Experiences with slowing weight gain, low percentiles?

[stretchad]

Can anyone share their experiences with babies that might have been lower on the growth curves or slowing their weight gain? How did you handle it? Can you share any advice?


In the last two appointments DS has slowed in his weight gain, only gaining about a pound in between each appointment.

He does not currently reside on any percentile within a growth chart because of his prematurity (7 weeks early). Even adjusting for his gestational age, he's no longer keeping up with the general growth curve trajectory and now resides just under the lowest percentile on the chart. Height & head size is good though...continuing to follow the growth curves or accelerate. He is 11.5 lbs, 25 inches.

After his last appointment we left with instructions to fortify more of the breastmilk bottles we give him (it's a higher calorie formula). Previously 2 bottles per day, and now its all bottles we give him (2-4 per day, depending on whether it's a workday or not). 

So, his 6 month appointment is in a couple of weeks and I can't stop thinking about it and wondering if he's gaining enough. I'm worried what the doctors will recommend next.  

[m1and1m]

The very very short version (I'm hoping to be able to come back tomorrow with more details) is this:

DD was barely full term, in the 50% range from birth to 6mos. No health issues, except she stopped gaining much weight. Dropped down to somewhere below 3% by a year. Diagnosed FTT. Got tested for everything under the sun, all was (and is) well. Got all the way up to the 3% line at some point, still there at 6yo. Totally fine, just made her own curve, apparently.

[CloudBee]

DS was slow to gain for months. We fortified BM with Neosure, and supplemented with Neosure. Now he's just on Similac Sensitive as his percentile hasn't taken a dip in months. I think he's hovering around the 10th right now for height and weight.

He's stayed on his own curve and taken off with solids. His pedi is no longer concerned.

[stretchad]

CloudBee, when did you start solids and what approach did you take (cereals, BLW, purees, etc)? We're using Neosure too. Haven't started to supplement yet, just fortifying BM.

m1and1m, we have no health issues either. I just wonder if DS will have his own curve too. I was tiny as well, and makes me wonder if he always would have been on the small side even if he was full term. Looking forward to your additional details tomorrow.

[redheadk]

We have struggled with my DD's weight from very early on. She was full-term (late, actually, I was induced) but just 7 lbs, 3 oz. Not big for such a late baby. So, she was always on the small side. By 4 months, we were seeing a GI dr because DD had terrible reflux and was dropping, dropping, dropping on her growth curve. I pumped and added formula powder to the breastmilk to increase the calorie count. Thankfully, all of her many blood tests came back negative and the GI dr just basically determined that she is just a small kid. Thankfully, she has always met all of her milestones on the early side, particularly physical milestones, so that has always been reassuring. She looks healthy, IMO, just petite.

At 18 months, she is still small but she is staying on her growth curve. I thought for a long time that her weight gain was because of the reflux but it didn't pick up noticeably when the reflux subsided.

I worried. SO much. For me, it greatly helped to get a scale at home. I felt better being able to weigh her periodically. I still weigh her every few weeks. I bought the scale from Amazon, it was around $50 I think.

I was a small infant and was also born late (3 weeks late, unheard of now).

We started solids at 6 months and did mostly BLW. I was super lazy about them, though, until closer to 8 months. She's a good eater so no harm done. I was very careful to always feed her an hour after she nursed or took a bottle so as to not cause her to refuse to nurse bc she was full of solids.

If you have any questions, please tag me or send me a PM. I remember clearly how stressful it was when she was younger. At this point, I don't really give it a seconds thought.

[niq]

V was 5th percentila at his 4m appointment, and then his weight gain dropped to near zero for several weeks. On days I'm home I add 1oz of formula to a bottle of BM. He eats 20-22 oz when he's home with him, and nurses 2-3 times on top of that. He gained 5oz last week, so maybe he has turned a corner and will put on some weight instead of get taller.

our pedi is so far not concerned.

[Deleted]

My 21m old is (and has been) stuck in the 1% for a while. She was 50-60% until 6m or so and had kind of a sudden drop and hasn't gained much since. We're in the middle of testing but all the big things have come back normal and we're getting close to the "she's just going to be petite" diagnosis soon. She's just under 20lbs at 21.5m and was 18.5lbs at 12m just for reference. (So she's gained less than 2lbs in 10months). She has the FTT diagnosis technically but our dr has told us many times she is definitely thriving! She just needed that diagnosis to see the GI. She started walking just before 10m and talks like 2.5yr old so there aren't other concerns developmentally.

