Weight gain struggles - help!

[dreamcrisp1]

Struggling with baby weight gain issues. L is 3 months old today.

For the first 7 weeks of his life, Leo gained weight so well - he gained 3 lbs 4 oz from his birth weight, not including the weight he lost after birth.

But since then we’ve been having troubles with his weight and he has only gained 11 oz in 6 weeks. He has grown in height and he is thriving. He is so happy, alert, sleeps well, pees a ton, and is perfect in every way. But he won’t gain weight.

I feed on demand, which is usually 2-3 hrs during the day and 1-2 times a night. He gets about 7-8 feedings a day. When he’s hungry, he makes it known. We are going to try supplementing with a bottle of pumped milk a day (which is a challenge by itself since Leo does not take a bottle as he’s always been EBF). I let him finish a side before switching and offering the 2nd side. He lets me know when he’s done with a boob.

Any advice, tips, help? I really want to continue with Leo being EBF if possible and I don’t understand why all of a sudden he isn’t gaining weight. Clearly my breastmilk was enough for 7 weeks but then all of a sudden isn’t? It’s perplexing.

[pooh8402]

8 feedings a day is really the minimum at this age. Can you try offering more, getting that number up to 10ish feedings? At that age, E2 was averaging 12-13 feedings, even though he was STTN.

[lovelyshoes]

It could be so many things as I have learned. I’d try to give a small pumped bottle after a feed just to see if he wants more. From what my drs said, ebf kids normally eat every 2-3 hours so about 10-12 feedings a day. I have a slow gainer and he just started to eat less after 6 months. He’s giving me a hard time finishing bottles.

[icedcoffee]

Is your pedi concerned?

Everything you've written sounds normal to me. If he's happy, sleeping and peeing I don't really see the concern? Weight gain does start to slow a bit and gain is not always linear. I f he was hungry I'd think he wouldn't be happy?

You can add solids in a month so that may help too. I know they say "food before 1 is just for fun.", but DS1 thought it was serious business.

IME 7-8 feedings a day at 3 months has been normal especially if they're good sleepers at night.

[lessel]

Sort of sounds normal to me too. Is he fussy at all? Good sleeper/napper? We had an issue with silent reflux and lag in weight gain and, in hindsight a lot of fussiness and sleep issues made more sense. After he started meds and wasn't in as much pain I was like, oh *now* he's a happy baby. But I would have said he was happy before I connected all those dots.

I also agree on maybe starting solids around 4mo if he's got signs he'll handle it well. We did that oatmeal and breastmilk at 4mo for reflux and weight issues. We started to supplement with formula too, but that was more my supply and response to the pump issue.

[jade]

DD gained weight super fast and then from weeks 9 through 12 barely gained anything. The only reason I knew was because I was going to a support group that had a scale. The nurses weren't terribly concerned because she was such a happy baby and she totally caught up by her 2 month checkup.

So my advice is not to worry as long as there are plenty of wet diapers and L is happy.

[imojoebunny]

I am a giant of a person with a tiny kid. When she was a baby they thought she was small for gestational age, and must be growth restricted, so they made her come at 38 weeks. They expected she would grow quickly, once born @ 5 pounds, 6oz, but she barely gained the minimum they deemed acceptable. We BF and FF fed at every feeding. She still did not grow more than the minimum, and sometimes less, (failure to thrive). She was tested for everything from short stature to Cystic Fibrosis. She is 13.5 years, and weighs 75 pounds, at 4'11". At 9 months, she weighed 13 pounds 6 oz. She didn't weight 20 pounds, until 26 months. (Some of these numbers stick in my mind because there was a lot of contention around those times) She is just fine. She nails her 3% to DH and I's 90%+. My advice, having spend countless hours, and a lot of money, is to do what the doctors tell you and ignore everyone else. Not everyone is average, and not every parent will have a child that is similar in size to them. If I had a dollar for all the free advice I have received...

[waverly]

Is your doctor concerned?

I would just aim for eating every 2 hours during the day and see if you can get the number of feedings up.

[stellelinds25]

I have a slow gainer who will be 7 weeks on Wednesday. Our issue is that they don’t think I have enough fat in my breast milk. I started taking Omega 3 supplements and we give L “milkshakes” 3x/day. Twice a day they are about an ounce of breast milk with 1/2t of formula powder and at bedtime he gets 2oz of fortified formula (we mix 110ml of water with 2 scoops of formula...this is split into 2 bottles). He nurses before each bottle as well. This is all at the recommendation of our pediatrician/lactation consultant. But after doing it for 12 days he gained 13oz! We were told they like to see babies gaining 15-30 grams/day. So that’s what has worked for us, but I would definitely talk to your dr and see if they’re concerned!

