Slow weight gain, b'feeding & regular vomiting ... advice needed

[Millie1]

Warning: Rambling message to follow!!

DS2 is 10 mths old. At the end of June, so about 29w, he weighed 20lb 6oz. He started solids at 26w and ate well. Around maybe 6-8 weeks ago he started to vomit regularly ... no specific triggers. Could be whilst latching on for a b/feed, after a feed or during a solids feed. He is pretty strong willed so will shake his head vigorously and push your hand away if he doesn't want any more food. Sometimes if you push it he will take more - maybe 1-2 spoonfuls, maybe a full pudding. However, make the wrong decision about whether or not to push another spoonful in, and you could well end up with his entire feed sitting in his bib!

After a few weeks of this and when he seemed to be in a pattern of vomiting every 3rd day, I took him to our GP who thought his tonsils looked a bit big, although not infected, and put him on Dimotane for a fortnight. This seemed to help - it certainly reduced the frequency of his vomiting but he still continued to vomit.

His intake of solids isn't huge. He'll take it or leave it - breakfasts are touch and go but that's due to how much breastmilk he takes during the night - more on that in a minute. Lunch and dinner he'll eat around 6 icecubes of a main course and puddings are few and far inbetween. Doesn't like yogurt, isn't fussy about fruit and will eat some milky puddings.

Breastfeeds are too many. 10am - a small one before his nap, 2pm - a sizeable one before his nap, 7pm at bedtime and then he starts the night shift and can feed maybe 3 times between going down and morning time. Tried cutting one feed out but gave up after a night when he got so distressed that he vomitted twice. If I could lessen his milk at night I feel he'd increase his solids during the day.

At the moment he has an absolutely dreadful cold and has been vomiting loads over the weekend. I know this is due to chestiness and being congested but took him to the Dr this morning nonetheless. Got more Dimotane and somthing else to try and clear his chest a bit.

On the subject of the frequent being sick, he suggested getting him weighed now and again in a few weeks. If he isn't thriving or is losing, then bring him back and he'd refer him. Me being me, I weighed him at home and he's only gone up to 22lb since the end of June bringing him down from almost the 75th centile to the 50th centile.

I'll get him weighed properly tomorrow but am concerned on several counts. Think if we could cut some night time feeds then he'd eat more during the day but think my HV might encourage ending b/f altogether in order to cut out the feeds given that he vomits so easily if we do cc.

Do you think the lack of weight gain is down to too much milk and he's just a pukey baby which he'll grow out of or is it the vomiting? Surely losing 1 feed every few days couldn't keep his gain so slow?

Gotta run but interested in opinions.

Thanks

Mine gained very little between 6 and 12 months -they became more active and calorie intake form solids took a while to compensate. Also bear in mind that your scales will differ from those he was weighed upon previously and even if you use the same ones tomorrow the callibrations may not be the same as they get moved around, so don't pin all your decisions on that.

Colds often make it harder to eat and he may take in more air as he'll be trying to breathe through his mouth. It sounds like he's been feeling a bit rough and needs to get over whatever is ailing him. tbh if he is unwell he may like the comfort of bfeeding so weaning him now may not be ideal.

Hope he feels better soon.

Thanks Lizs! It's reassuring to know that slow weight gain at this stage isn't unusual - and he is a terribly active little fella so that'll be keeping some rolls of fat off him!! I know I need to get him over the cold etc first and then had thought of maybe keeping a food diary/vomiting diary or something and see if it shows any pattern. Don't actually want to wean him at the moment - nor in the foreseeable future but have had run-ins with HV in past about b/f so wouldn't be surprised if that's what she recommends.

my dd1 went from 90th centile at birth to 9th centile by 10 months. she also vomited back whole feeds. doc referred her to hospital, they ran tests - never found a problem. when she started to walk the vomiting lessoned and then stopped by age of 2/2 and half.
now at 3 and half back up to 50th centile.

worrying at the time so can empathise. take him back to doc if it continues - to ease your own mind at least.

