Six Month Old in 1St Percentile

I agree with the others. Get a second opinion from a specialist. Also, giving her cereal is a bad idea at this point. If she hasn't lost the gag reflex she could actually choke on the cereal. Plus, the others are right it has virtually no calories. It isn't worth the risks.

Just a suggestion. I know you have benefits through the Navy but if all they offer you is a general practitioner then I would apply for Healthy Families and get a pediatrician. You can download the application online or apply over the phone. I have two kids and I only pay $18.00 a month. I have a great doctor treating my kids! It sounds like she needs help but I would definetly not give her cereal in her bottle. The last thing she needs is a food allergy on top of everything else. I have a lady in Hayward who is great with babies and eating. Her name is Sylvia Boyd. She is an amazing lactation consultant and lamaze coach. Her e-mail is ____@____.com
Contact her!

Good Luck,
N.

My daughter was the same way. She is now three years old and only weighs in at 26 pounds. She was on soy milk when she was a baby because she couldn't take the regular formula. They told me the same thing about putting rice cereal in her bottle but at first when I first started I put only like a teaspoon in it to see how she did and then I increased it if I felt she did good. Just try her on whatever you feel will help her. Try her on the baby food she might surprise you and be ready for it.

my daughter is in the 20% for height and weight,she is 8 months and 16 lbs which isn't anything like you are going though but we have small babies in my family (my grandfather was only 2.0 lbs when he was born. They gave him goats milk which is still available today at the health food stores and great on the stomach it easy for babies to digest, they say that its the closest thing the mothers milk for your little ones.
Hope this helps a little, god bless.

N.,

I don't have experience with a baby this small, but I am a military wife. I don't know if things are done differently through the Navy, but I have the option of having my infant seen by a pediatrician instead of the primary care through family practice. And as for rice cereal in the bottle, my little one is about 11 weeks old, and we've already put her on this option. Good luck and best wishes.

Children's Health Council in Palo Alto www.chconline.org, ###-###-####, ask for the Access Dept., Feeding Disorder evaluation and help, and ask for financial aid application.

Maybe Stanford, UCSF, Palo Alto Medical Foundation(ask these places for "Hardship Applications")...online google or web md search for feeding disorders.

If there is any way possible, take her to Children's Hospital in Oakland. She needs to be seen by a skilled pediatrician and they are absolutely the best. It sounds like she's had a rough time of it already and she needs to be seen by people who know EVERYTHING there is to know about babies.

My dear, I don't know if there is something medically wrong, or if your daughter is just naturally small. To find out, you must do whatever it takes to get your daughter to a pediatric gastroenterologist. Get a referral from your military family practitioner. Insist on it. Your child and you both need specialized help right now before any existing problems get worse. Do not take no for an answer. If the military won't give you this kind of medical care, contact the UCSF Pediatric Gastroenterology group and start begging. Their phone number is ###-###-####. If they won't help you, try Stanford.
Best of Luck!

I also have a baby that is small. At 6 months she was 12 pounds 3 ounces. We have been going in for monthy weight checks and she is staying at the bottom of the chart, but she is growing. Ask you family practioner for a referral to a local pediatrician or go onto Tricare's webpage and search for a doctor. We too are military and Tricare always entitles you to a second opinion, just make sure you get the referral or change her primary doctor to the pediatrician if you are Tricare Prime before you take her. We are in the north bay of the San Francisco Bay Area if you want a reccomendation for that area. There are numwerous things that can causea baby to be small but first don't overlook genetics, if you and your husband are both small then perhaps this is normal. Often if it isn't genetics then you need to look at the clues and address the root cause (reflux, food allergies, or disease). Our daughter's main issue is starting out small and then having had many viral issues, however we are checking inot Thyroid, silent reflux and celiac to be safe.

well my son stared eating solids when he stared to look at everything i test...is your child interested in trying any of your food? I also put rice cereal in his bottle when he really didnt want to eat a whole lot that day just to make sure his tummy was full. But I will tell you my friend in sacramento has a daugther and when she was 18 months she was still in her babhy car seat and my son out weighed her at 6 months. my pediatrician is excellent and located in pleasanton but not sure exactly where yu are located. his name is dr lionel herrera and my son has had the best care. their office number is ###-###-####

J.

