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Underweight 4 Mo. Old Baby

My baby is now 4 months old. At her check up last week, she was 15 percentile for weight and 95 percentile for height. (long & lean like her mom!) At the 2 month check up she was at 25 percentile for weight. So, the DR is a bit concerned. We take her back in 1 month for a weight check. If she does not put on 1 pound by then, we will need to supplement with formula. Baby is progressing well developmentally, she is happy and sleeps well at night. I feel sad at even the thought of having to supplement with formula. I know that it is not the end of the world, but I just feel frustrated. Has anybody else been down this road before? Any advice? How can I fatten up my baby? How do I boost my milk supply?

What can I do next?

So What Happened?™

Wow! I am so touched with all the responses the came back. I can not believe how many people shared their thoughts about low weight and breastfeeding. Thanks so much! I have a lot to think about now. Mostly, it is nice to know that there is support out there. Thank you!

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Hi K.
Not to worry. Here's my story...My daughter was born at 10pound 3 ounces and perfectly healthy (she looked like a 2 month old at birth!). At the age of 2 years she was only at 18pounds. The Dr. was a bit concerned but since she was healthy he said just to keep an eye on her growth and not be concerned about it. She is now 25 years old, has 2 little boys. Her oldest is long and lean and a baseball player at the age of 8. He is very active and eats well. The other is 2 and is average in weight and eats like a horse! Kids grow at their own pace. Feed her well, watch her and enjoy her. They GROW up much too fast!

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I too had a problem with my son gaining weight, and I had to supplement with formula. You can still get the connection of breast feeding. I would feed my son for about 30 minutes on the breast, and then give him however much formula he needed to feel full. He started gaining weight and has done great!

Blessed Be.

Hi K.,
I didnt experience this personally, but my little sis has a 4 month old and when she was 2 months old her weight was low (she was breastfed..not that that has anything to do with it) but she needed to put on some weight so the doctor recommended supplementing her milk with a little bit of rice cereal. Just a bit. She has picked up weight, and is now about at the 50% and she will be 5 months this weekend. There were no weird side effects or constipation or anything funny that happened to her baby Simone and she is just as happy and active as any other baby. So dont stress, she'll be alright! Good Luck. T.

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I have been down this road with both my children. I am a small woman and their dad is a big man. I looked back at both of our growing phases (heard from my parents and his) and it appears that my children are growing the same way that I did. I was small, never would grow either up or in weight. The doctors tried to tell my mom that she should supplement formula or even steroids to boost my system. I truely believe that this is a horrid thing to do.

If your child continues to gain in height, but not in weight, the only time I would worry is if they are sick or lagging behind in any learning area/developmental area.

I am a paralegal, not a doctor, but I've seen it time and again where one parent is either long and lean (my husband and son) and the other is short (me and my daughter). My whole family stood behind me when I decided that my opinion was stronger and more important regarding my child because I see these kids on a daily basis. Not that I think any less of my pediatrician, but remember, just like attorneys, doctors just practice medicine.

It is entirely up to you, but someones opinion, whether professional or not is always accepted. However, I have my own thoughts on what I will and won't do concerning my children and anything else in life. Back to the subject on hand, when my doctor told me that Austin was too little and to supplement formula, I was heart broken because I thought I wasn't producing enough. The same thing happened to me when I had Taylor. The thruth is, they gain weight at their own rate.

Please don't think of me too forward, but to increase your milk supply, eat lots of grains, fruit, vege's, chicken, and keep taking a pre-natal vitamin of some sort to keep the nutrients for both of you. Also, drink lots of juices, milk, water (especially), and get enough rest. If you have to cut out some activities, then do so. My motto for all mothers is "If you won't take care of yourself, how can you care for others?" I have seen this time and again, and that is why I chose that motto.

If you don't want to supplement formula, then at 4 months old, you can typically put a little baby cereal (1 teaspoon)in your baby's bottle and try that for a few months. Also, at 4 months old, I was already introducing soft baby foods to my kiddos. My oldest, Austin had tons of teeth by 4 months, and my Taylor was in the same spot you all are in with the weight issue. I took the advice from my best friend rather than my doctor because she has 4 beautiful girls and they are all healthy and growing into puberty right now.

I really wish you the best. I hope that this advice helped you and that you will take heed to some of the advice, but if you don't, just like I said earlier, everyone has an opinion, so you can take it or leave it like I do.

Just remember, you are their mom and you see more of them than the doctors do. The doctors have a guideline they follow, but you as the mom have the best role in the world because you get to see them grow strong, even if their growth does take longer than the charts say it should.

Keep your head up, you're a great mom.

K. B.

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Hi K.,
If I were you, I'd look for another pediatrician. It's a known fact (that many ped's acknowledge but maybe not yours) that all people (including babies) come in all shapes and sizes. She is probably just a long and lean person, like you said. If she is producing enough wet diapers each day, you can tell she's getting your milk (you have "let downs", you hear her gulping, and generally you can tell she is satisfied when done nursing) then she's doing just fine. I have had six children, whom I have all nursed atleast one full year, your milk is designed for them, supplementing with formula will decrease your milk supply, she may even loose interest in nursing all together if the bottles are giving her a full feeling, she won't try hard enough or will have to try harder because you won't be nursing as often, it's a downward spiral. Have you thought about contacting a lactation consultant? Or the "La Leche League" is a great resource. Look them both up, they are the breastfeeding pro's and will give you lot's of support!
Breastfeeding has soooo many benefits for both you and baby, don't give up! (or give in to the doctor!)
good luck!

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Looks like you have gotten a lot of great advice:) I just wanted to say that it never hurts anything to boost your milk supply. As a mom of exclusively breastfed twins I know all about increasing milk! Make sure you're eating and drinking plenty and then after a feeding (which ever one is most convenient) pump with a breast pump. Do this once a day and at first you will get only a tiny bit, but as the days go on you will get more and more. You can add this milk to cereal later in the day or the next day if you think she needs more calories (cereal is good because it adds calories and they don't get hooked on a bottle). When you start getting more than an ounce or two then you know that she's full because plenty of milk is available. If you end up not needing it then you will have extra in the freezer which is nice. It works best to do it right away after feeding - you don't want to take away from her next feeding - you want to make your body think that the pumping is part of the previous feeding. This completely empties your milk and signals your body to make more. When my twins were little I pumped after every feeding like this and that gets fast results, but after a while I found that just 10 minutes of pumping once a day was sufficient. Hope this helps!

