13 weeks old and not gaining enough weight at all - looking for advice please

[notveryinventive]

Hi

DD2 isnt gaining as much weight as she should and I dont know what to do.

She was in the 50th percentile at birth then dropped to 25th. HV wasnt that bothered as she is really long 91st percentile. Anyway now her weight is in the 9th percentile.

She is bottle fed, but when she doesnt want it, she doesnt want it and I personally dont think she's getting near enough as she should anyway and those bottles that she does have a fair bit of she vomits quite a bit (or so it seems anyway) back up. HV suggested getting hungry baby formula. I thought this was for babies who wanted more, whereas my DD2 wants less.

I know shes far too young to wean (isnt she?) and dont know what else to do. Any ideas?

HV is coming back in a month to check her weight so she cant be too bothered otherwise she would have come back sooner or refered her to hospital or something wouldnt she?

She's DC3 so youd think Id find this one easier having been there before

You could be describing my dd! She is 14 weeks and a fussy feeder, she pushes the bottle out of her mouth and refuses to take more than an ounce or two at times. She also has reflux and can bring up huge quantities of milk.
However in the last 2 weeks she has improved a lot - what seems to have worked is changing to comfort milk which is easier to digest, and moving to size 2 bottle teats. All babies are different but it could be worth a try for your dd.
I'm sure your health visitor is wrong by the way - hungry milk takes longer to digest to help babies feel full for longer - so would only make things worse for you.

She is on size 3 teats now as size 2 seemed so slow. Did you mean move down to size 2 or was your DD on size 1? She did have comfort milk as she wasnt pooing enough and was uncomfortable, but we moved her back to normal stage 1 milk. Wonder if it was that.

Yes Im a bit at HV's suggestion as DD2 is not wanting any more. Thats what I thought hungry milk was for, those babies that just more more and more which is so not my DD2.

Oh she was on size 1 teats so we moved her up to stage 2.
We also tried swapping her back to normal milk - she went straight back to refusing feeds so we will stick to the comfort milk from now on.
We have tried so many things - it's really difficult to figure out what works!

No experience with bottle feeding, I'm afraid, but my DS went from the 75th to the 4th... eep, then went up to the 90th. Don't know what he is now because I've stopped tracing it... Anyway, my recommendation would be, if the baby is fine between feeds, happy and developing, then the chart is wrong, not the baby's rate of gain.

OP can't really give any advice I also had a baby who dropped down centiles but we were bfing so different issues. Why not re-post this message in the breast/bottle feeding topic though as I think you may get some more advice there. If it looks like reflux there is also a reflux support thread which may help you too. Good luck it is pretty horrible when they don't gain isn't it?!

I honestly think that if there were any concerns about her, the hv wouldn't be leaving it for a month.

Look at her. Does she look well? Is she active and reasonably happy? Is she peeing and pooing? Is she responsive and smily? If the answer to all if these questions is yes, then try and relax (easier sqid than done!) you're obviously doing something right! If no- then maybe take her to the doctor and see what she says?

If you take her to the GP about the positing, he'll prescribe baby gaviscon to keep it down. It's just a tiny sachet of powder you add to the bottle. I got it for DS and it helped him.
I was concerned about his weight gain too, but as someone said, it was only because of the charts. If it hadn't been for that I'd have been none the wiser, he had plenty wet and dirty nappies and still smiley. I wouldn't worry too much x

Thanks ladies. I did post about this on facebook too and hade some really good advice, even though some was to wean her , I dont think so, not at 13 weeks .

The thing about her nappies made me relax as everything is normal there. Also with her development being as it should be Ive stopped worrying now. She is gaining, just not as fast as she should be.

I dont like the idea of hungry baby milk though as surely thats for babies who are wanting feeding constantly and DD2 is the opposite. Anyway, I feel a bit better now knowing that she's obviously not having any serious problems. Will see how she gets on in a few weeks when the HV comes back.

Was she a big baby? My ds was enormous at birth, and gained weight very slowly although perfectly healthy and devloping well. I discovered later that there is something called "catch down" growth where a baby that starts off very big naturally adjusts to a more "normal" size as they grow.

My DD always struggled with large quantities of milk, and had lost a lot of weight early on and started off being v slow to gain. By 13 weeks she was doing fine, but I know how you feel with a baby who just doesn't seem to want it or be abe to tolerate it.

What I did was persevere with keeping offering lots of small feeds. I don't mean making her have more than she wanted, but just little and often for a bit, until she had got comfortable with bigger quantities. She seemed to struggle with larger quantities at one go, but then was better with little and often until she got a bit bigger.

