Author Topic: Please help I'm confused and don't know what to do  (Read 2843 times)

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Offline tfuentes00

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Please help I'm confused and don't know what to do
« on: July 10, 2013, 15:34:49 pm »
So sorry if this turns out to be long....
 Background: My dd was four mths on the 7 th of July.  We have been having some feeding issues ( see previous posts) with her squirming while eating, not taking all of her feeds and so on.  I thought the squirmimg was due to her needing to be moved to a four hr easy and it seemed to help for a little while, then she started again a few weeks ago and quit taking full feeds, we were down to only taking maybe 5 oz each feed which only led to about 20-24 oz in the day, which I think is not enough. i tried switching milk and also called for the dr to up her dose for Zantac.  She is now eating a bit better but still her first bottle of the day she doesn't take all of it ( she does not have a df or nf and takes her last bottle of the day around 8-9 pm). 

So we went for her four mth check yesterday and she is only 13.6 lbs like around 20 percentile and has not doubled her weight which she should at four mths.  She was 7.6 lbs when born 19 in.  She was 13.6 lbs 24.75 in yesterday.  The dr was not in but saw the pa, who I really love and trust,  she said clinically she looks fine but wants to do another weight check next week and see the dr then.  Which of course makes me totally worry thinking she is failing to thrive.  She has wet diapers, is happy and content and no noticeable issues. 

Questions: should I not worry and do the same until next week?  Should I try feeding her every 3 hrs again? If I do that what about naps she sleeps well and sometimes I have to wake her to feed at 4 hrs?  If she was hungry would she not cry or let me know?  I feel like I have been depriving my baby but she doesn't fuss or cry hardly at all.  She sucks on her fingers all the time but if she was hungry wouldn't she cry bc that is not satisfying? 

She is currently taking parent choice brand equal to similac sensitive which is low lactose and takes .9 Mel's twice a day of Zantac.

Please any suggestions or help is greatly appreciated. 
Oh and we tried faster flow but it didn't seem to help just made her gassy bc she was drinking so fast. :'(
Tina



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Re: Please help I'm confused and don't know what to do
« Reply #1 on: July 10, 2013, 20:49:29 pm »
So I've been looking online and downloaded a growth tracker app and it doesn't seem she's too far behind.  In her book they wrote 20% w/l any idea whatthat is?  Should I been concerned?
Tina



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Re: Please help I'm confused and don't know what to do
« Reply #2 on: July 10, 2013, 21:57:23 pm »
Do you think she might have been weighed before her growth spurt?  If she has one soon her weight and length will increase again, just a thought.
Mine was born 6lb 13.5oz and at 4 months was 13lb 9oz, he gained almost 2lb between 3 and 4 months I'm sure it was down to the 4 months GS.  He always remained between 9th and 25th centile lines on the chart, sometimes closer to 9th sometimes closer to 25th.  So long as they don't drop 2 centile lines the fluctuation shouldn't be an issue.
(FWIW mine was similar length as yours too.  He is a small boy but he has small parents so it's to be expected.  He doesn’t look odd, all in proportion!)

20% w/l
I guess this is 20th centile for weight and length.  It's important to remember that all centile lines are normal as people are naturally different sizes, being heavier or lighter isn't 'good', maintaining roughly the same centile is what shows steady weight gain and also the comparison between weight and height/length (so the two can be different but dramatically different would call for further investigation).


Offline tfuentes00

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Re: Please help I'm confused and don't know what to do
« Reply #3 on: July 10, 2013, 22:44:37 pm »
I was thinking w/l was as you said but if her length is 75% and weight is close to 40-50% why would it combined be 20%? 

Both my husband and I are average height and weight, except for some pregnancy lbs still:) and my son was always 50-75%

I'm not sure about a gs.  I've had a hard time noticing hers.  I'm not sure if maybe she's going through it now or if its just the change in milk and up in med?? She's not eating more often or nw but she's done better taking the full bottle.

Glad I'm not alone with below 50% then, like I said my son was an eater and never turned down a bottle and at this age he was starting solids.  She on the other hand is totally opposite.  I tried some cereal when she was fussy at the bottle thinking she may be ready, but she totally is not nor did she like it. :). It's so hard not to compare the two as he was 17 lbs at this age and is not heavy now he's average size.

From my app I used I put in all weights and it is showing and upward line no drops yet.

I just freak out thinking I'm not feeding her enough, I guess she's just not a big eater.  I'm always forcing the last 1-2 oz bc I feel like she doesn't get enough.

