Baby Not Gaining Enough Weight

Hi Saimi,

What does the doctor say about her size and her health?

What you have to remember is if the doctor says she is okay, she is okay. Is she happy after feedings? If she is, and the doctor says she is okay . . . it generally then would be okay.

Increasing your breast milk supply is drinking more water and if yuo have a pump, pump the milk between feedings to get it going more.

If your baby ACTS fine and is generally healthy, she is fine. Some babies are just littler than others, and I think the whole percentile thing is an awful way to compare babies to one another and that it doesn't take into account heredity and other factors that may make a baby little, which results in parents stressing unnecessarily about something they can't control. Does she act satisfied after she eats? Is she perky and alert when she's awake? Does she have regular wet and dirty diapers (remember, "regular" poops for a breast fed baby can be every day or every few days, possibly more). Feel free to express your fears to your doctor, but doctors are seldom any help. And in almost all cases, switching to formula makes absolutely no difference at all, so unless you have real issues with your supply (like, she's obviously not satisfied after eatting) I wouldn't switch, because especially with a smaller than average baby you want them to have as many immunities as possible which she can ONLY get from you. Just keep feeding and enjoying your baby, and don't worry so much unless she starts to show other symptoms.

Hi S., I would start her on rice cereal and baby furits and vegetables. How much did she weight at birth? J.

You don't mention what the doctor is saying about her weight. It's not how much she weighs but rather how she's gaining on the curve. If he's not worried about her weight, you don't need to be either. I realize it's difficult because with a bottle, you have something tangible to look at and see exactly what and how much she's getting. Even after I fixed our problem and my daughter was on parr with where she needed to be (this was about 6 weeks old though) I still worried that she wasn't getting enough but she was gaining! I would try to wean her off the bottle more and back onto the breast entirely and I'll touch on that a bit later.

If the doctor said he's also concerned about her weight gain, First and foremost, if you're feeding your baby on a schedule STOP!! Feed her when she's hungry. Babies who are put on schedules to eat as directed by some of the more popular books have actually been diagnosed as failure to thrive so when your daughter is hungry, feed her. Sometimes during growth spurts, teething etc. You may be nursing her every hour but that's okay because it won't last forever and she's doing it because she NEEDS IT!

Then I'd start with the lactation consultants at your local hospital- You take your daughter in BEFORE a regular feeding and they will weigh her before she eats and after. That will give you an accurate idea of how much milk she's getting from you and taking in.
Stop supplementing with the formula unless the lactation consultant recommends it. Unless you're pumping like a mad woman when you do it, this is probably further decreasing your milk supply. The lactation consultant will also examine your daughter's latch and see if maybe you and she just haven't gotten your rhythm yet and show you how to correct it.
My daughter's latch was a little off so she wasn't getting enough milk (a lot of unproductive sucking) so I was told to supplement but I made sure that I pumped when she was having a bottle (twice as long as she would have spent eating) because you need that stimulation to get your milk up. I also drank Mother's Milk tea-not so yummy but you can add honey or sugar to make it more palatable, follow the brewing instructions on the box. I also would drink a dark stout beer every couple of days. (I would get huge when I drank a beer like the next day) I would also taper off the amount I was supplementing so that I could get her back exclusively on the breast.
I didn't have to do this but you can also get the herb fenugreek and take that which is also supposed to increase your milk supply.
DRINK LOTS and LOTS of WATER!!!
Just FYI, decongestants and some medicines can also decrease your milk supply.
Anyhow, I did pretty much all of that (I can't tell you enough how important that visit with the lactation dept was and if they say it costs money at first and you can't afford it, tell them. They can probably work around it)
and before I knew it, not only was my daughter getting plenty of milk but I was leaking like a mad woman too :)

was your pediatrician concerned about her weight? she may just be petite. so unless there are health concerns, i wouldn't worry. keep in mind that the growth charts are based on formula fed american (usually from caucasian background) babies. since you are primarily breastfeeding, she does not fall into that category.

