6 month, not enough weight gain.

LaBellaVida · December 2013

So, I went to Owens 6 month appointment today. I put him up on the table to get weighed, he weighs 14 pounds 2 ounces. the nurse begins to do his chart and tells me, "he needs to gain weight!" dumbfounded I asked her what he's charting at? She tells me he's at 5% on the chart. the doctor finally comes in, and asked me if I have any concerns today. I tell him I do now because your nurse told me that Owen needs to gain more weight. he then looks up the chart and tells me yes, he falling off the scale! He asked me if I breastfeed, i tell him yes. He tells me they tend to be leaner than formula fed babies, so he brings out another chart that they use for breastfeed babies. He falls at 2%. Wtf?? He then tells me something must be going on. Asked if I'm stressed....of course i am! Then now wants me to go pump my milk and get it tested, and get blood drawn from Owen to test his calories. Huh?? I've never heard of this!! He also wants me to start solids, and supplement with formula that is designed for breastfed babies.

I don't think Owen is starving, and he's gained weight!! He's also more active now with rolling, and jumping in his jumper.

is 14 lbs at 6 months not fall in the normal weight range? I thought it did!

Anyway, i really really don't want to supplement. Nothing against formula, but I'm pretty passionate about breastfeeding. I also have this fear that he will no longer want to nurse if he's got formula.

Owen is a later June baby he was born on June 22nd. for those of you who have already had their 6 month checkup, and your lo is around 14 lbs, was your doctor concerned? have any of you and had to have the testing done to make sure that your breastmilk has enough calories? anyone having to supplement with formula? he said it was Similac....just don't remember the full name.

PinkPuffyHeart2 · December 2013

So sorry that you are going through this! FWIW my LO is EBF and was 15lbs 2 oz and 24 3/4 inches at 6 months and 1 week (approx.)... She's always been small. Personally, I don't think that the weight should be an issue unless it is a dramatic drop on the scale or LO is unhappy. If he seems satisfied and happy, I don't personally see a big issue (but I'm no expert). Were you planning on starting solids soon anyway? Maybe try that along with the same # of breast feedings and weigh him once or twice a week to see if he is gaining? I understand how you feel about breastfeeding exclusively, so I would see if there are other options. If the dr recommends testing, it might be worth looking into, but does seem a pinch extreme to me... hugs, mama.

tttwalters · December 2013

My LO won't be 6 months until the 26th, however I weighed him yesterday and he is 15lbs. I EBF and we have started solids this week, but really only once a day and only about a tbsp. right now. I have a good friend who's almost 2 year old weighs 21 lbs and he is just a little guy. He is slender, but eats and is active. The nurse at my doctors office says they go a lot by how the skin and complexion looks. If his skin goes back when pinched then he is not dehydrated and if he has good colouring then everything should be ok and as long as they are gaining weight and not loosing. Good luck, sorry that you have to do all of those things!

PinkPuffyHeart2 · December 2013

Also, my sisters 1st child was 5 lbs 8oz at birth and only hit 15lbs at 1 year old... She's totally healthy, just a skinny lil Minnie.

She's 8 years old now.

WasNotWas · December 2013

Bradley was born at 8 lbs 5 oz and was around 16 lbs at 6 months. The pedi never seemed concerned as long as he was growing on the curve. I think you should trust your gut and maybe get a second opinion if you want

JessicaKS · December 2013

My LO is 6 months this week.

At birth she was in the 75% for weight. At 2 months - 50% for weight. At 4 months 20% for weight. She was EBF until 3.5 months when I went back to work. I supplement with formula since I went back to work. My pedi was semi concerned her percentile kept dropping each month. She suggested a 5 month appt and wanted us to increase formula. At 5 months she was in the 26% so went up five percent.

My pedi said that if she was always in the 20th percentile it would be no big deal but didnt like how her percentile was dropping so much.

Anyway, last week LO was at pedi at 5 months 3 weeks and weighed 14 lbs 10 oz. Her percentile hovers around 25 percent.

They didn't need to any special tests on either of us.

Does this help?

kelly422 · December 2013

It usually has more to do with the trend of his weight rather than individual amounts (I.e. Significant drop in percentiles). What was his weight at his 4 mo and 2 mo visits?

momofcatan · December 2013

Our 6 month appointment is tomorrow. When I was going in for weigh ins with DD (when she wasn't pooping) she had not gained any weight in 3 weeks. She was 5 months old at the time. Our pedi told us to start solids and we kept going back for weight checks, as long as she was not losing weight it seemed he was not going to suggest formula. In the end I figured out that my supply was low. I changed my birth control and started taking fenugreek.

