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Thread: Slow weight gain in 7 mos old. Panicking!

  1. #1
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    Jun 2014
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    Default Slow weight gain in 7 mos old. Panicking!

    My daughter weighed 14.6 at her 4 mos appt and now at 7 mos is only 15.2. she is gaining very very slowly and has dropped from the 50 or 75 % down to the 25% (95% -100% in height so long and skinny). It just keeps dropping. She's happy and meeting milestones fine.
    I'm mostly a stay at home mom so she has only gotten a bottle occasionally. I work 1 day a week generally so she'll get bottles that day.

    I started solids a few weeks ago and in the last few days I have been feeding her more and more (3 times today) plus I have been adding in an expressed bottle once a day just to increase weight gain (and we have had thrush so anything I pumped I wanted to give to her sooner rather than later to avoid re-infection later). None of this has helped.

    On top of all the stress of her not gaining I started my period this week for the first time and I feel like my supply has dropped. I'm drinking a ton of water, started fenugreek 2 days ago, and tried pumping throughout the day today when possible.

    I'm feeling very defeated. My older daughter started loosing weight at 4 mos and I had to supplement with formula. by 6-9 mos my milk had dried up.This time around things were going so much better but now I feel like things are back on the downward slide.

    Help

  2. #2
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    Try not to feel defeated. Your baby IS gaining weight, although slowly. Let's try to figure out what might be happening.

    I am confused about percentiles. Was your baby at 75, then 50, then 25? Or 50, then 25? And when was baby at what %? Dropping down the charts is an indication there MAY be a problem. In and of itself it is not a problem, if that makes sense. Most babies move around on the charts, and some babies are naturally taller and thinner than others. Also, is your doctor using the WHO charts for breastfed babies?

    what did your daughter's pediatrician say about weight gain and your child's health? Did he or she recommend any steps be taken?

    Have you seen a lactation consultant to have a nursing session observed? Is that possible for you?

    Are you taking anything that might impact milk production, such as hormone based birth control?

    What was baby's birth weight (Or lowest known weight if you know)? How was weight gain the first 4 months? Weight gain rate typically slows after around 3 months and then again around 6 months, so a more complete weight check history (if you have that) might help to understand when any problem may have started. Were there any weight checks between 4 and 7 months? Were those two appts. 90 days apart (approximately?) Are you sure the weight checks at both appts. were done accurately? same scale?

    Any nursing issues ever? Latch pain, etc? Any possibility of tongue or lip tie?

    Had you noticed anything unusual in your daughters health or behavior? Were you surprised that the gain was slow?

    How many times a 24 hour day does your baby nurse? Any major changes in nursing frequency or duration between 4 and 7 months (there usually are some changes) Any illnesses during that time? Are nursing sessions short, long? Does baby typically take both sides at each nursing session? How does baby appear after nursing...usually content, usually not content? Does baby like to nurse for comfort and too sleep? Has stooling always been normal or not?

    I started solids a few weeks ago and in the last few days I have been feeding her more and more (3 times today) plus I have been adding in an expressed bottle once a day just to increase weight gain (and we have had thrush so anything I pumped I wanted to give to her sooner rather than later to avoid re-infection later). None of this has helped.
    So how long have you been worried about your daughter's gain and adding the bottle of expressed milk?

    How long have you been pumping and with what kind of pump? Is it in good condition and fit you properly?

    Solids were started a few weeks ago. Was there any diminishing of nursing frequency at that point?

    Does baby typically sleep a long period at night (more than 5 hours?) Does baby use a pacifier much, or is she swaddled for sleeping?