Hi
I have a friend who had a similiar issue. IF I remember correctly, she had to add things like olive oil and butter to her child's bottle to give her extra calories.
Good luck
N

Tell the dr you are concerned and he/she can reassure you that she is ok. You can still try the cereal on a spoon. Just slip it in there. Thanks to your husband for serving our country and the sacrifices your family makes.

I think your child has a medical condition or several of them that need to be addressed ASAP. She definitely has a condition called failure to thrive and you should be asking her pediatrician to work her up for that. It also sounds like she may have a neurological problem or developmental problem that needs to be addressed by a specialist (either neurologist or pediatric developmental specialist). If your current doctor doesn't give you any answers seek a second opinion.

Good luck

My advice would be to try and feed the cereal off the spoon. She will learn pretty quick how to use a spoon and learn the refluxes that go with eating. My 4 kids were all started at 12 weeks with cereal and by 6 months were eating it all. They are healthy, happy and my 9 year old twins are in level 7 comp. gymnastics. So do what you feel is best for you. I even added a small spoonful of applesauce to the cereal and that really helped my son gain extra pounds. Now he is 15months and weighs 25lbs.
good luck, and need anymore help with cereal and spoon feeding let me know.

Even the military has great specialists when you get a referral--and you need one. Maybe your daughter is just a small child and always will be, but if she has a metabolic condition or a digestive problem (such as allergies, celiac disease, or other inability to properly break down foods) you need to know about it sooner, rather than later. They may put her on a diet that restricts a lot of stuff that normal kids could eat until she is old enough for definitive testing, but that is for her protection--as an example, celiac disease cannot be definitively tested for until about two years of age, but they still should be on the diet for life. Please, call the doctor who saw her last as soon as possible about getting a referral to a pediatrician who specializes in growth problems. It may take a while for the military system to hook you up with one, but they WILL do it and at least that way you will know whether this is a problem or not. And remember that it may not be one at all--but if it is, you want to act sooner rather than later. Good luck!

Hi N.,
My son had a very difficult time gaining weight as an infant (in our case it was due to his heart defect). But I do have some experience with changing things around to get extra calories. Our doctors gave us a recipe to make higher calorie formula. Regular formula or breast milk is 20 calories an ounce, and they told us how to mix it so it was 24 or 27 calories an ounce. Another thing they had us do was add a small amount of oil into his bottles because oil is high in calories. You should definitely ask your doctor before you try these things though. With him we also ended up needing to have a g-tube placed, which is a tube that goes directly into the stomach. At night we connected the tube to a feeding pump and he was fed high calorie formula all night long. I think you should try to find a pediatrician, or maybe a pediatric GI specialist to help you decide what to do next. Good luck!

All those issues that your daughter has scream food allergies to me. My daughter also has several food allergies so I highly recommend that you wait to start solids until closer to 9 months to one year of age. If she needs that special formula then she is not ready to break down the enzymes in solid foods!! The rule of thumb with weight and babies is that as long as they are not losing weight, they are perfectly fine!! My daughter was 15 pounds at 6 months... and was 18 pounds at one year of age. She is now 5 1/2 and weighs 35 pounds. She's a peanut, but well nourished and very healthy!! I would recommend adding probiotics into your daughter's diet, especially once you do begin solids. They make them for babies (FloraBaby)and sell them at places like Whole Foods. Like I said, I urge you to hold off on solids since she has constipation, reflux etc. And wait even longer 18 months to 2 years to introduce high allergy foods. Also consider taking her to a pediatric chiropractor. Many babies digestive systems and colic can be helped wth a simple and gentle adjustment. If you hold her upside down by her hips and her back arches to one side or the other then she is not properly aligned. Her back should arch straight back. Again... as long as she is not losing weight, I wouldn't worry. Good luck mama!!

The formula has more calories than rice cereal will have. If she is otherwise healthy, I wouldn't worry much. If you want a second opinion from a pediatrician, you can call the local maternity ward and they can give you a list of local peds. They can't give you specific recommendations, but if you're really sweet sometimes you can find out who the nurses would personally use (and avoid any jackholes). You might also see if there is a local mom's group- they could also reccommend someone. Good luck.

My daughter, who is now 7 1/2 had enormous difficulty gaining weight and we finally convinced Children's here in Oakland to do a sleepstudy and found that she had Streiters (a soft wind pipe) It was really difficult to do the sleep study on a 10 week old, they found that shse was burning 50% more caleries just by breathing! The end result was to have her sleep on her stomach. Your baby is older, so you might try the stomach sleeping to see if it helps calm her. Also, stomach sleeping reduces colic!