I think I've seen @kelly422 mention about getting milk tested.

mamainVA2013 · December 2013

My LO weighed 12lbs 15 oz at her 6 month checkup. Pedi was not concerned because she was following the same curve she had been on. I think it all depends on the trend of his own weight gain from the past check ups.

ETA: she is EBF and we have only started solids within the past 3 weeks.

ShelleyBQ · December 2013

I would not be concerned if your LO has always been small. What matters is if there is weight gain. My daughter was in 5th percentile at 2 months and 1st percentile at 4 months. The doctor was not concerned because she gained 2 lbs in 2 months which they said was good. I was told, "She can stay in the first percentile her whole life as long as she is growing."

kelly422 · December 2013

araziza said:

Our 6 month appointment is tomorrow. When I was going in for weigh ins with DD (when she wasn't pooping) she had not gained any weight in 3 weeks. She was 5 months old at the time. Our pedi told us to start solids and we kept going back for weight checks, as long as she was not losing weight it seemed he was not going to suggest formula. In the end I figured out that my supply was low. I changed my birth control and started taking fenugreek.

I think I've seen @kelly422 mention about getting milk tested.

@araziza is correct, I have mentioned it before. I've had it done on people but never done it myself. What they usually do is take samples of your milk from several different times of the day. It's normal to have fattier milk at certain times of the day. They use a little machine that's similar to testing hematocrit that spins the milk down and they can measure the amount of fat in it. They average the different samples to get the amount of kilocalories per ounce of breastmilk you make. We assume breastmilk is usually 20 kcal/oz, but if yours is less than that, it may not be enough for LO. Some women's is actually higher than that!

kmkaull2 · December 2013

Did you see the growth curve? My pediatrician always shows me the percentiles but emphasizes that they really just care that they are following their curve.

DD was 5lbs 9 oz at birth and now weighs just under 15 pounds. Percentile wise, she's the same today as she was all along in-utero. No concerns from doctor.

I wouldn't supplement at this point, but I would get my milk tested.

needanustart · December 2013

Lo is big but with G he was EBF and was in the 5% until he hit a year. He was fine and healthy and just a thin kid with a fast metabolism. Trust your gut for sure!

RedCherry1109 · December 2013

I wouldn't be concerned unless he has dropped in percentile. My LO went from from 25 percentile at 2 months to not being on the charts at 4 months. He will be 6 months on the 21st and last week he was 12 lbs. I did have to start supplementing due do not gaining from just getting milk from the breast. I started pumping and my supply has slowly dropped. I'm working on getting back on the breast in hopes of my supply getting better.

anyways, unless he had dropped I wouldn't worry too much. All of my babies have been little. My 3 year old is just now 30 lbs and my 6 year old is 55 lbs.

LaBellaVida · December 2013

kelly422 said:
It usually has more to do with the trend of his weight rather than individual amounts (I.e. Significant drop in percentiles). What was his weight at his 4 mo and 2 mo visits?

@kelly422
at 2 months he was 10 lbs, 4 months he was 13 lbs, and today he was 14.2 lbs.

yes he's slowed his weight down, however he's also more active now, and he sttn.

He was actually late for his 4 month appt. He was seen Nov 1. It's only been 6 weeks, so it's not like it's been 2 months and only gained a lb.

DS2 was the same as Owen. He's always been small. Dr.s were concerned with him too, around this age...more so because he didn't want to eat solids, but still he was always low on the charts.

LaBellaVida · December 2013

VASC said:
We haven't had the six month appointment yet, as LO won't be six months until January, but I'm bracing myself for a similar conversation. LO dropped from 50th % to ~15% between two months and four months. She has been gaining about a pound a month. Doctor wasn't concerned at four months.

However, I have an infant scale at home and weigh LO periodically. At four months she was 12-6; just last week, she was 13-6. I'm anticipating she'll be 14+ in time for the six month appt.

I credit the slow gain to a few things: 1) she regularly STTN, easily going between 10-12 hours without nursing. Of course she's missing out on calories during those times when other infants would be nursing.

2) She's picky about who gives her a bottle during the day. My DH SAH, but when he leaves her with a sitter, the sitter rarely can get her to take much from a bottle. My mom came to watch LO for three days back in October and she didn't take a bottle at all all.three.days.

3) She's just a dainty eater. I offer the boob numerous times evenings and weekends, but rarely does she seem absolutely ravenous.