If your dr is concerned they may run some tests but honestly I'm not sure at that age what they would do. Hopefully once he starts solids he will bulk up a bit. If he is thriving in other ways he's probably just small- are you and/or his dad on the smaller side?

[Deleted]

DD is barely on the growth curve. She started out small and has had trouble gaining weight partly because of her heart condition and because of reflux. She was never a big eater and to this day, will only still take 3-4 oz per bottle and still doesn't eat a whole lot of solids. She sees a GI doctor for her reflux issues and is starting feeding therapy next week. For her bottles, we fortify to 27 calories and I still do frequent feedings. For solids, I'll add a little coconut oil sometimes and we just started using a powder called duocal that our GI doctor gave us. I add a scoop of the duocal to her purees to give it a little calorie boost. I also give her lots of avocados And I second the scale recommendation for peace of mind. I know how stressful weight gain can be! Good luck at your 6 month appointment and feel free to PM or tag if you have any questions.

[lastnamejane]

DD was 6 weeks early, 4 pounds. She was EFF for the first 6 months of life and is now 30% for weight, and 95% for length for her actual (not adjusted) age. Enfacare (22 cal) really helped her gain weight in the first few months. At month four, the pedi switched her to gentlease and at 6 months we started solids (in addition to formula).

[megs193]

Jan 20, 2014 1:35:37 GMT -5 @lauralynne said:

2.5 year old has hit 5th percentile once - every other one he hasn't even hit the chart. EBF first 6 months, voracious BLW eater from that point on, extended nursing (weaned last month). This kid eats more than the school aged kids in his daycare. But doesn't gain much weight. Slow and steady. Pedi had us coming in for weight checks more often initially - basically because it was protocol. DS was hitting all milestones WAY ahead so development wasn't a concern. At 2.5 years old he's still not quite 24 pounds. Almost...but not quite there. And nobody's worried. He's just got a kick ass metabolism. And I'm jealous!

I could have written this word for word about my 18 month old. He is now up to 5% on the weight chart but he eats more than my 4 year old and nurses whenever he gets the chance. We go for weight checks all the time but he has always been very active and met all of his gross motor skills super early. I can not even fathom the quantity of food this child is going to need at puberty. Thank god for Costco.

[ijack]

I too had a preemie that didn't gain weight. I would follow your doc's advice for now. It's possible he'll just be a small person/slow gainer, but with preemies you do really want them to gain weight (and it's usually okay as long as they're following their own curve). When you start solids it may be a little easier to fortify some of that food.
Next steps might be doing some blood testing, or them asking you to supplement every feeding with some added calories.

[m1and1m]

Holy jesus. I had my response almost complete and DD closed my browser window, losing the whole dang thing. GAH!!!!


Anyway, as I said earlier DD was totally average until she was about 6mos old and her weight gain significantly slowed. She went from around 50% down to well below the 3% on the WHO BF baby chart. Her height was about the same, but her head was always around 90%, lol. Dh and I both have huge heads, though.
She was EBF until about 7mos when we started doing BLW, and about 8mos was when she started really ingesting the food. She continued to nurse until she self-weaned a week after her third birthday. She mostly day-weaned around 2.5, and was always an ample eater. We could never try fortifying pumped milk because she refused bottles starting at 4mos. The most concerning thing was that she was normal, and then suddenly wasn't.

She was 16#7oz at her birthday. DH was small, and I was HUGE- 10.5# at birth and 30# at my 1st birthday so we couldn't automatically write it off as genetics. We were watching it and doing weight checks but weren't overly concerned although there was some concern about her having CF. Her development was right on cue- average for some things, on the early side for some, on the late side for others. She was active in crawling and cruising, but did not walk until she was 15mos so "suddenly walking and burning more calories" wasn't a factor. We now know that's just her personality and it wasn't slow development- she's very cautious and waits, watches, then suddenly does things near perfect on the first or second try.

