Poor weight gain (and the nursing toddler)

Hi all, don't know where to post this, feel free to move.

One of my DS grew well, stayed up in the 30% on the growth charts until he hit 6 mos (and we introduced solids) and he's been steadily falling ever since then. He is now 20 pounds 3 oz at 16 mos and no longer on the growth chart (his head circ is in the 40's and height in the 60th).

So my pedi suggested meeting with a nutritionist as blood work and other testing come back normal. They both seem to think I should wean.

He is so stubborn when it comes to feeding. He's never accepted me feeding him from a spoon even at (6 mos - 9 mos), but loves to self-feed. He eats some of just about everything, just not very much. Like breakfast - I served buttered toast with jelly (1 piece cut into 6 fingers) - he ate one finger. so that's what 20-30 calories? Fruit-he ate six bite sized pieces. Cottage cheese, maybe 4-5 spoonfuls. No milk from the sippie, threw that on the floor.

Anyone have any ideas for me to not loose my mind? Snack or food ideas that are calorie packed and nutritional? The nutritionist gave me a receipe for this pudding made with half and half and carnation instant breakfast. If I could get him to eat a half cup it has 250 calories in it! But, that's a bigggggggg if, since even when the spoon is loaded with sweet chocolate pudding he swats it away. (yes, they do use spoons to self feed, and do an okay job of it, but I think about half of it goes everywhere but their mouths) And can you comment as to whether you think weaning will make him eat more food and gain weight? I guess I just feel that I know he'll nurse about 3-4 times a day, and those are calories that he's getting.

THANKS!

 

Has he been gaining in height & head circ, or are those stalled too? The falling weight percentiles may be a problem, but I've also heard of babies/toddlers slimming down significantly and being ok. Does he seem happy and healthy and developmentally on track? Any signs of malnourishment? (Lethargy, dull hair, dull and brittle nails, stuff like that...)

I think that weaning now would be a bad idea. He's a picky eater, won't drink milk from a sippy - and they want to cut him off from your rich, high-calorie, nutritionally perfect milk, which he drinks happily with no problem??? :huh: I seriously doubt that weaning would make him suddenly eat lots of solid food. It would only take away one vital source of calories and nutrition. (And breastmilk tends to get more calorie- and nutrient-dense as babies/toddlers get older, to make up for the decreased volume.) Doctors receive very little info about BFing, and probably none at all about nursing toddlers, AND there is a huge bias in our society against nursing toddlers. That's probably where that "advice" is coming from.

Now, as for food ideas... I don't know his likes and dislikes, but here are some things to try:

-adding more butter/olive oil whenever you can
-cheese
-avocado (you can spread it on toast to make it easier to self-feed)
-if it's too early for nuts (I know there are conflicting opinions about this), they make sunflower seed butter, which is kind of like peanut butter
-whole milk yogurt (straight up, or you can throw in some fruit and make smoothies)
-olives

I would consider heavily sweetened stuff a last resort. It may wind up being necessary, but if possible I'd try to steer away from empty calories. If you go for something sweet, maybe he'd be happy feeding himself little bites of Clif bar or something like that?

 

The only way I can see nursing interfering with feeding is if he was nursing all the time. You said he nurses 3-4 times a day which isn't going to distract him from food. If you are at all worried you could save the nursing for after the meal. Sometimes doctors follow numbers too closely. How are you and DH proportioned? We tend to forget we are a product of our parents genetics, so if you and DH aren't big, then he may just be slimming out.

My DS has never been on the growth curve but he is happy and healthy. He is picky but will eat peanut butter sandwiches, string cheese, yogurt-all things that are calorie dense. Your son may also be a natural grazer and not eat much at a meal but want little bits frequently throughout the day.

 

This topic is something that I worry about as well, my DD who is 15 months is less than 18 pounds still, so while recently doing research I cam across some interesting articles, which basically said that the growth charts that most doctors office's use are from the CDC, which are based on statistics of formula fed babies, and the WHO which promotes long term nursing have different growth charts. Here is a link to this article:

http://jn.nutrition.org/cgi/content/full/137/1/144

But like others have said, if they did blood tests, and your baby is developing fine, than I wouldnt worry.

 

Thanks for all the quick responses. It gives me some reassurance that continuing to nurse is a good thing. They always nurse right when they get up, before nap (which is right after I serve them lunch), and before bed (which is shortly after dinner and normally I try offerring a snack too).

