should I change something?

My baby has not gained an ounce in the last 6 weeks. In fact, by my scale he's down 3 ounces since his 4 month appointment. At birth he was above the 95th percentile, and by his 4 month check-up he was between the 75th and the 90th. He's going to drop a lot more if he doesn't gain anything between 4 and 6 months. I looked on kellymom.com and it says he should be gaining 3 ounces a week on average.

Things that make me feel a little better about him not gaining weight:
- I know he was born big and has to average out at some point. At 5 months he's still about the same size my girls were between 9 and 12 months. Also my girls had a really hard time gaining weight once they became mobile and he moves constantly.
- He nurses very frequently - about every 2 hours. He also is taking 3 solid meals a day. He has plenty of wet and dirty diapers.
- He doesn't act like anything is wrong.

Things that make me worry:
- I know he can't stay 16 lbs forever. At some point that's going to be too small. I'm terrified that at his 6 month check-up the doctor is going to tell me he's fallen off his growth curve.
- There's no way he's going to have doubled his birth weight by 6 months. I'll be lucky if he doubles his birth weight by 1 year.

Even though it's going to be a lot of work for me I am going to try pumping in addition to nursing him this week, and adding that pumped milk to cereal and mixing it in with his baby food. I can't cut out the baby food, that's out of the question. I already have to nurse him every 2 hours, I need that baby food to hold him off b/c I can't sit and nurse him all day. But if I am able to just add 2 ounces of EBM to his baby food that's 6 extra ounces he'll get in a day.

I just have this guilty feeling that if he was taking bottles he wouldn't be struggling with his weight. The kid loves to eat.

I want to call the pedi about it but just can't bring myself to do it yet.

Anyone with advice? Words of encouragement? He's got to grow.

 

Has he been sick at all?
My guy had a month (month 8 I think) when he lost weight due to a nasty stomach bug--he was eating well and happy the whole time, but much of what he ate went right through him.

I think size wise you shouldn't worry yet--you said yourself he was born big and it's got to even out sometime.

How about you? Are you eating enough? How about some high calorie, healthy foods for you both? like Avacado, black bean dip, turkey, etc.

 

Thanks for responding Melissa.

He has never once been sick. (knock on wood) That baby has never even had so much as a sniffle.

I am dieting. I've been dieting since he was 1 month old. I'm averaging a weight loss of 0.9 lbs per week. (I'm down 22.6 lbs since he was 4 weeks old.) One of my favorite dinners is this salad I make with a whole avocado, a whole cucumber, tomatoes and some grilled chicken strips. Maybe I'll run to the store and have that tonight.

I thought that it didn't really matter what I ate though as far as affecting the fat content in the milk? I'm not doing a crash diet, I'm doing weight watchers and you add in extra calories for nursing. My OB always told me to just be sure to get enough water.

 

I think it doesn't affect the fat content in your milk--your body will send that fat there.
But I think it does affect our brains. Good stuff in to get good stuff out sort of mentality.

His appointment is in three weeks, right?
If he seems like everything is fine and it dirtying diapers, I think it's okay to hold off talking to the doctor until then. When you do see the doctor make sure to talk to him-her about growth over the first year. What's the doctors take on a baby that was born big, and where they should be at 6 months and at a year. Also make sure the doctor is taking your babies genes into account. If the parents are not in the 95th percentile it seems logical that the baby would begin to drop in percentiles, rather than stay in the same percentile as he grows.

 

That's a really good point. I'm going to try to find out what percentile my husband and I are in. That might make me feel better. Thanks.

ETA: I'm between the 75th and 90th for height and weight. DH is between the 25th and 50th for height and 50th for weight. Really the baby could go either way. My side of the family is all tall bigger people, DH's side of the family is smaller people. I just have a feeling the doctor is going to say he's fallen off his growth curve. Keeping my fingers crossed he has a growth spurt in the next 3 weeks.

 

I know it's hard not to be worried, but from everything you describe he does sound really healthy. And my doctor was always very quick to remind me that the 3 oz/week was just an average; sometimes it might be nothing or even a slight decrease and the next week they more than make up for it. So perhaps he's just a fits and starts kind of a kid. If you're really worried I wouldn't wait for the 6 month appointment, I would take him in right away. If nothing else it will put your mind at ease.

If you're feeding cereal already maybe you can try a little bit of mashed avacado instead? That was one of my boys first foods and they loved it.. and it's a really good source of healthy fat.

 

Aimee I'm pretty sure he's fine, and in fact, I think this is a pretty typical pattern for a larger baby. Lena has followed a very similar pattern. I'm fairly confident that she will not have doubled her birthweight by the age of 1--she weighed 17lbs 7oz a few weeks ago, and she'd have to be 18lbs 6oz to double her weight. My DH and I are pretty average for height and weight (well I need to drop a few pounds, LOL, but if I ate right I would be average), so it would be odd for us to have a baby that was 95% for her weight.

From what I've read, larger babies take longer to double their birthweights. Coop was probably like the 99% for weight, so I wouldn't expect him to double his weight until more in the 9-10 month time frame.

A few other points
1)How's his height? Lena's weight is pretty slowly creeping up there, but most of her growth has been in her height.
2)Is he STTN? How many feeds does he have per day?
3)I think (no scientific evidence here just speculation) that babies born after twins have a tendency to have higher birthweights even if they aren't that big later. My DH was my MIL's largest baby and she had twins before him, so it could be the case.
4)Your other children are relatively thin, so I wouldn't expect him to be a big chunker for long.
5)I've heard, again not sure if it's true, that many breastfed babies tend to slow their weight gain more the FF babies in the latter 6 months of the first year.
6) If he's crawling, rolling or moving around a lot; then it would be reasonable for him to level off. All three of my kids gained very little weight from about 4-7 months, and all of them started crawling at 5 months. They all slimmed substantially.

