Need input: 8 mo old, barely gaining weight

Aliki · November 2014

STM with a 7.5 month old LO. I stayed at home with her for the first 5 months, during which she gained an average of 8 - 10 oz. per week. At all her well-visit appointments (birth, 1 week, 1 mo, 2 mo, 3 mo, and 6 mo) she has been in the 95th percentile.

I returned to work when she was 5 months old. She is EBF and started solids around 6 months (volume-wise, she has about 1 Tablespoon at lunch and 1 Tablespoon at dinner). She was introduced to bottles when she was a few days old (forced to supplement); but ever since 2 months old, she refuses all bottles most days (we have tried Tommee Tippee, Playtex Drop-Ins, Momma, Lanisoh, Avent, NUK, and more). Approx. once a week, one time out of the ten times they offer her, she will take 2 oz. of pumped fresh breast milk.

For the past 2.5 months since I returned to work, she has gained an average of 1 - 2 oz. per week, for a total of less than 1 lb. Looking at the growth curves, I think this means she is falling off the curves, down to 75th percentile. My pediatrician has always emphasized that the important thing is not how much a baby gains, but rather that they maintain their growth curve (i.e. if they were born at the 25th percentile, as long as they stay on that track, their growth is normal, even if they remain petite).

I am semi-dreading our 9 month appointment, because I suspect they will comment about her lack of weight gain. Do I need to be concerned? She simply refuses to drink anything from bottles during the 9 hours we are apart. Should I try sippy cups? Straw cups? Increase solid foods? Stick my head in the sand and wait for the pediatricians to chastise me at our next visit?

lauranicole91 · November 2014

Is she starting to crawl or roll around a lot? Extra activity and movement can easily cause more fat burning and less weight gain. Don't stress until your pedi does.

My daughter fell off the chart around 9 months and it's been a huge struggle with lots of tests and feeding therapy and specialists. But she is still happy and healthy 2.5 year old, she's just a tiny 20lb 2.5 year old. And it took a while/a few visits for her pedi to get concerned. So even if they mention the little gain at the 9 month appointment they may just suggest higher fat foods and more protein and such. You could try that now if it makes you feel better.

Avocado
Egg yolks
Adding real butter to lots of foods
Full fat yogurt
Ice cream
There are more but my brain is fried right now

As long as you feel she is being satisfied with her meals and milk intake and her amount of poop and pee seem adequate I wouldn't worry too much.

Nikkipal82 · November 2014

My LO has refused all of the bottles we've tried since I returned to work. She mostly takes milk by medicine dropper, which we have made due with. She has also finally figured out how to use a straw, so we are working on that. We use the munchkin weighted straw cup, which I highly recommend. It is also fairly common for weight to plateau when baby becomes mobile, as pp said. Finally, see if you can look at the WHO growth chart for breastfed babies, since the CDC charts mostly look at FF growth. Good luck!

TheBorg7of9 · November 2014

I'm sure the growth is fine, but have you tried a sippy cup for breast milk?

Aliki · November 2014

lauranicole91 said:

Is she starting to crawl or roll around a lot? Extra activity and movement can easily cause more fat burning and less weight gain. Don't stress until your pedi does.

No, she doesn't crawl, and only rolls from back to tummy. She's quite sedentary, and some days, it feels like all the birth moms (M14) have babies that are crawling, I'm the only one with a baby who doesn't move.

Thanks for the suggestion for fattier-foods like avocado and egg yolks. Right now, her favorites are carrots, mashed potatoes, and brocolli.

Aliki · November 2014

TheBorg7of9 said:

I'm sure the growth is fine, but have you tried a sippy cup for breast milk?

Because I've an older daughter, I already had sippy cups in the house... she didn't like it. I think she doesn't like tipping her head back (she only nurses in side-lying position, she doesn't like cradle or sitting up to nurse), so I also tested out a Foogoo straw cup and she seemed OK trying that out...

rubyredlucy · November 2014

If you're concerned about her bm intake during the day, try mixing some into her solids. Use it instead of water to make oatmeal or cereal, add it to purees, use it to make scrambled eggs...get creative. And weight gain does level off as they get older, even if she isn't mobile yet.

Does she nurse more at night to make up what she misses during the day?

opheliainwaders · November 2014

Also, this is kind of random, but if your DD needs help with the straw, I accidentally figured out a trick to help DD learn how to drink from a straw (she didn't mind it, but didn't get that she was supposed to suck to get liquid up). I let her have a tiny bit of my smoothie, which was thick enough that it stayed in the straw so she figured out what to do with it.

Aliki · November 2014

rubyredlucy said:

If you're concerned about her bm intake during the day, try mixing some into her solids. Use it instead of water to make oatmeal or cereal, add it to purees, use it to make scrambled eggs...get creative. And weight gain does level off as they get older, even if she isn't mobile yet.

Does she nurse more at night to make up what she misses during the day?

Yes, she still nurses 6 - 8 times a day, strictly between the hours of 4 PM to 6 AM. But since her weight has virtually stagnated, I'm worried about dehydration and "failure to thrive", two things she was diagnosed at 1 week old. She's not a barracuda-nurser like my first was (who would just nurse and nurse and nurse)-- she's very content to sleep and doesn't cry, which is what led to her weight loss during infancy.

I will try mixing BM into her solids instead of water, thanks! I do have a lot of it, from all the pumping, despite donating over 400 oz. to other moms in the area.

Aliki · November 2014

opheliainwaders said:

Also, this is kind of random, but if your DD needs help with the straw, I accidentally figured out a trick to help DD learn how to drink from a straw (she didn't mind it, but didn't get that she was supposed to suck to get liquid up). I let her have a tiny bit of my smoothie, which was thick enough that it stayed in the straw so she figured out what to do with it.

Ah!!! Good idea, thanks!!

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