Dear valued colleagues, My last post is exactly why I love Lactnet and value it so much. Thanks for your suggestions. As for the weight and growth, I really did not feel she should be concerned, everything that I found only confirmed a normal growth pattern. I wanted to make sure I was not missing anything (obviously I was missing the allergy thing). I will let you all know how it works out. The dad was a small baby (according to relatives) and mom and dad are both small-medium height and build. The baby had gained 16-20 ounces a month from the first month until the 5th month. It was not until the 5th month that the baby's gain slowed to 11 ounces. He doubled his birth weight in 6 months.( his discharge weight from the hospital at 48 hours was 6lbs) I had not thought about the allergy aspect. This baby definitely has a history of food allergies, the reaction baby had last week was more of an obvious reaction, hives, rash and vomiting. I did not think about the possibility of allergies causing slow gain but that makes total sense to me, and if the baby is not able to metabolize all of the foods that he is taking in then it will not help to add calories in that area. When I got really technical about the calorie intake, (which is impossible but since the pediatrician was so adamant we gave it a shot... and guestamated) If the baby takes in an average of 3-4 ounces each feeding, and nurses on average 7 times during the day/evening. Then calories from breastmilk (if all calories were the same, then the baby would be taking in approximately 21-28 ounces/ 420-560 calories. If then the baby nurses throughout the night, the baby would need to take in between 4.5-11 ounces. The feeding that I observed the baby took in about 3 ounces and this was an "in between" feeding. The mom is what I call a "natural breastfeeder" she nurses the infant for feedings, when he fusses, if he is tired, whenever he wants to nurse for whatever reason, without a lot of thought to it (as it should be) She only began counting his feedings when the pediatrician told her that her baby was not thriving well enough on breastmilk. She does not count all the extra times that he goes to the breast as a feeding. Breast compression is something that mom does as he nurses. And he would eat almost anything that is offered to him however often, he does not eat non stop, he does limit himself, when he is full he just turns away signifying that he is done. Mom has not forced any feedings on him, if he does not want it, she does not give it. Now that I have heard from some of you, I am going to suggest that she try just nursing alone for a few days, although baby does like to eat, so is there any suggestion as to some foods that are not as likely to be allergens? Or should she just decrease his table food intake? On Friday when I saw her I had suggested that she start meats, instead of all the veggies and fruits, because the meats are higher in calories and protein, but then I read that there are studies that show that an increase in protein intake did not increase the weight gain overall. That also makes sense to me if the baby is not able to metabolize the protein in the meats and utilize them as well as in the breastmilk. And even with the increase in calories over the weekend, he did not gain anything. By the way... I watched this baby spit up, it is the oddest thing, he does not even burp or make a sound, it just comes rolling out of his mouth, even when he was nursing once. It was almost like he overflowed, did not stop him from going right back to nursing. I thought of reflux but this baby never acts uncomfortable. He does not even cry out, just giggles and smiles as it all rolls out. And just to add to all of our frustration with unsupportive providers, when mom asked the pediatrician, would her baby could be so happy, never sick and so active and advancing if he were starving, the pediatrician responded "if he was never use to getting enough he would not know what it's like to be really full" What kind of response is that? Mom is frustrated by what she calls "the lack of common sense" of the doctor. Pam Price IBCLC, CBE Lactation Services Coordinator Women's Health Trident Health System 9330 Medical Plaza Drive Charleston, S.C. 29406 (843) 824-5013 office (843) 728-9640 pager > This email and any files transmitted with it may contain PRIVILEGED or > CONFIDENTIAL information and may be read or used only by the intended > recipient. 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