Somebody at her first birthday part was sick, and it set off an epidemic involving almost everybody who was there. Her party was 3w after her birthday, and she was so sick she ended up in the ER for dehydration- none of the other babies were sick longer than 3-4 days, adults about the same. She went home the next day and due to her symptoms her pedi ordered an US and some blood tests. The ultrasound showed some calcifications on her liver and spleen, and the blood tests showed some strange things with her liver enzymes and vit D. She had been sick for about a week at this point, and with those things combined with her weight loss from illness, and CF concern her pedi felt she would be best served by being admitted into the children's hospital where everything could be taken care of at once rather than waiting for new patient appointments with various specialists. She was down to 15#2oz by the time she checked in (2w after first getting sick), which is pretty significant so that was the driving factor.

In the week she was there, they did every test they could cram into that time. They all came back normal (except blood tests that didn't give a definitive answer) so we called a stop to the testing when the results would only give a reason as to her issues but not change the course of treatment. When we checked out, the main concern was her lack of weight gain and a wait-and-see approach for the calcifications and liver levels.
We also met with a nutritionist who wanted her to start drinking Pediasure, which we declined for a few reasons. 1) other than being small and not having much reserves in the event of illness, she was completely healthy until this incident, 2) she was 14mos old and opinionated enough to refuse it due to the taste, 3) homemade ice cream plus a daily multi-vitamin provides an equal nutritional profile from whole foods rather than chemicals. We did try the other suggestions, as well as consulting with another nutritionist who had a more whole foods approach than Pedisure and instant pudding mix. Sadly, none of them worked. She was a meat/fish/beans/veggies kind of girl, and wouldn't eat mushy food except for mashed potatoes, which you can only fortify so much.... She also wouldn't eat ice cream, so that was also a no go.

Around the same time we met with the second nutritionist we had a follow up with the GI Dr, who wanted to put her on Periactin as an appetite stimulant. We wanted to try the nutritionists suggestions first, which the Dr was on board with but when they didn't bring her any higher on the weight charts (our goal at that point was to get her to the 5% line) we tried the Periactin. It definitely increased her appetite, but in spite of this tiny little toddler packing away three adult size meals plus snacks and BF every day (which was quite funny to watch, so much food!) she still didn't increase her weight gain. Around this same time her pedi said that we needed to limit her nursing to get her to eat more calorie dense solid foods, which was ridiculous (see note below on this). Obviously we declined that suggestion, and eventually we all agreed to take her off Periactin because it wasn't making a difference.

This was all between 14mos and about 28mos. At that point we continued to do weight checks and try to boost her immune system just in case. She did have a lot of ear infections, and got H1N1 (which she handled well- part of our concern was her getting the flu and having an automatic admittance to the hospital again but I brought her in less than 12 hours after her fever showed up and she went on Tamiflu right away so pedi agreed to give her 24 hours before admitting) but was otherwise fine. We did wonder if there was some piece of the puzzle we were missing, though. When she turned 3 she got RSV, which developed into viral pneumonia in both lungs, and in turn became bacterial pneumonia. Also lots of EI's and she got tubes. The following winter she got double pneumonia again, which also turned from viral to bacterial. She started oral steroids, which we kept up through the scary season. We opted not to do them year round because they (guess what!) can cause growth retardation. She appeared to be recovered within 6w, but her lung damage took about 8mos to resolve. She started swimming several times a week when she was 3.5, which is the only way we knew her lungs were still suffering. Since then we started some more aggressive immune building and she hasn't had more than a cold since.

Her weight goals were re-evaluated and adjusted to just getting her to the 3% line, but that didn't happen until she was over 5y. Since she was about 2 she's had her own consistent growth curve, though. At 6yo she is still tiny at 42.5" and 34#. We call her "Tiny Tyrant", lol. We know there is nothing wrong with her because we've checked for it, and she's been consistent on her own growth curve for some time now. The only real issue we've had is bullying by school kids on field trips (we homeschool) because she's so little. They call her a baby and tell her she can't play there, try to make her cry, etc. Totally a non-issue in smaller groups or one-on-one, but if she sees a school bus at a place we are going she changes her mind about going most times. She had a hard time with larger kids being faster than her with regards to swimming even when they aren't as good as she is and haven't put in the work she has, but she now understands that it's going to happen just because they are bigger (it's hard when you are constantly told "if you work hard and focus you'll get it!" only to find out that hard work and dedication aren't always enough- tough lesson for a little kid) and that as she grows she will catch up and her dedication will pay off.

