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Baby not gaining weight. what should I do?



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amother
Powderblue


 

Post Sun, Mar 25 2018, 2:39 am
Looking for advice and some insight please.

7-1/2 month old dd has been slow to gain weight ever since she was born. she had a rough start with a couple of procedures as newborn so she was npo quite a few times. mentioning this, bec. while she was slow to gain weight then the hospital kind of put it on that and her needing to recover etc. she was not breastfeeding at that time. she was getting ebm though (expressed milk) and at one point started fortifying the milk so eventually she was getting 24 cals per oz.
she started nursing once she came home from hosp (at abt 2 mo) and now her slow weight gain was subtly blamed on me 'cuz maybe she's not eating enough'. we fortify her night feeds to 28 cals pers oz now (though she only gets between 5-10 oz).

she is happy between feedings so I doubt she is hungry. she is a very active very happy baby b'H and is more or less meeting her milestones (she is a little delayed physically)
At one point her pulm. said that she seems tachypnic. and the high resp rate is what is burning so much cals, hence the slow weight gain. at her last pulm visit after a thorough exam this was kind of ruled out, and I do see that her RR has kind of slowed down.

Her weight gain has plateaued though. we now have a baby scale at home and for the past 3 wks her weight is the same- fluctuating within 3-4 oz range.
I'm ready to cry.
she was sick for a few days in the interim but b'H her appetite wasn't so bad. so don't think I can blame that.
she is now eating solids as well so we try fattening up her food.
I find though that it is such a hard balance, here I still want her to bf so by giving her solids it takes away from that. increase calories in feeding at night- then I end up decreasing amount of her feeds b/c it effects her apetite during the day.

I'm so torn, not knowing what to do.
We do have a GI following her. he feels that her weight/to height is proportioned and from what he sees she is gaining consistently. so ya, when you weigh her every 3 months it may look better, but she is barely gaining (and now nothing). she is close to 8 months actually and weighs about 13 1/2 lbs. a full term 6.6 lb baby.
Gi is not at all concerned. e/o else following her care (a multitude of specialists) feel that she needs to gain weight.
Awaiting now a nutritionist appt. will see if they have any good ideas.
but in the interim if any of you dear ima's can help with a/t it will be greatly appreciated.
Thank you!

p.s. sorry for long megila, just wanted to give as big 'picture' as possible.
Scratching Head hmm, did I omit anything?
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blessedflower




 
 
    
 

Post Sun, Mar 25 2018, 10:23 am
Babies follow their own curve. As long as they gain it's okay. Even if it's rather slowly. Some babies are just smaller. (are you or your dh small?). Ask your mom and mil how their babies where. You might be surprised and hear that they also had small babies. It's sounds like your baby is eating well but burning lots of calories by being very active. Good luck
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smileyfaces




 
 
    
 

Post Sun, Mar 25 2018, 11:08 am
I had similar with my preemie.
Very very slow weight gain and sometimes not gaining at all.
Pm me if you want
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Ahuva's Mommy




 
 
    
 

Post Sun, Mar 25 2018, 1:17 pm
My son weighed about that at that age. People were concerned, but he is bh a healthy preschooler with an average height and weight. At one point he was put onto reflux meds and I was told to go off soy and dairy.
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Iymnok




 
 
    
 

Post Sun, Mar 25 2018, 2:28 pm
Weight gain isn’t by day, it’s uneven. As long as she follows her own curve. (Adjusted fur her treatments etc.)
Just below the curve is good too.
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amother
Salmon


 

Post Sun, Mar 25 2018, 4:31 pm
My baby was also underweight and stopped gaining weight a few times during her infancy. If it makes you feel better, at 1 year she didn't even weigh as much your baby does now. She finally made it onto a growth curve at age 4 - just at the 3rd percentile. But her weight gain was steady for quite some time before that.

