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Thread: 4 month checkup, pretty slow weight gain

  1. #1
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    Default 4 month checkup, pretty slow weight gain

    Now he was a big baby, at birth he was 9lbs 1 oz. So I take DS in for his 4 month shots. His weight on June 6 was 13lbs 9 oz. His weight today 14lbs even. WTH!! I've started him on solids last week, but it's maybe a tbs. When I tried him on the cereal first I gave it to him for 3 days then stopped for 2 giving him only breast milk then started the sweet potato, then waited again. I do do it before a feeding but he polishes off a 4 oz bottle right after. The only reason I started the solids was because he seemed ready, and he wasn't seeming to be very satisfied after his feeds. I've tried incorporating more nursing between pumping, but it seems to work with us just nursing at night before bed. Should I be upping the bottles to 5 oz now? or putting him to the breast more? I'm trying not to obsess over it, but I can't stop. Feeling so frustrated.

  2. #2
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    Default Re: 4 month checkup, pretty slow weight gain

    First thing, he's too young for solids. The current recommendation is that babies should be exclusively breastfed for the first 6 months. Intake of complementary solids before 6 months of age generally does not increase total caloric intake or rate of growth and only substitutes foods that lack the immunoprotective components of human milk. Before starting solids, you want to look for the signs of readiness referenced here: http://kellymom.com/nutrition/starti...s/solids-when/.

    I don't see anything wrong with your baby's weight. On this chart he's right below the 50th percentile: http://kellymom.com/images/growth/growthcharts.gif. That's a totally normal weight. He's dropped a tiny bit since last month, but that's normal, too. The charts make it look like babies should always follow the curve- but that sort of non-variable growth is a statistical artifact. Real babies will vary their rate of weight gain. It's very normal for a baby to sometimes pause in weight while shooting up in height, or to pause in height while allocating more calories to weight, and right in the 4-6 month window a lot of babies drop a few weight-for-age percentiles as they begin to allocate more calories to motion (reaching, rolling, kicking, etc.). My kids both went from around the 99th percentile at 3 months to around the 75th-80th at 6 months, because they were suddenly so much more active.

    When there's a concern about weight gain, the best thing to do is almost always to simply nurse more. That's better for your supply and ensures that the baby isn't being overfed or underfed, because when a baby nurses he takes what he needs, not what you think he needs. Right? You know of have to get into the hair of trusting your body and your baby to figure things out without assistance from the pump or the bottle.

    It sounds like you're doing a lot of pumping at bottles at this point. Do you mind sharing why? Maybe we can help you move to an easier, more spontaneous nursing style.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
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    Default Re: 4 month checkup, pretty slow weight gain

    I think the reason why is many things combined. I am able to see exactly what my output is, and that is a hard one to let go of. I don't feel like I'm constantly wondering if I produce enough for each feed, because I can see it. I'll say to myself that I'll nurse him for his next feed but it'll happen about 30-45 min after I've already pumped and I say to myself that I'm empty so it'll have to wait for the next one. It happens again the next time so it just ends up with him nursing before bed.

    I also don't feel so restricted to the couch and feel I am able to go places, do a few things with my toddler, let my DH help with a few feeds etc. I can't nurse in public. I have DD's naturally so bfing in public makes it super difficult for me. I can't hold on to him and my breast without support from a pillow or bed. And people watching me makes me uneasy.

    But I think the biggest part is that pumping is really the only way I know. I was so frustrated and devastated that I was having problems with bfing. I felt like a failure because this is something that naturally we are suppose to do, and I felt like I was just struggling. I loathed having to use a nipple shield. Then my mom bought me the pump so I was just able to have a break and give her a good feed. I was very reluctant to even start pumping with my DD, but once I started it was the first time I felt relief and relaxed. Then when DS was born and again the same problems happened I got discouraged from really whole heartedly trying, and started pumping a lot sooner then I had done with the first. It's hard to let go.

  4. #4
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    Default Re: 4 month checkup, pretty slow weight gain

    Your concerns are very understandable, many moms find it very hard to stop supplementing bottles. But it IS possible assuming you would like to do that! It is up to you if you would like to move away from pumping and bottles or not. Some moms ep or close to it a long time and that works well for them. But in some cases, moms start off feeling more freedom and/or control by pumping and bottle feeding, but later may find it hard to exclusively pump or to combine lots of pumping and bottles with nursing long term, because it is often more difficult to maintain production and the mom feels very tied down due to needing to pump so much. Plus there are health benefits to nursing at the breast. But whichever your choice on this, we can try to help any way you need.

    As far as weight gain concerns, what is the concern, exactly? That baby is not getting enough milk overall? Was the June 6 weight check and this new one done on the same scale with baby naked or in a dry diaper only? Was the pediatrician concerned? Is weight gain the only concern-is baby growing fine otherwise?

    A 4 month old baby needs the same amount of milk a 6 week old baby does (before that baby needs less) -about 25-30 ounces of milk per day. Some babies may need more, some a little less. The amount of milk baby needs each day does not go up much or at all after about 6 weeks normally.

    So how is baby being fed right now? Is baby nursing at all now, or fully bottle fed? How many times per day does baby nurse, how many times per day does baby get a bottle, and how much does baby take each time (it is normal of this amount varies.) Is baby cue fed or on a schedule?