Sometimes I wish we had just relaxed and played it cool, but at the same time I feel good knowing we explored every avenue and know without a doubt that she is 100% fine. It's scary though, and as a parent you can't help but worry. <3

(okay, my novel is over)

[mabillon]

My DD has been low on the curve and had several significant drops that required us to do more frequent check-ins with the pediatrician. In fact, she just had a weight check (at 21m) which the doctor said can be the last since she's done well since her 12m well-baby.

Any how, I supplemented but with pumped milk. Upping her bottle amount didn't make a huge difference, she ate what she ate and would just not finish a bottle if she was done. It took me a looooong time with becoming comfortable with her lower spot on the curve (didn't help when other mom friends would make constant comments about her petiteness) but that's just the way it is now. She's 22# at 21m, 8% on the CDC chart by 24% on the WHO.

When we started solids, we did lots of avocado, coconut milk yogurt (she's dairy sensitive), and anything else higher in fat. When DD had her biggest percentile drop (around 14m), the pedi asked us to do more desserts, ice cream, butter/earth balance/olive oil on veggies - whatever we could do. She put on a good amount after that so it helped show that the big drop was more of a fluke than sign of a physical problem.

[Deleted]

DS started dropping on his weight curve from 50s-60s% down to 14% I believe was his lowest. He was diagnosed FTT. He started dropping around 6 months or so. At that point, since he was eating some solids I started really pushing high calorie solids like avocado, lots of olive oil on veggies etc. I was able to get him up to the 20s% by doing this. We suspected a dairy allergy and at about 10/11 months we had the blood allergy test done and confirmed dairy, egg, and peanut allergies. We saw a pediatric allergist shortly after that and learned that despite the low blood levels DS was severely allergic to egg and dairy. I started following an elimination diet (was still nursing) and read labels for everything DS ate. By 15 months he was back up to 50s% and has stayed there. 

For us, we found out it was the dairy allergy causing his body to not absorb nutrients properly and therefore causing the low weight gain. Once that was resolved he quickly caught up. 

ETA: I do think some kids are just small kids. When DS first started dropping I just assumed he was going to be more like me. I was a small baby and I figured that could be the reason. Ultimately, yes, we did confirm another cause, but I think in a lot of cases it can just be kid's leveling out to match their genetic disposition. I hope that makes sense. 

[halfpint]

B is pretty much at the bottom of the growth chart, below 5th percentile at this point. He was EBF up until his 4 month visit, when we started adding 4 oz of formula to his daily intake. He was only 11 lbs at his 4 month visit. Height and head have always been fine, and in the 70-90th percentile ranges.

I had a LOT of angst about this, but I feel slightly more breezy about it since we've started to supplement. I just hope it helps him grow a bit! Pedi has never been overly concerned, but did urge us to boost his intake.

[Deleted]

Jan 20, 2014 15:30:31 GMT -5 @littlemoxie said:

Jan 20, 2014 14:25:45 GMT -5 @awinter said:

DS started dropping on his weight curve from 50s-60s% down to 14% I believe was his lowest. He was diagnosed FTT. He started dropping around 6 months or so. At that point, since he was eating some solids I started really pushing high calorie solids like avocado, lots of olive oil on veggies etc. I was able to get him up to the 20s% by doing this. We suspected a dairy allergy and at about 10/11 months we had the blood allergy test done and confirmed dairy, egg, and peanut allergies. We saw a pediatric allergist shortly after that and learned that despite the low blood levels DS was severely allergic to egg and dairy. I started following an elimination diet (was still nursing) and read labels for everything DS ate. By 15 months he was back up to 50s% and has stayed there. 

For us, we found out it was the dairy allergy causing his body to not absorb nutrients properly and therefore causing the low weight gain. Once that was resolved he quickly caught up. 

ETA: I do think some kids are just small kids. When DS first started dropping I just assumed he was going to be more like me. I was a small baby and I figured that could be the reason. Ultimately, yes, we did confirm another cause, but I think in a lot of cases it can just be kid's leveling out to match their genetic disposition. I hope that makes sense. 

Can I ask what made you suspect a dairy allergy so late in the game?  DS is dropping a bit (nothing drastic, and I suspect it's due to being sick on and off for months) and I wonder if I'm missing something.

