Happy Mothers Breastfed Babies
Page 1 of 2 12 LastLast
Results 1 to 10 of 15

Thread: 5 months and dropping off the charts

  1. #1
    Join Date
    Mar 2013
    Location
    Houston, TX
    Posts
    15

    Default 5 months and dropping off the charts

    Hello ladies!
    My son is EBF and was born in the 70th percentile at 8 pounds 2 ounces. At his 2 month check up, he weighed in at 11 pounds 12 ounces (around 50th percentile) , then at his most recent check up (almost 5 months old) weighed 14 pounds. This puts him in the 10th percentile. The pediatrician is concerned with decrease in maintaining his weight-gain "curve" (basically, not that he's in the 10th, but that he went from the 70th at birth to the 10th now).
    He has many wet diapers, a dirty diaper once a day or two. His skin is very soft, mouth is always wet and drooly, eyes are bright, he's very energetic and interactive. He did start sleeping through the night (about 10 hours) at 3 months. He also got his first 2 teeth at almost 4 months.
    I do have a slight oversupply, but have decreased it enough so that I don't have to pump to avoid being engorged (just by slowly tapering off pumping sessions). Now I only pump when I work one weekend each month.

    So after our check-up the other day, pediatrician wanted us to pump and bottle feed for 48 hours to measure intake. I was unable to do this, as he almost always refuses bottles from me. I was also a little scared that he would start to prefer bottles. As an alternative, she sent us to a lactation consultant where we did weight before and after nursing. He was nursed really well and transferred 4.5 ounces then fell asleep. She also checked for tongue tie and said that wasn't an issue.

    Are we missing something here? Is there a reason he wouldn't be gaining weight that could be nursing-related? He seems so happy all the time and is meeting all his milestones, just not staying on the charts!

    Thank you in advance!!

  2. #2
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: 5 months and dropping off the charts

    Some things to look at: How is other growth? Height, Head circ? Overall strength?

    Your baby's behavior and output sound normal, however, since your child's pediatrician is concerned enough to have you pump and give bottles, then it makes sense to look for answers about intake. I also find it somewhat concerning that you had overproduction, as overproduction almost always leads to FAST gain, not slow.

    However, I would disagree that the best way to measure intake at the breast is to pump and give bottles! That only tells you how much you can pump and how much your baby takes in a bottle. These tell you almost nothing about intake at the breast! So I am glad the LC and weighted feed was suggested, of course, that should have been the first suggestion and not the 'alternative!'

    If a baby is capable of transferring 4.5 ounces at a single nursing session, that indicates there is no issue with per session intake. But I am curious Did you tell the doctor or the lactation consultant about the long sleep stretch? And what did they say? Did either ask how often baby nurses every 24 hours? How often does baby nurse in 24 hours? When you say he nursed 'really well' at the LC appt. do you mean better than usual? Longer? More vigorously? More swallowing, then is typical?


    He did start sleeping through the night (about 10 hours) at 3 months.
    If you mean this is how baby sleeps most of the time, I think this is a rather long sleep stretch for a baby this young. Even if weight gain was not a concern, I would be somewhat concerned that such a long sleep stretch on a regular ongoing basis would be harmful to milk production, even for a mom who once had overproduction.

    Have you considered encouraging baby to nurse some overnight? Some moms find baby will nurse in their sleep and others choose to wake baby to get in more overall nursing sessions. Also, if baby uses a pacifier at night, is swaddled, or sleeps in room without you for a major part of the night, those are all circumstances that might cause a baby to sleep longer and not wake as often as they might normally.

    Oh and yes there are other reasons a baby might not gain well despite getting enough to eat at the breast. This is why gain is monitored so closely and causes so much concern- because poor gain is an early indicator of some illness or underlying health issue. Unfortunately, breastfeeding is often blamed. That is not to say, baby may not be getting enough milk to gain well. I think it is possible baby is not getting enough to gain well due to the long sleep stretch.
    Last edited by @llli*maddieb; November 2nd, 2014 at 09:34 AM.

  3. #3
    Join Date
    Mar 2013
    Location
    Houston, TX
    Posts
    15

    Default Re: 5 months and dropping off the charts

    He has remained in the 50th percentile for height throughout his 5 months, head circ has stayed about 80th percentile (my babies have big heads). His strength is great, doctor said he has wonderful head control, pulls himself up to sitting position, he's grabbing objects and pulling them to his mouth, reaches for us when we are near, etc. He makes great eye contact and follows things with his eyes.