If i were in your shoes I dont think i would give up the bf either (still feeding my one year old and everyone tells me that bf is cause of her wind probs... its not!) What makes you think the bf could be a problem with vomiting? As for weight gain, it does really slow down, get him weighed properly to be sure though. You do need to cut down milk feed to encourgae solids intake in day, but you dont have to do cc for this.

Spod & Janeybops, thanks for responding. I'll get him weighed properly tomorrow and let you know how we get on. It's good to know that he might just be levelling off. Spod, I don't think the b/f has anything to do with the vomiting just have a HV who I feel will use the frequent night-time b/f as an excuse to say I should call it a day now - which is not something I plan on doing!! My problem is finding a way to cut down on night-time feeds without him going ballistic and making himself sick - and a bottle isn't going to do that!! Any suggestions welcome. The reason I mentioned the cc is that we tried water a few weeks back along with cc but it didn't work.

Better go here as he's just waking up now.

Millie - could well be an allergy - dairy (do you mix his solid food with breastmilk or do you use formula or normal cows milk)? There are many things that he could be allergic to so the idea of a food diary is a good one.

Did he vomit regularly before you weaned him? If so then unlikely to be an allergy.

i was wondering if an allergy too. Don't be bullied into giving up bf especially if it could be an allergy, bmilk is best thing. When I wanted to stop night feeds (which I started to do at 7 months) i got dh to see to dd when she woke, that way she couldnt ask for milk. She was cross with this for a week or so.... then things got better. Have you got someone who could go to your son during the night? I think its more difficult for you to deal with him as he wont understand why you are withholding milk. The worst will be over withng a few days, as he gets used to the new rules! Encourage more solids intake during the day at the same time. try offering food in form of snacks, several times a day, rather than only at mealtimes... you can sort out mealtimes later, when night feeding has stopped. you must be exhausted with night feeding! Is he really hungry, or could he be waking for other reasons?

Soapbox & Spod - thanks! He didn't actually vomit (at least not often that I can remember) before starting solids - so maybe allergy? Although HV doesn't seem to think so - she wonders if he's simply one of these children who sticks his tongue back and makes himself sick. That aside, he's only put on 2lb in 20 weeks - eeek! She wasn't overly concerned as he's on the same centile as at 6 mths (he'd gone up a centile at 7-8 mths) and said to try to cut the night feeds thus increasing his daytime appetite and she'll weigh him again after Christmas. Unless the vomiting gets worse or I think he's losing weight in the meantime in which case bring him back. Regardless of that, I'm going to keep a diary of what he eats and when he's sick just to see if there's a pattern anywhere. I'll bring him back next mth anyway cos want to get his weight etc done at 12 mths. Wish we could get his cold cleared up soon.

And it never rains but it pours - we seem to have two of them tonight with diarrhoea and the older one vomiting to boot!

Thanks!

hi millie... dont worry too much about the weight thing... my dd was 21lbs at 6 months and is 12.5 months now and weighs 25lbs-ish. if its the same centile range... no probs i would imagine. Do keep a food/vomit diary, cos if you need to see gp/pead at any point they will ask you to keep one, this way you save some time. As for your hv's advice.... "she wonders if he's simply one of these children who sticks his tongue back and makes himself sick.".... sounds like a cop-out bit of advice to me! How does your ds seem generally?

Hi Millie

I have similar issues with my DS although he is only 7 months, he still waking 2-3 times for feeds between 7pm & 7am, eating what I consider quite little for a biggish very active boy.

He has always vomited loads from about 3 weeks old, so I know it is not an allergy, and it has improved since he's been on solids, but I also have to be careful how much to give as e.g. the other night he had a large tea followed by more milk before bed than usual and the whole lot came up all over my bed, lovely!!!!

Also he rarely has more than one side when BF as he has never been able to manage it, I am guessing he only has about 5 oz and any more the vomiting would be dreadful.

