4 month Appointment... Dr. has me concerned about weight.

Kristin Johnson · November 2011

Brooks measured in at 13 lbs. even. He is 23.5 inches long. He has rolls, and does not look under weight by any means. He is right on track with clothing sizes. She's concerned because he went from 10th percentile to 5th. We had a different pedi with Mattie, and he never told us percentiles. So how concerned should I be? She mentioned having to supplement with a bottle after I bf at 6 months if he continues to go down. She also wants us to start rice cereal. I didn't start that with Mattie until 6 months. I was planning to do the same with him, but I guess we will start. I really like this doctor, but she left me feeling really unsure about how well I'm feeding Brooks. He gets 4-5 four ounce bottles at daycare. The dcp said that she didn't think we needed to bump up the amount yet.

I guess I need some insight from you guys. Where are your lo's at? What do you think? Should I be worried I'm not feeding him enough?

jetskreemr · November 2011

Your doc is using a different scale than my doc. Our LO was 12lbs10oz at her 4 month checkup yesterday. She's 25 inches long. He didn't seem concerned about her weight at all, and when I asked about percentiles, he said she was at about the 25th percentile for weight, and the 75th for height. I asked if I should do anything about her weight, and he wasn't overly concerned, but said we could start solids soon if we wanted to.

amjo8286 · November 2011

My LO has his 4 month appointment in 2 weeks but we went yesterday for an appointment for his reflux and he was 13 lbs. 4 oz. They made a comment about him being a "little guy" and that he was very tiny. Personally I think he looks perfect. He's gaining weight and moving up in clothes sizes. At our 2 month check he was in the 11th percentile which they said was a bit small. He was born 3 weeks early so I've always just chalked it up to that. He currently eats 5-6 oz every 3-4 hours. I did have to start adding rice cereal to his bottles yesterday (for his reflux) so I'm thinking he'll put on a bit more. I know what you mean about worrying, my best friend had her LO 8 weeks after mine was born and he eats just as muchor more. She constantly tells me how small Liam is and it makes me wonder if I'm not feeding him enough. Personally though I feel if they're happy, healthy and growing we're doing our jobs.

ladybug122 · November 2011

My LO was 13 pounds at her 4 month appt, and my doctor was not at all concerned. I'm curious about the chart your doctor is using...

MrsI · November 2011

DD was 13lbs 6oz and 25inches and in the 50th percentile for both. Sounds like something is off with your 5% or she uses different charts. I wouldn't be worried about it yet... Our pedi also suggested starting cereal if we wanted.

dairygirl19 · November 2011

I just had my 3.5 month old weighed yesterday and she came in at 13.5. She gained 3 pounds in 2 months basically.

Pedi told me it was just fine. She's happy, healthy, alert and that's all that really matters to him. He said he only cares about weight when it stays stagnant or drops. Some babies are bigger, some babies are smaller but they're all usually fine. He did mention it's low on the chart but she's always been a low baby so it didn't really matter.

Shae777 · November 2011

DD was 14lbs at her 4 month checkup. The pedi says she is a "thin baby" but she's still within a healthy range. He said if we wanted to change that we could but she's healthy. He also advised that we start giving her rice cereal 2-3 times per day and she can start solids at 5 months if we wanted. I was a bit worried as well but he assured me that she is healthy.

jchickiem · November 2011

My DS was 13 pounds at his 4 month appointment and the doc said he was in the 25th percentile. (24.5 inches for height). Guess they are using different charts?

I wouldn't be too worried just yet (well, I guess I'm talking to myself, too.) Sounds like you are feeding him enough.

My doctor also wanted me to wait to start solids until after 6 months.

jillybean222 · November 2011

He is defintely on the smaller side, which, in itself, isn't a problem - soembody has to have the small baby or averages wouldn't exist. It seems that she is more concerned that his growth curve is not consistent (i.e. 10th to 5th). Mama knows best - if you think he seems satisfied, he has plenty of wet/dirty diapers, and is growing, albeit slowly, he is probably fine.

My doc was concerned about slower growth too but DD went from the 90th to 75th - obviously not as much of a problem b/c she started on the bigger side.

So, do what she says , which is exactly what you have been doing. Reevaluate at 6 months. If you don't want to start solids, wait it out. If you are concerned in the meantime, bring him in for a weight check at 5 months and go from there.

SarahRae812 · November 2011

MrsI:
DD was 13lbs 6oz and 25inches and in the 50th percentile for both. Sounds like something is off with your 5% or she uses different charts. I wouldn't be worried about it yet... Our pedi also suggested starting cereal if we wanted.

This exactly. DD was 13lbs 13oz at her 4 month appt yesterday. She's in the 50th percentile too. There's something wrong with your pedi's scale. My pedi (who has been practicing for 40 years) said DD was "perfect."

azzyberry · November 2011

At my DD's 4 mo appt she was 12 lbs, 6 oz - 15th percentile. She just had her 6 mo check up and she is now 12 lbs, 14 oz - 5th percentile. Her growth has slowed down a little but she is still on the growth curve and the doctor said as long as she is still on the growth curve and otherwise seems to be happy and healthy then there is no need to be concerned yet. I just started solids when she turned 6 months and I EBF. They didn't tell me I need to do anything different.

lucylea · November 2011

jillybean222:
He is defintely on the smaller side, which, in itself, isn't a problem - soembody has to have the small baby or averages wouldn't exist. It seems that she is more concerned that his growth curve is not consistent (i.e. 10th to 5th). Mama knows best - if you think he seems satisfied, he has plenty of wet/dirty diapers, and is growing, albeit slowly, he is probably fine.