    As far as the nursing, he nursed a "typical" session at the lactation office. He gets distracted easily, so I was worried how he'd nurse with a lot of babies and in a new environment and all that. It was about the same time he normally does a longer nursing session and goes down for his first nap of the day. He nurses, on average, every 2 hours during the day. Sometimes he only takes one breast, sometimes he takes both. I would guess he's at the breast around 10 times per day. I can feel my let downs still, and usually leak from the side he's not currently nursing on. He swallows frequently while nursing.

    I do nurse him at night if I notice him stirring. Most of the time he just does a minute or two of real nursing, then comfort nursing for a few minutes, then falls off so I lay him back down. This happens maybe once or twice per week. He doesn't take pacifiers, we don't swaddle him anymore (we use a halo sleep sack), and he does sleep in the same room as us (in a little crib beside our bed) about 3 feet from my bed.

    I haven't seen a huge decrease in production at all since he's been sleeping through the night. When I do have to work, I'm gone for about 10 hours and pump between 15 and 18 ounces, so I think that's fairly on track. He usually takes 13-15 ounces in bottles during that time.

  4. #4
    Join Date
    Sep 2012
    Location
    rockford,il
    Posts
    798

    Default Re: 5 months and dropping off the charts

    http://www.kellymom.com/bf/normal/gr...-gain_increase
    Do you happen to know which set of charts the doctor uses? The older cdc charts include info for formula fed babies, who grow at different rates than exclusively breastfed babies. The WHO charts are the standard to look at. Also, was baby weighed on the same scale, naked each time? Any fluids at birth to artificially inflate his weight then? Was your motherly instinct feeling anything was wrong before the charts came into play?

  5. #5
    Join Date
    Mar 2013
    Location
    Houston, TX
    Posts
    15

    Default Re: 5 months and dropping off the charts

    Thank you for sharing that article! I have been practicing the things suggested for increasing baby's weight.

    I did ask the doctor and the lactation consultant both about the charts, they both showed me the WHO charts. The pediatrician said it wasn't really a concern of where on the charts he was, rather that he's dropping from where he started. I did know that breastfed babies tend to do this and asked her about it, but she said it usually doesn't happen this soon and so drastically.
    He was born at a birth center and I didn't even have an IV, so no fluids at birth. We did delayed cord clamping (about an hour), so he might have had a slightly inflated birth weight. He never dropped below his birth weight. At 5 days old he'd already gained 5 ounces. After that, he we in the hospital for photo treatment for jaundice for almost 3 days where we continued to breastfeed. We also had thrush about a month ago (a very mild case for him, but I also had it in on my nipples). No problems since those 2 things though.

    As far as I know the pediatrician's scale has been the same one each time, and he is weighed in nothing but a clean diaper each time (I undress him and change him just before going to the scale at each appointment).

    Before this appointment, I didn't feel anything was wrong...quite the opposite! After the lack of growth was pointed out though, started to worry...only because I truly feel like our breastfeeding is going so well, that it might be some other underlying issue. I guess I'm just trying to figure out what, if anything, I missed in evaluating our breastfeeding.

  6. #6
    Join Date
    Mar 2014
    Location
    Central FL
    Posts
    1,575

    Default Re: 5 months and dropping off the charts

    Do you give vitamin D drops? Or are you taking lots of extra Vitamin D yourself or getting Plenty of full body sun exposure daily?
    What about Iron levels? Yours I mean since they won't have checked baby for Iron levels yet, they don't usually do that till 1 year unless you ask.
    My LO had milk transfer issues and I had supply issues but even after those were taken care of and I was having trouble getting him to eat enough and his weight gain was still not great. I found a new Ped and she recommended vitamin D drops and said they usually recommend those to all breastfed babies since few moms get enough sun exposure to have enough extra vitamin D in their breastmilk.
    Since we started the D drops DS seems to be making up for lost time and has climbed back up from 5th centile to 20th centile.
    Vitamin D deficiency can cause poor growth.

  7. #7
    Join Date
    Mar 2013
    Location
    Houston, TX
    Posts
    15

    Default Re: 5 months and dropping off the charts

    We haven't been doing vitamin D drops, but I take a supplement and we get in the sunlight for about 30 minutes each day. Wouldn't that cause lack of growth for height as well though? I will definitely look into my iron levels also.

