Not enough calories??

Question

My son is 9 weeks old and he has fallen to the 1 percentile in weight. He’s always been tiny. He was in the 3rd percentile after birth. He has struggled since birth to gain weight so we supplemented. I worked really hard to increase my supply though and he naturally stopped wanting the formula. For the past 3 weeks we’ve been exclusively breastfeeding. He seems satisfied after each feeding and definitely has times where he’s just happy and content. So I don’t understand why he just isn’t gaining weight. His doctor suggested today that my milk doesn’t have enough calories and he now wants me to supplement again. I just feel disappointed because I worked so hard to increase my supply and now it feels like it’s still not enough. He has PLENTY of wet diapers during the day. I mean the kid poops like 3-4 times a day. So I don’t get it. Has anyone else heard of this happening before? Is there something I can do to fix it? I will always do what’s best for my son and will supplement if I have to. I just wanted to see what you all have to say.

Answer

Maybe try having a higher fat/ calorie diet to see if that helps

Answer

Can you see a lactation consultant and do a weighted feed?  Possibly see another pediatrician for a second opinion?  My sisters kids are always off the bottom of the growth chart but they follow their own curve.  As long as the percentile doesn’t drop further, and continues to curve upward, your baby is growing fine for them.  
If you do need to supplement, I would ask about pumping and doing fortified breastmilk instead for a whole.  I did 1 tsp of neosure 22 calorie formula per 80ml of pumped breastmilk to get my preemie growing.  He went from 5th% for gestational age to 89th% for adjusted age (17th% for actual age).
Try googling “kellymom What affects the amount of fat or calories in mom’s milk?” And an article should pop up that you’ll find helpful.

Answer

Higher fat diet and alternate breasts at each feed so he’s getting enough hindmilk (fattier milk that comes after foremilk). I had the same issue with my second daughter. She was a small baby and didn’t gain well and my pediatricians wanted me to supplement but only I did so here and there. She’s still a tiny human at almost 4 years old but is perfectly healthy and smart. I doubt if I fed her more formula it would have made a difference. I’m not a big person and was a small child as well.

Answer

The blue line is the weight in percentiles, it dropped quickly after birth then lasted until 6 months(1.5months past revision) only because she was so far below the 1st percentile that it took a couple weeks to surpass the 1st percentile again

Answer

So, it sounds like a tongue tie to me.  Peds and PCPs are not educated in the matter, they'll tell you that ties don't cause problems or matter.  But they do.  You need a IBCLC and/or proffered provider ped dentist.  If you have Facebook, look up the tongue tie babies support group.  My daughter had a tie and had the exact same scenario.  She was well below the 1st percentile, but was satisfied, no signs of dehydration, plants of wet/dirty diapers, all of that but no weight gain.  At 4.5 months she got it fixed and is now in the 23rd percentile at 11 months old.

Answer

What abiht expressing your milk and giving via a bottle so you can monitor how much baby is getting each day. Even for a week. Maybe still do one or two breastfeeds so baby doesn't loose that skill.

Not enough calories??

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