This is what I was going to say. I'm guessing they are concerned about the fact that he is dropping in percentiles. However, breastfed babies tend to gain quickly in the first 3-4 months and then slow down while formula fed babies gain more steadily all along. Your doc also may be using the formula fed charts instead of the breastfed charts, which is why the percentiles are off.

My little man is TIIIIIINY at just over 9 pounds at 3.5 months, but we aren't concerned because he is holding onto his own curve (albeit in the first percentile). Do what you feel is right. Starting him on cereal will most likely get him to gain weight, but its just empty calories bulking him up, not necessarily making him healthier.

leducsmith · November 2011

My LO had his 4 month appt yesterday. He weighed 14lbs 3oz and 23.5 in long. I was told he is in the 16th percentile but at his 2 month appt he was in the 3rd percentile. My LO is also a preemie so they say he is doing really good. I don't think my LO looks thin or anything, he still has little rolls. I don't think you have anything to be concerned about!!

genekelly · November 2011

jetskreemr:
Your doc is using a different scale than my doc. Our LO was 12lbs10oz at her 4 month checkup yesterday. She's 25 inches long. He didn't seem concerned about her weight at all, and when I asked about percentiles, he said she was at about the 25th percentile for weight, and the 75th for height. I asked if I should do anything about her weight, and he wasn't overly concerned, but said we could start solids soon if we wanted to.

I thought boys and girls had separate charts so might account for the difference b/w your little girl and OP's little boy.

OP: FWIW, I'd make sure if you're EPing that the ped used the right chart for BF babies. I've also read that the amt of cereal they get is so small that the largest portion of their calories is still coming from BM or formula. I think I'd want to ask another ped's opinion.

peacelover · November 2011

I agree that those percentiles don't seem right. Maybe his growth "rate" slowed down. I know my pedi is more concerned that the rate remain constant as opposed to one big jump in weight or a decrease.

My LO was 24.5 inches and weighed 14 lbs and was at 50ish percentiles. Also, I have worried that I wasn't feeding DS enough (especially hearing all these bumpies say their babies were eating 7 oz bottles at 3 months!). Mine was only doing 3 oz up until the last 4 weeks. He is now between 4-6. I would try to give more but babies will eat what they need-I can never get mine to eat any more. When he is done, he is done! My pedi said we could start cereal too, but LO just isn't ready. We get a few bites in his mouth a day, but as to what he swallows....

CMM05 · November 2011

I totally understand your concern!

My DD is really tiny She was born at 38 weeks and weighed 6 lbs. 4 oz. At 3 months, I brought her in because I wanted the pedi to look at a flat spot on her head. She weighed 10 lbs. 1 oz. A month later at her 4 month appt, she only weighed 10 lbs. 8 oz......I freaked! She is my 3rd (and smallest.....). I don't have big babies, but I have never had weight gain issues (and we formula feed.....)

Basically, they want to see about 1 oz. gained per day. So, my DD only gained 7 oz. in a month She upped the calories in her bottle (so we are adding more scoops of formula, but same amount of water....) and we started her on cereal and solids immediately (I started my other 2 at 4 months, so I am fine with it).

We have to go back tomorrow morning for a weight check (it has been 2 weeks...) and I am a nervous wreck. My DD does not eat more than 4 oz. at each feeding and she only takes 4-5 bottles a day. She is just a small eater, I guess.

My pedi was not too concerned because her head and length are growing fine, but she wanted to see if upping the calories would work.

I agree that if your son is happy and meeting milestones, then he is fine.

I think if the pedi is really concerned, then he would tell you and he would have told you to make more changes immediately (besides starting cereal now.....)

My DD rolls both ways, babbles and coos like crazy, is starting to sit up and is a very, very happy baby. I am trying not to worry, but I also feel like I am failing at feeding her. So much pressure!

GL!

Bunniehug · November 2011

My DD has been slow to gain as well. She's BF and weighed 7lbs 6oz at birth. At three weeks she was 8lbs even. At her three month appointment she was 10lbs 8oz. The doctor wasn't really concerned cause she stayed on the same curve. We go for a weight check next week. Good luck to your LO!

AshleyM1985 · November 2011

Jacob is 13lbs 9oz and 23" and my pedi didn't seem concerned. Jacob is a chunk! I'm concerned! He does get BF and FF.

kellyloveszach · November 2011

I am thinking that it is not the actually weight of your LO but that he lost percentage. My LO is the same size but has always been on the same percentage line so it's not a concern. I would just keep trying to BF him in a quiet area. Also if he sleeps through the night offer some dreamfeeds. I would hesitate about the rice cereal. My Dr. said the same thing about offering rice cereal, thought it would beef him up a bit and sleep longer stretches. However it made my supply tank really bad (my supply was not so good to begin with). So he was eating rice cereal but not BFing like he should, it ended up being the beginning of the end of BF for me. I am still mad about it. Solids are okay to start at 4 months but shouldn't be used as a full meal source, IMO. GL.

Snapdragon750 · November 2011

DD was almost 15 lbs at our 4 month appointment and 27 inches. She'd moved up from 50th to 75th percentile in weight and my pedi said she was doing great.

Two things from your post jumped out at me:

1. Don't use clothes sizes as a gauge for whether or not your baby is "on track." They tend to run small or big or who knows depending on the brand and are absolutely not reliable.

2. It sounds like your Dr. is concerned because of the drop in percentile, not because of the percentile itself. That means the pedi is not concerned because your baby is too small, but that he's not gaining at the rate that he should. That sounds like a real concern to me. If you're really insecure about your dr., take your baby to another pedi to get a second opinion. But please be careful about comparing to what other doctors said about other babies because your pedi might be taking certain things into account that are specific to your baby's situation that you might not be aware of.