 

Have you checked into the WHO's growth chart for breastfed babies?

 

I was also going to ask about height. If he's growing in height, chances are he's getting enough. I also agree with what you and pp's said about him evening out because he started so big. Also, check out the WHO growth charts. They are based on breastfeeding where the CDC charts that most doc offices use are based on formula fed babies. The rise in weight gain is much slower on the WHO charts which is much more natural. It sounds like he is a kiddo who gained rapidly at first and now he is in a temporary lull. 16 lbs is still great. My two were only 19 and 18 at a year and the larger started at 7lb 12oz

 

Of course he's waking up right in time for me to respond - I don't remember what his height was at 4 months. I think I'm going to call the pedi and ask about that as well as all of this. It will be worth it for peace of mind so I can stop worrying.

He is sleeping through the night most of the time. He goes to bed between 6 and 7 pm and sleeps til 6 to 7 am. Sometimes he wakes up around 3 am for a feed but not every night. He nurses at least 6 times a day but most days it's more like 8 or 9 times a day.

It looks like he's right on the average for 5 months at 16 lbs on that chart. I'll see what the doctor says. I have a measuring tape here at home.

 

I dunno... IMHO I do not like the growth charts and averages etc. It is just one more thing for us parents to worry about. I kept being told that my DD who is 3 now was small and only in like the 20th percentile and at times fell off her curve and at times went up. She is perfectly healthy and very smart. I knew she was getting good nutrition, breast milk and organic homemade foods. My twins have already doubled their birth weights at like 4 and a half months (but they were 5 pounds) but my DD is slowing a bit and is smaller than my DS. BUT she eats well is healthy and developing perfect. I would not worry. It seems like your LO is perfectly healthy and happy. IMHO I wouldn't change anything. Good lucK!

 

You're probably right momof6. I just remember how bad I felt when Lily only gained 2 lbs between 6 & 12 months and I was told that if she didn't gain enough by the next appointment they were going to talk with me about failure to thrive. I felt so bad and was so worried. I don't want that to happen again with Cooper. I'm waiting for the doctor to call me back.

He is mobile now, he rolls and scoots all over the place. My girls are very thin and tiny. They're not even on a chart as far as weight goes, but 75th in height. But I'm used to them not being on the charts. With Cooper I didn't think I was going to have this to worry about it. You forget what it's like to worry about them before they can talk.

 

There is always something to worry about, isn't there? :hug: Mine were not that active at that age so they began to resemble giant mooses. :laughing:

 

Since Lily slowed down and is fine now and your girls are small, that would make me even less worried. Since he is so active, that shows he has energy to get around so that shows he is getting nutrition. If you are real concerned I would give him good fats, like avocado and whole milk yogurt. Add breast milk or whole milk yogurt to all his food. I just bet he is going through a slow time, just like they all go through a growth spurt. I am sure he is just fine!!! Keep us posted!

 

Aimee, I think you are doing everything right. You're doing a great job. You know something else to think about. You're girls were twins, and I'm pretty certain twins also follow a different growth curve, since they tend to be born smaller. It's much different for a 5lb baby to not double his/her weight opposed to a 9lb baby. I know Eli and Mark had more than tripled their weights by the time they were one. With Lena I just keep having to remind myself that she was 2-3lbs bigger than they were at birth.

I think your number of times nursing sounds about right.

I'm sure that was tough, and it's probably affecting you right now. I'm like that with sleep--my STTN experience with the boys was so awful, I was terrified of what would happen with Lena.

Just remind yourself that he's right in the middle of the chart right now. I know it is hard when you look at their weight and it's not going up. Lena didn't gain any weight for a period of time--I think like 6-9 months. My Dr is an LC, and I asked about it. She was fine with it. It's hard not to look at her and say how did that fat baby turn into a skinny little peanut. In fact, she was at her fattest and rolly polliest when she was born.

 

Cooper was too! I got a call back from the nurse. Assuming I'm measuring him correctly I have him at 1.5 inches longer than he was at 4 months. They had him at 25.5" at 4 months and I had measured him at 27".

So now I am feeling a little better. It looks like maybe he's going to take after the girls and be long and skinny. The nurse did say that if he hadn't gained anything between 4 and 6 months the doctor would definitely want to talk with me about it.

Thanks for all the replies. I'll let you know if anything comes of it at his appointment in a few weeks.

 

I agree with PPs - your baby sounds fine. Please don't worry too much.

That said: I totally understand your fear of a failure to thrive diagnosis or warning by your pedi. I received one of those warnings for one of the twins at 9 or 10 months (I think) and I was so miserable and felt like a mom-failure. I thought he was fine and I know he is the type to grow in spurts and gain weight in leaps and was due for both at the time of the check up. My pedi said I had a month for him to catch up in height and weight before he would recommend changes to nutrition and more constant monitoring. Oh the pressure for my baby to make that growth spurt and weight gain within that month ... In the end he did and everyone relaxed again but I never want to go through that anxiety and guilt and self-questioning again. In my heart I was sure that I was doing the right things and that my baby was well, but that did not stop the professional opinion from upsetting my self-confidence as a mom. BTW - I really like my pedis and trust them, this was the only issue where we did not see eye-to-eye and I understand that pedis have to watch these things - it is better to be a bit more concerned than too relaxed.