To answer questions : yes he is still gaining in head circum and height -those stats posted are from his 15 mo check up, so he's not on the chart for weight, but in the 60% for height.
As for my DH and I. We'll I'm 5'7" and the shortest in my family, my DH is 5'7" in shoes :blush: and all of his family is short. His dad is the same height and probably weighs 140-150 soaking wet. So I imagine he's probably got my DH's genes, and my other chunky super tall guy gets my family's genes.

Thanks for the link to the chart about breastfed babies/weight. I've seen that before, and it is reassuring.

I just feel at a loss, stupid things like, letting him graze -having snacks out all the time, versus trying to get more rigid 5-6 meal/snack times. Every little decision like that stumps me and makes me question myself! I've never fed a child before, so now I keep getting hung up on these things, how much is in a portion, etc etc.. I can't help but feel frustrated when one day I make a smoothie and it's like the best thing ever and he actually drinks it, and the next, it's like I'm trying to poison him. And seeing all my friends kids who are younger than mine and weigh much more than mine, hearing the boy, he's small comments. Like I'm not feeding him??

Yogurt - he loves the gogurts (probably because they are full of sugar, but I think it also has something to do with the self-feeding thing). Even if I take full fat yogurt and sweeten it up, he doesn't eat it with the same gusto as when he can squeeze it out of a tube. You know what I do sometimes? Squeeze it up into a turkey injector, take the tip off the injector, and then let him hold it while I push it up out of the injector. It works sometimes.... lol...

The other piece of advice from the dietician was to only give him drinks with calories, even specifically juice. I have a hard time with that...

 

Sabrina is 4 1/2 and weighs 27-28 lbs. She's never been on the charts for anything except head circumference and even then it was only like 3rd percentile. She's tiny and very thin. In fact the other day she came walking out of the laundry room in capris... then I noticed there were snaps all along the crotch and I realized she was wearing Spencer's pants. He's 14 months old. I still find myself doubting myself about things with her. And I have fed other children (my twins are #s 4&5 of 6). My other kids range from thin to a little poohbearish, but none are like her. Now she's on Pediasure to help her, but it's kind of a catch 22... if she drinks it, she eats less. She's always been a tad picky, very slow at eating (nursing took forever!), and has a super sensitive gag reflex.

This isn't really an answer to your question. I do agree with what others have said about nursing actually being a benefit, and it doesn't make sense to cut that out for helping with weight gain. But mostly, I just wanted to let you know that you're not alone and even when they're not your first kids, it's easy to stress and be confused about what's best for your child!

 

I also can't quite understand why you'd want to take away a foodsource the child actually likes which is very nutritionally good for him. This makes no sense to me...

 

Hang in there. I would keep nursing. My pedi said kids usually settle into their % on or off the curve around 9 months so she wasn't really concerned with decreasing % from birth to 9 months, more concerned with some growth and thriving in other ways.
My DD was 20 months before hitting 20 pounds and DS was 17 months for 20 pounds. At the 3 year check they are both above the 5% for the first time.

 

I also wouldn't quit nursing. At about 15 mo. our babes had a cold and were sick near their 15 mo. visit and their weights stalled and the pedi recommended pediasure. I didn't really want to start giving that since I could increase their diet with other nutritious foods. like the avocados, peanut butter and almond butters etc. by the next visit they were at least back to gaining. we

here's our "stats"... for what its worth - they are finally up to about 20% and 10% with their heights around 50%.

21mo-D24lb 4oz; J-22lb 4oz
18mo-D21lb 12oz 10%; J-20lb 4oz 5%
15mo-D19lb 12oz 2%; J-18-9oz 3%
12mo-D19lb 0oz 7%; J-18lb 3oz 10%

Our pedi never mentioned dropping the nursing... that's just silly talk. like the pp said, at least that's one thing you know he is eating.

I also had good luck making sure that they were hungry when I served meals... so that they would actually eat. I also served the items that I wanted them to eat first. the items with the most nutrition etc.

good luck! there are so many things to worry about with being a mom... and I know that I worried for several months about their weights. I now know that we just have skinny babies.

 

My friend's son is the same age and a self-feeder and loves chicken...excellent source of protein.

Personally, if he's healthy and happy, I would concentrate on having a balanced diet (easy on the sweet stuff), plus the breastmilk.