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Different Ped. Dr. will say different things. My son has always been under the 25% for weight and over 75% for height. My reg Dr. has never been concerned, because he's healthy and developing on time. I did see another dr. at urgent care once who felt he was under weight and should be evaluated more closely. I think that he keeps growing taller and it's hard for him to catch up with weight. So I would suggest getting a second opinion before worrying to much.

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I rented a hospital grade pump and pumped every 2 hours after feeding my son. I was then able to look at the ounces that he was eating. I know that there is that issue of nipple confusion, but he had no problem breast feeding as well. My feedings went breast, bottle of breast milk, pump. He gained weight and I was able to continue breast feeding. I also ended up supplementing on the days that my milk was low.
I hope this works for you as it is such an emotional issure.
Take care.

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As a lactation consultant we see this a lot, and it is usually a case of look at the BABY not the CHART. If she is doing well developmentally, she is "long and lean like mom", she is happy and content after feedings, and she is having plenty of diapers, she is very likely FINE. Has she begun moving, scooting, crawling? Has her height increased? Does she use a pacifier (if so, stop and breastfeed more often)? Is she still eating at least 7 or 8 times a day? basically, is the only concern the weight chart??? If that is the ONLY issue, then I would politely inform the doc that she is simply following mom's genetic growth pattern and I would NOT use formula, which comes with its own health hazards and can easily undermine your breastfeeding. There are ways to boost supply, mainly via more frequent feeds and pumping, and possibly herbs based on your full medical profile. My thinking is that as long as baby is eating well and feeling well and acting well she is likely WELL, and doc needs to relax... 15th percentile is still ON the chart, someone has to be there. If you are truly worried, I would get a lactation consult and maybe a second opinion from a different doc. Best wishes to you!!!!

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Before you think about formula, please, please call a lactation consultant. They will give you ideas for boosting your milk supply as well as reassure you that your baby's weight is fine. And 95th % for height is great! As a mom of an underweight baby I've spent so many hours worrying about my sons size. He dropped from 25th to 15th and now he is in the 0 %. He has never lost weight, he is just gaining at his own pace! All babies grow differently and often size is determined by your genes. Are there other slender babies in your family? Ask your mom about your own growth patterns. Anyway, I talked to so many different people about my sons weight and the lactation specialists always gave me the best advice - I worked with the women at Beyond Birth in Portland, Oregon and they are awsome. Breast milk is the BEST thing for your baby! Don't be discouraged you are a great mom, and breast feeding is the most loving and healthy way to nurture your baby! Good luck!

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My advice is going to be something that is not easy and that I struggle with myself on a weekly basis. Stop worrying! :-) I have a 3 yr old daughter that still weighs barely a thing. She is the brightest, most energetic child but she just has NO fat on her body. You mentioned that you are thin too. Before having a baby I was quite thin as was my husband. Not all kids are going to fit on the dr.'s charts...although they certainly have a fuss if they don't.
As long as she is alert and her head is in proportion to her body...try not to worry! Easier said than done I know. I hang out with my pediatric nurse quite often and she is constantly telling me the same thing...don't worry. :-) So I'll pass it on to you for what it is worth.
Also not sure if you are interested in natural approaches, but seeing a naturopathic physician would allow you to determine if your baby has food allergies without fussing over charts.
Wishing you the very best of luck on your fun journey as a mother.
Take Care!

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Oh momma, I hear your struggle!
First, if you haven't spoken to a lactation consultant I urge you to. Not only would a l.c. have some weight gaining tips, but they also come with knowledge about what weight gain is "normal" for a breastfed baby, as opposed to formula fed babies that many of the percentile charts are based on. Formula fed babies have different weight surges at different times than breastfed babies.
www.kellymom.com will have some great tips, and if you can go to a La Leche League meeting, I would highly recommend that. There may be advice there, but also mommas who have been where you are, and that is always so helpful to be around.
If you are certain that your milk supply is well established, and if you are currently feeding a bit on both breasts at each nursing session, you may want to consider nursing for a long time on one side. The milk at the beginning of the feeding (foremilk) is to quench thirst, and the hindmilk comes later and is packed with the fatty calories.
Keep us posted! Your baby is so lucky to have a determined momma who reaches out for help! You are doing great=)

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Hello K.,
Don't get too discouraged or down. My son is 18 months old and still in the 5 percentile for the weight, 25 percentile for the height and 95 percentile for his head! Big brains I say. He did have issues when he was born, where he had to eat thru a tube that was in his stomach. It gets very frustrating trying to get them to gain weight. As long as they are gaining some weight then they are good. My doctor always told me that even though he's still in the low side of his weight, that he will catch up and he will do it on his time. I had to fight with surgeons to have his tube removed because he didn't weigh enough to their standards even though he hadn't used the tube in months.

We did have to switch to formula since I dried up because I couldn't breast feed normal, I could only pump and then place it through his tube. I know rice cereal will help some as well. But don't sweat it too much, your little one will feel your stress.

I wish you the best of luck!

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Hi K.
Not to worry. Here's my story...My daughter was born at 10pound 3 ounces and perfectly healthy (she looked like a 2 month old at birth!). At the age of 2 years she was only at 18pounds. The Dr. was a bit concerned but since she was healthy he said just to keep an eye on her growth and not be concerned about it. She is now 25 years old, has 2 little boys. Her oldest is long and lean and a baseball player at the age of 8. He is very active and eats well. The other is 2 and is average in weight and eats like a horse! Kids grow at their own pace. Feed her well, watch her and enjoy her. They GROW up much too fast!

