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Thread: When to worry about weight?

  1. #1
    Join Date
    Nov 2014
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    Question When to worry about weight?

    Let me start by saying i live in a foreign country where health care is not the best. The doctors are 20 years behind, at least! Everything my doctor says i take with a grain of salt, although looking back i have made MANY mistakes based on his advice.

    I recently went in for my twins 6 month check-ups and he informed me they were not gaining enough weight. I'm supposed to come back when they turn 7 months to check it, and if it's not sufficient i'm supposed to start supplementing with formula. I have worked extremely hard to build up my milk supply and the thought of giving them formula just like THAT just doesn't feel right. He suggested giving them two feedings of solids instead of one. That seems like too much to me, and i thought breast milk had more calories in it? In the mean time i decided to go back to taking my fenugreek and blessed thistle in case its a milk supply issue, i also am trying to feed them for a little bit longer at each feeding. I typically have 3-4 letdowns per feeding, more in the evening. When they wake in the night, i bring them both into bed with me, and they feed quite a bit until morning. Slightly difficult/annoying, but i do love the night time snuggles and the extra sleep i get.

    Here are the facts.
    Baby A was born at 5 lb 3 oz, Baby B was born at 4 lb 1 oz. They were born at 36 weeks. I don't have all the weights in between, but I'm pretty sure it was 4 months when they doubled their weight. Now, Baby A is weighing 13 lbs 9 oz and Baby B is at 13 lbs 2 oz. I know this is sort of relative, but they're in 6-9 month clothes, so i never suspected any weight issue. He says they're weight gain has slowed and they are no longer "thriving". Somebody mentioned in another post something about Vitamin D deficiency? I have neglected to take my vitamins for 2 months, so i started taking them again.

    So, when should i worry about their weights, and what should i do about it?

    Extra detail: They're both rolling over both ways just fine, and they seem close to sitting up on their own. The smaller one lags her head slightly when pulled to a sitting position when she is sleepy, but they seem fine developmentally speaking. Third edit (brain a bit fuzzy): they poop once or twice a day and have 5-6 wet diapers.
    Last edited by @llli*3littlesprouts; November 18th, 2014 at 09:15 PM.

  2. #2
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    Default Re: When to worry about weight?

    If they are gaining and developmentally are fine, wet and dirty diaper output is ok, I would be hesitant to start formula too.

    Are babies being plotted on a WHO chart? These show average gain lines for breastfed babies... That said they are averages and you can't expect a baby to follow a line essentially made by some fancy statistics.

    If weight gain is truly an issue the first option should always be to supplement with your own milk, and IF that is necessary at 6 months you can jump straight to sippy/open cups/ use milk in their solids and avoid bottles all together if you wish.

    You can also offer more solids if you wish, and Jack Newman comments on using solids instead of formula to help with weight gain, but again only if necessary and from what you've written I'm not sure it is! That said at 7 months you may find them wanting more solids and grabbing your food - Mine at 7 months would cry unless she ate when I ate, but other babies aren't fussed until much older. I'm a big fan of baby led weaning/solids and following their lead!

  3. #3
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    Default Re: When to worry about weight?

    Oh and another thought, if they were truly worried I don't think they would leave them a month, they would be doing blood tests etc to see what the matter is!

  4. #4
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    Default Re: When to worry about weight?

    http://kellymom.com/bf/normal/weight-gain/

    Here are the charts for calculating breastfed babies gain. I'm too fuzzy this morning to try the math myself. It is typical for breastfed babies gain to show after 4 months while formula fed babies grow more slowly at first and faster later. Your doctor may not be used to normal infant growth. There are additional resources at the bottom including ' how might I increase my child's weight gain?' though it sounds like you are already taking several of the recommended steps. Kudos for nursing twins, mama!

  5. #5
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    Default Re: When to worry about weight?

    Here are some things that might impact growth, especially when weighing it against the WHO growth charts: I don't know the answer to this, (maybe someone here does, or has found a good source that discusses this?), but I have read a fair amount about the research methods that went into creating the WHO growth charts. They utilized only babies who breastfed per WHO feeding recommendations (exclusively for 6 months, with slow addition of complimentary foods after that point), so that's really great, but the pieces that I think may relate to how you and your doctor (or you and your own research, if your doctor isn't a 100% informed and reliable source), are that they only included babies who were singletons, and who were born at term.

    So, the question I have, is do the same growth patterns hold for multiples, or can we expect to see any variation that is still totally indicative of healthy growth? I know that 'full term' is different for multiples, as well, but I also think that its a question worth asking, with babies born at 36 weeks, is it correct to assume that they would follow WHO growth charts, or could there be variations that are also still indicative of healthy growth?

    That said, here is a calculator that you can use to plot growth on the WHO charts:

    http://www.infantchart.com/
    Last edited by @llli*erin.in.middletown; November 19th, 2014 at 07:17 AM. Reason: added link

  6. #6
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    Default Re: When to worry about weight?

    I wondered that same question myself after posting today!

  7. #7
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    Default Re: When to worry about weight?

    That's an interesting point, usually at 36 weeks a baby is considered early and weight is plotted at a corrected age... Are the rules different for twins?

  8. #8
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    Default Re: When to worry about weight?

