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Thread: slow weight gain, tongue-tie?

  1. #1

    Default slow weight gain, tongue-tie?

    Hey all!
    I am in the midst of figuring out what, if anything, is causing slow weight gain in my baby, or if there is possibly no issue at all. I'm starting to feel overwhelmed with the possibilities (food allergies, low supply, oversupply, agh!) Maybe some of you have insight?

    My now 6 month old was born 6 lbs. 5oz. and 21 3/4 inches. Shortly after birth, her then-pediatrician mentioned that she has a slight tongue tie that *may* need to be cut if she had any issues gaining weight. She can definitely stick her tongue out past her gums, but sometimes seems to have suction issues. We never had it trimmed because she started out so well!

    By 2.5 months, she had doubled her birth weight and was 15lbs 12oz. at 4 months. The problem is that she has gained only 10oz. or so since - in 2 months! - and is around 16lbs. 6oz now. We do have a scale at home, and when I've weighed her after meals, she's usually getting about 2 oz. She gets disinterested in nursing after the first let-down (mine is fairly fast), even with compressions, and so does most eating right before & after naps. We co-sleep so I think she's getting most of her food in the early early morning. Depending on the time of month, my supply is either way too much or not enough so I adjust accordingly.

    She still produces about 5 wet cloth diapers a day, and a soiled diaper every 1-3 days. Her sleep has been pretty poor with lots of nightwakings and she's fairly gassy all the time since around 3 months but who knows what's happening there. Has anyone's baby plateaued so early? Is there something else going on? What should I be focusing on? Is there any way I can get her to eat more? Or do I have nothing to worry about?

    Sorry this is so long. I just wanted to be thorough. Any insight would be greatly appreciated!

  2. #2
    Join Date
    Oct 2013
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    43

    Default Re: slow weight gain, tongue-tie?

    I've been going through this since my daughter was 2 months old. Slow weight gain. I didn't understand because she was nursing for 45 minutes every 2 hours. So how could she not be gaining?? A bunch of blood work was done along with urine test to make sure there wasn't a medical cause for it. In the mean time we supplemented with an oz of formula after she nurses. And she gained. Turns out she just needs extra calories.she is 3 months d and weight 9lbs 7.5oz We supplement with formula because I haven't been able to pump. I do t get any milk when I do. Which I'm trying to figure out. And right now she is pulling away from me lately because the bottle.

  3. #3
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    Jun 2009
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    Default Re: slow weight gain, tongue-tie?

    What did your pediatrician say? It is common for weight gain to slow after 4 months and to continue to slow. This is why there is a growth curve. Yes, this gain is very slow, but it is gain, and my point is, it's not like this was the gain at 1 month or 2 months.

    My quick math guestimate is that baby's average gain was almost 10 ounces per week in the first 2.5 months, and about 8 ounces per week in the subsequent 6 weeks. This is very good, fast, above average gain. If your baby kept gaining like that baby would be a giant. So a slow down IS normal. Whether THIS slow down is normal or ok depends on your baby.

    First I would suggest, rule out the scale or human error. Was the 6 month check on the same scale as the 4 month? Was baby naked or in nothing but a dry diaper both times, was baby laid on a disposable sheet both times, or was some kind of blanket used that might have thrown off one of the checks? Were you present and watching when the weight check was done? Had baby just pooped before being weighed? Are you absolutely positive the weight was noted and written down correctly, using the same type of units etc? If not, can you have baby weighed again to be sure before worrying more?

    Then look at your experience of your baby & breastfeeding over the last two months. Was baby ever ill? Were you ever ill? Did baby ever strike (not want to nurse) for an extended period of time? Did you start hormonal birth control? Did you return to work or take longer hours? Have you introduced “solids” and if so, when and how much/often/what? Was baby ever given any other liquids- water, juice, teas, formula, cow milk, or anything besides your breastmilk in the last two months?

    It sounds like you have a good idea that intake per session is normal, although not huge for this age. So nursing frequency may in particular be important to consider. About how many times in 24 hours does baby nurse? Does baby suck on a pacifier for sleep, is baby swaddled for sleep? Are you scheduling nursing sessions, trying to stretch out the time between sessions, or just getting busy or out more so nursing sessions are less frequent?

    Has baby started rolling or scooting or otherwise using more physical energy?

    Does baby appear healthy? Meeting milestones?

    I am not saying tongue tie is not a possibility, it is. Sometimes a mom has such an overabundance of milk in the early months that baby gains ok, despite tongue tie, yet over time, as milk production naturally slows, baby is more and more unable to extract milk. I believe you would have seen something in your baby’s behavior indicating an issue if that was part of it, but it should be considered. But there are many other things to consider, including that this is entirely normal. Some babies simply have a month here and there of very slow gain.

  4. #4

    Default Re: slow weight gain, tongue-tie?

    Thanks for the thorough reply. I mentioned it to the pediatrician, but because she gained so much weight early on, weight between her 3 and 5 month appointments was still on target and didn't create any alarm. She only said that if it indeed appears slower at her next appointment (in December) that she will need to start solids. I wanted to delay solids so I'm hoping to find a different solution - she currently has no signs of solid readiness, and she also has a few food intolerances and history of food allergies in the family. That's why I came here for advice.

