Mandi,
This sounds like a very frustrating case for all concerned. I hope someone
can figure out what is going on. The weight gain was very very good for
first 9 wks, looks like 350-500gms each week (12 - 16 oz per week for the
metrically challenged!).
At 5 wks started to refuse feeds. This made me think of oversupply or
overactive letdown or both. Then baby seemed to have plateau-ed out and
didn't gain much weeks 9-12, but heck he was already ahead of schedule! Is
he now 21wks old? or is he 21 wks plus 12 wks in which the 12 wks he only
gained 580 gms? I can't tell from reading the post. If he is 21 wks then it
seems he has gained about 7 lbs in 5 mos and is now about 17 lbs. His
pattern has not been very steady but he is gaining.

Anyway the unsettledness is what is so worrisome. Here are some things that
might need to be investigated: 1. reflux or some other swallowing issue.
Does the baby have any respiratory symptoms or posturing? A swallow study
could show something. 2. Low supply because the supply has down-regulated
too much due to baby's feeding behaviors. Also has the mom started any meds
or birth control meds? 3. Sometimes a chiropractor or craniosacral
practitioner can help w/ therapy. 4. Has any before/after weights been done
to evaluate milk intake? 5. Has mother expressed to see what her supply is
like? 6. Has the baby been ill at all during his life, and if so with what
signs and symptoms? 7. Is the baby on any foods now (this could explain the
new things in his diaper)?

Hope some of this is helpful.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA

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