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Thread: Weight loss despite normal behavior, diapers???

  1. #1
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    Nov 2016
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    Exclamation Weight loss despite normal behavior, diapers???

    Hi y'all!

    TLDR: My baby's lost 3 oz in the last three days despite feeding whenever hungry, increasing supplement, being content after feedings, having heavy wet diapers every few hours and big poops every other day (his normal), sleeping normally, etc. What is going on?

    Long version: Poor weight gain at first despite working with LC to increase intake and pumping. Began supplementing with formula at 1 month and quickly started gaining. We've been supplementing ever since (and still pumping 6-7 times most days), using a Lactaid for the past few months. Supplement was steady at 12 oz per day, 3-4 of that my pumped milk, with good gain. He is 5 months old today.

    Then a week ago we had almost a week with no gain and fussier behavior at the breast when I wasn't using the Lactaid (we weight him every other day). Near the end of that I had a day when my pumping output dropped, but it went back up the next. We upped the supplement from 2 oz at a time to 2.5 oz at a time and added an extra supplemented feed on the days when he ate frequently enough to fit it in. Gain picked back up, 2.4 oz in four days.

    Then on Saturday my pumping output dropped again. I didn't stress too much because it had gone back up before. On Sunday it dropped even more and he ate much more frequently--9 supplemented feeds vs. 6 or 7, for a total of 21.5 oz of supplement that day (he left an ounce behind in one of them). So I was already planning to bump the supplements up to 3 ounces each for Monday, when his weigh-in on Monday morning showed a 2.8 ounce loss!

    On Monday I went ahead with 3 oz supplements and he didn't need to eat quite as frequently, so he got 20 oz of supplement (again had one he didn't finish--and another time I tried to nurse him when he wasn't really hungry and he wasn't interested). My pumping output went back up again to the high side of normal for me.

    This morning I weighed him again and another .3 oz loss over yesterday! What gives? Could it be scale error--it's a cheap scale but we've never had a problem with it before, it's always comparable to the one at the dr's office. I just weighed a gallon of water on it and it was correct.

    Is there a chance that he is not getting enough to eat despite normal behavior and diapers? Could there be something else causing loss? What can I do to get him gaining--I am feeding him as much as he wants!

    HELP!
    Last edited by @llli*rachellemarie; January 17th, 2017 at 08:39 AM.

  2. #2
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    Jun 2009
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    Default Re: Weight loss despite normal behavior, diapers???

    Hi Rachelmarie. Weight loss does seem strange in this scenario. I would say it sounds like it could be scale error, yet if you have checked your scale to your satisfaction it is clearly not that.

    You are correct output sounds entirely normal and if that remained unchanged, again, that would not fit with weight loss.

    What are the current expectations about gain-yours, the doctors, the LC? As a baby gets older and bigger, gain rate slows, especially after 3-4 months there is a noticeable drop in gain rate, normally. Also gain is never steady- such and such ounces per day. Gain is always to some degree in fits and starts. In other words, in an otherwise healthy 5 month old baby with normal overall gain, a week or more of a weight gain plateau would usually be entirely normal. At least that is my understanding. Would a small amount of loss here and there also possibly be normal? I am not sure. But we have to remember that gain expectations (based on growth charts) are not based on daily or even weekly weight checks. What the charts show is the average normal gain over several months. IMO, that possibly leaves room for not only plateaus but small amounts of loss, possibly.

    You mention how much baby is getting supplemented, but not how often baby is nursing? And do you have any idea what they expect baby to eat every day? 20 ounces is a very large amount of supplement, since the average total intake is 25-35 ounces per day.
    So pumping output is back to normal? I wonder if something happened to you that temporarily reduced your production, and if that possibly contributed to the recent weight gain concerns? Have you been ill, super busy and not staying hydrated, or taking any new meds or herbal products?

  3. #3
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    Nov 2016
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    Default Re: Weight loss despite normal behavior, diapers???

    I'm not sure what gain is expected--I haven't talked to LC in a long time, and the dr was happy with his weight at his 4 month checkup but didn't say anything about what to expect going forward. Somewhere between 3 and 4 months old he went down from about an ounce a day to about .75 ounce a day. At this point I am looking for at least half an ounce a day; one thing I have read said 4-5 ounces a week between 4 and 6 months. He still has almost 1.5 pounds to go to double his birth weight so I think he is still catching up and I think it would be better to stay on the higher side if possible. I know that gain can ebb and flow a little bit and every other day weight checks is a bit of overkill (we started when I was trying to reduce supplement and wanted to catch problems as soon as possible, then we just kind of got in the habit), however we have been doing it that way for several months and never had plateaus or loss like this before.

    If I average the last month it is about a third of an ounce per day.

    Baby nurses probably 8-10 times a day. Typically once overnight (although he was a little more unsettled at times over the last week or two and had some extra early morning snacks), 6 times during the day when I nurse, supplement, and pump, and then a couple additional feedings during the day without a supplement--to nurse him to sleep, to hold him over if I am about to eat or we are going somewhere, etc. Of course over the last few days things have been different as we have been having 7 or more supplemented feeds on some days.

