Infant Not Gaining Weight

I think the suggestion to look at Celiac is an excellent one, as both my boys were not diagnosed until much later and it is currently way under-diagnosed by the medical community as alot of doctors were taught it was rare (i.e., 1 out of 9600), whereas recent research shows it is quite common 1 out of every 120. There are millions that have not been diagnosed.

That said, you don't mention whether the baby is getting formula or breastmilk. My kids are now older (almost 11 and 13 1/2), but my understanding when they were that age was that the majority of the baby's diet/nutrition until age 1 should come from the breastmilk or formula. Also, it seems to me that some of the recommended foods are ones that can be quite allergenic and shouldn't be introduced to a child under one - eggs in particular.

My oldest son had very slow weight gain (he was always at the 18-20% until he was 4 years old) for two reasons: 1. He was breastfed and breastfed babies do not necessarily gain at the rate on the charts that were developed by the formula companies. 2. He had undiagnosed celiac disease.

However, I was just checking my younger son who gained tremendously early on because I was so worried he would not gain enough like his brother and his weight gain slowed tremendously once he got mobile. He went from 85% to 25% between 3 months and a year. So, whether this is a problem should also depend upon earlier weight gain. If your son also did not gain well earlier, then definitely there is a concern. But, if the slow weight gain is new, then I wouldn't worry. My younger son kept at that 25% for over a year and then he gradually worked his way up to his current 90% in weight and about 80% in height (he's now 11) - both my kids height and weight has never flattened out like the curves show they should.

I would also look at family history and see whether your husband's or your family had large toddlers or petite ones. The pediatrician said my older son would be petite based on where he was at two years. He's now about 5'10" at 13 1/2. His shoe is a size 13.

In short, I wouldn't be too worried unless the baby is also seeming to have less energy and doesn't seem happy and alert and I personally would avoid adding some of the foods to avoid potential allergies (unless of course there's absolute no history of any allergies at all in either families).

J.,
There could be an absorbtion problem going on.... something like Celiacs. I would ask the MD to please send you for a full GI (gastrointestinal) work up.
This is just a GUESS- I am going from my experience as a pEDI RN. It does warrent further studies. If this Pedi won't look into it you may want to try a different Pedi.
PLease feel free to e-mail me!
D.
____@____.com

Jamie,

The exact same thing happened to my son. He is 3 years old and still only weighs 25 lbs. When he was around the same age as your son he had completely fallen down hill in reguards to the weight charts. Initially when we went to the doctor they seemed a little concerned and tried the high fat diet. After doing that for about a week and not feeling good about the decision I transfered doctors and got a second opinion. I took him to a doctor that practices at a Childrens Hospital. I use to live in Kansas City Missouri so I went to Childrens Mercy but they are very compariable to Childrens Medical of Dallas.

They ended up giving him zithromax and another medication that helped empty his stomach after he ate. This actaully gave him the feeling of being hungry. Before this he would snack around but wasn't really interested in eating. The doctor said b/c his stomach always felt full the natural instinct to eat wasn't there.

To keep a long story short we were on the meds for about 2 months and eventually he grew out of it and his body got on a schedule and was able to recognize the differences between hungry and full. Although he is still small he is definetly growing so there are not any concerns now.

I would recommend trying a different doctor. We know our children best and know when something doesn't feel right. Get a second or third opinion and keep trying until you are satisfied and you son starts gaining weight.

the same thing happened to my first child. she gained nothing between 6 and 9 months. the doctor had us start supplementing her breastmilk with formula. she did not show any other developmental problems. nothing bad ever happened and she very slowly gained weight until she was about 3 yrs old..then she started catching up. now she is a healthy 9 yr old.