about your milk supply. every time you give your baby a bottle, you're telling you body that you need to make that much less breastmilk. so if you're giving her 2 ounces, you're telling your body to make 2 ounces less.

sometimes latch can be an issue. you probably think that since you've made it this far and she has gained weight that her latch has been good. but a baby can still gain weight with a poor latch if there is enough milk. see if you can get in touch with a specialist that can check for this. if it is a concern, you'll be amazed at how much more efficiently she'll be able to feed with a proper latch and how much more milk you'll make.

it's not recommended by the academy of pediatrics to give anything other than breastmilk or formula to babies under 6 months. remember, filling her tummy up with anything other than breastmilk is telling your body that you don't need to make more. and you want to make sure that she's developmentally ready for cereal or other foods. your pediatrician will help you determine that.

there are many ways to increase your milk supply. here are a few websites that might be helpful.

http://workandpump.com/supply.htm
http://www.kellymom.com/bf/supply/low-supply.html
http://www.kellymom.com/bf/supply/index.html
http://www.askdrsears.com/html/2/T022800.asp

good luck with everything.

S.,

I myself had an itty bitty baby (5 lbs 8 oz at birth) she was under 11 pounds by 4 months and now at 8 she is only about 45 lbs! She is just small! She has always eaten well and is super athletic! The first two Mothers are right...as long as she is hitting the mile stones for her age and seems to be satisfied after feedings the SHE IS JUST FINE! :0) I was the same way you are I have to admit. I didn't think I was making enough milk simply because she wasn’t a "chubby little baby" like the other babies I saw. So I drank TONS of water ate veggies, lean meats, and fruits ONLY and pumped after every feeding. I ended up with enough milk to feed quadruplets! IT WAS PAINFUL! LOL! The pumping was beneficial because I was able to freeze my milk which made going back to work much easier. It also helped, when I forced too wean her at 6 months. It is so true that stress is a big cause of milk deficiency! Your body is going through so much, stress just adds to it...try and relax, enjoy the time you get to spend with your little ones...everything will be just fine.

Peace~Love~Light
V.

The best methods for increasing your milk supply are:
1) Drink lots and lots of water
2) Get rest and try to relax before feeding (stress can prevent let-down)
3) Increase the number of her feedings on you or pump extra milk (more demand = more supply) - just make sure you drink extra water to keep up.
4) I'm not sure why this works, but someone recommended to me that I eat honey. Maybe it's because I usually put it in decaf tea and it helped me relax but it really seemed to help with the let-down.
5) Increase your own intake of healthy foods, especially protein and iron rich foods (meat, spinach, leafy vegetables) - I think you need about 500 more calories while nursing than you did when you were pregnant.

How much did your little girl weigh when she was born? Was she born early? Is she gaining enough weight proportionately? My son weighed 8 lbs 1 oz. when he was born and was 14 lbs at his 4 month check-up. He was considered small. He was always small until after a year, when all of a sudden he went through a couple of growth spurts and ate a lot. Now he is starting to get up into the average percentile at 16 months / 24 lbs. So, as long as she is getting enough nutrition or there isn't an underlying health problem, do not worry too much about how much weight she gains. She'll probably eventually go through some growth spurts and catch up to her predestined weight/height.

One other thing, even though I was nursing, my pediatrician recommended I start my son on rice cereal around 4 months instead of the now recommended 6 months because 1) he acted interested in food 2) she thought he probably needed more iron intake and 3) his stools were always really loose and watery. If your daughter appears interested in food, it probably wouldn't hurt to try a little rice cereal once a day with pumped breast milk or water.

Hope this helps!

Quick question S., how big was your daughter when she was born??? That makes a big difference when asking a question on weight gain. My daughter was born at only 5lb 7oz (not pre-term, just a petite little girl), but she was 12 lbs at 4 months. Her doctor did not seem concerned and neither was I, since she doubled her birth weight in 4 months. So I guess the big question is has she doubled her birth weight???