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Thread: 16 months old, 16.5 pounds

  1. #1
    Join Date
    Sep 2008
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    21

    Unhappy 16 months old, 16.5 pounds

    I happily breastfed my son until after I was pregnant with my daughter (a little after he turned 2) and have happily breastfed my daughter for the 16 months of her life so far.

    My son was a skinny kid with food texture problems who fell off the growth chart for a while. It took a lot of effort to get him to eat nutritious food but we put in a lot of effort. He still, at almost 4 years old, is a picky eater who doesn't always notice when he's hungry.

    My daughter, on the other hand, will try just about any food, but she doesn't eat much of it. She won't drink formula or milk from a sippy, but she'll drink apple juice. She's developmentally doing great- runs around, learning to talk, etc. But she hasn't really gained more than a few ounces since she was 8 months old, and she's way, way off the growth curve.
    At six months she was around 12 lb
    At 8 months she was around 15.5 lb
    At 12 months she was 16 lb
    At 16 months she is 16.5 lb
    When you look at her growth curve, it has a sharp turn where she was growing until 8 months and it has been a flatlined growth curve from 8-16 months.

    Her doctor was really patient at first, but is now deeply concerned. It's just gone on too long to be a growth blip, and even kids who fall off the charts are supposed to gain weight, just on their own lower "curve", and growth charts aren't supposed to have sharp turns for the worse (gradual curves maybe, but sharp turns are alarming).

    We ran a battery of blood tests and found nothing wrong.
    We kept a diet diary and it does seem as though she's not getting enough calories in her diet. We've been adding butter, fat, and cream to everything she does eat... and I suspect she's now eating even less.

    Her doctor thinks my breastmilk has fallen in caloric content so much that by filling up on breastmilk she's leaving little room for foods of denser nutritional value, and that's why she's flatlined on the growth curve. Therefore he wants me to wean her from as many feedings as possible. This doctor was supportive throughout the last 4 years of both kids extended breastfeeding, so he's not a head-in-the-sand type. But he says kids who literally don't grow at all look developmentally fine for a good long time, and then can crash suddenly, where a flu ends them up in the hospital or something.

    I don't want her malnourished during these first few years of life. But my gut feeling is that he's totally wrong this time about what approach to take to this growth problem and the accelerated weaning process has been wrenching on my family. Does anyone have advice for me? For example,

    -many, many of you have posted similar stories about kids who didn't grow for a 3 or even 6 month stretch and were totally fine. Anyone out there heard of a 8 month or more flatline on the growth curve?
    -does anyone have data showing a correlation between failure to thrive toddlers weight gain when weaned or not?
    -does anyone have experience with starting a supplemental feeder of formula for a kid like this, to help her learn to like and drink formula regularly from a sippy? (Not the usual intent of supplemental feeders, I know... but if my breast milk supply is insufficiently caloric it's a less emotionally trying way to wean, and it's not like I'm trying to keep up my supply)
    -does anyone know an easy way to get my breastmilk tested for its caloric value so I can see if his theory has any validity at all?

    Honestly I don't know where to begin. This doctor has been so supportive in the past that I have trouble not following his direction to wean, but every day feels like hell.

  2. #2
    Join Date
    Oct 2006
    Location
    Surprise, AZ
    Posts
    3,026

    Default Re: 16 months old, 16.5 pounds

    I'm so sorry you are going through this!! I have no advice, just ! Hopefully someone will be able to give you some advice!
    Steff, proud mom to:
    Ian (6) born naturally
    breastfed from 7/3/06 to 6/16/08
    &
    Erin (4) born naturally (with Hypnobirthing)
    breastfed from 5/18/08 to around 5/18/10
    &
    Seamus (3), my allergy baby, born naturally (with slacker Hypnobirthing) breastfed from 12/28/09 to 8/20/11
    &
    Connor (1) breastfed from 12/28/11 to current



    Ian's age ticker Erin's age ticker Seamus' age ticker
    Connor's age ticker


  3. #3
    Join Date
    Jan 2006
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    18,063

    Default Re: 16 months old, 16.5 pounds

    the doctor is wrong...


    Did they test her iron? Low iron can affect their eating!


    heres a link about the fat in mothers milk



    http://www.kellymom.com/nutrition/mi...e-milkfat.html


    I know a little guy whos mom started him on pedisure suppliment and after that he refused all solids. And just wanted his milk shakes

    Hes still a little guy! Mom is short and his dad is short also.
    Hes just not ment to be tall.
    They tested him for all kinds of things and told her there had to be something realy wrong with him.
    He had terriable poops from the time she weaned him at about 6 weeks to go back to work....
    she tried all kinds of formula's and they never did tell her that maybe he should have milk or soy or wheat...
    IT was very frustrating to her and to others that were worried about him.

    does your dd have signs of allergies?

  4. #4
    Join Date
    Aug 2006
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    1,987

    Default Re: 16 months old, 16.5 pounds

    If he's really insistent that it's a problem with your milk, insist that he have it tested. Chances are VERY good that your milk isn't the issue. If he doesn't know where to have the milk tested, you could call a milk bank and see where they have their milk tested.
    DS 1/2006 9 lb. 2 oz. 22 in.
    DD 10/2008 8 lb, 2 oz. 20 in.