He recently had first teeth & a cold which seemed to cut his appetite alot, so I would wait unitl the cold is completely over & then see if it picks up a bit.#

I too am desp to get him to take more calories during the day, and he still has 5-7 feeds in a 24 hr period, but one thing I have tried is dropping his mid morning feed and giving him a cup of progress milk instead, as he is not that proficient at the cup yet so doesn;t take too much. This seems to have improved his appetite for lunch. I am going to try this with his mid afternoon feed too in a couple of weeks, and just keep on BF morning & evening, plus nights on demand, until hopefully he doesn;t need it any more.

Have never tried CC at night and not intending to at this stage.

My sympathy with you on the lack of sleep, I am a zombie some days.

ps sorry forgot to say DS has also fallen from 90th to 75th centile in 4 weeks, have been advised to weigh again in 4 weeks.

Spod - he acts and looks as fit as a fiddle! He's really alert, lively, his skin colour is good, to quote the hv, his muscle tone is good. So you wouldn't think there was a thing wrong with him!

Interestingly, at lunchtime today he brought up some lunch half way through, so I gave him a few mins break before offering more and he cleared what was left. At dinnertime, he ate a huge dinner and pudding ... chomped on a really thin sliver of apple, gagged and .... whole lot back up. I could've cried - well, I did cry - I just felt so sorry for him. But I'm thinking, that he's clearly not feeling sick when it happens so maybe I'll just offer more instead of calling it a day.

Vicdubya ... the lack of sleep is exhausting, isn't it? I can sympathise with the sick all over the bed too ... DS2 did this the other day 15 mins after I'd put clean bedclothes on. Interesting that cutting out the midmorning feed has helped your little one - at the moment I'm reluctant to do that for fear of pushing more feeding to during the night!

Naturedoc - thanks for the tip - I'm nowhere near London, otherwise I'd get in touch, but you've certainly given me food for thought!

Sorry, haven't read all the replies to this thread, so I may be repeating, but DD2 has reflux, and one of the things they were trying to eliminate before deciding on their diagnosis was whether or not she was bringing up food/milk at the same time as burping because her stomach muscle opened up too much when she burped (I guess this is pretty similar to reflux anyway). The doctor prescribed something called Instant Carobel which can be mixed in with bottle feed, taken by spoon before breastfeed or mixed in with solids, and it weighs it down so it doesn't come up so easily. Maybe worth asking HV if it would help him.

You all sound like you have had a terrible time - has the doc checked for reflux (easy test but they can be a bit reluctant to do it)? If it is reflux it is likley that any food that has stayed down has not been digested properly leading to gas/colic and probably malabsorption which could be the reason why weight is falling. Other thoughts....there may be something in your diet that is getting into the breast milk? Have you considered a food intolerance/allergy test.

If the doctors won't co-operate I would go down the complemenatray medicine route.

Mummytummy - thanks for that advice. I'll ask the HV when I get him weighed next. Might be well worth trying.

Naturedoc - no tests done. He vomited v. little prior to solids so surely that in itself would rule out reflux? Although, he was pretty colicky and hard to settle as a baby. Don't think it's my diet as it's pretty bland and boring at the moment and hasn't changed since his birth ... oh, for a nice meal out!!

3 meals kept down today - yipee! Although, tiny vomit at lunch and at bedtime but both induced by chesty cough ... still, the food came up when he coughed hard so maybe reflux related?

colicky and hard to settle might indicate hidden reflux. As a small baby dd didn't vomit all the time but she was difficult to settle flat, cried afair bit and was diagnosed because she got an ear infection at 8 weeks, caused by the regurgitation in her gullet (creates a great enoviromnet for breeding bacteria apparently). Your ds' tonsillitis could be similar so i'd go back to the doctor again.

We were really careful during weaning - no lumpier or finger foods until almost a year as she just puked when we tried them. At that point she just started to help herself off our plates and she seemed to improve quickly although still throws up readily when she has a cough or on a bumpy journey, even at 3.