Here's what I can tell you from our experience with an underweight baby and professional guidance we were given:
- As long as she's gaining on her own curve, even if it's below the charts, no reason for concern. If she's not, then yes, increasing weight gain rate should be done.
- Nutritionist made a HUGE difference. baby's weight gain kept plateauing, and working with the nutritionist really got it back on track. We still use strategies we learned then. make sure to see one who specializes in babies and toddlers. Also, to maximize your first appointment, keep an accurate and comprehensive food log of all your baby eats/drinks for 1-2 weeks prior to your appt - all food, meals, snacks, feedings - include all types of food and approximate amounts. This will allow the nutritionist to tell you right off the bat if your baby is getting enough calories in general and if specifically getting enough of certain food groups important for weight gain (protein and fat). She can then help you adjust accordingly to meet baby's nutritional needs. We 'wasted' our first appt a little, because we didn't know to do this.
- Protein and fat are both important for weight gain in babies. Protein is important for muscle mass, which is a large part of baby weight gain. One of the key things we were told by the nutritionist is to never give fruits/veggies/carbs without fat and protein as well - always add something - we added expressed breastmilk, cream, butter, olive oil, tehina, almond butter, mayonnaise, etc (not all those have protein, so take note). No baby food jars were ever given themselves, because fruits and vegetables have calories which feel somewhat filling but don't provide any protein or fat to help with weight gain and development. Carbs also generally lack enough protein and fat, so spread on those spreads (egg salad, hummus, tehina, nut butter, cheeses, etc.).
- If your baby is alert and active, doesn't' sleep too much, and is generally happy and not too kvetchy, then she is probably fine. This means weight gain may still be needed, but she isn't suffering from severe malnutrition or anything.
- If your baby's development is raising red flags, then that's something important to consider. Our baby also had a motor delay. the question is whether your baby's developmental delay is really a delay or just the low end of average. If there really is a delay, sometimes this is an indicator that there isn't enough caloric/nutritional intake, though sometimes both are symptoms of some other underling factor and fixing one won't fix the other. For babies with a developmental delay, protein is especially important, since it is the main building block of muscle mass. Fat is also extremely important, as it is crucial for proper brain and nervous system development.
- Being sick can throw them off for a week or more, so if your baby doesn't gain well for a week or two after being sick, don't worry about it.
- Don't weigh your baby more than once a week - babies don't have the same appetite every day, so limit it to once every week or two at MOST. Just like kids and adults, babies can have a big eating day one day and a minimal eating day a different day. It usually balances out over the week though. Weighing her more often will just make you all crazy and won't give you useful information.
- If weight gain isn't good make sure to test for mono (EBV) and CMV - when our daughter had this as a toddler, she stopped gaining weight for two months, with no other symptoms. These are very common in young children, and usually display no symptoms, but can affect appetite. It's probably not the culprit in most cases, be we had the doctors going crazy until I suggested they test for this - but again, this was only the case for 2 months, and not the rest of her bad weight gain.
- How often is she being fed during the day and at night? They had us wake up our baby during the night to be fed every few hours from when she was born. A real pain. Don't do this unless they tell you to. But how much she drinks at each feeding is much less relevant than how much she drinks over 24 hours. Also, eating lots of smaller meals as opposed to a few large meals was very helpful - small babies have small stomachs, and feeding her less food more often allowed her to eat better. The nutritionist also had us put her on an eating schedule - this helped, because her body seemed to learn to expect food at certain times and her appetite improved. Obviously, if she was hungry in between, we'd give her a very small snack to hold her over. But we reduced and stretched those out over time, with more frequent snacks built into the schedule if she needed it. All meals and snacks cotnained protein (cheese, cottage cheese, oatmeal, scrambled eggs, pancakes, chopped meat, etc).

That's all I can think of. Good luck!
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strawberry cola




 
 
    
 

Post Sun, Mar 25 2018, 5:01 pm
my friend had the same problem. discovered she had celiac went gluten free and Boruch Hashem all is well.
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amother
Aubergine


 

Post Sun, Mar 25 2018, 6:02 pm
strawberry cola wrote:
my friend had the same problem. discovered she had celiac went gluten free and Boruch Hashem all is well.
my son has the same problem and is showing strong signs of celiac. Definitely get baby tested but my son's blood results were inconclusive more were doing biopsy
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amother
Olive


 

Post Sun, Mar 25 2018, 6:40 pm
Im sorry you go through this, it does make a mother torn and insecure if the scales show the same weight and docs say info that the mother doesnt know what to do with exactly... I hope the nutritionist will help you.


just as a side note: I learned through my kids that when they are happy and kinda gain (even if only little) they most probably are fine.

one kid was a very slow gainer he ate a ton but just didnt grow/gain fast at all.

another kid hardly ate and was a round cheaked very full baby...

I really dont know what it all depends on.

sounds like you are a caring mother who tries her very best and I pray that soon you baby will gain well and all docs and you will be calmed down by your babys great success!!!

kol tuv Smile
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amother
Powderblue


 

Post Mon, Mar 26 2018, 10:34 pm
Thank you everyone for the replies.
I will definitely work on incorporating these tips, and bring up the celiac thought when we meet with GI next time.
I like the idea of keeping a food log, though it is a little tricky knowing the amount when she is breastfeeding for most of her daytime feedings.

Thank you!
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