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Make sure you're drinking enough water so you can make plenty of milk. Ask if they are using the weight charts of formula fed babies or breastfed babies. See a lactation consultant or talk to a La Leche League leader now, before your next appt, and certainly before you supplement with formula. Read up on the risks of formula feeding and weigh them against the risks of being somewhat underweight. Many doctors don't know much about breastfeeding and consider formula a close approximation. Many babies are fine with formula, but many are allergic to milk formula and soy formula. We also know that once formula is introduced, in many cases the baby is weaned from the breast completely within a few months. In some cases, that might be because of lack of commitment to breastfeeding, but it could also be because of a decrease in breastmilk supply, causing the momma to lose faith in her body and switch to formula all together. So it's a slippery slope and not one you want to go down before you have to. So my advice is to get second and third opinions before you decide what to do. Good luck!

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Been there almost! We had weight issues with our daughter at her 9 mo. check up. She was already on solids, so a few of the things we did won't work for your yet, but here's a few things we did that helped us and hopefully can help you too.

1. Make sure you breastfeed both breasts at EVERY feeding!
2. Try eating tapioca. A friend suggested that it upps the fat content of your breastmilk. I tried it and pumped and could see a difference. My milk seemed to go from about 1% fat (at the most) to 5% fat.
3. You can also try fenugreek or mother's milk tea. They are both known to help increase milk while they are being taken.
4. Relax and spend time with your baby. It'll be good for both of you even though it sounds like you're already doing that quite a bit!

Also, if you REALLY don't want to start formula, ask your pediatrician for any other possibilities. It may be that they recommend starting solids or something instead. Either way, stick with breastfeeding as much as you can if that's what you want. Good luck to you!!

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i think weight charts are a little misleading. If you caught your baby girl on the wrong day, maybe she was just about to growth spurt or something. Also, if you are small, maybe she is just small.

In short, i think that as long as your daughter is happy and acting healthy and meeting milestones, put the weight to the back of your mind. It will probably work its self out anyway.

The doctor is just being proactive because of the small chance that there is something wrong. But you worrying about it won't help too much.

In the meantime, let her nurse as much as you can muster. That will help boost your milk supply and make sure that she is eating enough. It occurs to me that foremilk is less fatty than hind milk, so, make sure she completely nurses on one side before you switch or to the other side or have her stop. This may take trying to get her to relatch a couple of times. You may also remember to nurse her some immediately before the next appointment.

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every time you are ready to nurse then drink a glass of water. Make sure that you eat enough to support your weight and the baby. Add more time feeding.
Now with that said not everyone can breast feed with out supplementing. I have more than enough milk but my sister found out that she didn't have enough glands. Don't be sad. You gave your daughter a GREAT start!! Good for you and HER! Do try these things though. I found that water (not pop or coffee or any other things) works for more Moms than you would think.

Your little one may have a medical condition. It won't matter what you feed him if this is the case. My daughter's weight also fell off the curve when she was about 4 months old. The problem isn't that your kid is just small, it's that she's not following a curve and may actually be losing and gaining weight and losing it again. By weighing my daughter weekly at a lactation group, we found this out. We did a urine test and blood test on her, and it turned out that she had a serious problem. She has something called "Bilateral refluxing ureters." It's where her pee doesn't stay in her bladder but flows back up and gets into her kidneys. This was giving her urinary tract infections and kidney infections! It also creates a sodium imbalance which affects a baby's desire to eat as well as their ability to use the calories they do take in. Please talk to your pediatrician about having your baby tested for this. The blood test is a little unnerving, but it will reveal answers that go deeper than just "feed your kid more!" On the flip side, if your kid DOES need more calories, and doesn't have a medical problem, then put your pride aside and give your baby some formular after she's done nursing once or twice a day. Don't agonize over your ability to produce good milk. Just do what it takes to get your baby healthy. For me and our situation, I tried all the power pumping and one-side-nursing techniques... I tried feeding her solids early and formula... She didn't gain weight again until I started giving her salt and we got the infections under control. The good news is that I went on to nurse her for a total of 26 MONTHS!!!

My daughter has always been very long in height and light in weight. DR told me not to worry too much as long as she is healthy and reaching her developmental benchmarks. What I did to boost milk supply though was pump, pump, pump, in addition to her normal nursing. It increased my flow by alot, and I froze the milk so it enabled others to feed her later. When she was 9 months I also supplemented with goat milk but never formula (have you read those labels? I can't believe what they put in that stuff!). Good luck!

I'm surprised that your doctor wants you to supplement if she is she is progressing. It is a percentage and that means some will be above and some below. My daughter, who was almost 9lbs at birth, dropped to the 10th percentile for weight. We watched this in the first few months and the doctor said, as long as she continues to move along the graph and not drop down sharply all is fine. At 15 months she barely weighed 20lbs, but is healthy and happy.

Hi there. My little girl is now almost 18 months old and has always been little. I don't think you should be too worried. If your baby doesn't act hungry all the time and you feed her when she wants to eat, then I think you're doing all you need. My daughter was in the 25th percentile for her weight for the first 4-6 months and then dropped into the 5th. She's still in the 5th. Her doctor was concerned at first, but since there has been no change, she has figured out that's where she's supposed to be. There are all these averages and what kids are supposed to be doing when, but I think that it is obviously just an average. Some are above and some are below. Maybe your daughter is just going to be petite. That's okay. She'll be a cute little girl. So unless she's really not getting enough to eat and seems unhappy, which doesn't sound like the case, I think you're doing a good job and I wouldn't worry too much!!

