Re: slow weight gain 6 month old (my daughter)

[Guest guest]

Donna,Have you looked under her tongue.  Is she tongue tied?  This sounds like a typical posterior tongue tied baby.  She only drinks on let down.  That means she is incapable of transferring milk on her own.  She only transfers when it is poured down her throat during a fast let down. 

Many times when mom has an over supply these TT babies glide by.  But when mom's milk down regulates the problems start.I would have her seen by a PedENT that clips and knows posteior TT's.Also she probably needs body work.  CST.  C-Sections can be very traumatic.  The docs pull the baby out by the nap of the neck.  Many times they use vacuum ext. in C-Sec.  And if she was breech, her body would not develop in the natural position.  She may have asymmetry or torticollis. 

Just a few thoughtsShari Silady IBCLC

 

Hello wiser ones

I am a newbie here, and I don't know if I'm overanalyzing or I am missing something. My daughter was born 6 ½ mos ago c-sec, due to breach position, unsuccessful version (I also have a 3 year old who was successfully breastfed for 2 yrs). Her birth weight was 6 lbs 5.6 oz, and doubled her birth weight at 5 ½ mos. Today she weighed 13.8. Her pediatrician is concerned about her weight and decrease in percentile, from 23 to 10 (I don't think he is using the new WHO growth charts and will find out). I have another appt with him next week and want to come prepared with answers. I obviously did not take his advise to start solids at 4 mos and we had a heated discussion about it!

So here is the story…She was a tongue thruster from birth, causing bloody nipples and vasospasms. She was down to 10% weight loss. My milk increased in volume day 4 and was engorged. She was back at birth weight by day 14. I then had overactive letdown until about 4 months. She projectile vomited (sometimes several times a day, and sometimes not at all). This also surprisingly lasted the same 4 months. She also spit up excessively (drenched clothing several times a day) until about 2 weeks ago. The dr prescribed meds for reflux but I just couldn't give it to her. My POC was BN position as well as side lying. I also pump every morning when I am very full (which keeps me soft for the rest of the day). I used to get up to 8 or 9 oz. I now only pump 2-4, if at all. Since I stopped having the overactive letdown I find that she isn't transferring much. I did weight checks for 12 hrs (not at night, we cosleep) and she only transferred 18 oz (11 feeds). That morning I had pumped 4 oz, so she was getting hindmilk and not much volume. She took in about an ounce for every letdown that I felt. Some feeds she didn't transfer at all, when no letdown was felt. The most she transferred at a feed was 2.2 oz. and Every time she took in more than 1.8 oz, she spit up. The next day she gained 0.4 oz (average for what she gains/day). It was very interesting (and not what I was expecting)! I also feel like since the overactive letdown has stopped she isn't doing many swallow in between letdowns.

If I don't pump in the morning she does not gain weight for the day and sometimes even looses weight. When I don't pump in the morning I am full all day.

Am I overanalyzing this? Is she just petite and a slow weight gainer? Or am I missing something?

Thank you so much for your time and expertise!

Donna

Donna Cohen, BA, IBCLC

Momma's Milk

donna.MommasMilk@...

Join me on Facebook for the latest in breastfeeding news

http://www.facebook.com/Donna.MommasMilk

-- ~~~~~~~~~~ Shari Silady ~~~~~~~~~~~~~ " Mothers have as powerful an influence over the welfare of future generations as all other earthly causes combined. "

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[Guest guest]

Thanks Shari. She is definitely not TTed. I thought I missed it so I had it checked.

As I pushed send on the email I realized I forgot to mention that.

Donna Cohen BA , IBCLC

Momma's Milk

Join me on Facebook for the latest in breastfeeding news www.facebook.com/Donna.MommasMilk

> Donna,> Have you looked under her tongue. Is she tongue tied? This sounds like a

> typical posterior tongue tied baby.> She only drinks on let down. That means she is incapable of transferring> milk on her own. She only transfers when it is poured down her throat> during a fast let down.