My daughter was also in the first percentile. She weighted 15 pounds at one year. She now 11 years old and still tiny. Medically there is nothing wrong with her, she'e one of the healthy children around. When they make up the charts, there are always ones at the high end and the low end. Our pediatrician wasn't concerned, as she was hitting all her milestones as she was suppose to. She walked at 10 months and has always been very athletic. She can run circles around some of the other kids who are much taller.

Hope this helps.

Both of my kids had to be on Alimentum, and one was in the 95th percentile and the other was in the 75th, so I don't think it has to do with the formula. It sounds like she just got off to a rough start, but she will probably start catching up when she starts solids regularly. Good Luck

I'm not familiar with military medicine but your child should see a specialist. GI perhaps? There is medication that can help with reflux and there is alot of info out there about how to manage it in additon to medication. Untreated reflux can slow weight gain. Kellymom.com should have some reflux info. You want to keep your kid upright after feeding and let them sleep on a slight incline with their head raised. Some people use the car seat but these generally cause them to slough forward and compress their stomach with can agravate reflux. The inability to digest certain protein really makes me think a specialist is warranted.

N.,

You need to get her to a Pediatrician, Try Palo Alto Medical Foundation, they have multiple locations, Dublin ,Fremont, Palo Alto, Los Altos, Redwood City.

Next try giving her the rice ceral, my son had severe reflux and my pediatrician advised me to start him on rice ceral to thicken his formula up, this helps with the reflux. And yes you can add it to the bottle, try 1-2 teaspoons per 4-6 oz.

Its not so important that she is in the 1% look at the entire growth chart. She needs to make a curve on the chart, if on the curve she has started to drop down then she needs help.

Hi N.,
Your little angel sounds like she is having a tough time. I would like to suggest you call your local Regional Center and ask for an assessment for your daughter. They can send out a team to see what areas, besides medical you might need to help your daughter. My son was a premie, not gaining weight, would not eat(kept pushing out his food with his tounge) "failure to thrive", acid reflux, you name it. We were connected with our local regional center when he was 6 months, they are a non-profit agency to give services for people with developmental disabilities. They have a great program for children 0-3years old to prevent a developmental disability, they can connect you with services that could help your daughter get caught up on her weight and nutrition. Here is the link to find where your local regional center is and the number: http://www.dds.ca.gov/rc/rclist.cfm
I am not sure if you have been given this information before, just want to help. Please e-mail me if you would like more information or just to chat: ____@____.com were very helpful in connecting us with specialists for our sons care. He is now 9 years old, still has medical needs, but he is handsome, happy and a little lovey-bug.
S. L.

Dear N.,
I know how nervous this may be making you. On top of having three kids 3 years of age and under. You have your hands full!
You don't mention if your baby was born prematurely, how early, or what her birth weight was.
My daughter weighed 5 pounds, full term. She only weighed 14 pounds at a year old. I was a nervous wreck about it. And they tested her for everything. She did have some constipation and reflux problems, but nothing that normal babies don't experience. She was checked constantly and tested by her pediatrician and although small, there were no concerns. In fact, she was mentally very bright and walking at 7 months. It was the weirdest thing to see....a 10 pound baby walking. She didn't crawl, she dragged herself, and she couldn't sit up by herself until she was almost a year old, but she would find something to pull herself up on and walk. Size isn't always an indicator.
She is perfectly normal, beautiful, and healthy today at 22 years old. I am 5'8", her father is 6'2". She is just a smidge over 5 feet and built exactly like my mother. All babies develop differently.
The main thing is to get her to a pediatrician. I am certain that in your area, there are clinics that charge on a sliding scale and they can evaluate her and also be very understanding of your fears and concerns and help you through this. They may even have a specialist on site. One of the best pediatricians in my area practices out of a "clinic", so don't let that word fool you. It's worth it to have another view point and get the added support.
My daughter screamed every time I bathed her until I figured out she didn't like warm water. She wanted it as warm as I would like it. That problem solved. She screamed every night at dinner time. She could smell me cooking and she was hungry. I held her and gave her tastes of food when we ate. Just little bits at a time. Every time. They have to get used to the different tastes and textures and 99% of the time will stick their tongues back out until they learn it's supposed to go down. You just have to keep trying. You will find what works specifically for her.
Best of luck to you!