If she settles in the night with her fingers then she's likely not hungry right?  She would cry or not settle back right?  She rarely cries for hunger that I can pick up.  I worry that I'm not picking up her cues or she won't let me know.
Thanks for your help.
Tina



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Re: Please help I'm confused and don't know what to do
« Reply #4 on: July 11, 2013, 06:36:58 am »
I was thinking w/l was as you said but if her length is 75% and weight is close to 40-50% why would it combined be 20%? 
When I looked on my chart yesterday it looked like she was between 9th and 25th centile for both weight and length (and like mine a bit higher for length than weight, not enough to make it unusual or a problem, like I said if there is 2 centile lines between then that would raise a question but just being one line difference is fine).  I just used an on line checker now and it came out as between 25-50 for length and 10-25 for weight.  This is just how mine was too (just above the 25th for length so between 25-50 and under that line for weight so making it between 9-25).  I assume somewhere on your records you have worked out or they have written 75 and 40-50 which doesn't match up with either my chart or the one on line. Is it possible they have made an error in writing it down?  A couple of times our health visitor marked his chart incorrectly, getting the age totally wrong so the chart looked skewed and I had to scribble it out and mark it in the correct place.

Both my husband and I are average height and weight
When I said we are small parents so my DS is small too, I didn't mean anything unusually small.  We are very average, but average has a very wide range.  I'm 5" 4 and weigh about 136lb (a big heavier than I'd like but still within a healthy BMI) so very normal.  I was certainly not the shortest at school or amongst my 'very normal and average' friends.
The centile lines aren't a goal to aim for the 50th as the healthiest, they are just a comparison to see how LO is growing, if for example they are on the 90th centile at every weigh in they are fine, just on the larger end of average and normal (bigger build, taller and wider structure it doesn't mean they are over weight so long as weight and length are in proportion).

I also used to worry about DS not eating enough, he took roughly half the guidance amount of milk.  When any baby takes less than guidance amounts I would always say to get it checked, but I know in our case all my worry was for nothing, he grew and is growing fine, he just ate to his fill and being smaller needed less.
I wouldn't try solids yet, it's advised to wait until 6 months and milk gives her more calories than solids, the risk of introducing solids early is she will be full on solids (on lower calories) and not have enough room for all the milk she needs, so it is the opposite of what you hope for.  Milk should remain her primary food until 12 months.
If she is self settling at night then she is not hungry.  If she is turning away from her bottle with a little left then she is full.  I didn't know my LOs hunger cry until he had as illness at 10 months (hospitalised for 4 days) following which he ate like a new born, frequently and night feeds too. I was so used to him not having night feeds that initially it took me some time to work out why he was crying - hunger - ah! That's the hunger cry! I had finally heard it!  There are many parents who do not distinguish the cries, especially if you've been on a routine like EASY because the milk is prepared and offered regularly and LO seldom has opportunity to cry for it, they know it's coming and know their needs are being met, so no reason to shout about it, yk?

I'm sure if she was hungry she would let you know. This is one (of the very many) reason why we always respond to our LOs cries or calls for attention. If we ignored their crying then there is a possibility of hunger or some other need not being attended to.  This is certainly not the case with your Lo, if she was hungry she'd cry and cry and you would know.

BTW mine had silent reflux and started his meds around this age or a little older.  He was very ready for solids and clearly let me know it. I tried to hold him off until 6 months but he screamed the place down every time he saw me eating even if he had just had his fill of milk.  I swore I'd make him wait until 6 months but in the end caved at 5.5 months.  he was a very willing solids eater, some are some aren't.  Some really get into it later, and again the range is fine.

Have you moved to 4hr EASY yet?  This could help with reducing her fussiness at the bottle.  If she isn't quite hungry enough at 3hrs then the 4hr EASY could work well for her, 4 months is the right age to switch (go gradually, 15 mins per day).  Mine actually couldn't go longer than 3hrs between E so we never switched I just worked feeds around naps as the S changed but the E remained.  At 6 months he could go 4hrs between milk feeds because he had a small solids meal between.

hope this helps some. Obviously if you are worried it is always best to get her checked out.


Offline tfuentes00

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Re: Please help I'm confused and don't know what to do
« Reply #5 on: July 11, 2013, 11:27:34 am »
It does greatly thanks! 
What chart did you use?   I think the app I downloaded is the who, or that's what it says on the description of the app.  What do you mean by 2 centile lines between? Is it two between where she is and the mid line?  I don't actually shee the graph at the Dr the nurse writes it down in a book they gave me so that's where those numbers came from.  The pa said her length line went up but her weight went down a little, I didnt see it I should have asked.  I  she didnt bring it up either so I guess it wasn't a real noticeable change for her.  I asked about it bc to me she just is small and not gaining like my son he was 17 lbs at this age.  I feel better knowing yours was there and just fine now.