  3. #3
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    Thank you for responding and so thoroughly! I will try to answer all of your questions…
    Here are her weight checks. All done in ped office on same scale with only a dry disposable diaper on, except her birth weight which was done in home by midwife on a hanging scale. Her newborn appts were approx. 1 and 2 weeks…they were off a bit because after her home birth I didn’t rush in to the dr. I can’t remember exactly when we went.
    Birth: 8lb 6oz 1 week: 8.1 2 week: 8.6 1 mos: 9.4 2 mos: 12 4mos: 14.6 6mos: 15.2
    In between four and current (7 mos this last weekend) she has not fluctuated much according to my home scale (not perfectly accurate but just to get an idea). At 5 mos I hadn’t noticed any weight gain. Again at 7 mos I see no weight gain according to my scale. 15.2 lb was her weight yesterday. I looked at the WHO charts and it looks like she was in the 75% at 2 mos. 50% at 4mos and now down to the 25% at 7 mos.
    My dr did not make any comment regarding her growth at 6 mos. He said that she looked fine. She is meeting all of her milestones. Is happy. And seems otherwise healthy. However, this is my second child. My first child started losing weight while breastfeeding by 4 mos. I had seen a craniosacral chiropractor and lactation consultant without effect (she was not happy so I had sought out help early), And ended up supplementing and drying up. So I am very concerned to see this trend again. I haven’t sought out any help yet this time short of this email. I did email my midwife and she’s out of town. I also looked up a LLLI meeting in my area on Friday and considered going if I can make it work.
    I am taking no meds or birth control. I have not been sick. Both the baby and I have been sharing thrush, we tried niastatin for about a week and then started treating it naturally. We have it pretty well kicked. Though my nipples are not quite 100%. We are still treating with vinegar / motherslove cream, and probiotics.
    No indication of tongue tie. My midwife checked early on because we had tons of pain in the beginning. This had cleared months ago with no issues until recently when she got teeth and then we got thrush. She is a bit of a biter, which I think caused the thrush. The thrush was fairly mild. Throughout her life my nipples never stopped getting sore if she would nurse marathon style, which she liked to do until recently. I assumed she was just a slow nurser, but lately has shortened her bouts more and more. Yesterday she was pulling off very quickly and seemed angry. I was very stressed and tired and worried about my milk. This action didn’t help. She also woke up every two hours the night before last. Whereas she normally sleeps through the night and wakes up once or twice early morning to feed and then back to sleep. Hoping this was her upping my milk naturally.
    I don’t’ know how often she nurses honestly, but if I think about her normal daily schedule, then I would guess somewhere around 8-12 times? I feed her on demand. Usually directly after a nap and then again before she goes to sleep. She’s usually awake for 2-3 hours between naps and takes 3 naps. She seems content after nursing. If she bites me I take her off or if she starts pulling off to look around. If she cries when I take her off, then I put her back on. If she starts acting grumpy when playing I feed her. I just try to follow her cues. She does not nurse to sleep unless she is eating during the night. She just started solids so her stooling has changed. Nothing that seemed worrisome though.
    I started supplementing the bottle about a week / 2 weeks ago. Partially because of slow weight gain and partially because we had thrush and any milk I pumped I wanted to use so we wouldn’t re-infect later. I have been worried about the weight gain since about 5 mos.
    I have pumped since she was about 6 weeks. I try to pump once a day (after she goes to bed at night) but often go a week without pumping. I don’t leave her often so I don’t need to pump that much. I have an Ameda purely yours. It is older , from my first daughter. I recently ordered a new pump (same model) through my ins because of these issues and wanting to institute power pumping I felt that maybe the pump was getting older and less suction. I have only used it once with my same tubing / flange / etc because I didn’t want to transfer thrush to the new hygiene kit. I was planning on throwing away all of the old parts once I felt that the thrush was 100% gone. I think the fit is good… I’ve never had anyone check it. I didn’t notice a huge difference between the power of the old and new pump.
    I only feed her solids after she has already nursed. I still nurse her just as frequently, but yesterday she was pulling off and mad a lot so I fed her more solids than normal and felt like she didn’t want to nurse as much. Might have been an off day. I had worked the day before… maybe she was just thrown off schedule kind of.
    Baby does use pacifier. She usually only wants it while sleeping / to go to sleep, or to play with / chew on. I don’t swaddle.
    Sorry for writing a book. I truly appreciate any help. I would like to get back on track. I really don’t want her to wean!

