>Looking for thoughts on slow infant weight gain, permission to post:
>
>Mother has successfully bf 2 siblings. Oldest sibling suffered from 
>severe reflux affecting wt gain and hypothyroidism. Mother is 
>currently tandem nursing infant and toddler.
>
>Infant is 7 months old and has consistently dropped weight 
>percentiles since birth. Today's wt check reveals an 8 oz wt gain 
>over the past 2 months. Baby has gone from the 3rd percentile (2 
>months ago) to off the charts.


I agree this deserves investigation to check nothing is going on that 
would mean a restriction of intake - simplest and most obvious would 
be 'has the mother introduced solid food which is replacing milk?' 
Most babies at 7 months are eating other things .

>Baby's output is great, pre and post weights indicate transfer of 5 
>oz on day 1, 3 oz on day 2 of assessment. Mom is nursing on demand, 
>day and night. No artificial nipples. Mom reports fussy infant after 
>some nursings, but not all. Baby is responsive and active during 
>both days of assessment.


All that sounds 100 per cent normal.

>Infant is being treated for reflux. Rarely vomits.


Why is he being treated for reflux?

>  At 4 months of age had frenulum clipped. At 5 months of age, head 
>circumference had risen 20 percentage points while wt had decreased. 
>Extra fluid felt by dr at fontanel. Hydrocephalus was suspected by 
>pedi and CT was performed. CT came back normal.
>
>I see a happy infant who is consuming a sufficient amt of milk and 
>losing weight.


But he's not actually losing it, though, is he? He is falling on the charts.


>Thoughts on further testing recs...I'm thinking metabolic 
>disorders/autoimmune issues...? PKUs were normal at birth.


This baby has been investigated and treated a lot  (at least by UK 
standards!) - reflux, frenulum, head measuring and CT performed - and 
he is still,  apparently, fine,  to all experienced observation.

As I say, my first thought would be 'what's he eating/drinking as 
well as breastmilk?'  It could be he's having too much, or perhaps 
that the quality of the foods he is eating could be more calorie 
dense, *without* replacing the breastmilk.  The mother might have 
read that pureed fruit and veg is a good first food, and of course 
they are fine, but they're low in calories and should not replace 
milk...and for this baby, other first foods might be more suitable.

Heather Welford Neil
NCT bfc, tutor, UK

-- 
http://www.heatherwelford.co.uk

http://heatherwelford.posterous.com

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