> Many times when mom has an over supply these TT babies glide by. But when> mom's milk down regulates the problems start.> I would have her seen by a PedENT that clips and knows* posteior TT's.*

> Also she probably needs body work. CST. C-Sections can be very traumatic.> The docs pull the baby out by the nap of the neck. Many times they use> vacuum ext. in C-Sec. And if she was breech, her body would not develop in

> the natural position. She may have asymmetry or torticollis.> Just a few thoughts> Shari Silady IBCLC> >

> >>>>>> Hello wiser ones>> I am a newbie here, and I don't know if I'm overanalyzing or I am missing>> something. My daughter was born 6 ½ mos ago c-sec, due to breach position,

>> unsuccessful version (I also have a 3 year old who was successfully>> breastfed for 2 yrs). Her birth weight was 6 lbs 5.6 oz, and doubled her>> birth weight at 5 ½ mos. Today she weighed 13.8. Her pediatrician is

>> concerned about her weight and decrease in percentile, from 23 to 10 (I>> don't think he is using the new WHO growth charts and will find out). I have>> another appt with him next week and want to come prepared with answers. I

>> obviously did not take his advise to start solids at 4 mos and we had a>> heated discussion about it!>> So here is the story…She was a tongue thruster from birth, causing bloody>> nipples and vasospasms. She was down to 10% weight loss. My milk increased

>> in volume day 4 and was engorged. She was back at birth weight by day 14. I>> then had overactive letdown until about 4 months. She projectile vomited>> (sometimes several times a day, and sometimes not at all). This also

>> surprisingly lasted the same 4 months. She also spit up excessively>> (drenched clothing several times a day) until about 2 weeks ago. The dr>> prescribed meds for reflux but I just couldn't give it to her. My POC was BN

>> position as well as side lying. I also pump every morning when I am very>> full (which keeps me soft for the rest of the day). I used to get up to 8 or>> 9 oz. I now only pump 2-4, if at all. Since I stopped having the overactive

>> letdown I find that she isn't transferring much. I did weight checks for 12>> hrs (not at night, we cosleep) and she only transferred 18 oz (11 feeds).>> That morning I had pumped 4 oz, so she was getting hindmilk and not much

>> volume. She took in about an ounce for every letdown that I felt. Some feeds>> she didn't transfer at all, when no letdown was felt. The most she>> transferred at a feed was 2.2 oz. and Every time she took in more than 1.8

>> oz, she spit up. The next day she gained 0.4 oz (average for what she>> gains/day). It was very interesting (and not what I was expecting)! I also>> feel like since the overactive letdown has stopped she isn't doing many

>> swallow in between letdowns.>> If I don't pump in the morning she does not gain weight for the day and>> sometimes even looses weight. When I don't pump in the morning I am full all

>> day.>> Am I overanalyzing this? Is she just petite and a slow weight gainer? Or am>> I missing something?>> Thank you so much for your time and expertise!>> Donna>>

>> Donna Cohen, BA, IBCLC>> Momma's Milk>> >> donna.MommasMilk@...>> Join me on Facebook for the latest in breastfeeding news

>> http://www.facebook.com/Donna.MommasMilk>>>> >>> > > > -- > ~~~~~~~~~~ Shari Silady ~~~~~~~~~~~~~

> " Mothers have as powerful an influence over the welfare of> future generations as all other earthly causes combined. " > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[Guest guest]

Did you have it checked by someone who knows posterior?

 

Thanks Shari. She is definitely not TTed. I thought I missed it so I had it checked.

As I pushed send on the email I realized I forgot to mention that.

Donna Cohen BA , IBCLC

Momma's Milk

Join me on Facebook for the latest in breastfeeding news www.facebook.com/Donna.MommasMilk

> Donna,> Have you looked under her tongue. Is she tongue tied? This sounds like a

> typical posterior tongue tied baby.> She only drinks on let down. That means she is incapable of transferring> milk on her own. She only transfers when it is poured down her throat> during a fast let down.