  8. #8
    Join Date
    Mar 2014
    Location
    Central FL
    Posts
    1,575

    Default Re: 5 months and dropping off the charts

    Quote Originally Posted by @llli*jennavee View Post
    We haven't been doing vitamin D drops, but I take a supplement and we get in the sunlight for about 30 minutes each day. Wouldn't that cause lack of growth for height as well though? I will definitely look into my iron levels also.
    But how much clothes are you both wearing and are you using sunscreen? Both block the rays that are needed to make vitamin D. Think 15 minutes of full sunbathing at noon on a sunny day in the tropics is way more than enough sun but we are not quite in the tropics and if wearing much more than a bathing suite or sunscreen it means you need much more exposure. Hence why they recommend drops.
    Most supplements only have about 400 IU of Vitamin D which is no where near enough to make it amply available in breastmilk.

    My babies growth on the height and head stayed pretty close to on their original lines, it was just his weight that worried everyone. He has also been spot on or ahead of the "average" for all other milestones. I'm glad I learned about the D drops though since Rickets is a D deficiency disease but I don't think it usually shows up immediately so there is still time to catch back up.

    I have also read that Flu is also a vitamin D deficiency disease.

    Now they do make a Vitamin D test that you can do on yourself at home and send off to get the results if you are worried about D levels (since it is possible to over dose on Vitamin D so you do still need to be careful if trying to get YOUR levels high enough with supplements to provide it in breastmilk to baby.)

  9. #9
    Join Date
    Mar 2013
    Location
    Houston, TX
    Posts
    15

    Default Re: 5 months and dropping off the charts

    Quote Originally Posted by @llli*tclynx View Post
    But how much clothes are you both wearing and are you using sunscreen? Both block the rays that are needed to make vitamin D. Think 15 minutes of full sunbathing at noon on a sunny day in the tropics is way more than enough sun but we are not quite in the tropics and if wearing much more than a bathing suite or sunscreen it means you need much more exposure. Hence why they recommend drops.
    Most supplements only have about 400 IU of Vitamin D which is no where near enough to make it amply available in breastmilk.

    My babies growth on the height and head stayed pretty close to on their original lines, it was just his weight that worried everyone. He has also been spot on or ahead of the "average" for all other milestones. I'm glad I learned about the D drops though since Rickets is a D deficiency disease but I don't think it usually shows up immediately so there is still time to catch back up.

    I have also read that Flu is also a vitamin D deficiency disease.

    Now they do make a Vitamin D test that you can do on yourself at home and send off to get the results if you are worried about D levels (since it is possible to over dose on Vitamin D so you do still need to be careful if trying to get YOUR levels high enough with supplements to provide it in breastmilk to baby.)
    We go out in "normal" clothes (shorts and t-shirts for most of the year in Texas!), but you're probably correct in saying that it's still not enough for us. After your first comment I just went ahead and ran to the the store and got some. How quickly did you see weight start to pick up? I definitely want to make sure he gets all the vitamins he needs! Thank you for your input!!

  10. #10
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: 5 months and dropping off the charts

    Ok thank you for answering my questions. Everything sounds pretty good to me and it is reassuring baby's other growth is not problematic.
    Nursing 10 times per day would typically be enough for normal gain at this age. On the other hand, there is little to no downside to offering/gently encouraging baby to nurse more often just in case.
    Since you were surprised at the weight check, maybe the check was wrong. Human error is a possibility as well as scale error.
    I am not as conversant about vitamins as tclynx but I do think there is no reason to assume a vitamin deficiency, rather, maybe request testing. As far as vitamin D goes the recommendation these days is that all infants be supplemented with D because there is such widespread vitamin D deficiency.
    You can get infant vitamin D drops which require one drop a day on babies tongue it can be done very easily with no ill affects to breast-feeding.
    I am not saying that is the issue I would actually kind of doubt it. However that is the current reccomendation at least it is in the US.
    I would suggest that because your baby is overall healthy this is probably not all that big of a deal. However I would suggest continuing to look for answers that makes sense to you. Why? Because your baby is five months old and is soon going to be reaching a time when typically weight gain slows considerably. After about six months most babies tend to stop gaining nearly as fast as they did before. So if a baby is already being closely watched for poor gain that could potential become more problematic just because of normal slowing of gain.
    The answer may just be that this is who your baby is.
    A good book on the entire subject of weight gain, charts and eating (breast-feeding, bottles or solid foods) is the book my child won't eat which I would recommend.

Tags for this Thread

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •