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Thread: Concerned about weight gain

  1. #1

    Default Concerned about weight gain

    My 3 month old DD started out gaining weight at an expected rate but she's slowed down significantly in the last month and I'm very concerned. Her pediatrician is not yet concerned and says we'll see how she gains between now and her four month spot (9/21). Here are all her weights to date:

    5/20/17: 7 lb 9 oz
    5/22/17 : 7 lb 1 oz
    5/29/17: 8 lb 3 oz
    6/21/17 : 9 lb 13 oz
    7/21/17 : 12 lb 2.5 oz
    8/8/17 : 12 lb 12.5 oz
    8/22/17 : 12 lb 14 oz

    She hasn't even gained a pound in the last month. Particularly concerning is her 1.5 oz gain between the last two weights. Her wet diapers have stayed the same (5-7 per day) and her poopy diapers have decreased to 2-4 per day but they are considerably larger than when she was small.

    I offer to feed DD at least once every 2 hours, if not more often but she sometimes refuses (turns her face away, arches her back, and fusses). I also respond to her hunger cues. She only nurses for about 10 minutes each time but I've got a fast let down and I hear a lot of swallowing when she's nursing.

    I'm worried I'm not feeding her enough, but she rarely complains. Usually, she only fusses when she's tired or when I've offered the breast and she's not interested. Is it possible that she's hungry and just not complaining about it? Why is the gain so slow despite having expected diaper output?

    She also spits up A LOT. And large amounts. She seems to be a happy spitter but I'm worried that's contributing to the slow gain.

  2. #2
    Join Date
    Jun 2009
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    10,756

    Default Re: Concerned about weight gain

    I think sometimes it helps to look at the big picture. This is how charts are designed- not to look at how much a baby gained two weeks here or there, but (once normal gain is established by about 2 weeks) to measure overall gain over several months. This is because it is normal for gain to be in fits and starts, not steady.

    From age second day of life(?) (5/22) to 8-22, a period of 3 months, your newborn gained 6 pounds.

    6 pounds in 3 months is textbook, normal average gain for the newborn period.

    Gain rate will slow now, that is normal, babies cannot keep gaining so rapidly as they do as newborns, or they will become gigantic. Maybe your baby's gain rate slowdown came a little early, but that could be normal because baby gained so rapidly before that.

    A baby who is pooping several times a day at 3 months is almost certainly getting enough milk. By this age it is normal for poop frequency to reduce, even much more than that, even to only once every several days. It is also normal for poops to still be frequent- but in that case it is unlikely your baby is not getting enough to eat, nor is it likely baby is spitting up so much baby is not getting enough, after all what comes out as a poop obviously was not spit up! Also the vast majority of the time spit up (even lots of spit up) is normal and not a cause of slow gain. Fast letdown often = lots of spit up, and again this is normal and not cause of poor gain.

    3-4 months is an age many babies start nursing wonky. Usually they just grow out of it.

    For tons of information about the variables in normal gain and why usually there is no reason to worry, I suggest the book My Child Won't Eat by Carlos Gonzalez, a pediatrician. He also explains in detail the "crisis at 3 month" concerns that so many moms have and why in fact usually all is normal.

    Aside from that I would suggest think about what might possibly be causing baby to not gain normally (if that is the case.) Baby nurses 10 minutes, but that is normal at this age. You have fast letdown, so I assume milk production is not a concern. Baby nurses frequently, day and night? If so, then that is not the problem either. So what could be the problem, are you thinking?

  3. #3

    Default Re: Concerned about weight gain

    I will take a look at the book; thank you for the recommendation!

    I guess I'm concerned that maybe there's a health problem going on? It just seems weird that she could be getting enough but not putting on weight. Although her demeanor does not suggest that she is malnourished (she's alert and typically content when awake), so I suppose a medical problem is unlikely...

  4. #4
    Join Date
    Jun 2009
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    10,756

    Default Re: Concerned about weight gain

    I guess I'm concerned that maybe there's a health problem going on?
    Ok well I think this is actually exactly the right thing to be wondering. Not because I think it likely your child IS ill, I think that is unlikely as there are no other symptoms. But becoming alerted to the possibility there is a medical issue is exactly why weight gain is monitored- it is like an early warning signal, and could indicate to parents or physicians that baby might be ill and some closer monitoring may be appropriate.

    Unfortunately all too often, if a baby is not gaining at mid average or higher rate, or has an "unexplained" slow down in gain rate, everyone immediately assumes the issue is breastfeeding and throws formula or some other intervention (making mom pump and bottle feed, or early solids introduction, etc.) at the issue. They think that slow gain must mean that either baby is not getting enough milk, or there is somehow something "wrong" with mom's milk. The latter is too ridiculous to even consider, but of course sometimes the former is the cause of slow gain. However in your case baby appears to be getting plenty of milk. So I would suggest if the slow gain continues, an appropriate action would be to run whatever tests baby's pediatrician deems appropriate to see if there is a medical issue that is slowing baby's gain rate.

    Also, I think it is safe to say that with this kind of gain there is no way baby is malnourished...malnourishment assumes either baby is not getting the nutrients needed (highly unlikely with a breastfed baby, in fact is even very unlikely for a commercial formula fed baby to be malnourished assuming the formula came from a reliable source) or that baby has been underfed for a long time. It tends to be a long term issue with warnings before it becomes serious.
    Last edited by @llli*maddieb; August 25th, 2017 at 03:38 PM.

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