Anyways, not sure if any of those explanations might apply to your little guy, and maybe they're all just my weak attempts to justify her slow gain, but I wouldn't be worried if I were you. Someone's gotta be at the bottom of the charts, right?

This is us too.
He only took a bottle from my h while i worked. I did notice though that he would eat alot while he had the bottle. I'd be gone for 5 hours and he would eat 10 oz. Maybe that's normal...idk. I think it's alot though.

FordFalcor · December 2013

Wyatt dropped from 85th for weight at 4 months to 50th now at 6 months. The nurse said this was normal for ebf babies but that it was time to start solids. Seems my boy knew that too because even after a good nursing session, he cries for some solids.

I was kind of bummed because I wanted solids to be a slow introduction as I love BFing but he really does need (and seems to LOVE) solids. We have a weight check next week.

LaBellaVida · December 2013

Clearskies77 said:
My DD was 14 lb 7 oz at her 6 month apt. EBF. Started solids at 6 months. I was told she was 15%. 2% seems super low considering they are only a few oz difference. I think they were looking at the wrong chart to be honest. Looking at the WHO chart for EBF babies, their percentile should have gone up not down (from 5 to 2). Since BF babies tend to be skinnier. I also don't want to supplement with formula. I would see that as a last option if we tried other things first. There is a lot of great info out there for breast feeding support to help you figure out how your LO compares to otherBF babies growth wise, to figure out if you do have any issues with your. Supply and if you do to help you work through it. I have found using an IBCLC really helpful. I also go to La Leche League meetings and their leaders are incredible knowledgeable and happy to help for free. Unfortunately Drs get almost no training on BFing and so tend to give crap advice on it. I tend to think moms know best on a lot of issues. If you feel your child is happy, healthy, gaining weight, etc then I would trust your instinct and get a second opinion like from an LC. By the way my dr was totally fine with my 26 inch baby being only 14 lb 7 oz. she's super long and skinny but healthy. She was only 5 lb 4 oz at birth and so she's been pretty consistent on the growth curve after she played a bit of catch up.

Yeah..i thought the drop was strange. I side eyed that chart for sure.

I think I'll call a LC and see what she says. Not to discredit a Dr. but he's only seen Owen twice....and he seems super rushed during the visits. Idk...

LaBellaVida · December 2013

FordFalcor said:
Wyatt dropped from 85th for weight at 4 months to 50th now at 6 months. The nurse said this was normal for ebf babies but that it was time to start solids. Seems my boy knew that too because even after a good nursing session, he cries for some solids.

I was kind of bummed because I wanted solids to be a slow introduction as I love BFing but he really does need (and seems to LOVE) solids. We have a weight check next week.

Yup..I'm supposed to start solids too. I was hoping to kinda wait a while longer.

HeartLikeMine3 · December 2013

I'm sorry I know you don't need this added stress on top of all you already have going on. I would probably start solids and continue EBF. I would probably do that for one month and then weigh LO if he hasn't gained getting milk tested would be my next step. HUGS

CoffeeBeanFiend91 · December 2013

If LO isn't deemed failure to thrive and is over all healthy don't stress.

summer2times · December 2013

My baby was 15 pds and 7 ounces and 28 inches. He's long. He gained about 2 pounds since his 4 month check up. Doctor said he at a lower percentage but no concern. We've been in solids for about a month and since I'm stressed at work...home ect my BF supply is low. I supplement already for a couple months. So I think your doc is a little crazy! Hope this help.

kanga1622Wed220857 · December 2013

If it makes you feel any better my oldest was born at 9 lbs 2 oz. At 6 months he weighed 16 lbs 12 oz. He did drop percentiles but we weren't worried. He looked healthy, was active, and met milestones. Now at 3.75 he is around 37 lbs and 40 inches. He's been holding steady for the past year at the 50th percentile.

ASmallWonder · December 2013

I agree that it seems like overkill to jump to testing after one instance of less weight gain than they'd like to see. My midge was 14 pounds 10 ounces last week at his 6 month but they're accepting of that because I'm small. Which is just weird because a person of any size can have a small child, kwim? I'd start solids and see if you can get him to gain a little and maybe ask to go in for a weight check in 6 weeks or so, rather than waiting for the 9 month appointment.

nikel13 · December 2013

Lily is a girl, but she didn't gain as much as would be thought. The nurse started to harass me about her weight gain, but the pedi wasn't worried. I think that they chalked it all up to Lily moving around more.

bumpuser8448316 · December 2013

Have you seen a lactation consultant? DD is failure to thrive and we're seeing several specialists and have been able to rule out feeding or supply issues.