I actually suspected he had the allergy around 7/8 weeks. His poop had turned bright green and looked mucousy. The pedi we had at the time brushed me off saying it was very rare and the diet for me, since I was nursing, would be very restrictive. Eventually it seemed to go back to normal so I assumed I was being a paranoid FTM.

Around 7 months he got his first ear infection and continued to have them nonstop until he got tubes at 12 months. After several ear infections that never seemed to clear, I started researching and found that allergies may be a cause. At that point I asked the pedi (different one at this point) about allergy testing. Based on my research there seemed to be a lot of things suggesting an allergy, the ear infections, the poop, the drastic drop in weight, and by now he also had eczema. She agreed that if he got another infection it couldn't hurt to test. Sure enough he got another infection and we did the blood allergy test. 

I think his allergy was a bit harder to diagnose because it isn't as though he was eating dairy, egg, or peanuts himself. He was only exposed to them through the breastmilk. So the symptoms really had to build over time. We had tried to give him yogurt once at about 8mo and he broke out in horrible hives. But we knew lots of kids that young can't handle dairy so we expected him to outgrow it and weren't sure it was an actual allergy. 

FWIW, I do think the ear infections also contributed to the drop in weight gain. When the infections were really bad he refused bottles at daycare. I switched him to a sippy cup early on and that seemed to help but he also had trouble nursing effectively and would pull on and off. He would also vomit sometimes with the infections so I felt like we kept losing ground. 

[Deleted]

Jan 20, 2014 16:42:40 GMT -5 @littlemoxie said:

Hmmmm, thanks for that @awinter. DS loves yogurt and has never had a reaction to that or cheese, never had an issue with green poop or spitting up, and has no eczema or anything else. He has only gained 3 pounds from 6-11 months, but we've had many colds and ear infections in that time (like 5) and he just started daycare at the beginning of December. He is still over 22 lbs at 11 months, so it's not like he's small or anything, it's just that we keep making progress and then lose it the next time he gets sick.

The ear infections usually come after getting congested; there's no way a food allergy is going to cause green snot, right?

I'm being totally paranoid and his tubes just don't drain well and traveling, MDO, daycare and more traveling all in the fall/winter probably just kept giving him colds.

No, the link between ear infections and allergies is that the allergies can cause constant congestion. With DS he was congested non stop. If your DS isn't showing any other symptoms and has eaten dairy without a reaction I would bet he is probably ok there. I really think being sick can set you back quite a bit. DS is is also one of those kids that just doesn't eat much when he is teething or sick so we always lose ground then. 

[redheadk]

@little_moxie: Is L mobile? Bc their weight gain slows when they start moving, so perhaps that + illness has made his weight gain slow down?

[redheadk]

Jan 20, 2014 16:55:37 GMT -5 @littlemoxie said:

Jan 20, 2014 16:48:42 GMT -5 redheadk said:

@little_moxie: Is L mobile? Bc their weight gain slows when they start moving, so perhaps that + illness has made his weight gain slow down?

Yeah, he started crawling at 8 months and cruising at about 9.5.  He's been using little push walkers since Christmas and he will climb up the stairs and be panting on the top, so I know he really exerts himself a lot.  He just started standing unsupported on Saturday.

(No one call CPS, we stay one step behind and spot him as he climbs).

I'm being weird for being so paranoid.  I'm still scarred from it taking 3 weeks to get back to birth weight and going to the pedi expecting to see good news and not getting it.  

Ironically, DD was back to birthweight at her pedi appt at 10 days old. I thought she'd have no trouble gaining weight! L is bigger now at 11 months than C is at 18 months.

[soozy87]

Jan 20, 2014 0:11:03 GMT -5 stretchad said:

Can anyone share their experiences with babies that might have been lower on the growth curves or slowing their weight gain? How did you handle it? Can you share any advice?

My 11 week old is currently in the 8th percentile. He started out in the less than 1 percentile. He was 3 weeks early and basically since he was born we have been feeding him whenever and whatever he will eat. If he is hungry or wants to eat we feed him. He started at 4 pounds, 4 oz, went down to 4 pounds in the hospital and 11 weeks later he is 10 pounds 5 oz. The doctor is happy with his weight gain and we are hopeful that someday he will catch up with his peers, but if he doesn't that is okay too.