BLS for littlies

[AliBaby]

is she getting plenty of milk (bf or ff)?

It does sound like a little bit of a concern if she is right off the bottom end of the scale only because they need their reserves if they get sick but as you said you cant force her to eat. The only thing I can think of is to up her milk intake if she prefers that. Not sure how old your little oneis though.

[Early Kids]

Sorry to hear your DD is sick Balmaingal.

Tristan is below the %ile chart, well below it. At 6 months old he was only 5.7kg roughly 700 grams off the bottom of the chart (3rd %ile) At 9 months old he was 7.04kg still roughly 500gm from the bottom of the chart. Interestingly he is smaller than Brendan was at the same age, yet he was twice Brendan's birthweight. Anyway... We have been doing BLS here for around 1-2 months now and he loves it. He is far happier to feed himself. Weight gains have been a little better than what they have been even when he was spoon fed and seemed to eat more!

I think you should trust your instinct. If she is happy and healthy and gaining weight (even if it is not what they want) then that's all that matters. The charts are only a guide

My little guy is on the 10th percentile, so he is quite little - BUT, he is the same weight and height as my DD at the same age and on the charts in her baby book they are on the 50th percentile - they have changed the charts in the last few years, so on the old BF based charts your DD wouldn't be so 'little'.

Boys and girls have different charts. A boy and girl weighing the same will be on different percentiles despite being the same age. My boys have the same charts in their books, from the National Centre of Statistics ... ect year 2000. The chart in my book is pretty much inline with the WHO charts.

[Swoop]

Thanks girls.

BellaBambina - she's just over a week shy of 7 months. She's demand fed 100% bm and feeds fairly regularly, I'm not really sure where I could fit many more feeds in, I offer very regularly already.

The only time she doesn't feed so well is when we are out, she's so easily distracted and I've also never really got the hang of feeding her without a pillow as I have big bbs and need to use my hand to support. With that in mind we never go out for the whole day and when we are out I offer even more frequent bf and if we go in the car chuck a pillow in and take her there to feed.

Her feeds haven't been the best while we've had house guests coz even though i'd use a nice quiet room an avid 3 or 4 year old would track us down and she'd get totally distracted.

Sally - that's exactly what T weighed this week, 5.7kg. On the charts they use at the dr that's right off the scale, I need to look in the blue book to check what it measures up as in there.

[MantaRay]

hun. That must be very worrying for you.

The charts that you should be relying on are the WHO ones which I posted the link to earlier in this thread. They are the latest charts showing normal growth patterns - the ones in the blue/red books are old and show formula fed growth patterns which are not normal patterns. Having said that, unfortunately your DD is off the bottom of the WHO charts too from the information you have given in this post. While this is not necessarily a problem, it might be reassuring to have her checked just so you know for certain that there is no medical issue.

It's also worth keeping in mind that bm is the main source of nutrition for growth until around the 12 month mark, so her not eating much solids really is not contributing to her small size. There are many reasons why babies can be off the charts. I hope you get some answers and reassurance soon.

[Swoop]

I think our GP uses the WHO charts too MantaRay, when I looked at the link you posted they se to corelate with the ones I'd seen on the screen at the surgery. The paed refered to the blue book though.

I'm just worried that there's something serious wrong with her and I've been missing signs.

[Early Kids]

Please don't worry or stress, that will not help anything.

Not all children are meant to be on the charts, they are purely a guide. Is your DD following her own little curve? Tristan's chart looks like a pair of steps, not all children have a perfect curve. Also take into consideration your family's general size too. Another thing you need to bring into the equation is her length, is she still growing in length? Is her head circumference still moving along the chart? Is she doing anything, crawling, sitting, ect? How are her sleeping habits? Has she been sick at all? When a child has a cold their growth stops for the duration.

Small size on it's own its not a huge drama so long as they continue to gain weight. Of course there is always risks of something underlying, but that's when the rest of the above gets looked at.

How much did your DD weigh at birth?

Tristan was 3kg born, started off on the 25th %ile for actual age. By 6 weeks he hit the 3rd %ile, at 10 weeks back up to the 10th %ile At 4 months he dropped below the chart and that's where he's stayed. I have a brilliant child health nurse, Tristan has not seen a paediatrician once. Our CHN monitors Tristan fortnightly-monthly depending on the weight gains/loss.

I hope this helps, of course you need to trust your instinct, if you feel everything is ok it probably is, same if you feel something is wrong that's a possibility too.