> Many times when mom has an over supply these TT babies glide by. But when> mom's milk down regulates the problems start.> I would have her seen by a PedENT that clips and knows* posteior TT's.*

> Also she probably needs body work. CST. C-Sections can be very traumatic.> The docs pull the baby out by the nap of the neck. Many times they use> vacuum ext. in C-Sec. And if she was breech, her body would not develop in

> the natural position. She may have asymmetry or torticollis.> Just a few thoughts> Shari Silady IBCLC> >

> >>>>>> Hello wiser ones>> I am a newbie here, and I don't know if I'm overanalyzing or I am missing>> something. My daughter was born 6 ½ mos ago c-sec, due to breach position,

>> unsuccessful version (I also have a 3 year old who was successfully>> breastfed for 2 yrs). Her birth weight was 6 lbs 5.6 oz, and doubled her>> birth weight at 5 ½ mos. Today she weighed 13.8. Her pediatrician is

>> concerned about her weight and decrease in percentile, from 23 to 10 (I>> don't think he is using the new WHO growth charts and will find out). I have>> another appt with him next week and want to come prepared with answers. I

>> obviously did not take his advise to start solids at 4 mos and we had a>> heated discussion about it!>> So here is the story…She was a tongue thruster from birth, causing bloody>> nipples and vasospasms. She was down to 10% weight loss. My milk increased

>> in volume day 4 and was engorged. She was back at birth weight by day 14. I>> then had overactive letdown until about 4 months. She projectile vomited>> (sometimes several times a day, and sometimes not at all). This also

>> surprisingly lasted the same 4 months. She also spit up excessively>> (drenched clothing several times a day) until about 2 weeks ago. The dr>> prescribed meds for reflux but I just couldn't give it to her. My POC was BN

>> position as well as side lying. I also pump every morning when I am very>> full (which keeps me soft for the rest of the day). I used to get up to 8 or>> 9 oz. I now only pump 2-4, if at all. Since I stopped having the overactive

>> letdown I find that she isn't transferring much. I did weight checks for 12>> hrs (not at night, we cosleep) and she only transferred 18 oz (11 feeds).>> That morning I had pumped 4 oz, so she was getting hindmilk and not much

>> volume. She took in about an ounce for every letdown that I felt. Some feeds>> she didn't transfer at all, when no letdown was felt. The most she>> transferred at a feed was 2.2 oz. and Every time she took in more than 1.8

>> oz, she spit up. The next day she gained 0.4 oz (average for what she>> gains/day). It was very interesting (and not what I was expecting)! I also>> feel like since the overactive letdown has stopped she isn't doing many

>> swallow in between letdowns.>> If I don't pump in the morning she does not gain weight for the day and>> sometimes even looses weight. When I don't pump in the morning I am full all

>> day.>> Am I overanalyzing this? Is she just petite and a slow weight gainer? Or am>> I missing something?>> Thank you so much for your time and expertise!>> Donna>>

>> Donna Cohen, BA, IBCLC>> Momma's Milk>> >> donna.MommasMilk@...

>> Join me on Facebook for the latest in breastfeeding news

>> http://www.facebook.com/Donna.MommasMilk>>>> >>> > > > --

> ~~~~~~~~~~ Shari Silady ~~~~~~~~~~~~~

> " Mothers have as powerful an influence over the welfare of> future generations as all other earthly causes combined. " > ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

-- ~~~~~~~~~~ Shari Silady ~~~~~~~~~~~~~ " Mothers have as powerful an influence over the welfare of future generations as all other earthly causes combined. "

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

[Guest guest]

Donna,Your baby sounds exactly my two younger children, especially the second child - she was TT, had torticollis - which I did not realize until she was 6 years old. They both spit up all the time - Chloe, it would be buckets, and she never nursed more than 8 minutes in the first year.She also gained nothing between 5 and 6 months of age. I would have her evaluated for TT and torticollis.~Leigh Anne

Hello wiser ones

I am a newbie here, and I don't know if I'm overanalyzing or I am missing something. My daughter was born 6 ½ mos ago c-sec, due to breach position, unsuccessful version (I also have a 3 year old who was successfully breastfed for 2 yrs). Her birth weight was 6 lbs 5.6 oz, and doubled her birth weight at 5 ½ mos. Today she weighed 13.8. Her pediatrician is concerned about her weight and decrease in percentile, from 23 to 10 (I don't think he is using the new WHO growth charts and will find out). I have another appt with him next week and want to come prepared with answers. I obviously did not take his advise to start solids at 4 mos and we had a heated discussion about it!

