Underweight at One Month

Updated on August 31, 2010
T.R. asks from Los Angeles, CA
15 answers

My baby girl was 6 lb 12 oz at birth and was only 7 lb at her one month checkup. Her pediatrician gave us one week to try to increase her feeding to see if she will gain more, but said that if she hasn't gained they will have to run tests to see if there is another cause.

Does anyone know what medical causes there might be for a baby this young to not be gaining weight and what the tests are she might have to endure?

Thank you so much for your input. I am obviously extremely worried about this.

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M.H.

answers from Harrisburg on

My daughter is the same way, She has never gained weight fast. Sounds like she might just have a fast metabolism.

She's always been on the bottom end of the chart for weight but everything else was normal. We never did any tests, since she was eating normal and everything else was fine.

So, hopefully thats all it is.

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P.S.

answers from Bloomington on

What is your feeding schedule for the baby? Try to feed her every 2-3 hours. Babies lost weight immediately after birth, so you baby may have dropped to just over 6 lbs in the first week if you were exclusively breast feeding. So if that was the case, she has gained a lb in 1 month.

Just increase the number of feedings, try to feed longer from each breast (hind milk is the fatty milk) and don't switch her until she lets go of the breast herself.

Add 1-2 formula feedings if you want. Now that she is 4 weeks, the possibility of nipple confusion is reduced.

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P.F.

answers from Las Vegas on

We have four mostly grown now (our twins are nearly 18 now) a 20 yr old and a 23 yr old. So daughter #1 was 7.14 at birth and she never really gained very quickly. The doctor said she was just small and she had her own growth chart. However, just to be sure, they sent us to the Childrens Hospital for testing. The tests were no fun but not terribly traumatic. Then son #2 was 8.2 1/2 at birth. And he was following the same pattern as our daughter. The kids were healthy, happy and thriving and so when the doc wanted to send us to Children's Hospital for testing, I refused. There just seemed no reason. Mind you, I am 5.3 and my husband is 5.7 so we are not large people. When the twins came along, they were 5.5 and 6.5 and took to the same pattern. They were all approximately 30 lbs. going to kindergarten...Always, always one of the smallest in their classrooms and the school group pictures! ha ha I certainly would not worry at this point. You can probably know and feel in your gut if she is happy, content and eating. My kids were totally happy and content, just seemed no reason to worry too quickly, but with your first its hard to really know what to expect.

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J.P.

answers from Los Angeles on

My neice had the same thing going on....but it was a super fast metabolism...and it was her 2 month check-up she was the same as her birth weight. So, she breastfed, but freaked out, so she started supplementing formula out of fear and that ruined her breastfeeding.

Remember, most babies lose 10% of their birth weight and then have to gain it back, so theoretically, your daughter might have already gained a pound.

Are you breastfeeding? Are you eating good quality foods (protein and veggies) and drinking enough water? Most breastfed babies need to eat every 2-3 hours, sometimes more when they are younger.

Breastmilk starts being digested in the stomach within 90 seconds. Formula hangs for much longer....like a large Mexican dinner....and is slower to digest. ;)

One week is NOT enogh time to see. He's covering his butt. Don't stress. She's NOT losing weight. And breastfed babies TYPICALLY gain weight slower than formula fed babies.

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J.C.

answers from Columbus on

Are you breast or bottle feeding? We found that my breast milk was low-cal so we had to supplement with a high calorie formula once a day. Even so, our girls still struggled for a bit. One (our 2nd) was even hospitalized for testing. Don't worry about the causes other than calories yet. It will get you worked up. It could also be something as simple as Anemia, which is what caused my 2nd to be diagnosed with Failure to Thrive. A high dose of iron for a month solved it.

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K.M.

answers from San Diego on

My daughter was born at 6.7, went down to 6lbs her first couple of weeks (so scary because they started to discuss drastic feeding measures) and then slowly started gaining - was 8lbs at 2 months. I was nursing and she just didnt have a big appetite once she figured out how to feed.