  4. #4
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    I forgot to say that she only nurses on the right side. she started refusing the left side months ago. I tried to force it on her, but my milk on that side has steadily decreased. Now I can only pump a tiny bit from that side (less than 1/2 oz) and she immediately pulls off when offered. I still offer it to her though. And I have been considering trying to pump a ton on that side to regain my supply in that boob... and to even them out

  5. #5
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    ok thanks for answering my ?

    here are some of my thoughts. I am typing one handed so please excuse.
    pediatrician not concerned. Why? it might be worth having a conversation. It may be there is less reason for concern than the numbers might indicate.

    Birth: 8lb 6oz 1 week: 8.1 2 week: 8.6 1 mos: 9.4 2 mos: 12 4mos: 14.6 6mos: 15.2

    So by my (shaky) math, gain was totally on track for at least first two months, with baby gaining ~ .5 lbs a week or more. That is normal gain for first three months.

    between month 2 and 4, baby gained 2 lbs, so more like a 4 ounces per week. Normal gain after 3 months is about 4-6 ounces per week. but the gain for that entire period is off because it should have been more than that before three months.
    between 4 and 6, gain was 12 ounces, or about 3 ounces per week.

    So by my calculations, gain is slowing down more rapidly than it normally should.

    When did baby start nursing on only one side? that may certainly be part of the issue.

    otherwise, this weight gain pattern suggests to me that either baby was not/is not nursing efficiently and/or not nursing often enough. In the first few weeks, moms often have lots of milk, so even a baby who is not an efficient nurser gets enough to gain normally. But over time, this inefficiency causes both poor gain and/or a lower milk production.

    This is a common gain pattern for a baby with tongue tie or lip tie. It is also what you might typically see if baby is being sleep trained and/or meals scheduled.

    You report that baby has always been nursed on cue, and I am guessing that if baby nurses between 8 and 12 times a day now, baby always nursed that often or more often(?) that should be often enough for baby to be getting enough assuming normal production and baby efficient at the breast. I don't recall if you answered about baby taking long stretches at night or paci use or swaddling. All of these can cause baby to not get enough so if you are or were doing any of those, that should probably be taken into account as well.

    but a physical issue is also indicated by the nursing pain and also by the breast refusal/supply issues on the one side.

    Sorry I have to run. I will try to post more later, I do have more to add. But I guess my question right now is, is, are you very sure there is no tongue or lip tie?

  6. #6
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    IMAG2754.jpgIMAG2758.jpg

    Knee jerk answer when you asked if it was tongue tie / lip tie. I don't think I'd ever even heard of lip tie. As I think I mentioned above, the midwife had looked at tongue tie. She said that it was minute if there, but that if we continued to have pain to have it checked. Which we didn't. I Couldn't get a look at her tongue but I'm attaching a pic of both my 7mos lip and my 4.5 yr old's lip. I'm pretty sure this is lip tie.

  7. #7
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    OK so I cannot diagnose lip tie or tongue tie. (For that matter, neither can a midwife or an IBCLC. (Lactation Consultant) at least, not in the US.) A doctor (or dentist) needs to do that. So I am sorry, I do not even want to give an opinion.

    I would suggest that you do some research in this area. It is a controversial one, although progress is being made. Many lactation consultants and many pediatricians and ENTs and dentists agree that tongue and/or lip tie adversely affect breastfeeding and thus, should be treated in young babies when breastfeeding (or weight gain) is appearing to be impacted. Others disagree, or think that bottle feeding is the answer rather than treatment, or that treatment "can wait" even if it IS adversely affecting breastfeeding. So IF you suspect tongue and/or liptie is part of the issue, it is important to try to have baby seen by someone who understands the potential impact on breastfeeding and will treat if warranted. I wpuld also suggest that it MAY be that treatment at this age might pose more problems than earlier treatment may have. So I think research and discussions with professionals who can guide you is probably indicated.