Thanks for the reassurance on the cues.  I worried maybe it was me bc ds let me know.  Like yours he watched me like a hawk and tried grabbing my food.  She don't care anything about me eating.  When I say I gave her cereal I mean like she literally had a taste, not even a baby spoon full only the tip :). I've just been playing with it to get her used to sitting in her chair and use to the spoon but I don't force it, bc clearly she is not ready.

That makes sense on the goal of the line thanks.

We have moved to the 4 hr easy.  Shes been doing it so.ce she was about 3 mths.  She was squirming real bad and didn't want to finish so I tried the 4 hr and she started eating better.  Then it started again and she started arching her back so I called the dr bc i figured her dose needed to be upped.  I also switched to a low lactose milk the same time and she has been doing good.  This just happened this past weekend.  So I'm not sure if she's eating good because of the med, milk, or if its a gs.  Ykwim?  Im hoping she will keep it up because its so much easier to feed her now.  We go back wed so we will hope for some gained weight:)
Tina



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Re: Please help I'm confused and don't know what to do
« Reply #6 on: July 11, 2013, 21:09:11 pm »
In the UK we are given a book when baby is born, in there is a chart where the numbers are plotted.  There are guides to how frequently LO is weighed and measured (the key thing here seems to be not too often, for weight it is monthly up to 6 months, then every 2 months up to a year, then once every 3-6 months to 2yrs.  Length and head circumference are less frequent. Obviously if there seems to be a problem measures are taken more often). So, the weight is written down as a figure and plotted as a (rough) dot on the chart.  The chart is like this
http://www.rcpch.ac.uk/system/files/protected/page/A4%20Boys%200-4YRS%20%284th%20Jan%202013%29.pdf
here's the source page with some other charts available too
http://www.rcpch.ac.uk/child-health/research-projects/uk-who-growth-charts-early-years/uk-who-0-4-years-growth-charts-initi

On that first link, if you zoom in to the weight chart you see not every centile is written on, rather it is in groupings (eg a line for 9th and a line for 25th but no lines between), the dots are put on semi- accurately but we are only told for example that it is 'between 9 and 25 centiles' and you can look for yourself to see if it is closer to 9th or closer to 25th and have a guess at what centile baby is on. So when I talk of centile lines the guide here is if they drop or rise TWO centile lines, not 2 centiles.  So it would raise a question if baby suddenly dropped from the area between 50-75th down to 9-25th.  But it wouldn't be seen as a 'problem' if they just dropped one line (50-75 down to 25-50th). I hope explain well enough.
Clearly other factors must be taken into account, if baby is poorly, lethargic, spitting up most of their food etc.

For your own peace of mind you could print off the graph/chart we use here and mark on it the weights and lengths you have recorded since birth. It is stressed here mummies shouldn't become too focused on measurements and charts, they dissuade mums from weighing baby too frequently as it can cause panic if baby loses a little, but would naturally gain it again the next week.

One more thing about the charts, when I looked yesterday I looked on the boy chart because I was comparing to my LO. There is a girl chart (link above) which is different so they might come out slightly different centiles but still similar-ish.

The on-line calculator I used for your babies measurements I just googled and picked one, it was this
http://www.babycenter.com/baby-child-growth-percentile-calculator

I have always been told it doesn't matter if the length/weight went up a bit or down a bit, they don't have to be on the same centile line either, but a BIG discrepancy would raise a question.

My little boy looks just fine, totally in proportion but is petite.  He is just 2.5yrs now and his t-shirts are size 6-9 months, 9-12 months and 12-18 months depending where they were bought.  His trousers are 12-18 and 18-24 months and some I add elastic or a belt to the waist to fit him better because he is slim.  Shorts we can wear full length trousers age 0-3 months, 3-6 and 6-9 months, they just stop at the knee like long shorts and fit great on the waist.  He's never had those chubby thighs, arms and tum like some other toddlers, he just looks sleek and well formed (and he has a healthy appetite, eats really well).  And there are lots of kids like this...and there are lots of kids that are much bigger if they are around the 98th centile.

