear is the doctor will suggest going to formula. I love breastfeeding, it seems to have been going pretty well for us so far... and my daughter will rarely take a bottle of pumped milk.

    She hasn't seemed particularly interested in eating today or yesterday--she will eat often enough, but not for very long. She's had poopy and wet diapers and aside from her evening reflux screaming as been quite happy and pleasant.

    Should I work on encouraging her to eat more?

  2. #2
    Join Date
    Jun 2009
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    5,294

    Default Re: Slow weight gain and breastfeeding paranoia

    Hi, sorry you are worried. A child being in the 26 percentile is nothing to worry about, taken on it's own. A child can be in the 1% (or the 100%) and be perfectly healthy. This is a huge misunderstanding of what the charts are measuringto think that what percentle a child is in means anything on it's own. Even "falling down" percentiles may be fine, it depends on other things.

    Also, Formula does not cure nor is it a treatment for reflux. If your child has reflux so severe it is causin slow weight gain, medication to treat the reflux is probably called for. Not formula.
    Formula is ONLY needed if baby is not able to get enough breastmilk. There are many other things to try before adding formula supplements, and even if formula supplements are needed, you may certainly continue to breastfeed.

    It would help to have a little more info?

    What you want to be looking at is weight gain overall. Can you give a complete weight history?
    How is baby's overall health otherwise?
    Can you describe what symptoms of reflux you are seeing? How was baby diagnosed?
    From when to when did your child 'only' gain an ounce? Or was this a before and after nursing weight check?
    Does baby still poop every day? Yellow, mustardy? How many pee diapers and poo per day (fyi some babies stop pooping daily around this age and it is normal)
    How often does your baby typically nurse overall? How many times a day?
    Do you usually nurse baby on 'cue' or on a scedule?
    Does baby nurse for as long as baby wants, or are feedings timed or limited in any way?


    FYI good article on GER http://www.askdrsears.com/topics/par...-faq%E2%80%99s

  3. #3
    Join Date
    May 2006
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    20,846

    Default Re: Slow weight gain and breastfeeding paranoia

    How is baby's general health, growth, and development? Is she growing in length and head circumference and meeting her developmental milestones at a normal rate?

    There's nothing intrinsically wrong with being in the 26th percentile. The growth charts are not a test, where every kid who scores below the 50th percentile fails. There are healthy babies in ALL percentiles, and statistically speaking there are just as many healthy babies in the 1st percentile as there are in the 99th, and just as many in the 75th as there are in the 25th.

    With young babies, all weights should be done in the nude and on the same scale. Differences in calibration between scales can make a big difference to where a baby falls on a chart, so you don't want to compare the weights done at the doc's office to those done on your home scale. Also, you do not want to zoom in too close on a baby's weight. There's a good reason why we don't generally weigh healthy babies every day, and that is because weight gain varies from day to day and week to week. Some days a baby may allocate more calories to growing lengthwise and pause in weight, or vice versa. And as babies get mobile, they tend to allocate increasing a punts of calories to action (kicking, squirming, reaching, rolling) and pack on fewer as fat. Don't be too surprised if your LO drops some percentiles as she gets closer to the middle of her first year, especially if your doctor is using the CDC charts rather than the WHO charts. The CDC charts were developed using data collected from a population of predominantly white, mostly formula-fed babies in the Midwest in the 1950s. The WHO charts used data collected from an ethnically diverse sample of breastfed babies, and present a much different picture of normal infant growth. Measure a breastfed baby on the CDC chart and it will often appear to gain weight "too quickly" during infancy (when formula-fed babies grow relatively slowly) and "too slow" as they round the 6 month mark (when formula-fed babies' weight tends to escalate).
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
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  4. #4

    Default Re: Slow weight gain and breastfeeding paranoia

    When my LO was in ICU he was weighed every day. Quite often for one and sometimes 2 days he wouldn't put on any weight but on the 3rd day he'd put on 80 grams! Using the same scale, so I think weighing every day is not a good idea as it is worrying for parents. Maybe try weekly weighs instead.
    My son is also on fortifier which is added to one bottle of breastmilk per day as he was slow to gain weight. This might be an option for you.

  5. #5
    Join Date
    May 2013
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    Utah
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    Default Re: Slow weight gain and breastfeeding paranoia

    I decided to put away the scale for now.

    She was diagnosed after the doctor listened to everything (screaming, gulping/swallowing, spit-up, etc) and giving her an exam. Doctor also believes there is a dairy intolerance going on. I feed her on cue mostly, though I will offer her the breast if it seems she hasn't eaten in a while. She nurses for as long as she wants, which is on average 15 minutes. She's been eating about 6-9 times a day, more often on the higher end of that spectrum. She has mostly mustard-yellow diapers, though we still get a couple a day of green and mucusy ones (working on this with the doctor). We get a wet diaper for about each feeding, a few less on the poopy diapers.

    Here's something else: just moved, this is a new doctor. The one who gave her the 2-month checkup had her at about the same percentile, comfortably on the graph. The last appointment was a week later with the new doctor... who weighed her during the exam and plotted her weight off the graph. Which worries me. The follow-up appointment is tomorrow and I plan on bringing the charts from the other doctor.

  6. #6
    Join Date
    Jun 2009
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    Default Re: Slow weight gain and breastfeeding paranoia

    Okay if you read the article on reflux from Dr. Sears you can see that typically this is the way reflux is diagnosed -from the history the parents give. However there are tests that would confirm it I think most doctors feel they are too invasive and instead just medicate the baby which may or may not be appropriate.
    Drs. always think there is a dairy allergy going on. But it is in fact rare. However if that is part of the problem you will want to address it If you Google Academy of breast-feeding medicine and go to their website you will find the protocol for food allergies I suggest you read that and perhaps printed out and bring it with you.
    Of course if there is a dairy allergy almost all formulas contain an awful lot of dairy so again formula would be contraindicated. As you'll see from the protocol breast-feeding should continue while mother eliminates dairy from her diet.
    What concerns me about your post is you have mentioned a couple times that your baby seems uninterested in eating. For a two-month-old eight to 10 nursing sessions a day or more would be typical but anything less than eight and I would be a little concerned especially if a slow gain is also involved. It never hurts to offer to nurse
    So keep doing that and do it even more if you like. A baby really cannot nurse too often. It is usually fine if your baby only wants to nurse for a short period of time as long as baby is controlling the feeding and deciding when it ends which it sounds like baby is doing then the nursing length each time is probably fine.
    It is possible the doctors are using two different charts? I don't think it would cause that dramatic a difference but that's something else to consider. Also if your baby is being plotted from birthweight and baby had a significant drop from birthweight then the birthweight is going to be throwing off for her growth curve.
    Again what is important to look at if there are weight gain concerns is the rate of gain between doctors appointments-how many ounces is baby gaining average per week basically is what you want to be looking at. To make this even more confusing since your baby was weighed at one doctors office and then later at a different doctors office the scales themselves could be off.
    Oh and the occasional greenish or mucousy poop is not usually anything to worry about. What is good is your baby is pooping regularly I take it? that indicates your baby is getting enough milk.
    Last edited by @llli*lllmeg; May 23rd, 2013 at 03:42 PM.

  7. #7
    Join Date
    May 2013
    Location
    Utah
    Posts
    6

    Default Re: Slow weight gain and breastfeeding paranoia

    Today on the doctor's scale she was 11 lbs 2 oz, so I'm feeling better there. She still thinks there is an allergy going on, so now we have a referral to an allergist.

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