[Barb Glare]

hi,

It is hard when you feel "the stopwatch is on, and ticking down" for you and your baby.
It is an interesting assumption that spooning puree into a baby will result in a higher weightgain that allowing your baby to lead the process.
Think about it - if you were on a weightLOSS diet you might eat something similar to the purees babies are sometimes fed - rice, stewed apples or pears or vegetable. Then, if the baby won't eat - you can't force them, as many of us have learned the hard way!
Babyled solids is not about letting your baby hold it's own carrot stick. It's about allowing your baby - at 6mnths when their digestive system is mature enough to deal with it- full access to the healthy family foods you eat. Anything off your own plate is fair game - whether it can be eaten with fingers or spoon.
In most cultures weaning foods are a dense mix of cereals/grains, meat, fish or chicken and vegetables. With your little one - no need to "hold" the good oils - butter her sandwhich. If she is not sensitive to dairy, cheese in sandwhiches or cubes is great. Homemade "chips" sauteed in olive oil and baked in the oven. Spahetti bol is fabulous - and a favourite with kids.
And underpinning this all is your breastmilk - important in the second half of the first year and beyond

[Swoop]

Sally - Tristan sounds like he has had a very similar growth pattern to my DD. She was 2.9kg at birth - 25%ile and had dropped to 3rd by 6 weeks, back up a bit to above the 5th by 8 weeks then back down gradually. She's consistently put on weight, just never very much!

Neither hubby or I are small, but most of her cousins on both sides are fairly slim kids. Her length and head have continued to grow although her length did drop percentiles at one point it was less significant as she was always higher on that chart. She's doing pretty well developmentally, sits really well, is almost crawling (intermitently shuffling backwards on her belly and pushing herself up on her knees while yelling with frustration right now) and chstters away constantly with mumumum and dadada etc. She doesn't sleep brilliantly, but not terribly either (currently wakes twice a night and naps 3 times, usually pretty short but more and more often one longer sleep too).

Barb - it does indeed feel like the clock is ticking right now.

DD is eating many of the food that you talk about, she just eats very small portions of them. She has what we have, I only hold back when I'm concerned about salt/sugar or for the rare thing that I feel is a choking hazard.

I understand that bm is the most nutritionally beneficial food for babies, but I always thought that bulky solids would give higher weight gain (although I don't personally see the point in compromising nutrition for weight gain), and I suppose that by us shovelling it in they will get more than if they do it for themselves. From what you've said this is incorrect though? This seems to be the assumption of most people around me too and I am constantly defending my decision to do BLS with other mums/family etc. and my worry is that I will end up having the same discussion with the paediatrician so it would be great to get my facts straight first.


My instinct does say that everything is alright, but every time she gets weighed by a professional and they start raising concerns it makes me worry that I've missed something vital and haven't been doing the best for her at all. I know worrying isn't helping anything, but it's really hard not to!

[Early Kids]

They are very much alike! In my opinion I don't think you should be concerned. She is doing everything she should be. She is consistantly gaining weight and is happy and healthy. That's all that really matters.

If it were me, I'd continue doing what you are doing (and maybe skip one month of weigh in too! Nothing worse than having a "professional" making a mum feel bad for no good reason!)

You are doing a great job and your DD is developing well Keep up the good wrok mum!

[Swoop]

Thanks for the vote of confidence Sally

We had the paed appointment today. He agreed that DD appears perfectly healthy, happy and developing well.... but skinny. He showed me how her height and head circ are developing in a perfect curve.

MummyTummy, looks like you were on to something. In spite of me thinking that all was fine with my supply following my previous experience with motilium the paed said that everything (frequent feeding, weight dropping while everything else is following the curve etc) points to her not getting enough milk. I've got a script for motilium and I'm going to give that another go... if that doesn't work he wants me to start comping with formula. I've told him I'm not keen to comp as I'm worried that she may wean... which he was understanding about.

He was okay about BLS... I wouldn't say enthusiastic, but he asked me what she was eating and seemed happy with my answer but also said that as we have chosen this route it's important to get the milk issue sorted.

We're on to fortnightly weigh-ins but don't need to go back to the paed for another 3 months which suggests to me that he's fairly confident in his feeling that milk supply is the issue. He said we would start running tests if after 3 months we're not back in the grey.

On a plus note, we went out for lunch with my cousin before the appointment today and DD ate loads of the food I'd packed for her , which is a change from the last few days when having this cold/cough has been putting her off a bit.

I feel happy enough with the outcome, guilty that I didn't figure it out sooner and that my poor little girl has been going hungry for such a long time but very very relieved that it's most likely not something more serious. I've got everything crossed that the motilium does the trick so that I don't have to start comping.

Thanks all so much for your suggestions and support with this, it really helped me to work things through in my head before the appointment.

[Early Kids]

Sounds like a good plan I hope your milk supply picks up soon

[Barb Glare]

Hi,
This is such a difficult area. If only we had that crystal ball that told us what is really going old. I don't quite understand why the dr thinks your milk would be low? Milk supply works on supply and demand - the more you feed the more you make - and it sounds like she feeds frequently. Am I right in thinking she's 7 mnths old? At this age your baby need for rather than formula. Nutrition for babies and young children is different to adults. Fat has twice the calories if carbs and protein - and while adults are advised to steer ear of fats good fats are nutrtious for babies. Dairy is great for adding calories. Butter and cheese are great - try adding somecheese to her maser potatoes. Yoghurt is great and just because you need a spoon doesn't mean it's not babyled solids.
Does your lo have any signs of allergy? Eczema? Ashma. Any in the family?