Hi J.,

I had the same problem with my daughter. She weighed 16lbs at her 9month check up and again at her 12month check up. She too was put on a high fat diet and now at 18months she is barely pushing 20lbs. As long as your baby is growing in length that's a good sign. The dr's just want to rule out any physiological/metabolic issues so just keep watching his weight. You might get the book called "Feed me I'm yours." It has tons of great meals for kids that are easy. In fact, my mom used it when I was a baby. It has a recipe for nutritious brownies that my kids just love! My daughter is a picky eater on top of everything else and so this book has helped us get creative and get the high fat foods in that she needs. Another problem we had was cutting down on her milk. I knew she was getting too much which was making her eat less, but she cried uncontrollably for it and I gave in. Now, we finally have her on 8oz of milk 2/day and water the rest of the time and she's eating a little more. Once your baby's a year old you can try peanut butter which has a lot of fat. So do avacados if you can sneak those in. My daughter didn't start gaining weight until after her first birthday when we could offer her more foods that she was more willing to eat. We also give her pediasure. you might talk to your doctor about that too. And keep in mind that some kids are just smaller than others. My mother-in-law has 14 kids and she told me all of her babies were like my daughter, which makes me feel a lot less worried.... but I still watch her. hang in there!

It is really very normal for babies to slow down their weight gain a ton between 6-12 months. Once they start crawling and pulling up and trying to walk and everything, they just burn a lot more calories. My oldest son is a prime example of this; he was 22 lbs at 6 months but only 24 pounds at a year. Now, at age 6 he's still a perfectly healthy guy.

I would ask you, doctor visits, and weight checks aside, what does your gut say? Does he seem to be growing and developing normally? If you didn't know what your son's weight had been doing, would you have thought there was anything wrong?

If you're concerned at all, then it certainly wouldn't hurt to get another opinion and discuss your questions.

Oh, and I also agree that if you're really concerned about him gaining weight, solid food in the first year is really not the answer. The bulk of their calories should be coming from breastmilk or formula. I love the way our pedi put it: "solid food in the first year is for experimenting with tastes, not really about nutrition".

I wouldnt worry too much. My daughter did the same thing and she was premature and only weighed 1.8 pounds at birth. Some kids just grow at a much slower rate. My daughter is 3 1/2 now and around 3 feet tall and only weighs 25 pounds...she can still wear 18-24 months in waist. Just give it some time and she will gain slowly and if its a really long time and she seems unhealthy then I would worry. Im a worry wort so I understand and felt the same way for awhile.

Please, Please, Please get a second opinion. I know your MD is probably great but I work at Childrens and see misdiagnoses all the time. Sometimes they're too late. People come in with problems saying they'd taken their child to the pediatrician several times but it wasn't until it worsened that they were referred elsewhere. Three months of no weight gain on a high fat diet is long enough to know there's a bigger issue here. You are your child's only advocate!

Hello Jamie,
Both of my boys had difficulty gaining weight, however, never did they go without gaining weight between well child checks. I would definately seek a different opinion. Your Dr needs to be running tests to make sure he doesn't have some kind of enzyme deficiency etc. My Dr was very proactive even when my child only gained 2 pounds between visits, and had ALL kinds of tests run as well as ended up sending me to a genetic specialist, come to find out he may have aarskogs syndrome. I am not telling you this to scare you, however, being a teacher you are aware that this is a very critical time for an infant and if he is not gaining any weight for 3 months I would be looking for some answers. If you have any questions please feel free to contact me.
Thanks, and good luck
K.

J.,
A couple of things-first, are you sure you and your husband don't have the cystic fibrosis gene? I know poor weight gain is one of the early signs, but of course there are many others like developmental delays.

Celiac is another possibility. My son was tested for it.

On the positive side, my son has gained about 4 lbs since 6 mo (he's almost 14 mo). He's very tall and very thin. He also has cow's milk intolerance. My ped GI (Cook's) says to put him on rice milk, but I worry because he's already so slender that it's not enough fat. So, while the GI can help you, I would recommend to always do what YOU think will be best for your child within limits.

We go to Cook Children's GI clinic in the hospital district in FW. If you're in Tarrant county, email me, and I can give you the lowdown on the office...
R.

Was your son big at 6mos? Did your son start crawling? Is he much more active? Is he still growing in length? Both my kids made huge percentile drops in their weight from 6mos to 9mos. (For example, my son was 18 1/4 lbs at 6mo and 18 1/2 lbs at a year!) They were both breastfed and very good eaters, they were also both early crawlers. Now they are healthy 6 and 3 yr olds. It wouldn't hurt to get a couple of 2nd opinions from doctors, but don't worry yourself too much about it if your instinct feels like it is not a problem. Some kids just need to even out their weight. They can't stay michelin babies forever. ;-)