[dreamcrisp1]

Yes, doctor is concerned (saw them yesterday for L’s 3 month check up). We’re going to try supplementing with a bottle of pumped milk per day and go back for a weight check on Monday. I made an appointment with a lactation consultant and they will come today so hopefully they can also help.

stellelinds25, I’m wondering if maybe I have a similar issue and not enough fat. I know I have the supply so I can’t think of anything else.

[dreamcrisp1]

Dec 2, 2019 15:36:30 GMT -5 icedcoffee said:

Is your pedi concerned?

Everything you've written sounds normal to me. If he's happy, sleeping and peeing I don't really see the concern? Weight gain does start to slow a bit and gain is not always linear. I f he was hungry I'd think he wouldn't be happy?

You can add solids in a month so that may help too. I know they say "food before 1 is just for fun.", but DS1 thought it was serious business.

IME 7-8 feedings a day at 3 months has been normal especially if they're good sleepers at night.

That’s my theory too - when he’s hungry, he’s very vocal about it and seems very content between feedings. They also said we can start with solids next month so that’s good. I can’t think of how to add in a feeding as he really does every 2 hours in the day but sleeps 7-7 with 1-2 feeds in the night.

[dreamcrisp1]

Dec 2, 2019 16:01:43 GMT -5 lessel said:

Sort of sounds normal to me too. Is he fussy at all? Good sleeper/napper? We had an issue with silent reflux and lag in weight gain and, in hindsight a lot of fussiness and sleep issues made more sense. After he started meds and wasn't in as much pain I was like, oh *now* he's a happy baby. But I would have said he was happy before I connected all those dots.

I also agree on maybe starting solids around 4mo if he's got signs he'll handle it well. We did that oatmeal and breastmilk at 4mo for reflux and weight issues. We started to supplement with formula too, but that was more my supply and response to the pump issue.

Very good sleeper and napper. Naps for 4-5 times a day and 45-1.5 hr naps. Sleeps at night 7-7/730 with 1-2 wake ups. Only ever fussy if he’s hungry or tired. Once those are addressed, he’s perfectly content and happy.

[dreamcrisp1]

Dec 2, 2019 22:37:20 GMT -5 stellelinds25 said:

I have a slow gainer who will be 7 weeks on Wednesday. Our issue is that they don’t think I have enough fat in my breast milk. I started taking Omega 3 supplements and we give L “milkshakes” 3x/day. Twice a day they are about an ounce of breast milk with 1/2t of formula powder and at bedtime he gets 2oz of fortified formula (we mix 110ml of water with 2 scoops of formula...this is split into 2 bottles). He nurses before each bottle as well. This is all at the recommendation of our pediatrician/lactation consultant. But after doing it for 12 days he gained 13oz! We were told they like to see babies gaining 15-30 grams/day. So that’s what has worked for us, but I would definitely talk to your dr and see if they’re concerned!

Do you think adding the formula has affected your supply at all? I’m worried about this because I love breastfeeding him so much. If the pumped bottle doesn’t work, this may be our next step.

[aprilsails]

DD (4yo now) hit a weight plateau at 2 months and slowed down on gaining a lot. I remember freaking out since she went from 85th percentile to 50th to 30th by 6 months and stayed there. I was eating a lot and loosing baby and pre-baby weight rapidly. She ate lots, spit up rarely, and outright refused any bottle ever (I think drank all of 3 oz from a bottle in her lifetime). She was a pretty happy baby and otherwise perfectly normal.

However, my doctor was not concerned. She remained at 85th percentile for height and I really did nothing to address the issue other than to make sure I ate lots of healthy food and I stayed on top of my vitamins, etc. My Mom has all my height and weight records and she followed the exact same weights and growth curve as I did. We might have told the doctor this which might have been why they were unconcerned. Do you know how you or your husband gained? There may be clues there.

[boiler717]

I would also try to increase daytime feeds. I know you can’t feed a baby that isn’t hungry but shoot for 1.5 to 1.75h instead of 2, you may get in a few more Oz over the day for that.
My son’s slow weight gain was later attributed to a dairy allergy (I EBF). I had asked about it several times when he was an infant but was always told since he was so happy and wasn’t a big spitter he couldn’t have a dairy allergy. I don’t love recommended diet changes for BFIng but may be worth a shot?