    Also, Is baby getting anything else besides breastmilk and the small amount of solids? Water, juice, formula, anything else? These days the recommendation from the AAP is solids start at 6 months. At LLL we are a bit more loose and suggest that most babies are ready for solids sometime ‘around’ 6 months and when baby shows several readiness signs. One thing about infant cereals and "1st step" very liquidy purees is, they are designed to be basically drinkable by baby so they can be fed to babies who are actually NOT ready for solids.
    Last edited by @llli*lllmeg; July 6th, 2013 at 05:30 PM.

  5. #5
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    Default Re: 4 month checkup, pretty slow weight gain

    Self-doubt can really mess with your head. What do YOU want to do, mama?

    For nursing in public, I recommend a well-stuffed diaper bag, which can double as an on-the-go nursing pillow, and a supportive nursing bra. I particularly like this one: http://www.sears.ca/product/playtex-...1360_Intimates. It's really good for providing support for a full breast- believe me, I know! I was a DD even BEFORE I got pregnant with my second child. I never let my post-baby DDDs stop me from nursing in public, though.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  6. #6
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    Default Re: 4 month checkup, pretty slow weight gain

    I want to move towards more nursing, and save the pumping for when we go out, or have a date night etc. Maybe my problem is the positions? He seems to be the most comfortable in my bed, but I can't leave my 3 yr old downstairs alone, lol.

    It was the health nurse that weighed him and did his shots. All other measurements were fine. She wasn't really that concerned, said it was a little low, but said that by looking at him and what he was doing that he is doing fine and she isn't concerned. I've been seeing this health nurse since my DD because she also does BF clinics. She said that by knowing me and how I think, If I'm going to freight about it to bring him in to be weighed whenever I want.

    Right now I only nurse him at night, so just once a day I nurse. And I'm still only pumping 4X a day. He's pretty much fed on just hunger cues. Sleeps through the night around 11-12am and will wake between 6-8am, feed, go back to sleep. Then will wake between 10-11am and feed about every 2-3 hrs. I give him 4 oz bottles. Some times he polishes it off and wants more and other times he'll have only 3 oz. The majority of the time it's 4-5 oz.

    Today though I did nurse him at 3am when he woke up instead of a bottle. Went through 3 bottles from 10am-2pm. Again I nursed at 3pm about 20min. then he had a bottle at 5pm nursed him again at 550. So today I've done it 3 times. But here I am now at 630 and I'm itching to go and pump, because there is one bottle in my fridge that only has 2 oz in it and I want it topped up. lol My goodness I sound like a nutjob!

  7. #7
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    Default Re: 4 month checkup, pretty slow weight gain

    He hasn't had solids since Thursday. But it was just what I did give him and breast milk. Nothing else.

  8. #8
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    Default Re: 4 month checkup, pretty slow weight gain

    Ha ha. You don't sound like a nutjob! TRUST ME. All mommies worry about baby and baby getting enough to eat! My husband needs to use the computer so I have to run, but I just wanted to throw that out there.

    So I am really sorry but I cannot add it all up. I don't know which times you mean a nursing session, which times you mean a bottle, etc. So Can you add it up and tell me simply how many ounces baby consumes a day via bottle and how many ounces you pump per day. Generaly.

    Here is why I am asking. Because if your baby was/is only nursing once a day or so, you know almost exactly how much milk you make each day and how much milk baby drinks! Certainly you have a much better idea than the average breastfeeding motherr. I have NO idea how much my baby gets or I make. kwim? So Lets compare those numbers. If they are roughly the same, that suggests you make enough milk. So then the problem is why baby cannot (or why you are concerned baby cannot) get enough to eat via nursing.

  9. #9
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    Default Re: 4 month checkup, pretty slow weight gain

    Roughly I pump about 30-40oz a day. He varies between 6-9bottles so 24-36oz/day. I've tried nursing more today and so far he has nursed 4 times totaling 60min and he has had 26oz in bottles. So I guess it's not a supply issue. But then I don't understand how in a month he would only gain 6oz. At least he isn't losing weight, right. lol

  10. #10
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    Default Re: 4 month checkup, pretty slow weight gain

    OK, yes you make plenty of milk! And I agree I have no idea why your baby is not gaining faster as it appears you know for sure baby is consuming the right amount of milk. I am not good with charts but mommal points out this seems normal chart wise, but I agree, a gain of 7 ounces in what- 30 days? seems low. Assuming baby has been healthy and all else is a-ok, I suspect a scale error or human error. Was the scale the same one used for the June 6 weight check?

    Now that you know you make enough, the next step is to figure out how you are most comfortable making the transition from bottle to breast. You could simply eliminate a bottle at a time, maybe one every few days? You could slowly reduce the amount IN each bottle, or some combination. As you ease off on the bottles, you can slowly ease off on the pumping. I would suggest talking this transition over with your nurse or doctor, mostly becasue of the perhaps odd weight check numbers this last month.

    Your baby may well want to nurse more often than baby bottle fed previously. That is fine and normal. You can also encourage more nursing if you are concerned baby is not getting enough. I suspect baby will nurse more, as 4 ounces at a time is a lot for EVERY feeding. At the breast, amounts taken in normally vary even more than with bottles. And of course it is fine and normla for baby to nurse "for comfort" when baby also takes in milk, but more slowly.
    Was milk transfer ever a concern? When baby nurses now, does baby appear content when done?
    Last edited by @llli*lllmeg; July 7th, 2013 at 02:42 AM.

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