My Dr's had me in to see the "lactation coach" almost every other day til we got it right. In the meantime they recommended supplementing with formula if i didn't have enough milk. She was under 25th percentile for height and weight forever and then suddenly at 2 she was in the 60th percentile and now she's considered tall at almost 3 years old.

So this doesnt help you regarding tests, etc. But it may help you monitor her eating (the lactation specialist would weigh my baby before I nursed her and then after to see how much she was consuming). For awhile we switched to my milk in a bottle so I could see how much she was taking at each feeding. And i did supplement with formula.

Good luck!!

A.S.

answers from Davenport on

Failure to Thrive comes to mind. Google Health can tell you all about it but the info may alarm you needlessly. You might just want to wait until the week passes and you talk to your baby's doctor again. As to the tests, they will probably start with blood tests and a urinalysis (not always possible with wee ones) and maybe X-rays.

H.H.

answers from Los Angeles on

Breast fed or formula? Just went through this myself, but can't offer you help unless you are more specific about what your routine is now. does she cue to eat every 3 hours or does she go longer? Are you getting 8 feedings in a day?

mine was bf. I had to pump after each feeding to supplement her with expressed breast milk. I also added a little formula supplement when she seemed to need it. I had to set alarms to feed her every 3 hours because she would go 4-5 if left to her own. You really need to get those 8 feedings in a day. I've been working with a lactation consultant. Mine was a lazy eater. I had to give her the bottle because she was not extracting the milk effectively enough. formula can mess up the supply/demand system your body uses to know how much milk to make. But if you take a few days to pump after every feeding (day and night), you will tell your body to make more. I also took mothers' milk plus and feel I had results with it. The best advice I can give you is to see a lactation specialist.

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J.C.

answers from Anchorage on

My son lost weight and it turned out it was because my milk never fully came in, so it was not fatty enough. We had latching problems, and it took almost a month before my milk really came in. I started supplementing his feedings with formula and the his weight came right up.

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J.L.

answers from San Diego on

T., low weight does not necessarely mean a medical problem. two of my daycare children, are smaller than what the ped's think they should be, not the 8 month old little boy on;y gained one pound from one check up to the next, and they were concerned, this baby's dad is built like a tooth pick and not average height for a man, my 18 month old little girl, to me is a normal size 18 month old but the ped's said she was below the percentage of weight that she should be, her dad is little, and her mom is not very big. 6lb 12 oz is not big baby, both my neices were 4lbs 3oz and didn't not put a lot of weight on the first couple months. Try not to worry and wait and see what the ped says. The 8 month old's mom was told to formula feed because breast milk is mostly water, and that came from her son's pediatrician, he's doing better on formula and baby food, still does not hit the charts, but who cares he's healthy, happy, but lazy. J.

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T.C.

answers from San Diego on

I had the same issue with my youngest... it took him almost 3 weeks just to get back to his birth weight. The doctors kept telling me to add formula after each feeding, which I hated the idea of- and he wouldn't take it. I was very frustrated and I felt in my heart that he was fine and just needed my milk and a little time! We just breast fed on demand as often as he would take it. He just had a high metabolism and his growth and development are normal- now the doctors tell me I'm lucky because I don't have to worry about his weight being too high. Try to relax... I hate how the doctors can make us unnecessarily stressed out because we trust them so much. As long as your baby is eating and seems healthy, don't worry too much. Also try to remember that if the have just eaten, that adds about four ounces and if they've just peed or pooped, that takes some off. When they weigh that little their weight those ounces can make a big difference! If you are breastfeeding, try going to a lactation consultant and you can weigh her before and after to see how much she is taking at a feeding and they can help you to optimize her success. Good luck, and try not to let your mind go to the worst case scenario... She's probably fine and just recovering from her grand entrance into the world :)

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R.L.

answers from Los Angeles on

Hi T.,

There are a lot of things that can cause a baby not to grow rapidly, ranging from simple genetics (for example, parents are small or had similar early slow growth) to serious health issues, such as kidney dysfunction, genetic syndromes, and metabolic disorders. Your child's doctor should consider a number of factors and may have had building a level of concern in him/her over the past month. The best person to ask about this is your pediatrician. Do not be afraid to ask lots of questions. Think about what you want to ask before the appointment and write the questions down. Be ready with paper and pen to record the answers so you can review them later, think about them and do more research if warranted. Don't be afraid to ask your doctor to slow down, explain things more clearly, and give you more information. Remember, YOU are paying the doctor. Demand satisfactory responses. If your doctor can't give them to you, you have the right to refuse testing or treatment and seek a second opinion.