    I know 20+ ounces is a lot, and I have been kind of freaking out that I am losing what supply I do have, even though most days I have been getting my normal amount at the pump. I haven't been sick or busier than usual, I'm just home with the baby most days, with some evenings out visiting friends but in a context where I can nurse almost as easily as at home. I've been taking alfalfa and goat's rue since around Christmas. I did increase my goat's rue dose a couple days ago but that was after things had already gotten weird. No other changes in supplements or diet. My husband had some cold symptoms for a day or two last week, but no illness for me or baby that I can tell. Also I haven't gotten my period back yet.

  4. #4
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    Default Re: Weight loss despite normal behavior, diapers???

    Ok, so baby nurses a normal amount, and gets supplements, and gain was fine on that protocol, and now despite increasing supplements, gain has plateaued for 2 weeks. Meaning , there was a plateau, then a little gain but then a similar amount of loss, so baby pretty much weighs the same as two weeks ago- or was it longer?

    I think 1/2 ounce per day average gain is a very reasonable expectation at this age. Does the 1/3 a day average include the last couple weeks of no gain? Or is that the average baby was gaining BEFORE the gain stopped?

    I think it is normal for gain plateaus to occur more often and for longer as baby ages. I really do not know how long a "normal" plateau would be though. Given your baby's history with gain issues and since there have been no obvious potential causes for an extended gain plateau or loss, I think it makes sense to have both breastfeeding and your baby's health assessed if that is possible.
    Last edited by @llli*maddieb; January 17th, 2017 at 03:08 PM.

  5. #5
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    Default Re: Weight loss despite normal behavior, diapers???

    Well the weirdness continues--we weighed him this morning showing a 10 ounce gain in one day! Is that even possible? LOL

    But at least it confirms my feeling that he was getting plenty to eat. Yesterday he had a big poop, second day in a row, which is a lot for him, and he ate 24 oz of supplement. He really was acting hungry before feeds too. I upped the amount of each one just to make sure I really was feeding him as much as he wanted, and there were a few that he didn't finish. Even still he finished or almost finished a 4 ounce bag every 2 to 2.5 hours in the late afternoon/evening--which seems like a lot even if he wasn't getting anything from me, doesn't it? Guess he is going through a growth spurt?

    I am planning to look into tongue/lip ties. I know the LC said it looked like he had an upper lip tie, though she acted like it might not make a difference to revise. Now I wonder, especially since I've read that tongue ties usually go along with. I might also try to talk to the LC again, just to talk through if there's anything I'm missing. I'm not sure what else I would look for in having his health assessed, I can imagine his doctor just saying he looks fine.

  6. #6
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    Default Re: Weight loss despite normal behavior, diapers???

    I do not want to speculate about the strange gain according to scale fluctuations. To me that all screams scale or human error but there may be other things going on.

    Babies can certainly go through growth spurts and eat more. But how much a baby takes in a bottle is generally considered an inaccurate measure of need. In other words, overeating with bottles is common. On the other hand, given your baby's age and long history with taking just enough supplements in bottles to have ok gain, I am not sure bottle intake would be as misleading as it generally can be. It's hard to say. Maybe also talk to your LC about bottles and how they are given.

    If your doctor is just going to say baby looks fine, maybe it all IS fine?

  7. #7
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    Default Re: Weight loss despite normal behavior, diapers???

    Yes, I think something must be going on with weighing--even though I checked the scale and we weigh him a couple times to get one (or ideally, two the same) where he is least wiggly. Who knows.

    I don't give him the supplement in bottles, I have been using a Lactaid for a few months now. Sometimes it is hard to tell when he is really done--for a while he would pretty consistently cry hard for a few minutes after he finished it, but wouldn't go back on the breast and would be fine after a few minutes, sometimes he slows to nibbles and falls asleep when there is still some in there--so I tend to rely on frequency and weight gain to help me know. If he wants to eat again 2.5 to 3 hours after the start of the last feeding I figure that is about right, shorter and I think maybe I didn't give him enough, longer and maybe too much. Does that make sense? So I guess that's part of why the scale weirdness was freaking me out, it made me question if I was totally misreading his cues.

  8. #8
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    Default Re: Weight loss despite normal behavior, diapers???

    I don't give him the supplement in bottles, I have been using a Lactaid for a few months now.
    Oh, ok. got it.
    Sometimes it is hard to tell when he is really done--for a while he would pretty consistently cry hard for a few minutes after he finished it, but wouldn't go back on the breast and would be fine after a few minutes, sometimes he slows to nibbles and falls asleep when there is still some in there
    Ok, that sounds pretty normal.
    so I tend to rely on frequency and weight gain to help me know. If he wants to eat again 2.5 to 3 hours after the start of the last feeding I figure that is about right, shorter and I think maybe I didn't give him enough, longer and maybe too much. Does that make sense?
    I understand what you are saying, but actually relying on frequency of nursing can be very unreliable, because babies nurse for comfort as well as for food and drink. Many moms have found that their babies at 4 or 5 months actually want to nurse more often then they did at 2 or 3 months, and this is usually not a sign of any problem. I am sure you have heard mothers say their toddlers are nursing like newborns. Again, this is normal. More frequent nursing does not rule out any problems, of course. But it does not necessarily suggest any problem either.

  9. #9
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    Default Re: Weight loss despite normal behavior, diapers???

    Yeah, it's not really as simple as every 2.5 - 3 hours, sometimes there is comfort nursing in there too, to sleep.

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