4 Month Old Not Gaining Weight

Hey L.,
I have a 7 year old and now almost 12 month old (in May) and they are both slender. My son was ALWAYS in the 5-6% and my daughter is the same way. They told me my son was nearly failure to thrive (which is just an average for all kids) and to let him eat whatever and whenever he wanted. He did and still does but doesn't gain much weight. He'll be 8 in July and is barely 50lbs. My daughter is the same way she'll be a year old next month and she's only 16lbs. I think that the kids who are slender and on the small side are considered failure to thrive simply because the average child is heavier now a days. Just because they are on the thinner side doesn't mean they aren't healthy. My ped told me that it's actually healthier for them to be skinnier than heavier... obviously... she's not worried about them so neither am I. Both my husband and I are slim so we shouldn't expect our babies to be any different. Everyone has this idea in our heads that if a baby isn't "chunky" they aren't healthy... that's not true at all. I chart my kids growth on this website (http://www.mybirthcare.com/favorites/babygrowth.asp) you should check it out and it'll help you keep track of the weight and also be able to see a graph to go along with it. Hope that this helped :o)

I don't wish to alarm you with this, but for what it's worth, I have a friend who's baby did not gain weight between 2 and 4 months. He was diagnosed at 9 months with a RARE glycogen storage disease (GSD), a genetic metabolic condition where he cannot store glycogen in his liver to use as energy when he's fasting. He never drank more than a few ounces of breastmilk at a time. As it turns out, his body could not process the galactose in it. Once he switched to hypoallergenic formula, he gained weight right away. Other signs included pudgy cheeks, slim limbs, and a distended abdomen.

With regard to feeding cereal, studies have shown feeding cereal too soon can contribute to the development of type 2 diabetes. Seems to me it might fill her belly with less caloric starch, leaving less room for more caloric (and nutritious) breastmilk. If you pump at all for her, perhaps you can fortify the milk from time to time with formula? I'm not a fan of introducing formula simply for weight gain, but if the docs insist...

hi! please don't worry about the failure to thrive thing. that diagnosis pertains to much, much more than slow weight gain. Those babies tend to be at risk from the start and very often there are environmental and social aspects as well. if you don't have a weekly appointment with your ped for weight checks then your baby is fine! keep nursing and don't listen to anybody telling you to add this and that. your milk is fine! enjoy your little one and think of the extra chances she will get to wear all those cute 0-3 months outfits!

how much does she weigh?

I would trust your instinct. If she is meeting all her milestones, happy and smiling a lot, I wouldn't be too worried. If your ped suggested rice cereal and that's it, he's probably not that worried. I would hold off until you feel she is ready, and when you do introduce cereal, try mixing it with breastmilk instead of water for additional calories.

I also have a small babe...10lbs 9oz at her 4 month check-up.

Don't just rely on your Pediatrician for breastfeeding advice. I did that and got bad recommendations which ended our nursing. Contact the La Leche League and visit the website kelly mom. Stick with it, I know personally how frustrating it is when they don't gain weight. My Ped said some moms just make skim milk! I was heart broken and I had never heard of that before. I talked with a couple lactation consultants after my supply had started to diminish because I was told by the Ped to supplement with formula a couple times a day. The consultants couldn't tell me exactly but they thought he wasn't gaining weight because he was getting too much foremilk which isn't as fatty as the hindmilk. The simple suggestion would have been to pump off a little at the beginning of the feeding so he would get more of the fatty hindmilk. If my Ped would have told me this I could've maybe breastfed for longer. I was pissed to say the least and was kicking myself for not getting help elsewhere. Good luck and make sure you get some advice from someone other than the Ped.

My daughter was also slow to gain. At one point she had just gained 1lb in 3 months! Breastfed the entire time and started solids at 6months, but she still didn't gain enough weight get her over the 12-18th percentile.

I was concerned in the beginning, but then felt better about it because she hit all of her milestones beautifully. My doctor wasn't concerned either. Both her dad and I are slim to average build, so there's no need to expect our daughter to be big.

Hope this helps.

~L.
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