N.,
We have an almost 13-month old who is also smaller than the 1st percentile. She has never been sick and breastfeeds and eats just about all types of solid food - she just never eats a lot. Everyone we talked to said not to worry that she's so small. The first percentile just means that 99% of other babies are bigger than she is - it doesn't necessarily mean she's in a danger zone. By the time she's a few years old, she'll probably have caught up with other kids in her age range. When your daughter gets to solid food age, just consider feeding her higher calorie but healthy things, like avocados, almond butter, or bananas. I know it's hard to relax when your child is not in the norm, but just consider that if you start making a huge deal about getting her to eat more food, it may carry over to later in life, which is definitely something you don't want!

Good luck!

Hello,
My 6 month old was born with an underdeveloped jaw, cleft in soft palate and reflux. He was in the NICU for 2 months. When we got him home he was ranked at the 5th percentile for weight. My issue was different because he has had feeding issues because of the cleft and jaw problems and so he has something called an NG tube (a tube that goes through the nose to his stomach) through which we feed him the rest of his milk once he can not take anymore from the bottle.

I went to a nutritionist to get his weight up and she calculated for me the recipe on how to fortify my breast milk or strengthen my formula that I give my son. Also, due to food alleriges in the family and the reflux, we use Nutramigen as the formula. ANyway, as you may know pure breast milk is 20 calories per ounce. Formula, if mixed as per can instructions is also 20 calories. The nutritionist calculated recipes so that I would put formula in my breast milk to increase the calorie intake from 20 to 27 calories per ounce. The same was calculated for formula. After 4 weeks, my son jumped in weight and is now in the 40th percentile for weight.

You should find a nutritionist or GI specialist and definitely a pediatrician who understands these issues. As for my son's reflux, we have him on reglan and prilosec and slowly weaning him off the reglan. You should definitely speak to someone about your child's reflux as some severe cases do require surgery.

I went to a private nutritionist in Menlo Park for which I paid - out of my own pocket - $110 for a session. Worht every penny. She is on University in Menlo Park and her name is Gretchen Flannigan. She can help calculate caloric intake needs for you. As for what formula to be on, etc consult a pediatric GI. I go to Lucile Packard for this.

our youngest was an alimentum for like 4-6 months because of stomach issues initially. Once his body got used to things and his tummy did better he gained weight okay. He's 6 years old now and average for height and weight. He's been average since around a year old when his body caught up with everything his tummy went through. Alimentum actually is the easiest one on their tummies so it's easier for them to keep it down and digest it, so she has a better chance of gaining weight on something she can tolerate than on something that could possibly make her sick. Now, once she is better and tolerates things okay, I'd ask the doctor about switching, mainly because that one is twice as expensive as others. We went to Soy after alimentum just because it's easier than regular formula. Good luck!

rice cereal doesn't provide much in caloric nutrition, at 6 mos you could start with sweet potatoes or oatmeal as a first solid food. my twin girls were in the 2nd & 5th percentiles at 9 mos & have battled being lighter than most kids, although my girls are breastfed & are on the appropriate growth chart for a breasfed baby. Ramblc Pediatrics in San Jose is great! Our pediatrician was very aggressive with weight, prior to 9 months, asking for additional nursings or formula supplements (which we chose not to do) but at 9 mos. she said she's not worried, they'll catch up.

Hi N.,
take a deep breath, remember you're a great mom and babies are designed to stress us out.

Next - someone has to be at the 1st percentile or it wouldn't be the 1st percentile. More important then where she is on the chart is the big picture of what she is doing in general when it comes to growth (including length and head circumference) and development.

Cereal in the formula or solid foods are unlikely to increase her caloric intake unless it is on top of what she currently takes rather then instead of some of what she currently takes.

My son started at 55% for weight and headed straight to 3%. He also had severe reflux, recurrent yeast infections and a couple of other things to deal with. Our wonderful and mellow pediatrician ruled out the big malabsorption issues such as cystic fibrosis and then said "ok, this is him". He was gaining length well and head circumference (always had a big head) but was slow to gain weight.

He was also (still is) a very active child always wiggling and squirming. It doesn't sound like much but I work with babies a lot. It makes a difference in weight gain if a baby is quiet and calm, rarely moving much versus always active. The active babies burn more calories so gain weight slower.