    I wonder if karengramada is going to have info about growth as far as twins go. www.karengromada.com

    However off the top of my head I do not see what the difference would be. A baby is a baby. What may change weight gain expectations in this case is babies being slightly premature and rather small to start.

    It is entirely normal for growth rate to slow after around 3 months, and again after 6 months. If babies kept gaining like they typically do during the newborn period we would see some scary giant toddlers. I would strongly suggest getting both babies weight check histories out and talking a gander at those that info may be valuable.

    Also I agree, why is formula the immediate recommendation? First option should be more breastmilk, IF there really is a problem with gain and that problem is due to babies not getting enough calories. Nursing more frequently (if babies go for it) would be the simplest way to achieve this, longer session (again if babies agree) would probably also help.

    But I would also say that at this age, as long as it does not interfere with how much breastmilk they take in at all, no reason to not offer a bit more solids. You can choose to offer solids that are higher in healthy fats and proteins. Your babies may or may not be interested, but this is generally not a bad idea, again as long as solids are not in any way replacing breastmilk feedings.

    Vitamin D supplements are available in tiny drops that can go on babies tongue. Vit D deficiency occurs in very large numbers of people in the US and Canada and perhaps elsewhere, so in those countries supplementation it is now suggested for all babies with no testing. Generally deficiency tends to be more prevalent the further one lives from the Equator, the darker toned ones skin is, and for those who spend less time out in the sun and/or are covered with clothing or sunscreen when they are exposed. Your vitamin D levels while you were pregnant would also affect your babies levels. So while I have no idea if this is causing any slow gain in your case, there is probably no harm in giving Vit. D supplements.

  9. #9
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    Default Re: When to worry about weight?

    Yes, I'm pretty sure the doctor is using the WHO chart. I don't have their weights recorded, but I know he does. When I go in I'll request their records. That's an interesting thought Erin.in.middletown, you would think at least he would take their adjusted age into account. I know twins aren't technically premature at 36 weeks, but you can't say they're developmentally caught up to their singleton peers born full term. How could you expect a four lb baby to catch up in 6 months?

    Also, thanks for the suggestion on adding breast milk to their food instead of water. I pumped every 3 hours the first month for their supplements, but haven't done it since. Will I have trouble starting up again?

    Another thing. Since taking my herbs again I started leaking a tiny bit, which I haven't done since the beginning. Am I making too much milk now? Or is it just from my supply adjusting?

    This is a random additional question and maybe there's already a thread that somebody can direct me to. Is it true that my body filters everything from my milk? My lactation consultant told me when the girls were born that spicy and gassy foods have no affect on the babies, but it sort of seems like really spicy things keep them up?

    Thanks for the input and the links!

    Oh also, can I just take them out in the sun more in case it's a vitamin d issue?

  10. #10
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    Default Re: When to worry about weight?

    Oh also, can I just take them out in the sun more in case it's a vitamin d issue?
    More safe sun exposure is great, but it is not likely to be enough if they are actually deficient or borderline. Also it would depend how close to the equator you are, if it is winter or summer where you are, (Almost everywhere on earth except directly on the equator has some length of a "Vit D Winter" when sun exposure is not going to do the trick,) how babies are dressed, what their skin tone is like, and, probably most importantly for babies and young kids, how long you could safely expose their skin to the direct sun without increasing the risk of skin cancer. In other words, getting enough sun for optimal Vit D. exposure is quite complicated and varies situation to situation, so that is why supplements are usually suggested now in the US and Canada and I do not know where else. This does not mean everybody needs them. It is just the general recommendation for all. Whether you or your babies actually need more D I have no idea, but what the research seems to be showing is that most humans (including babies) need more D, at least in countries where indoor lifestyles have become the norm.
    Perhaps You could request a blood test to see if you or they are actually deficient.

    I am pretty sure that Officially, the definition for term or preterm is not different for twins. 36 weeks is premature, even for twins. Yes more twin sets are born preterm than singletons. Multiple pregnancy is a rick factor for premature birth. But that does not change the definition of term. term is term and term is defined as at least 37 weeks in utero. Yes your babies were born very near term, and that is awesome for twins.

    This is a random additional question and maybe there's already a thread that somebody can direct me to. Is it true that my body filters everything from my milk? My lactation consultant told me when the girls were born that spicy and gassy foods have no affect on the babies, but it sort of seems like really spicy things keep them up?
    No, it is certainly not true that your body filters everything from your milk! Food proteins can and do pass to breastmilk from moms diet. BUT, usually this is not in any way a problem, and in fact is nature's way of gradually and safely introducing baby to the adult diet of their family and culture. but if you are seeing a correlation between what you eat and your babies discomfort, you could try eliminating those things from you diet to see what happens. First I would look a what baby is eating directly though.

    Another thing. Since taking my herbs again I started leaking a tiny bit, which I haven't done since the beginning. Am I making too much milk now? Or is it just from my supply adjusting?
    Assuming babies are nursing as often as ever, it probably indicates your milk production has increased, which I assume is why you were taking the herbs. So you may be making more milk, but that does not mean 'too much." Too much is if your milk production is so much it is causing a problem. So, Leaking would not indicate too much milk, as your body is handling the increase by leaking. Getting engorged or overfull might mean too much. Also some herbs (fenugreek) have been reported to cause some gastrointestinal issues for SOME moms and babies. So if you are seeing an issue there, maybe it is the herbs and not your diet?

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