Might be no use at all, but it might help.

DD also had reflux, which we only discovered at about 8-9 weeks, but that explained a lot of her feeding fussiness and once we fixed that, everything else clicked into place.

Obviously 13 weeks is too young to wean, but I ended up starting DD at about 20 weeks on advice of paediatrician, and it really helped her, as a bit of solid helped keep the milk down. I didn't give much, but she was suddenly like a different baby, seemed much more comfortable. This was related to the reflux tho, so if you rule that out, it probably won't be relevant.

D

My HV said that if there was plenty comng out (wet nappies and one dirty nappy a day/every other day) then there was enough going in. If you suspect reflux there are 2 types (i) acid reflux which you will know about as they often SCREAM through feeds and (ii) the type my DD has where basically the valve at the top of the stomach doesn't do it's job properly and so she vomits (Little Britain style) at the slightest thing, it was like a milk fountain sometimes.

So - what next? Worth seeing your GP rather than HV to discuss your concerns. Take the red book with you to show the weight chart to evidence your concerns, and make notes before the appointment so you can stay factual/focussed and he/she will be more inclined to take you seriously...

Keep baby as upright as possible through feeds and for at least the next hour afterwards (get gravity on your side to keep that feed down!). Worth winding several times through the feed rather than just at the end too imho.

Domperidone has been AMAZING for us, it works by speeding up the way the stomach processes things apparently. We've gone from a puke every feed to a puke once a month.

Gaviscon/infant Zantac/Ranitidine can be prescribed for acid reflux (these are different drugs so if one doesn't work might be worth exploring the others).

Good luck :)

"the valve at the top of the stomach doesn't do it's job properly and so she vomits "

When my son had those symptoms age 3 weeks he had to have it corrected surgically. It was pyloric stenosis, not reflux causing him to vomit lavishly after every feed and he was also losing weight alarmingly. My HV at the time said really stupid things like 'all babies throw up' and 'it's probably just wind'.... so I bypassed the silly woman and went to the GP. He recognised there was a serious problem and that night DS was in hospital.

So OP, if you're genuinely worried, don't try to diagnose your baby on Facebook or MN..... take your concerns to a doctor.

She does sick, but its not projectile. Was going to make an appointment with the DR, but last night I weighed her on our own scales and she was ok.

I am going to keep an eye on it by taking her to a baby group next week (would have liked to this week too, but with it being the end of Dec they are not on) to get her weighed properly and to speak to a different HV.

She has gained some weight, but I have come to the conclusion that if she wasnt weighed then I wouldnt have any concerns at all. Im actually wondering if the HV weighed her right as she was back up. Everything else she is fine at. She has good head control, has started 'talking' to us, sleeps well and is ok in herself, its just her weight isnt building as much as it should.

I will keep an eye on her. I know I shouldnt look to MN or facebook for answers, just wanted advice really if it was worth going to the DR or to do as the HV says and get some hungry baby formula or just to carry on with what I was doing and see what happens in the next couple of weeks or so.

As seeker says, sometimes babies can be born on a higher centile than the one they end up settling on. So if she was born on the 50th but then went down to the 25th which she's been fairly static on and then gone down to the 9th, disregarding the birthweight centile she's only dropped one from the 25th to 9th, which is well within the realms of normal and nothing to worry about at all.

If you had fluids during birth or baby was late these things can both contribute to a higher birth weight than perhaps they would have had.

TBH the advice on mumsnet tends to be closer to current guidelines and more consistent than the advice that people seem to receive from GPs and health visitors! (Not so sure about facebook, all ideas and experience are usually helpful though :)) Of course you should always seek medical opinion if you are concerned, just don't be afraid to seek a second opinion if one HCP's advice doesn't sit quite right with you.

Thanks Bertie

Infact the advice you can get on a website can work because other people may have been there before (the facebook was a parenting group with over 500 people) and my give you ideas. I would never ask for medical advice on the internet and actually carry out the advice without taking a longer harder look at it.

Im keeping an eye on it, but Im not overly worried anymore. Yes its something to make sure doesnt get worse, but at the same time I dont have any concerns to take her to see a GP.

At the start of this thread you were worried that your baby wasn't thriving, wasn't eating and was throwing up too much. I can't believe you've gone from that to being totally happy now that everything is A-OK. It's your call but I think you're now rationalising away a genuine concern just because you don't want to be any trouble....

Cogito I started this thread a week ago, Ive had time to think and look into it a bit more since then so have decided that Im looking into it a bit too much (which is something I do a little too much and I shouldn't) so no Im not as worried now as some time has passed.