In your post you said your baby sleeps well at night. One question no one has addressed is how long is she sleeping? there could be a possibility its too long if more than 7 hours straight without a feeding...maybe she just needs to be woke up after 7 hours and feed...this is a little change could make a big difference if this is the case. I wish all the best for your baby and her next weigh in. :)

Hey K.,

I just wanted to let you know that even though we as a society see adorably fat little babies as "the norm" Not ALL babies will be cute little super chunks. Just like not all adults are built the same.
My oldest was the fatest thing you ever saw, (unfortunately formula fed after 4 months, but he was chunky before that) and both of my younger boys were/are long and lean and always have been. They NEVER had baby rolls or chubby cheeks, just wasn't in their DNA (different daddy from the first)
Remember that there is a completely different growth chart for breast fed babies. I'm hoping that someone else can give you that info because I don't have it. As long as she is healthy, happy, and growing I wouldn't worry too much.
Plenty of dirty diapers tells you that.
If you DO want to add some fat into your milk, start eating some yummy healthy fats like avacados. Make up some flavored oils (Olive oil and rosemary is super yummy) or buy prepared ones at the store and dip super yummy bread in it. There are lots of healthy ways to add fat into your diet to help plump her up.
Also, make sure she is nursing for a while on each breast so that she gest the high fat hind milk or what I like to call dessert!
You are welcome to email me personally if you need anymore tips!
Formula isn't the answer.....not yet anyway! :)

My sister went through the same thing with both of her kids. She never did supplement with formula. Her doctor kept a watch on the kids, but also told her that he wasn't real concerned because both my sister and her husband were thin. Her kids are now 5 and 3 and are in the 50% range for weight. I had to supplement with formula for both my kids because I didn't make enough milk. I cried when I found out both times, but my 19 month old now still wants to nurse. If you have to use formula--at least there are good ones out there. I understand whole heartedly what you're going through. Ask the doctor if you can continue to monitor the baby's weight on a weekly basis (or however often they want). Hope this helps-------

I went through a similar experience with my second daughter. She was growing fine and was a very happy baby. She never cried and always seemed content. I took her in for her 4 month check up and she hadn't gained any weight since her 2 mo. c/u and grew only an inch. She never really acted like she was starving! I was so sad! At around 2 mos. post partum, I started Birth Control. After her appointment, I went home and looked at the side affects! It specifically said not to prescribe to nursing mothers!!! It took my milk away! I was DEVASTATED! I tried pumping and nursing her all the time. I didn't have much luck so I had to put her on formula. Are you taking BC? I was on the Nuva Ring. I will never do that again! I hope you have better luck! I am currently nursing my son who is almost 6 mos. I always have that experience in the back of my head! Wondering if he is getting enough! But he growing!! :) I wish you the best of luck!!~A.

I too had a problem with my son gaining weight, and I had to supplement with formula. You can still get the connection of breast feeding. I would feed my son for about 30 minutes on the breast, and then give him however much formula he needed to feel full. He started gaining weight and has done great!

Blessed Be.

Hello K.,

Little bit different scenerio, but my daughter was born weighing only 2.6 lbs (-5 percentile). So getting weight on her was very important - in the hospital for 6 weeks. I wanted so badly to have breastmilk be her only food - and it was a noble idea, but the fact was my daughter need calories and formula has more calories. So we added formula to my breastmilk and I bottle fed her and breastfed her. However, because she was so tiny and weak, she didn't learn to breastfeed properly until she was about 10 weeks old - every feeding I tried, no latch - had to pumped and handed her to my husband (thank goodness he was on summer break from school) to bottle feed. Once she finally learned to latch and breastfeed, she was also big enough that I could stop the breastmilk/formula mix and so off we went breastfeeding only - what a joy to me. My daughter could then also switch from bottle to breast with no little trouble - although 98% of feedings were breast.

Today she over 5 years old and a bright, fun child with a huge amount of compassion for other (people and animals). She is still below the 5th percentile, but she is just like her mommy.

Gotta run - best of luck to you.


My son is one half of a set of twins. However he is in the 5th percentile for weight and the 10th for length. His Ped told me the same thing. The baby is on the PERFECT food right now. Your breastmilk. Your baby is eating all the nutrients that it needs. I agree with the others about the fore/hindmilk. But do not feel like you need to go to formula. I did that and my son did not gain any weight. I lost my breastmilk and now feed my son and daughter Goat milk. I tried to get my milk back but it didn't work. Tell the PED to take a HIKE and continue doing what you are doing! Good luck Mama. Know that you are doing the best thing by breastfeeding.

What happened to letting people be who they are?! If your baby is happy and healthy and sleeping well then let her be! Both my kids were in the 97th percentile for height and weight and my doctor never even suggested putting them on a diet so why would you need to do something if it was the other way around. My son is now 3yrs old and has grown long and lean. I say follow your instincts as a mother and if you are happy with the way your baby is developing then don't let the DR push you around. Good luck!

Okay, first of all, DON'T WORRY AT ALL! Drs start throwing around terms like "failure to thrive" but if you look at what that actually means, it means not gaining weight AT ALL for 3 months! This is not the case for you! :) My last 2 were in the 15th percentile, then the 10th, then the 5th... and my fourth is now 7 months and under the 0%. Cause for concern? It's something to watch, sure, but his own curve keeps moving up. He's skinnier than others his age, but everything is slowly but surely going up. My daughter who also had trouble gaining weight had a SUBSTANSIAL belly on her by 18 months :) And still does at 3 :)

That being said, I'm not one of those nursing moms who can loose weight, i mean, I CAN, but I don't let myself loose too much or I can tell that I don't have enough milk. I have actually supplimented my diet with SlimFast, not as a diet aid, but as a boost before bedtime of vitamins and minerals, not to mention protein. It really helps my milk supply. I eat lots of protiens... like yogourt, meat, cheese... I wish I could use this as an excuse to eat more ice-cream, but that's not the right route. :) That's one thing that I have a hard time ballancing because I do have 4 kids, sometimes it's easier to grab a cookie than an apple, but that does nothing good for milk, so I have to keep really healthy.

I hope this helps! Don't let anyone freak you out! My first 2 gained weight fine and they were horrible babies :) My last two were skinny, but they were allert, intelligent, bright-eyed, sweet, sweet babies. I think you can tell if they are "thriving" by your gut instinct and it sounds like yours is doing great!

Also, nursing more is not always the best route. I have found that my babies spit up a TON more if I nurse them too frequently. This tells me that they simply are not ready to eat yet! My son is now on a 2.5 hour schedual and that seems to keep him as full as he can handle :) He'll still spit up a lot if he rolls around on the ground too much after eating (pressure on the belly).

And FORMULA... HA! I tried to give my son some and he cried like I had offended him in a horrible way... it was so sad/cute! He never cries, so this told me that he was not going to buy it :) Once your baby gets older, you can add food and it will all be great.