  5. #5
    Join Date
    Mar 2006
    Posts
    8,591

    Default Re: 16 months old, 16.5 pounds

    Your doctor is crazy if he's blaming breastmilk. My dd wasn't as small as your dd, but she was, and still is, well below the growth curve. She was in the 50th for the first 6 months and then started dropping off, and she has never regained her status on that curve. At almost 3 she weighs 23 pounds (my almost 1 year old weighs 21). We've tested for everything and its all come back fine (well most of it has--she has some liver sstuff going on that has yet to be diagnosed, but I'm sure its just freaky test results at this point.

    Anyway, you can read more about our story here Still to small

    Her stats are on post 60.

    Erin
    Wife to a grizzly
    Mama to my little deer (12/05) my loving bear cub (9/07--), and our little tiger (3/22/10)
    Born by one c-section and 2 amazing VBACs


    Miles in 2012: 350.5/900 (Actual Miles Ran: 189)
    Miles in 2011: 708.5 (Actual Miles Ran: 509)
    Miles in 2010: 800.5 (Actual Miles Ran: 620)

    January Miles: 37.5/75
    February Miles: 59/75
    March Miles: 42.5/60
    April Miles: 64
    May Miles: 41/70
    June Miles: 59
    July Miles: 39.5

    227.5 miles on my new shoes
    338 miles on my old shoes

  6. #6
    Join Date
    Oct 2007
    Posts
    611

    Default Re: 16 months old, 16.5 pounds

    IS she super active? I think your doc is wrong. I would continue to nurse but keeping adding, butter, oil etc to all her food. Try adding flax seed oil to stuff too. Will she eat eggs or avacado's?
    Are you and your DH petite?
    My dd is bigger than your dd... 20 lbs at 15 months but still less than 10 percent for weight. Trust your gut. If she is meeting milestones...
    is she short too? Super skinny? Whats her build like.

    Married my man Michael 5/12/2006
    Keira Joyce 6/1/07 Breastfed for 22 months Peanut Allergy- Outgrown 11/2010!!!!
    Israel Benedict 10/10/09- Breastfed for 27 months ( 9 months tandem with his sister)
    Nairi Anne 4/1/2011 still nursing at 14 months
    My Daily Blog
    Cloth diapers on the bum!

  7. #7
    Join Date
    Aug 2008
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    37

    Default Re: 16 months old, 16.5 pounds

    I agree with all the pp's advice! Your breastmilk is probably MORE calorie-dense now that she's older instead of less. I think the only things I can add are to get as much fat into her solids as possible, but with olive, coconut, or flax oils instead of butter and cream. More dairy may even contribute to a malnourishment problem instead of help it. If there are any foods that she's eating that are coming out the same as they went in, I would eliminate those too. If she's not digesting it, it's just taking up space and causing her to eat less. Also, if she's having ANY issues with constipation try to get her going regularly (maybe some tolerated fruits or even some Miralax). If she's backed up she won't be as hungry either. Good luck with everything!
    AnneMarie
    Mom to Liana Hope
    Born 12/25/06 at 31 weeks, weighing only 2 pounds!
    Now she weighs 26 pounds
    and is the best!
    Food allergies are the pits

  8. #8
    Join Date
    Mar 2008
    Posts
    198

    Default Re: 16 months old, 16.5 pounds

    I don't think your doc is blaming your BM (unless he said those exact words). I think he may just be saying you need to start supplementing some sessions with dense solids. At this age you LO should probable be eating a little bit more solids. Like you said such a dip in the curve probably isn't a normal thing. I by no means think you should completely wean, just substitue some nursing sessions with some fun solids. My LO is 16.5 mons and we nurse one or two times a day, and she eats like a nonstop champ. She is 95% in height ans 50% for weight, and EXTREMELY active. Her curve declined but still slowly goes up. She only gains about a pound every three months. Maybe try letting her be a little more independent with eating. My LO went on strike for a few days until I figured out she wouldn't eat until I gave her a fork or spoon to use. I hope everything goes well. Good Luck!
    Mommy to Madilyn Born 4/25/07 9lbs. 15oz.
    C-section
    for 17 months. Greatest momments of my life!

  9. #9
    Join Date
    Sep 2008
    Posts
    21

    Default Re: 16 months old, 16.5 pounds

    Thank you all for your replies. As I see it, there are three possible points of view...

    1) The breastmilk is not high enough in calories
    (And yes, her doctor really DID say that. in the most supportive way he could, indicating that he knew how much overall stress I was under and how that could affect my milk, etc. We're already down to only 3 nursings a day, and he recommended that I eliminate two of them this month)
    it seems her doctor is the ONLY one who thinks this, so thanks for the moral support ladies!

    2) The lack of weight gain is not a problem
    most or all of you fall into this opinion. Unfrotunately I don't think I agree with you. I've compared DD growth to the WHO breastfed baby growth curves too, and she is more than 2 SD below the median (below the red line). I agree that it's not a problem if a baby doesn't grow for 3 or 6 months but where do we draw the line and call it a problem? WHO indicates the red line is a flag indicating a baby is not growing as he or she *should*.