[Swoop]

Hi Barb,

Yes, she's just under 7mo. She does feed very frequently - every 2 hours or sometimes more frequently than that, although the feeds are usually relatively quick.

The paed told me he thought that she was feeding so frequently to try to boost supply. His other reasonings for thinking milk supply was the issue were that she's waking more frequently at night to feed now and has less than 5 heavy wet nappies per day and that all her other stats were following a very clear curve but her weight isn't.

I started the motilium on Thursday night and since Friday she's been almost frantic to feed very often - not sure whether it's a coincidence or not. I feel like I've had a small increase in supply but not a big one as yet... I know it usually takes a while to kick in though.

We do have alergies in our family... DH gets excema and his mum
asthma and I used to get psoriasis although not in recent
years. I haven't seen much evidence of it in our DD yet, although she did get a red mark on her face where she had a blob of cream cheese the other day... it went quite quickly and she eats cream cheese often (and very enthusiastically... a favourite) and this has never happened before or after. She does still poo frequently (3-4 times daily) which I've wondered if it could be related to an intollerance before, but I mentioned it to the dr and he said he thought not, and it was probably just the breastmilk. She's also had nappy rash for the first time on and off since starting solids... not sure if that could be an alergic reaction.

She's hit and miss on the solids at the moment, sometimes she's full of enthusiasm and other times whingy as soon as she goes in the highchair - I think largely related to timing, but on a 'good' meal she is starting to eat more. She does eat yoghurt from a spoon, bread or cruskits with cheese spread and macaroni cheese are all quite popular with her too.

[Early Kids]

How are you going now?

I had Tristan weighed today and at 10 months he is 7.26kg (up by 240 grams in one month) we are now on a path to see a dietician, trying to prolong seeing a paediatrician as I don't feel it's necessary for him.

[Swoop]

Hi Sally,

Is 240g considered 'acceptable' for a months growth at that age? I'm guessing perhaps not if you're starting down the path of a dietician. Was that suggested by the nurse? You will have to let me know how you get on.

We'll be weighing on Thursday so I'll have a better idea of how we're doing then. I have noticed a definite increase in my milk, but T's got another cold so her appetite for solids has been pretty small the last few days, so I'm not sure how she will do. I'm dreading the thought of her weight not having increased because then we are supposed to think about introducing some formula and I know that won't do a thing to help my milk supply.

[Early Kids]

It's borderline acceptable. If Tristan had been gaining normally and then had a gain of 240g in the month then he would be considered "normal" but because he has never really gained average amounts in a month we have to start thinking about if there is an underlying issue (which I don't think there is) My CHN is also the co-ordinator for the therapies here and yes she was the one who suggested it, she tried to get me to go two months ago.... but I believed and still do, that Tristan is absolutely fine, just little. Of course I am a little concerned about the weight, but for Tristan this is his only issue. Height and HC are all following their curve on the graph and Tristan is developmentally doing well (delayed in speech though)

Don't be too disheartened if DD doesn't gain well, as when they have a cold they don't grow due to fighting the cold. Make sure you tell them she has been sick this month!! Also if you don't want to go down the formula path you don't have to! If it were me, I wouldn't. I hope it all goes well for you. I hope they don't put too much pressure on you either, because you are doing a great job!

[Swoop]

Well I suppose going to the dietician can't do any harm though. It'll be interesting to see if they offer you any good tips. It sounds like you're doing a great job with him anyway, and he's enjoying eating BLS style. Hang in there and keep trusting your instincts

I took T to get weighed today, and she's put on 500g in the last 2 weeks!! I was so excited, I walked down the street looking like a Cheshire cat! I couldn't believe she'd done so well in spite of having a cough and a cold on that time. I am very relieved that I don't have to have any formula conversations, particularly with DH who I think has been getting a bit anxious and it would have taken me some explaining to make him understand that if she demanded less bb my supply would likely dwindle.

[Early Kids]

WOOHOO! That's fantastic news!! I'm so pleased for you

I don't think the dietician can offer me any advice to be honest, Tristan eats a huge amount and a wide variety too. I have to keep a food diary which started this morning, so far today he has eaten: Woke at 7:30, at 8:30am had a 5min breastfeed, 8:45 1cup of nutrigrain (+cows milk) 12:50 1/2 rasher of bacon 1/2 fried egg and 90% piece of toast, 3:30 1/2 a banana and a slice of apple. He had a 2hour nap in there and is currently asleep again (has been for an hour) Today is below average for Tristan he usually eats more. It's only 5pm and we will have dinner around 6pm. He will then have a breastfeed and be in bed by around 8:30.