Hi K.,
My daughter is now 23. She was 6lbs 8oz, 21" (long and lean like me) at birth, Apgar was 10. My daughter was breastfed too. She steadily gained weight, growing, and progressing in all areas. However, she was below the median line at each checkup. She was about 14 months old when the doctor threatened to send me to a parenting class if my daughter at her next checkup was not above the median line. Perhaps because I was an older Mom, I didn't let this threat bother me since I knew that my daughter was healthy. We could all see her steady impovement and she was a happy, inquisitive child.

From what you have said your daughter is also a healthy baby. Progressing in all areas. Is it just that she is below the median line but making steady gains or is she losing weight at each checkup?

Since you are breasfeeding what's your diet like? You need to continue to eat like when you were pregnant. Take a multi-vitamin and be sure to exercise and get sleep. Not sure about the sleeping since you have a 4 month old ^j^

Please understand, I'm not suggesting that your doctor's thoughts have no merit. Only to take what is said and use it with what you see in your daily interactions with your daughter. What does you husband, family and friends think about your daughter's progress? If supplements are needed, make sure you understand why, for how long AND use something natural. You know her best.

Hang in there, your daughter will continue to grow and achieve on her own schedule.

Oh, my daughter at her next checkup had gained weight but was still below the median line. I refused the parenting classes. My duaghter is now 5ft 5", 145 lbs (she takes after her Dad's side of the family).

You're misunderstanding the growth curve. This isn't like school, where a higher percentile is better. Your baby is normally long and lean. As long as she stays on the same growth curve, she is FINE FINE FINE. Do NOT worry about fattening her up!

All the curve means is that, if your baby is in the 15th percentile, then 85% of babies are heavier than she is. So what?

This is coming from a mom with kids that wee 10-15% for weight and 95% for height all along their growth curve. I have two healthy, happy, amazing daughters. Who are tall and skinny. Lucky them, huh?

Hi K.-
I am surprised that your doctor is concerned. Your daughter went from 15th to 25th percentile! That is a big increase! My youngest was in the negative 5 percentile for pretty much her first two years. At her 2yr apt she finally registered on the chart at a positive 5%. All along the way, the dct was never concerned since she was consistant- albeit consistantly small. She has been happy and healthy the whole way, just small. She is about 50% for height. That has been consistant too. So I wouldn't worry about it at all. When she gets to solid food, then you can give her fatty food, but until then- at least she's growing! That's all she needs to do! Hope that helps!

My Ds was the same from the beginning and I fought for 3 months to avoid supplementing. I finally gave in at three months when he had only gained 1 oz in two weeks, but we only did one bottle a day until he turned one, then went to milk. You can try to start supplementing with breast milk... offer a bottle after you nurse. To boost milk supply, drink lots of water, and eat foods rich in "good" fat to boost the calories in your milk (cheese, eggs, nuts, etc.) You can also try herbal supplements like mother's milk tea, fenugreek, etc....find them at the health food store. There is also a few perscription medications (Reglan or domperidone) that increase milk supply. Now that baby is 4 months, with doctor's okay you may be able to start cereal, using breat milk instead of water. Give these things a try... and good for you for breastfeeding!

Maybe someone has suggested this already...have you tried Fennugreek? It is an herb that you can find at any natural food store or maybe even at Fred Meyers etc. Also, sometimes other moms that make too much milk are willing to share their supply. I have 2 friends that did this for their friends. Just a thought before going to formula. Formula can be really difficult on a baby's GI. It can cause hemorrages in the belly b/c of the amount of iron that is in it.

Our son has consistenly been in the 25th percentile or lower for weight, and the 90th percentile or higher for height. His pedi has NEVER been concerned, as each measure (height or weight) doesn't take the other into account. As long as your child is growing consistently there's nothing to be concerned about. If your daughter was dropping off on one of the scales I might be concerned, but it sounds to me like you have a healthy, tall, lean girl. Good for her!

oohhhh thses doctors now days. I am a mom of 5 girls. My last now 2 was born 3 weeks early and a whopping 5 lbs 13 oz and 18 inches. She to me was tiny all my others were 8 lbs. The dr told me she was too small etc.. told me to give her food etc... I did give her food as she could handle, but no dramatic gain. If your baby is developing every other way- take the baby in for weight monthly, but do not worry about it. Just because x number of babies at x age weigh x amount does not mean your baby has to weigh x amount. And, trying to fatten up a baby is only settling them up with extra fat stores for the rest of their life.
Had the same issue with my now 5 yr old- dr told me to give her butter, icecream, avacados- anything with high fat- I did not do it. She is still thin, but has a little fat on her body. Both are happy, healthy, full of energy kiddos.
Doctors also are saying no food before 1 yr old is the best.
So sorry, but when a child does a nose dive into moms plate for moms food- it is time to give the child some real food. Or when child starts grabbing food from moms plate it is time.
I did not wait for that to happen- as soon as my children were able to sit on my lap at the table, they were getting little tastes of my food mashed up.

My third had some weight-gain issues at four months also, and the doc thought it was due to how much she was spitting up, even though the reflux wasn't causing her any discomfort. So we started an antacid (which I really didn't want to do!), and she gained a pound in one month. I don't know if your daughter is a spitter, but it might be something to consider. The antacid definitely did its job! The only down side was that as soon as we put her on it, her nighttime sleep disappeared for a while. I think she went through such a fast growth spurt then, she was hungry all the time! Good luck!

In addition to Taffy's advice, try "power pumping" once a day for two to three days. In this exercise, pump every ten minuts and leave yourself ten minuts of no pumping, off and on for an hour a day. There are also suppliments like Mother's Milk tea, fenugreek and Blessed Thistle in the herb isle that can help get the milk supply going. These are not long term solutions, but can usualy jump-start breast milk supplies.

