My personal experience of a baby who gained not a gram between 4 and 10 months, but drifted down the percentiles from 75th to 3rd, was that I developed a policy of 'making every mouthful count'. She was a reluctant eater, a terrible sleeper and constantly on the move. I disregarded concerns about allergies and went straight for nuts and seeds; for example almond butter on nutrient dense toast. It's amazing how much nutrition you can cram into home-made bread, and then slap onto toast. Linseeds, sunflower seeds, ground and added to porridges, and roasting carrots in olive oil rather than steaming them. There is a dip you can buy here made with beets and cashew nuts. Horrific for stains but sweet and nutritious.

"I have a mom who started showing up last month at my support group just to weigh her 3rd daughter who now has just turned 6 mos. Older girls are 3+ & 6 and were breastfed also. Baby looks quite bright-eyed, but slender small. Mom was not very interested in talking about increasing feedings to get more weight on (I think she was only seeing gains of 2 or so oz/week, again not very willing to say what the gain was). Indicated that daughter wouldn't take more milk. Today she called & daughter had just been in for 6 mos check & is in the 1st %tile on weight charts. Don't know if WHO chart was used. She has dropped %tiles since 2 mos check. Doc said to push solids. Mom called me for suggestions. She has a quantity of frozen breastmilk & I suggested thawing & spooning off the fat that rises to the top and adding it to foods, avocado, & anything calorie dense. I don't know how many breastmilk feedings mom is doing. What would be your suggestions for calorie dense foods for this mom to offer?"

Miranda Buck, RN, (Paeds), IBCLC
PhD Candidate
Mother and Child Health Research 
LaTrobe University
Melbourne

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