I'm not sure what the issue here is IMHO. Baby had doubled birth wt at 4
mos and 10-12 oz in 10 hr is adequate intake. Breastfed babies tend to slow
weight gain at about 4 months (compared to formula feed babies) and it is
important that baby is being tracked on the WHO/CDC charts not the old CDC
charts. My question would be what has the length growth been during this
time of "no weight gain" and what is the proportionality percentile? Babies
do not always gain weight and length at the same time, but if they are
remaining proportional that is the biggest indicator we use at our WIC
clinic that weight gain is indeed on track. Too many times I have moms
coming in saying the Doctor is concerned about weight gains. And when I ask
about length and proportionality. They either tell me that the baby's
length wasn't taken or that it was taken once when the slow weight gain was
first seen and never again (even if babies are not growing length quickly
it is always good to keep checking for accuracy as a small inaccuracy in
length can make a big difference in the weight-to-length proportion). And
they usually have no idea about the weight-to-length percentile. I think my
recommendation would be to have mom skim off the fatty layer of her pumped
milk and give that for the bottle feedings, as we know the risks of
powdered formula and it is too early to introduce solids based on current
recommendation.

Sally W. Greene, MS, CLC, IBCLC

> ----------------------------------------------------------------------
>
> Date:    Tue, 10 Sep 2013 23:14:22 -0400
> From:    Lisa Bell <[log in to unmask]>
> Subject: low weight gain
>
> I have a mother who's baby was 5lbs 7oz at birth(fullterm), 10-8 at
> 3months, 11-2 at 4 months. Pediatrician gave her recipe for mixing
> breastmilk with powdered formula. She has not done this yet but instead has
> been pumping off 3oz and setting aside then pumping additional 3oz and
> sending that milk to child care. Baby is now 4  months plus 20 days, has
> gained 7 oz and no longer gaining(past week). Mother is having difficulty
> getting infant to nurse for very long and child care provider is having
> difficulty getting infant to take more than 12 oz in the 10 hour period he
> is with her. Any ideas? Start solids? Give the powdered formula in the
> breastmilk while at childcare?
>
> Thanks,
> Lisa Bell RN, IBCLC
>
>

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