    We have the scale at home and I weigh her at the same time every morning, naked, pre-poo, and have been taking an average over the week. There hasn't been any weight gain at all again now for another 2 or 3 weeks...so I really doubt it's the scale (thought she does wave her arms and try to roll off of it now!).

    It feels like we are constantly nursing. She likes to nurse to sleep and while co-sleeping (though that makes her really gassy and creates sleep issues), and I do full feedings after every nap, and offer the breast anytime she is fussy. But if she's wide awake she'll either arch away, distracted, or barely make it through one let down. We're home all day and I don't schedule nursing sessions, though I did try to implement an eat-play-snack-sleep routine because of gassiness - she does better if she can have lots of tummy time after eating, otherwise she can't sleep. I notice she doesn't demand to nurse like she used to, could using a routine be why? If so, how do I move back to nursing more on demand? Also, I'm confused about the effect swaddling would have on nursing? She is swaddled for sleep (she nurses better like that too) but she doesn't take bottles or pacifiers.

    She's been on 100% breast milk except for probiotics and the occasional 1/2oz of chamomile tea if she's fussy. Would that affect weight gain? Should I stop? I also give her a sippy cup of pumped breastmilk while she's playing. I feel like I am constantly trying to get her to eat more, worried about my supply, etc.

    I have noticed that she has a few food intolerances that I've identified (dairy, soy, corn), and she gets really reflux-y from coffee and chocolate. She has also been super gassy to the point where she refuses the breast until she can get all of her gas out (which can take hours, even with massage). During part of the time in question, I had started drinking coffee with cream in it every day before I figured out that it was causing fussiness and breast refusal. Would that have caused her to not gain any weight during that period?

    She does seem healthy other than having the minimum of wet diapers and being a bit behind on her milestones (she used to be quite a bit ahead). She definitely uses more energy perpetually rolling across the floor and grumbling quite a bit.

    If it's a tongue tie issue, would a lactation consultant be able to sort that out? We have monthly meetings here and I'm hoping to go to one. Also, what type of behavior would I have been looking for?

    Thanks again for all the help. It's so hard sometimes to figure out what's happening! Being a first time mom with no friends really that have breastfed (except the one who has had no issues at all!), I just feel a bit lost.

  5. #5
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    Default Re: slow weight gain, tongue-tie?

    Hi, ok, so your baby is 6 months old now, and you have not started offering solids? or baby will not eat when offered? I am not saying you should have started solids, I am just trying to get clarity. If gain was not an issue, did you have an age in mind for starting to offer solids?

    Because I am wondering what your peds specific, initial concern is about. The slow gain, or your decision to not introduce solids at 6 months. Many mothers are told to start solids at 6 months (and sometimes earlier) even when gain is fine. The AAP specifically suggests this, so many doctors will get concerned if a baby is not being given solids at 6 months no matter what the gain.

    So, a baby getting anything aside from breastmilk to drink (or eat, but liquids are worse for a few reasons) potentially fills baby up with that substance, and baby is thus less interested in nursing. That is why i asked about water and teas & juice. I really do not know about the safety specifically of Chamomile tea. Personally i would not give any tea to a baby.

    Swaddling, like using a pacifier, is a sleep 'lengthener.' So there is the possibility a swaddled to sleep baby will sleep through hunger cues and nurse less often. This does not mean swaddling for sleep is a problem necessarily. Just that it might be. If swaddling baby to nurse encourages baby to nurse more, that is fine. (FYI, safe bedsharing guidelines say swaddling is not recommended if a baby and mom are sharing a sleep surface.)

    if your baby has a true dairy allergy, (or any other food allergy) being exposed to dairy or the other allergen even through your milk could possibly cause weight gain issues.

    An IBCLC (A board certified lc, not a LLL Leader) can probably 'suspect' tongue tie if they get a chance to see baby in action (nursing) and some will examine baby's mouth. But you would need to see a doctor, ent or dentist for the medical diagnoses and treatment of tt. Unfortunately, it can be hard sometimes to find a doctor etc. who will treat tt for breastfeeding issues. If you have any local IBCLC's, I would suggest trying to get a one on one appt with one if possible.

    I will try to find a tt resource for you. There are many possible symptoms.

    As far as solid introduction being the best course of action when a baby has unexplained weight gain issues, I guess I question that. Is any other possibility being considered- that baby is ill, for example? Breastmilk has more calories than most early suggested 'solids' and is certainly much more nutritionally complete than any solids. This does not mean I necessarily think you should delay solid introduction, but on the other hand, a baby who is not showing any signs of readiness is probably not going to eat enough to make any difference in weight gain anyway, unless they are force fed, which I am sure neither you or your doctor want. But I am not sure what you can do aside from getting a second opinion.

    If you like to read, I suggest three books. Making More Milk, My Child Won't Eat, (ostensibly about avoiding food battles, this wonderful book is about so much more and has info relevant to babies who are still ebf. Offers great clarity about charting and infant gain you cannot find anywhere else that I know of) and Baby Led Weaning (this is about solids introduction, not weaning)
    Last edited by @llli*lllmeg; November 15th, 2013 at 06:10 PM.

  6. #6
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    Jun 2009
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    Default Re: slow weight gain, tongue-tie?


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