My youngest son was below the fifteenth percentile for weight for his entire first year. He nursed exclusively and ate well. He was happy, healthy, and active. The doctor wasn't worried about him - and neither was I. I knew I was producing enough milk because my son was satisfied after a feeding and he regularly had dirty diapers. I wasn't worried about fattening up my son. As long as he was healthy and developmentally on schedule I was happy. He's two now and is just a tiny bit smaller than average and he's just the happiest, healthiest, most active toddler you've ever met.

Don't worry! My breastfed babe was also at the bottom for weight and the top for height. At each visit he was gaining weight and height, and moving up the chart to higher percentiles. The pediatrician said as long as his percentages were moving up, then all was well. He is now almost 9 months old and still long and lean. I still breastfeed and never needed to supplement with formula. Sometimes babies just grow longer quicker than their weight can catch up.

If you feel strongly that you do not want to supplement, and the pediatrician still insists, then maybe you should think about seeing another ped. All doctors have their own opinions and sometimes we are treated by doctors that we just don't see eye to eye with. You might find that another pediatrician will have views more in line with your own. You definitely want to feel comfortable with your babies doctor!

Best wishes!

If your baby is happy and healthy and developmentally on par, then I wouldn't take any action. Before you know it she'll be sitting up and starting on finger foods. I am on WIC, and a number of the dieticians there are excited about the new growth chart that is coming out this fall for exclusively breastfed babies. They said that finally what they have known for years - that breastfed babies are longer and lighter than their formula fed peers for the first year - is finally being recognized "officially".

Make sure that you are eating a well-balanced diet full of fresh fruits and veggies and drinking lots of water. Keep up with your pre-natal vitamins or take a multi vitamin each day. Watch for any new developments with your daughters health, but otherwise, keep her off the formula!

Here's my 2cents - it frustrates me when the doctor rants and raves about the obesity dilema....you on the other hand have the problem on the other side. Hey - my additude is if she's healthy, happy and eats.....so be it. I'm sure she's fine. The doctor's go off those stupid charts - which is a bunch of nonsense - in my book. Ask your mom about how you were when you were a baby....a lot of times your children follow what you were as a baby...same as the daddy traits. I wouldn't fret to much - especially if she is not crying because she isnt't hungry. Good luck.

Hi K.,

My daughter was very small at 4 months old too, and actually she is still VERY petite. She's 20 months old and only weighs 19lbs. My Dr. had me still breastfeed and give her watered down infant cereal starting at 4 months just so she'd have some extra vitamins. Even after that she was still small, so they came to the conclusion that she's just going to be a peanut. Her dad and I aren't big people either, so we really weren't worried anyway. Maybe, if you don't want to do the formula thing (we couldn't because it gave my daughter acid reflux), try the cereal and see if your baby: A: Likes it, and B: puts any weight on after you feed it to her. On a side note, if she won't eat it the first time you try, just put a tiny bit of sugar in it and it will sweeten it up enough to take the blah taste out of it. Hope this helps!

Good Luck,


Hi I too have a now 3yr old daughter that was born weighing in the 5th percentile and length measuring always in the 50th. Her pediatrician always was concerned about her weight. To boost my milk supply I took all natural supplement of fenugreek tablets 3 tabs 3x a day and smelled like maple syrup.. I also enjoyed the herbal tea called mother's milk. Both can be found at GNC. But what really made an immediate huge difference was when my OB/gyn prescibed reglan 3 tabs daily. I noticed alot more milk and after you are done breastfeeding pump each breast for 15 minutes. I have to tell you though no matter how much extra supplements of formula and added calories and breast milk I added to her diet, my baby would jump to 25% in weight and back down to 5%. After exausting her and myself at the doctor's worrisome request and after 3 years I have finally come to the acceptance that she is going to be long and lean like her dad and always be tiny. Don't let the doctor's tell you to quit breastfeeding use your own intuition. Maybe try the reglan or just pumping at feeding time to see how much you are producing? I breast fed my daughter until she was 2 and soo happy I did not let the doctor destroy that awesome bond of breastfeeding earlier than not! Today she still weighs in at 261/2 pounds and healthy! Good luck!

nurse more often like every hour and to increase milk supply drink some mother's milk tea, it will help increase too... but nursing more if you can will give her more food plus bring in more milk, and just eat small snacks through out the day inbetween your normal meals.. but make sure that they are healthy ones soo you don't gain alot of weight :D but it will help you produce more milk that and drinking a ton of water too... hope this helps you

Talk to your doctor about it when or if he suggest formula. Make sure it is a must not just a suggestion. Remember that you were long and lean, maybe she is going to take after your body type. Explain that to the doctor if you haven't already. From what you say it sounds as though she is growing. Her percent is getting higher, just at a rate different than thousands of other kids. Try not to focus on the percentage and rely on her development. You said she is a happy, content, and sleeping well. Trust me she would let you know if there was a problem. And remember we moms know our kids better than the doctors. Try to be confident in your mothering and not take every word the doctor says the only way.

My daughter has been very small since about 2 months old. She was born in 50th % across the board. Then fell to 25% then to 10% and has stayed between 5-10% since she was about 4 months old. My doctor was only concerned about the drops, but once she stabilized she wasn't concerned anymore and she is in the 5% for weight. She is between 30-40% for height and 85% for head. But she doesn't have any developmental delays sleeps well and is happy. She is 16 months now. We did have to do some monthly weight checks just to make sure she didn't continue to drop. But if your daughter is going up in % for weight then she is growing good. Before you give her formula if you do not want to supplement her, get a second opinion. If she is gaining weight and doesn't have dramatic drops or increases in her % then she is great according to my doctor!!

I found that offering my baby the breast more often and having her nurse boosted my milk supply a lot. It may take a few days of that, but it works. Also, eating small amounts throughout the day instead of three big meals helped me feel better as my body started producing more milk for my baby. Go with your instincts on your baby's health.