You may want to try human milk. Relactating can be a lot of hard work, however there is the option of donor milk through the San Jose Milk Bank. You need a prescription and it is pricey, however it may be the boost your daughter needs. Often donor milk has higher calories per ounce. They also sometimes have milk that is clear of some of the more common major allergens, you just need to check with them (if that is an issue for you). You can also add powdered formula to the human milk to further increase the calories though this needs to be done with care. Increasing the concentration of formula can be dangerous as it can mess with electrolyte balance and cause other problems. It should be planned by a pediatrician or pediatric nutritionist.

If your 6 month old daughter is growing and developing fine except for weight, then I would not be overly concerned. Asking to check thyroid and possibly do a sweat test to rule out cystic fibrosis may be reasurring though.

Our son was 18 months before we could turn his car seat to face forward (20 pounds) and at 8 he is almost to the 10th percentile for weight (and that due to muscle gain). He is a healthy active boy who is bright and actively participating in life at many levels.

The reflux will usually be "grown out of" though may reappear later in life. The more severe then often the longer it takes for the child to learn to control it or for the valve to mature and strengthen. Certainly starting solid foods before your daughter has the oral development and general readiness is not likely to help.

It does sound like an evaluation by a pediatrician would be advisable.

I hope you find the support you need. Feel free to write directly is you wish to discuss this further. If you are on the Peninsula or South Bay I may be able to recommend some peds.

K.

I agree with the other moms about feeding. Cereal doesn't give much nutrition. My daughter is 7 months old. When she was born she weighed 4 lbs. 13 oz. & lost 7 oz. in 3 days. It took her till she was a month and a half to keep her weight at 5 lbs. Anyway, she is doing better now & eats quite a bit. Her doctor, during her 6 month checkup, said that she was just under 10% for weight for her age group. I also have been getting help from WIC. A lady there told me that for her height she is in the 90%. So, this all seems like a class to me..different percentiles for different things.
N., I just want to encourage you to 1) get a pediatrician, 2)see if there is a Families First program in your area (this will encourage you in resources in your area), & 3)know that you are doing a great job as a mom. Please try not to worry if she is gaining weight, but get her help that you feel she needs. Our country doesn't appreciate most of the sacrifices you & your family make. Thank you for that! I'll be praying that your little one will get the help she needs. God Bless!

A super pediatrician is Dr. da Pala in Petaluma. He knows is stuff and is really patient and caring.

Both my sons have used Alimentum. My 6 month old son is using it now and he is on food as of a few weeks ago. I have small kids My 6 month old is probably only 16 lbs. Alimentum is a great for allergies too. My husband had asthma & allergies as a kid and there have been studies that it helps. good luck

Hi N.,

I used to work at an outdoor ed facility and we did a lot of accomodating for food allergies and intolerances. We had a kid one week who could not digest protein, PERIOD. This is a fairly rare condition, I was told, but it is very challenging. For most people, the biggest problem is misdiagnosis, so they go for years (unfortunately the years they should be developing) with big health problems. I would definitely see a specialist, if this condition is the problem, (or something like this) it can be dealt with, but better SOONER rather than later. The kid I mentioned could only grow with a very specialized diet. I wish you good luck and great medical care.

K.

ps: if your pediatrician hasn't sent you to a specialist concerning the weight deficiency you describe, you might need a more attentive dr.

The fact that your daughter is in the 1% and is clearly having several probs... your DR's MUST refer her out... if their answer is I don't know... then they need to find you someone who does.... this is where you have to get quite forceful... I'm sure there are some good Dr's in the military... but there are a lot of bad ones learning on you... don't accept that... if you have to fight too much... consider getting your daughter her own insurance... as much as you can afford... I pay $45.00/month for each of my boys to have a PPO with healthnet... the options through my husbands work were MORE expensive with worse care!!!! Generally speaking they are healthy... but if something major comes up... we won't go broke going to the best dr's

Best to you!

I don't know if you are interested in consulting a pediatric naturopath or other holistic doc. Sometimes "alternative" practitioners are better at treating the whole child, and not focusing solely on numbers and statistics.

My son had some chronic problems that were solved with alternative therapies, but we had to exhaust our traditional medicine options first for peace of mind.

http://hpakids.org/

The website above has a link to different practitioners. We used Dr. Randall Neustedder in Redwood City and think very highly of him.

Good luck. Listen to your mommy voice.