So here is the story…She was a tongue thruster from birth, causing bloody nipples and vasospasms. She was down to 10% weight loss. My milk increased in volume day 4 and was engorged. She was back at birth weight by day 14. I then had overactive letdown until about 4 months. She projectile vomited (sometimes several times a day, and sometimes not at all). This also surprisingly lasted the same 4 months. She also spit up excessively (drenched clothing several times a day) until about 2 weeks ago. The dr prescribed meds for reflux but I just couldn't give it to her. My POC was BN position as well as side lying. I also pump every morning when I am very full (which keeps me soft for the rest of the day). I used to get up to 8 or 9 oz. I now only pump 2-4, if at all. Since I stopped having the overactive letdown I find that she isn't transferring much. I did weight checks for 12 hrs (not at night, we cosleep) and she only transferred 18 oz (11 feeds). That morning I had pumped 4 oz, so she was getting hindmilk and not much volume. She took in about an ounce for every letdown that I felt. Some feeds she didn't transfer at all, when no letdown was felt. The most she transferred at a feed was 2.2 oz. and Every time she took in more than 1.8 oz, she spit up. The next day she gained 0.4 oz (average for what she gains/day). It was very interesting (and not what I was expecting)! I also feel like since the overactive letdown has stopped she isn't doing many swallow in between letdowns.

If I don't pump in the morning she does not gain weight for the day and sometimes even looses weight. When I don't pump in the morning I am full all day.

Am I overanalyzing this? Is she just petite and a slow weight gainer? Or am I missing something?

Thank you so much for your time and expertise!

Donna

Donna Cohen, BA, IBCLC

Momma's Milk

donna.MommasMilk@...

Join me on Facebook for the latest in breastfeeding news

http://www.facebook.com/Donna.MommasMilk

Leigh Anne O'Connor, IBCLCleighanne625@...www.leighanneoconnor.comwww.mamamilkandme.wordpress.com(917) 596-3646

[Guest guest]

I agree that you should have her evaluated by someone who knows posterior tt and/or torcollis. My daughter was a slow gainer (she doubled her bw at 18 months and on the weight charts was around -5 percentile, not even on the chart). But this isn't at all close to her behavior or the way I would describe my letdown or feelings of fullness I had. She nursed for short periods, her weight gain was consistent but low and she was meeting her development milestones on time or early. While I usually see slow gainers as one end of normal this pattern is concerning.

Just my .02 as a mom of a slow gaining baby.

Felicia Henry, BCCE, IBCLC

Oxnard, CA

From: dc91381

Sent: Sunday, May 15, 2011 6:44 PM

To:

Subject: slow weight gain 6 month old (my daughter)

Hello wiser onesI am a newbie here, and I don't know if I'm overanalyzing or I am missing something. My daughter was born 6 ½ mos ago c-sec, due to breach position, unsuccessful version (I also have a 3 year old who was successfully breastfed for 2 yrs). Her birth weight was 6 lbs 5.6 oz, and doubled her birth weight at 5 ½ mos. Today she weighed 13.8. Her pediatrician is concerned about her weight and decrease in percentile, from 23 to 10 (I don't think he is using the new WHO growth charts and will find out). I have another appt with him next week and want to come prepared with answers. I obviously did not take his advise to start solids at 4 mos and we had a heated discussion about it!So here is the story…She was a tongue thruster from birth, causing bloody nipples and vasospasms. She was down to 10% weight loss. My milk increased in volume day 4 and was engorged. She was back at birth weight by day 14. I then had overactive letdown until about 4 months. She projectile vomited (sometimes several times a day, and sometimes not at all). This also surprisingly lasted the same 4 months. She also spit up excessively (drenched clothing several times a day) until about 2 weeks ago. The dr prescribed meds for reflux but I just couldn't give it to her. My POC was BN position as well as side lying. I also pump every morning when I am very full (which keeps me soft for the rest of the day). I used to get up to 8 or 9 oz. I now only pump 2-4, if at all. Since I stopped having the overactive letdown I find that she isn't transferring much. I did weight checks for 12 hrs (not at night, we cosleep) and she only transferred 18 oz (11 feeds). That morning I had pumped 4 oz, so she was getting hindmilk and not much volume. She took in about an ounce for every letdown that I felt. Some feeds she didn't transfer at all, when no letdown was felt. The most she transferred at a feed was 2.2 oz. and Every time she took in more than 1.8 oz, she spit up. The next day she gained 0.4 oz (average for what she gains/day). It was very interesting (and not what I was expecting)! I also feel like since the overactive letdown has stopped she isn't doing many swallow in between letdowns. If I don't pump in the morning she does not gain weight for the day and sometimes even looses weight. When I don't pump in the morning I am full all day.Am I overanalyzing this? Is she just petite and a slow weight gainer? Or am I missing something? Thank you so much for your time and expertise!DonnaDonna Cohen, BA, IBCLCMomma's Milk(818) 448-8608donna.MommasMilk@...Join me on Facebook for the latest in breastfeeding newshttp://www.facebook.com/Donna.MommasMilk