It's great she is eating a bit better now, hard to know what's increased her appetite, with LOs we never want to wait and try one thing at a time do we, we just want them out of discomfort and happy as quick as possible.  If you're happy to stay on the changed milk until she weans to cows milk at 1yo (or later) then I'd prob just do that.

hope this info helps some x


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Re: Please help I'm confused and don't know what to do
« Reply #7 on: July 12, 2013, 14:26:51 pm »
Thanks so much.  When I looked under the girls  she between 25-50%, with the boys she is 9-25.  It makes more sense thinking of it as an incline instead of 50% or more.  Thanks for your help, will see next week and hope she hasn't dropped.  She did real good eating the day before yesterday and took 30+ oz and yesterday it was 25- oz it was hard to get her to take 5 oz and today its starting the same as yesterday.  So we will see and just hope there's increases every time.  Thanks.
Tina



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Re: Please help I'm confused and don't know what to do
« Reply #8 on: July 12, 2013, 19:11:13 pm »
she between 25-50%
Then she is a higher centile section than my DS :)  So long as she keeps gaining and not losing weight I wouldn't worry at all :)

If it turns out this larger intake is a growth spurt don't be surprised if the milk drops back down a bit again.  I remember at a GS mine took about 260ml in one feed when normally he would have 180ml, it was staggering, but he returned to his regular size bottles after the GS.

hope it continues to go well x


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Re: Please help I'm confused and don't know what to do
« Reply #9 on: July 12, 2013, 20:10:38 pm »
Thanks it very well could be a gs.  With a gs do they get clingy after it?? She's been clingier then normal today.  She seems well other wise just clingly, she doesn't want to play by herself as she usually does. 

It's hard to think she gets the nutrition from around 20-25 oz a day but I guess like you said as long as she keeps going up a little she should be fine.  Now if I can just keep telling myself this :)
Tina



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Re: Please help I'm confused and don't know what to do
« Reply #10 on: July 12, 2013, 20:31:28 pm »
It's hard to think she gets the nutrition from around 20-25 oz a day but I guess like you said as long as she keeps going up a little she should be fine.  Now if I can just keep telling myself this :)

Just to reaasure you on this - my DD VERY rarely took more than 25oz a day (also a refluxer) and she has stuck to the 91st centile like glue since she was a couple of weeks old! She was 8lb 11oz at birth and just under 16lbs at 4 months so not double her birth weight either but nobody was worried about that. I constantly worried about her milk intake but she grew just fine on what always seemed not enough!

Laura


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Re: Please help I'm confused and don't know what to do
« Reply #11 on: July 12, 2013, 20:31:28 pm »
I understand the worry, I was worried about my LO too.  It's our job to worry isn't it :)

Clingy, yes, pretty normal.  Things change for them, with size they fit differently in their space, mine just had a GS and someone has had to remind me that's why he is falling over more, it takes time to get used to the new size!  Happens every time can't believe I forgot!
With developmental leaps they get very clingy, a phase of separation anxiety is normal and the easiest and quickest way through it is to keep them close and take them everywhere (maybe cut back on housework for a few days to make life easier).  It'll pass.


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Re: Please help I'm confused and don't know what to do
« Reply #12 on: July 12, 2013, 22:32:55 pm »
Thanks ladies.  I guess I'm just gonna have to get it in my mind she is not her brother and I don't need to compare and except the fact she's a finicky eater.  She hasn't taken a whole bottle all day and her last one I only put 6.5 and she nearly took it all.  So I guess she eats what she wants  ;). I will keep reminding myself worry when the line goes down a lot and not percent. :) easier said then done sometimes :p
Tina



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Re: Please help I'm confused and don't know what to do
« Reply #13 on: July 21, 2013, 02:48:28 am »
Went for recheck of weight Thursday and she gained a few oz she is now 13.8. Dr said no worries and that she should double by 6 mths and triple by one yr.  I've just been feeding her what she wants and letting her lead the way.  Shes still not eating but around 25 oz but I'm comi.g to terms with it.  Thanks for your help.
Tina



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Re: Please help I'm confused and don't know what to do
« Reply #14 on: July 21, 2013, 06:50:50 am »
Glad to hear things are ok and the doc said no worries :)

We usually had the same health visitor through DS's first year and she was always 'ignoring' my worries on the amount he ate.  When on one occasion I spoke to a different HV she sent DS for a weight check immediately she was so concerned about the amount (lack) of oz he was taking...and his weight was still fine. It seemed our regular HV just saw him growing, looking fine, acting fine and that's why she 'ignored' the low(er) intake.  Guidance intake and charts etc are there for good reason but it's important (I think) not to let them rule us and to listen to our LO too.