[mrssandro]

Does he seem to be in any pain post feeding? Like Arching back or fussy? I only ask because my DD struggled with silent reflux which caused her to be FTT for a long time. She had stridor which was a result of laryngomalacia. This is rare case I am sure I only bring it up because it took so long for us to figure out why she wasn't gaining.

[stellelinds25]

Dec 3, 2019 3:31:59 GMT -5 dreamcrisp1 said:

Dec 2, 2019 22:37:20 GMT -5 stellelinds25 said:

I have a slow gainer who will be 7 weeks on Wednesday. Our issue is that they don’t think I have enough fat in my breast milk. I started taking Omega 3 supplements and we give L “milkshakes” 3x/day. Twice a day they are about an ounce of breast milk with 1/2t of formula powder and at bedtime he gets 2oz of fortified formula (we mix 110ml of water with 2 scoops of formula...this is split into 2 bottles). He nurses before each bottle as well. This is all at the recommendation of our pediatrician/lactation consultant. But after doing it for 12 days he gained 13oz! We were told they like to see babies gaining 15-30 grams/day. So that’s what has worked for us, but I would definitely talk to your dr and see if they’re concerned!

Do you think adding the formula has affected your supply at all? I’m worried about this because I love breastfeeding him so much. If the pumped bottle doesn’t work, this may be our next step.

It hasn’t because I still nurse him for every feeding. He just gets the formula in addition to breast milk. I’ll cut his feeding a little short before the 2oz formula bottles are bedtime, but otherwise we still nurse as usual. I hope they’re able to figure something out for your LO!

[dock]

How long is he nursing on each side? I talked to a friend who’s an LC when DD was having trouble gaining, and she said (not always, but pretty typically) kiddos who are actively eating can empty a breast in 10-15 minutes. If he seems to be still working to eat (not just using you as a pacifier) beyond that point, it starts to become calorically negative, and she recommended switching sides even if DD didn’t seem “done.” It either worked or was a coincidence, in our experience, because she started gaining more efficiently.

[pooh8402]

Dec 3, 2019 7:14:40 GMT -5 aprilsails said:

DD (4yo now) hit a weight plateau at 2 months and slowed down on gaining a lot. I remember freaking out since she went from 85th percentile to 50th to 30th by 6 months and stayed there. I was eating a lot and loosing baby and pre-baby weight rapidly. She ate lots, spit up rarely, and outright refused any bottle ever (I think drank all of 3 oz from a bottle in her lifetime). She was a pretty happy baby and otherwise perfectly normal.

That is true. I just checked E2's growth chart and he was about the same. 75th %ile at 2 months, 50th at 4 months, 25th at 6 months, and has remained about 25th since (he's 8.5 months old now). E1 was about the same, except his highest percentile was at 4 months, which was about the same time that we stopped formula supplements with him since my supply caught up. E1 has remained between 10-25th %ile since. Doctors never concerned. DH and I have always been on the lower end of the growth curve growing up.

I also eat a ton and am about 5 pounds over my prebaby weight.

[lovelyshoes]

If you give him a bottle, just make sure to pump and your supply will be fine. I hope the bottled feed helps. From talking to a gi and reading a ton about this, I think it’s really hard to figure out unless you get an allergy diagnosis.

[jamaicam]

DS2 was 9lb 4 at birth. And then he didn't grow much at all and dropped to below the 5th percentile by the time he was 6 months old. He was eating, alert and fine but just didn't grow. My pedi wasn't worried but she told me she'd start running tests once he got to 6 months if he wasn't gaining.

WHen he was 7 months, he was still 5th percentile. Same at 8 months. He found his line. Basically he was born big but wanted to be small! He is now healthy and ridiculously active and 5. And he is still small - 10th percentile.

Hopefully your baby is the same - just finding his line and then will follow it.

[dreamcrisp1]

Thank you all for all your replies!

As a quick update, I met with a LC and she helped me improve L’s latch since he has a shallow latch. By deepening his latch, he’s able to eat more instead of the milk being stop and go. We had our weight check yesterday and he gained 110 grams! This was pre-feed and he pooped 4 times in 5 days! He usually poops 1-2 times a week so he is definitely getting more food. We haven’t even been able to supplement with a bottle since he absolutely will not take 1 so I’m happy that BFing worked and the LC was so helpful.

[lolo]

That's a great update! Remember as well that they should be using the WHO chart for EBF babies, not the CDC chart.