[Guest guest]

Donna, I will be happy to plot the weights and lengths of your baby to give you

ammunition to use with your pediatrician to discuss a sensible plan for solid

introduction WHEN your baby is ready.

Email me privately and I'll make you really pretty CUSTOMIZED WHO charts that

you can send to your pediatrician and if need be you can use my credentials as a

PhD in nutrition from Cornell. I've actually gone through the WHO charts and

doubling the birth weight is a ridiculous indicator. The spread of when a normal

healthy breastfed baby doubles her birth weight is four months. The bigger the

baby at birth, the longer it takes.

Often the WORST thing you can do with a slowly gaining baby is to shove a lot of

solids into the picture. There is NO solid on this planet that is as

concentrated in nutrients as breastmilk. What happens when you switch to

shoving solids into baby's at four months is that it displaces the more nutrient

dense breastmilk and growth slows. This is a well documented phenomenon. I

simply do NOT understand why pediatricians are following advice that is over 20

years out of date on solids. Babies do need a small amount of solids for iron

and zinc AROUND (not on the dot) of six months when they show signs of

readiness.

You said that she transferred 18 ounces in 12 hours. If you are night feeding

she most certainly is getting and average amount in 24 hours even if she isn't

eating as much during the remaining 12 hours. If she ate the same amount in the

subsequent 12 hours (another 18 ounces) it would be 36 ounces. If she ate half

as much (9 ounces) it would be 27 ounces. And if this was AFTER you pumped out

4 ounces, she might have taken more. What is important here is the pattern.

You said that you are pumping, but you didn't state whether you are doing this

AFTER a feed or instead of a feeding, nor what you are doing with the pumped

milk. As Genna has reminded us again and again on Lactnet with solid

references, foremilk and hindmilk is a continuum and it does NOT make a

difference for weight gain. It is the total VOLUME that matters and it seems

like the volume is reasonable.

The most striking thing in your post, is that she takes starts to spit up when

she drinks more than 1.8 oz. She may very well be a self-limiting feeder and

developed this in response to reflux. My son fed this way -- stopping always at

2 oz. No way you could ever stuff more than 2 oz into him. I did go back to

part time work and the caregiver could never get him to take more than 2 oz

either. Your management style seems to be similar to my own, which was to feed

African style - very frequently. Most mothers in our culture would not feed

this way, but it actually can work quite nicely if you are willing to feed this

way. Keep in mind, that if you feed frequently, she will not transfer that much

at one feed -- but she might not do it if you feed less frequently either -- and

she might really lose weight.

Please please STOP comparing the gain from day to day. The amount she takes in

which can be as much as 2.2 oz is MORE than the average weight gain per day. I

have measured babies that can have a diaper that contains 3 oz or more. I would

ONLY compare a gain in weight over the course of two weeks. This is because the

day to day variability is too great to be of any use.

My sense is she is a petite, slow gaining, self limiting feeder because she has

a touch of reflux. There may be a little slowdown in the growth because she

doesn't transfer much milk -- but without really looking at the WHO growth

charts I would be VERY hesitant to make any judgements whatsoever. As I said,

I'd be happy to make you pretty charts to help you analyze her growth based on

what YOU know about her.

Best regards,

E Burger, MHS, PhD, IBCLC

NYLCA President

sburgernutr@...