Hi K.,

First, pat yourself on the back, you"re doing your best:)

Clinically I would ask about your baby's bowel movements, are the stools slippery and yellow or seedy with a texture? If your baby is getting the fatty milk (hind milk) the stools will have a texture if not then definitely the foremilk/hindmilk imbalance is in the picture. That being said, you want to let your little one nurse and certainly you can offer both breasts, but after she eats use a breast pump to completely express your milk. This milk can be offered by cup, spoon, bottle just give it to her.
The theory of one breast at a feeding is a good as the infant's feeding. When baby comes off the breast, hand express and observe the color of your milk---if it is still cloudy not creamy then babe did not obtain the "hindmilk".
I would advise you to monitor your little ones weight weekly, you don't want to find out in month that the weight hasn't been achieved. If you are in the SW part of PDX, come up to St V's Lactation Clinic, we have a community scale and we are open 7 days a week. You can call me if you have questions
###-###-####. I work at the lactation clinic and have a private practice as well so don't hesitate to get some additional information.

Take care,

One other thing that may help (especially while doing those things) is Lecithin.

It worked for me throughout nursing, and has done the same for several friends. You can find it in the "Natural Foods" section at Fred Meyer in either syrup form or capsules. I put a few tablespoons in a good smoothie with protein powder every morning because nutrition is also vital in increasing milk supply.

It works well. Drink water, put your feet up, eat well and try Lecithin. Good luck!

I have been through this with both of my daughters. Breast fed babies are often slimmer than their formula fed counterparts and thus should not be measured on the same scale. With my first daughter I caved to my pediatrician's advice and took her to children's hospital where she went through a whole battery of painful and scary tests looking for everything from cystic fibrosis to malabsorption issues, only to find that she was perfectly healthy. With my second baby (16 years later!)the pediatrician was mildly concerned and had us come in for monthly weight checks for awhile but ultimately decided that she is healthy and has left us alone. I see no reason to supplement with formula as it sounds like your baby is doing just fine without it.

K., deja vu! I know you've rec'd all the responses, but I have to share our story. My son was born with a heart defect and was below 5 percentile in weight for the first year. Because of his surgeries, I breast fed the whole time. However, one thing I did was pump and add vegetable oil to his milk. It helped to add the fat he needed. Now he is 4 years old, as tall as his friends and weighs 31 pounds. I haven't really stressed too much since his development was normal. Just hang in there and best of luck!

Hi K.,
I didnt experience this personally, but my little sis has a 4 month old and when she was 2 months old her weight was low (she was breastfed..not that that has anything to do with it) but she needed to put on some weight so the doctor recommended supplementing her milk with a little bit of rice cereal. Just a bit. She has picked up weight, and is now about at the 50% and she will be 5 months this weekend. There were no weird side effects or constipation or anything funny that happened to her baby Simone and she is just as happy and active as any other baby. So dont stress, she'll be alright! Good Luck. T.

please don't believe everything your doctor tells you! Many doctors tend to go "by the book" and "by the charts". Like others who have responded, I recommend to rely more on your daughters development. If she is content and developing normally, then she is probably fine. Introducing formula could potentially ruin your breastfeeding relationship. Breastfed babies often have very unique growth patterns. My little guy tends to have plateaus and then big spurts of growth. It really caused me concern when he was younger, but now I have accepted that he has his own rate of growth, which is perfectly healthy.

Don't be afraid to say no to your doctor and get a different opinion, maybe from a lactation consultant, who would also be well-qualified to make an objective assessment about your daughter's growth, but who will be supportive of your decision to breastfeed. She can also give you ideas to boost your supply, if that is truly necessary.

It sounds to me that your baby is genetically lean like yourself. Not all babies are chubby!

Good luck

Hi K.,

I might have a few suggestions that will help you. The first one to boost your milk supply is to try nursing every two hours for a little while until you build up your supply. You can also use a breast pump and store milk, but if you demand more milk then you will produce more.

Secondly, and possibly more important is that you baby get the hind milk. Often I will ask my mothers who are wanting to boost milk production to nurse often and only on one side at a time., and pump on the other side. Next time I would switch sides. The reason for only nursing on the one side and pumping on the other simultaneously is that this way baby is likely to get the hind milk which is higher in fat. Often babies are only getting the foremilk from both breasts and not the fatty hind milk. I hope this helps you.

Best of luck,
T. Nelson CD

Hi K.,

Kids are all built and develop at rates that are right for them. My son was in the 0th percentile for height and weight until his 18 mo. checkup. He's gone up a little bit, into the 25th percentile, then back down to 0. His doctor told me that unless he was missing his developmental milestones, there was absolutely nothing to worry about. He's now almost 4 and still very small for his age. However, he's way ahead of the game on almost all of his developmental milestones, with the exception of potty training which we're still struggling with (it's a power struggle issue). So, don't worry. Know that your little one is perfection in her own individual way and, support her in learning and development, and expect only the very best for her. She'll be just fine.

S. M.

Yes! have you tried the herbal teas and supplements? They really do work. Just ask your lactation consult. She will have the names of at least 2 good ones- Or just go to the health food store. One tea is mothers milk but you want tablets too.

Same thing happened to us but my milk supply dried up after 3 months bc I kept getting sick from lack of sleep. Don't beat yourself up I did for months. At least you are giving her some now and she is happy and sleeping. I just told myself it's not my fault. This culture RIGHT NOW is obsessed with nursing it's like a trophy or something.

I too struggle(d) with a small child. My son lost close to a pound while we were in the hospital, gained a little so they let us go home, and then didn't gain for the next month. I did end up supplementing with formula for about a month. During that time I changed my diet to help my milk have more protein and fat. I make sure that my average protein intake is around 60-70 grams per day. Eating peanut butter also helped. The doctor also suggested dairy, although I couldn't eat that as I am allergic. I also drink the Mother's Milk Tea and drink lots of water...that has helped increase my supply. My little guy is still tiny, but healthy. He tends to stay around the 10-14th percentile for weight, but seems to be developing well, so our doctor has not been worried. Good luck and know that you are not alone in this.

I had similar issues with my daughter. She is 27 months now and is still in the 5% or less for her weight. We had to go see several specalist and have lots of test done. To no avail. She's happy, healthy and excelling in her develepment. YOU know your child and YOU know when something is wrong. I did what my gut told me to do. But we did try what the doctor said. My daughter didn't take a bottle so it never went beyond that.