Hi N.,
Please call California Children's Services. Your little one may qualify for physical & occupational therapy for free. These children are overseen by physician's: pediatricians, neurologists and orthopedists. Google this and look up your county for the medical unit you would apply for. It does sound like your little one could use some specialized care.

Good luck!

It sounds to me like she is having trouble metabolizing the formula. Our second child has very severe food allergies and was on special formulas. He was miserable (rashes, congestion, reflux, stomach cramps, diarrhea, etc.) until we figured out what foods he was allergic to, but even then, he still gained weight. So I think this may be something more than allergies.

There is a formula called Neocate that is even more broken down than Allimentum. It's the last resort for babies with severe food allergies and/or digestive issues. I've also heard of kids with problems digesting any proteins, and there is a special formula for that too. You have to order them on-line from the manufacturer (www.shsna.com), but you need a prescription from a doctor.

I think you should skip the pediatrician and take her directly to a pediatric GI specialist instead. We went to several different pediatricians and they were not much help. We eventually got help from a GI specialist and allergist. There is only one ped GI practice in the South Bay.
www.pediatricgisanjose.com
I don't know if there are any in the North Bay. You could also go to Packard or Oakland Children's Hospitals. They both have GI departments. It may take a few months to get in though, so I would make an appt right away. If there are issues with military families and payments to specialists, I think both hospitals accept patients without insurance.

-D.

I don't have any advice about what to feed your baby, but I do have military experience. Are you on Tricare or do you go up to Travis for medical care? If you're on Tricare, you have to get your PCP to refer you to a specialist. I would nag about that until it gets done. Remember, Tri-Care is short for "try to get care!" :)

Hi N.. I don't have any advice for a local pediatrician, but I can give you some advice for the other things. Rice cereal can cause constipation which can increase the reflux. First of all I would suggest using Dr. Brown's bottles. They have nipples especially made for using cereal. Add oatmeal in to the bottle instead. Our pediatrician and GI doc said to start with a teaspoon and then increase/decrease until the refluxing went down or away. Our two reflux kiddos ended up needing about three tablespoons to get any comfort. It will thicken it so she can keep it down better and not give her the constipation. Just be forwarned that the Dr. Brown's bottles are a pain to clean, but so worth how well they help a refluxy baby. You also may want to ask the doctor about Neosure. It's the formula they give to preemies to gain weight. Part of the reason they don't want to add in food is because she's going to get more calories from formula than from baby food. She needs as many calories as possible.

If she hasn't seen a GI doc yet, she needs to. They need to at least do an upper GI to see how bad she's refluxing. I know that sounds strange since it's coming out of her nose, but they can see how quickly she's doing it. They can also run a test to see how much and quickly she's absorbing it. They can also "scope her" to see if the reflux is doing any damage to her throat.

Also, reflux improves as a baby gains more physical strength. About the time the baby starts crawling and walking, the reflux is supposed to go away. I say supposed to because I have a 3 y.o. still on medication to control her refux. More times than not though once they start walking the reflux does go away.

Oh, smaller amounts and more frequent feedings can help too. My one sone (preemie with severe reflux) came home from the hopsital only able to take in one teaspoon every twenty minutes. He was almost 4 months old before we could get up to 4 ounces at a time. He was 8 months old before we could get him up to 8 ounce bottles.

I hope this helps some. Just know it does get better. All my kids with severe reflux, suckling problems, constipation, etc. are all average height and weight now. Their reflux was so bad that when our last little guy came home (my kids are adopted) we went to get burp rags and my now 6 y.o. went and got receiving blankets because that's all she had ever seen us use for burp rags.

L.

get her to a pediatrician, family doctors do NOT have the expertise needed to treat an infant in the 1%.

The formula she is on is not the cause of her slow-weight gain. Being broken down simply means the cow-milk protiens were broken apart so they are easier for her to digest. This should help her gain weight if anything.
I would echo others who reccomend a specialist after a pediatrician. Best of Luck, hang in there.

just to add, baby cereal has very few extra calories considering how much more full it make your baby full. Check serving size and how many calories is in it (mine say 4 tablespoons are 60 calories) and then think about how little you would have to put in the bottle for it to still be liquidy. People usually use baby cereal to make their baby full longer (ie sleep through the night) not gain weight.

You may want to check out the website www.momswearingpuke.com
It helped me out with similar issues that you are experincing. It also provides information on more serious feeding/weight gain issues that you can disregard.