    I suggest, get in touch with your local LLL. You can call a Leader and also attend a meeting, or do one or the other. The support and info LLL offers is free (or should be, at least in US) so definitely take advantage. YOur local LLL Leaders may know who in your area you can talk to about tongue or liptie.

    If you can, get an appointment with a professional IBCLC (Board Certified LC.) They cannot diagnose lip or tongue tie, but they certainly can suspect. Also they can observe your baby nursing and give you ideas that may help.

    Meanwhile. If we are going to assume there IS an issue, that the issue is at least in part milk production related, and at least in part baby having difficulty transferring related, what can you do about it?

    For milk production:
    I suggest yes, start Pumping the side that baby is refusing. Do not worry about how much comes out. Just pump as much as you can. Add hand expression as well to see if that helps.
    I would suggest it is possible that the Purely yours may not be the best pump for you. Is this the same pump you had with your older child where you lost milk production? If you can rent a hospital grade pump, that might be helpful when trying to bring back production in the one breast. Also, flange size matters, age matters, etc.
    Consider treating the thrush more aggressively so that headache can be out of the picture. See Jack Newman candida protocol.
    Encourage baby to nurse more. Try to avoid pacifier use as much as you can-encourage baby to nurse instead. Also try to avoid and long stretches of over 5-6 hours overnight (or anytime) of no nursing.
    Consider galactagogues if you are not already?

    For helping baby get more milk:
    Try breast compressions, again, see Jack Newman's info. Pediatrician from Canada.
    Be careful about solids. Breastmilk contains more calories and healthy fats than the vast majority of foods a baby typically will eat-often MUCH more. So encouraging baby to nurse more is generally more important than solids for gain.
    Avoid any juice or water or any other liquid. nurse instead. Tiny sips of water with a meal ok, but probably not necessary if baby is encouraged to nurse before and after eating.
    Be careful about bottles. Every time baby gets a bottle, for best milk production, you should pump as well. It does not have to be at the exact same time of course.
    OK I have put lots of "shoulds" because I am in a hurry, as I have to go offline for the night. So Let me add one more-you should ONLY do what works or makes sense to you. These are just suggestions.

  8. #8
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    Also, when I'm nursing her I try to 'jam' as much of my boob in her mouth as possible, but I feel like she pulls it back out. Like literally she grabs my boob and pulls it away from her mouth.
    I posted these pics and posed the question to my local LLL facebook group. I haven't had a lot of response but someone said that there is generally more to lip tie than meets the eye essentially. I'm going to start googeling it. Any info is appreciated. And I really appreciate you helping me. I should be relieved to know there is something tangible and simple wrong. But I kind of feel overwhelmed and like crying. I know that's silly. I feel like everyone around me has had such a simple breastfeeding story and then there's me... constantly struggling.

  9. #9
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    I posted that before I saw your response ^^. After re-reading it I realize it doesn't say what it meant for it too.... I don't mean she literally pulls my whole boob out of her mouth. She just pulls it away so that she has a shallower latch. Like as if she prefers a shallower latch. I know I should let her latch as long and much as she wants, but when she nurses for long periods my nipple gets really sore. I would imagine this is shallow latch. But since she refuses me putting more of my boob in her mouth it's really a viscous cycle.

  10. #10
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    Default Re: Slow weight gain in 7 mos old. Panicking!

    Below I linked are some ideas for encouraging a good latch. Usually latch issues occur and are addressed when baby is younger, however, the basics stay pretty much the same. One thing to keep in mind with older baby is that a baby needs room to latch well. A baby may not be able to latch well if the chin is tucked, which might happen if a longer baby is held cradled in a curled position in moms arms, for example. So think about positioning too. Positioning and latch are things your local LLL Leader and a lactation consultant should be able to help you with.

    Here is an article with many suggestions for positioning and latch: http://feedthebabyllc.com/latch-and-positioning/ and http://www.llli.org/docs/00000000000...astfeeding.pdf

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