I have a darling 3 1/2 year old daughter who has always been 25% weight and 90% height. Her pediatrician has never been concerned because she has maintained the same percentiles at every visit and has always been developmentally where she needed to be. (She was a formula fed baby)

Hang in there.

My daughter has always been very lean as well. Under the 5th percentile for weight, her entire 1st year, and now at 4 years old, she is still at the 15th. Our pediatrician was NEVER concerned, and I breastfed her for 17 months with no formula. From what I've always been told, as long as the child doesn't fall significantly off a growth curve they are just fine. And, since birth weights are always very average, it can take a child a few months to settle into the growth curve that they will likely stay on. As a big proponent of breastfeeding, I would work on increasing your own milk supply before ever trying formula. I drank Mother's Milk tea everyday, took fenugreek (herbal supplement). Also, you can feed a little more frequently for 2-3 days, and allow your body to respond to the increased demand. You could also pump to increase stimulation time at the breast. Good luck, and I hope that helps.

Yes. I have been there. My daughter was very thin at that age. Even though I fed her whenever.... I had to start her on solids at 5 months. And she was still thin. By 12 months she was tough thin, and very bronze looking. She would eat as much as a grown up at lunch and dinner. But only when I fed her. The Doctor knew she was getting her vegetables because she was so bronze. (carotene). She is today (29) still thin, athletic, and healthy.

And so was I. I would nature be as nature is. As long as she is healthy and happy. W.

My son was born 7 pounds 11 ounces and dropped to the zero percentile around the time he was 3 months old. At his 2 year check up he was at the 15th percentile in weight (his dad is a really big guy too). I never suplemented with formula. I couldn't if I wanted to since he would never take a bottle. He dropped below the zero percentile several times during the first year of his life. Luckily, I had a doctor who was concerned enough to do some tests BUT finally told me that he's happy and healthy and is developmentally off the charts so his weight should not concern me. We never supplemented him; he stayed on breastmilk until 18 months and took a long time to drink milk. He was also very slow to start solids since he had oral sensory issues. But he's a very healthy eater now, and is growing a lot since his 2 year appointment where he was at the 15th percentile in weight. If your daughter's happy and developing then weight should not be an issue. I know of doctors who freak out because I child is below the 50th percentile. Once your child starts doing solids you can fatten them up with healthy, fatty alternatives like avocado. For now, I wouldn't worry about having to supplement her. Just enjoy her! Also, you don't need to boost your milk supply if your daughter is happy. Sounds like she's getting everything she needs.

I'm not sure about this, but make sure you aren't dieting while nursing. Your milk needs to have lots of fat in it for the baby, so have some ice cream. ( I think the rule of thumb is 500 extra calories per day whild nursing. )

AAHH!!!! I HATE the stress of the weight checks!! I say just don't do it! (Much easier said than done- I know). I have a 19 mo old and we are going through the same thing now. In some ways it is different and less stressful when they are not so young, but it still sucks. My daughter was born small- 6.10 and the dr was VERY keen to closely monitor birth weight gain for "such a small baby" (HELLO, i'm 5'2 and weighed a whopping 124 at her birth, what did they think would come out of me?!) Luckily she gained alot of weight VERY fast (7lb 10oz by the 2 week check up. At one point she was in the 75% for weight. The growth curve slowed (as it's supposed to, esp with BF babies- If they grew at that rate forever, we couldn't even carry them by 12 mo. Well, my daughter leveled off so well that she gained a full 2 oz from the 12 to 18 mo check up. Now she's in the 5% and dr is concerned. However, Just like your daughter, mine is progressing very well developmentally and even grown 2 inches taller. We have weaned, but now it's supplementing with extra butter and oil on everything instead of formula. I'm certainly not long and neither is my child. But I do get the sense she's going to be pretty lean like her mama. I think it's safe to say that I'm probably in the 5% of grown caucasian adults at 100 lbs. I feel that is almost worse to have to feel bad, and force food on your child than it is to have a smaller but still healthy in every way baby. Obviously you and I aren't med professionals, but we are mamas, and that should count for something! Good luck.

K. you listen to your gut AND take into consideration the Dr advice. My youngest was at one point in only the 4th % for her weight and her ped dr was just fine because he knew all my babies were very petite but very healthy. The specialist we saw for her constipation problems had a fit and wanted to supplement with formula and later give her an extremly high fat/calorie diet. In our case I prayed about it and went with my gut and she is doing just fine and finally put on some pounds on her own. Hope this helps...S.

Wow! I had a totally different experience. My daughter was born, on time, with a height/weight of 95%/50%. She wouldn't stay awake to eat and we didn't get her back to birth weight until she was 5 weeks old. This was with the help of a home nurse, Breastfeeding, pumping and finally supplementing with formula. When we finally got her going she was 95% for height and 5% for weight. I was sooo anxious about that, but my doctors kept telling me that she was fine as long as she stayed on her curve (at 5% weight) and didn't drop below that. She stayed at 5% for a year and a half, got up to about 25% for weight at about two years old and went above the 95% for height. At four and a half, she's been gaining height and weight like mad and is above 95% for her age in height and weight. She looks like a big 5 year old or a small 6 year old - but proportionate. She was long and lean like her dad for the first four years and had a jump in weight just like his at four years old. Now they are getting on me about how MUCH she weighs - but she is proportionate (95%/95%) and I feed her a lot more healthy that the American average! LOL, it's just how she grows on her own.

She sounds like she is gaining weight pretty well, if not rather overquick, if she jumped from 15% to 25% in just a couple months. And, if she is happy, growing, sleeping, and eating okay and developing normally - I think she's fine. Don't worry overmuch if she keeps doing well in all those things. She is growing as she needs.


I have four children that are all skinny, heriditary. Also know that nursed babies weigh less than formula babies. If your baby is hitting all the milestones, active, healthy and happy... SHE'S FINE!

I had round after round with our doctor and he finally let up. Turns out most are panicked if something goes wrong they might be held liable. Sad. Your precious child is not a number, a statistic, nor potential lawsuit.

Know that you are the parent, not the doctor, not his insurance company, not your insurance,... YOU! Took me until recently to get that through MY head [[[hugs]]]

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