    3) The third possible opinion would be that yes, there is a problem, but that breastmilk should be part of the solution, and weaning her is probably a bad idea. This is what I'm thinking...

    Many of you have indicated that developmental problems are when you'd draw the line to call it not enough growth... she doesn't have any yet (thank God!) Yes she has been tested for anemia (which was a problem for DS) and she is on iron and not a problem there. Yes she has been tested for the most common allergies, and nothing came up.

    But medically, we are not problem free. She has two significant issues: (a) a heart valve defect causing a small murmur and (b) volvulus-- when she was born her intestines were rotated relative to the rest of her body and when she was about a week old they filled up with milk sufficiently to twist off the passage of food through the intestines and twist off their own blood supply. Fortunately I noticed something was wrong and rushed her to the hospital before she died, and following emergency surgery and a stay in the NICU she was OK. But, there's nothing to hold the intestines into the untwisted position, so they could spring back at any time. She may be having intermittent difficulties passing food through her body. Pooping does seem to require a lot of effort and sometimes pain for her even though she is not remotely constipated, so this could definitely be a part of the problem. There are reasons to worry.

    As far as height, DD is at the 10%ile... small but certainly on the growth curve. I am really short, but as a little kid I was short and tubby. DH is very average in weight and height and always was. DS seemed like a little skeleton, but stayed on the low end of growth chart... but DD has what looks like a normal sized belly and just really skinny (but strong) arms and legs.

    I did donate a bunch of milk to a milk bank while she was in the NICU, so I imagine those tests maybe included calorie content? Good idea to start there to get the BM tested, and they'll have a baseline too. But nowadays when I pump I get very little volume... I even rented a hospital pump for a while to see if that would help... and I think the breasts only express well with her suck. So I worry that pumped milk might be all foremilk and low in fat content anyway if I do test it. I could of course use fenugreek to boost supply, but I have so far matched supply and demand enough to avoid mastitis so I'm not sure if that's a good idea either...

    Sorry to have such long posts. I'm overthinking this, I know, but I really want to walk into her doctor armed with real data to convince him, not go on instinct and shop for a doctor who agrees. As I said, this doctor has been very supportive in the past, and with this many medical issues she really does need expertise beyond my instinct...

    Thanks again for your thoughts!
    Imágenes adjuntas Imágenes adjuntas
    Last edited by @llli*minerva; September 13th, 2008 at 11:59 AM. Reason: adding picture

  10. #10
    Join Date
    Mar 2006
    Posts
    8,591

    Default Re: 16 months old, 16.5 pounds

    You have added a lot of info that your initial post was lacking, wrt her overall health. And I DO believe that insufficient weight gain over time is a concern...if you read the thread of mine that I linked you to you will get that impression as well. Its easy for everyone else to say there isn't anything to worry about, but *you* need to be concerned. You're the mom.

    The problem isn't breastmilk, though, or how much/often you are nursing. Its unlikely, IMO, that if you work to further wean your dd, she will start eating more. It sounds like she doesn't eat all that much, and if she had stomach issues earlier, I'm sure that's contributing to her growth, at least a little bit. If it were me, and I've walked down your road, believe me, I would have her tested for celiac (the blood test first), cystic fibrosis, and growth hormone deficiency (if those haven't already been ruled out). I would also test for liver function, and have her intestines checked out. While the tests were underway, I would NOT work towards eliminating any nursing sessions--leave the nursing as is. In the meantime, work on getting lots of healthy fats into her diet--coconut oil is very palatable in things like oatmeal, yogurt, breads, wholegrain cookies, smoothies, etc. Avocados are an awesome source of fat and calories. Olive oil or coconut oil goes on all veggies. Milled flax seed in cereal/breads/cookies. I make whole wheat flour oatmeal cookies with flax and coconut oil for dd--kinda like a granola bar. I use turbanado sugar, so she's getting the best sugar she can get. I swore I would never feed her cookies on a regular basis, but she loves them, and they are pretty darn healthy (but they do have sugar, so you have to weigh that yourself, kwim).

    I make everything from scratch. No food colorings or high fructose corn syrup, or even white sugar, for the most part. I was good about this before hand, but when she started having growth issues, I got even better, becuase we had to make every bite count.

    Anyway, I'm with you on the 3rd train of thought. There is a problem, and breastmilk should be part of the solution. Along with some other things...


    Erin
    Wife to a grizzly
    Mama to my little deer (12/05) my loving bear cub (9/07--), and our little tiger (3/22/10)
    Born by one c-section and 2 amazing VBACs


    Miles in 2012: 350.5/900 (Actual Miles Ran: 189)
    Miles in 2011: 708.5 (Actual Miles Ran: 509)
    Miles in 2010: 800.5 (Actual Miles Ran: 620)

    January Miles: 37.5/75
    February Miles: 59/75
    March Miles: 42.5/60
    April Miles: 64
    May Miles: 41/70
    June Miles: 59
    July Miles: 39.5

    227.5 miles on my new shoes
    338 miles on my old shoes

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