Good medical practice should include good communication with the patient. In that vein, make sure you're giving the doctor complete information, too. Is your baby eating regularly? Is she falling asleep before finishing? Does she have good periods of wakefulness? Does she move her limbs a lot? Does she seem lethargic? Can she focus on an object held 8" in front of here? Is she reaching for things? Does she cry a lot/very little? Is she fussy? Is she wetting 10 - 12 diapers a day? Does she have regular stool/bowel movements? Is she spitting up a lot? Is she vomiting (especially projectile vomiting). All of these are important considerations. Also, you should let the doctor know if there is a family history of any kind of infantile disorders (in other family members or their children). Most important -- what is your gut feeling? You're with your daughter a lot more than the pediatrician -- learn to trust your instincts. Moms know when something is wrong!

Here are a few questions to start with:
What do you feel should be my child's growth rate at this point? Rate is often more important that actual growth. If you child is growing at a regular rate, but possibly just more slowly than the norm, this needs to be considered. As long as you child is within 2 standard deviations of the average (your doctor will know what this means) for growth rate for children your daughter's age, there may be less reason for concern.

Are there other symptoms or physical indications that concern you?

Have you had experience with whatever disorder you're concerned about?

Is it really necessary to test now? Is there risk in giving my baby more time to grow and/or display other symptoms? What are those risks?

What kinds of tests are you thinking of running? These are likely to be blood tests, so followup questions should be:
How much blood will you have to draw?
When will the results be back?
Will you call me, or will I need to check back? When should I check?

If results do suggest a problem, you should seek out a specialist in the appropriate field immediately.

Keep in mind that most true disorders are very rare. Think horses, not zebras! Other moms have already suggested some good, nonpathological reasons for slower growth. I would question the doctor about these first. As hard as it is, try not to worry!

All the best for you and your baby,

R.

A.G.

answers from Pocatello on

yeah I think the question is what are you feeding her? Breast milk or formula? If it's breastmilk make sure you are drink plenty of water and eating lots of high protein so you have good rich milk and make sure you are feeding her on demand. Also how long is she going between feedings at night? If she is sleeping through the night then you should start waking her up at least twice in order to get her to eat more. If she is formula fed try feeding her every 2 to 3 hours if she will take a bottle.

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L.K.

answers from Austin on

Are you breastfeeding? Breast fed babies typically are underweight on the growth charts. This is normal as long as the baby is meeting its milestones and is growing, albeit slower. I have a 4 month old baby. She weighed almost 8lbs at birth. Last monday she weighed 11.5lbs. She should weigh at least 14lbs right now according to the charts. She has fallen off the chart for weight. However, she is way above average on her milestones. She rolls over both ways, she is crawling, and she is trying to sit on her own. So, she is not failure to thrive. People come in all shapes and sizes and she maybe on the smaller side. I weighed her again today and she has gained almost a one pound so she is gaining, just not as fast as the chart says she should. Trust your instinct, if you feel nothing is wrong, then it probably isn't. If you are breastfeeding, keep doing it. Do not give her formula. Increase her feeds if need be. Check out www.kellymom.com for advice on low weight breastfed babies.

Lisa

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H.L.

answers from Cleveland on

My step-sisters boys have a rare genetic disorder called Russell Silver Syndrome,which was diagnosed at the Cleveland Clinic here. I'm sure there are other things too, not to freak you out, but if they can't figure it out, this is one to look into.

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