Underweight Infant

[decathmom]

I have been on a gluten-free diet for the last five years. I now have a six and a half month old daughter who weighed 7lbs, 14oz (the 65% range) when she was born. At her six month check-up, she weighed 14lbs, 6 oz (the 13% range). The doctor is concerned and wants me to fatten her up. I exclusively breastfed for the first five months and then began feeding one meal of rice cereal and one baby food per day. I am now feeding her two meals a day and pumping so that her bottles are one-half breastmilk and one-half formula. I want to keep her gluten-free for at least a year. Now for my questions: Is this common for the child of a Celiac? Are there any symptoms that a gluten-free Celiac infant exhibits? Does anyone have any other ideas on what to do to fatten her up? Thank you.

[lbsteenwyk]

Since you are using some formula, you could use a 24 calorie per ounce formula. All of the major formula companies make them, although they are more expensive. (Standard formula is 20 calories per ounce). You can make the baby cereal with formula or breastmilk instead of water to add calories as well.

Where does your baby's height fall on the growth charts? Head circumference? Your doctor should be considering these measurements as well in evaluating your child's growth.

Since your child has been gluten free since birth and you are gluten free as well, I don't think your child could be having any celiac symptoms. Does your child take a bottle well? Does she seem interested in the food you are feeding her? Do you have to coax her to eat? If you are having difficulty getting her to eat or take a bottle, or if she doesn't seem interested in breastfeeding, her current weight should be concerning. But, if you aren't seeing feeding problems, it may just be that she is genetically small. Are you or your husband small framed? Remember, anything above the 5th percentile on the growth charts is still considered within normal range.

[decathmom]

Kylee has consistently fallen in the 75-90% range for height and 75% for head circumference, so I think that is part of why the doc is concerned with her consistent slide on the weight chart. After a rough start the first week of life, she eats well; although it does seem that if she eats more than five ounces at a time she spits up. Consequently, she still eats every two and a half to three hours (including at night). She is developing "normally" or faster than normal in all other areas. As for genetics...I would put us both in the average range. I am adopted and don't know much about my genetics, my husbands family is all different! We each have a child from a previous marriage. My son was 9lb, 10oz when he was born and stayed at the top of the charts for his first year of life. My step-son was 6lb, 15oz when he was born and stayed in the 50% range for for his first year.

Thank you for the advice on the formula. I had no intention of using it, but hope that by adding it to the breast milk it will help. I had no idea that there were formulas with different calories!

[Merika]

Hi!

I strongly recommend checking out www.kellymom.com and www.lalecheleague.org for accurate information. My experience being with LLL for the last few years is that doctors often don't know what they're talking about when it comes to infant growth rates and breastfeeding. It sounds like your dd is healthy and growing, and without his comments you think she is fine. Mommy gut is often more accurate than pediatricians looking at a chart.

The growth chart you mention, btw, that almost all US docs use, is 30 years old, and based on caucasion *formula-fed* babies. Your baby is breastfed, and will follow a different (and better, IMO) growth pattern. The World Health Organizition (a international well-respected group which the American Academy of Pediatrics gets its direction from) is in the process of publishing, after years of research, a NEW growth chart for breast-fed babies, which will give you a more accurate view of your child's growth.

As for celiac, I know how concerned you must be I am celiac, and worry about my son (age 3) too. The celiac toddlers I have met exhibited extreme signs of celiac. What we decided to do was keep ds gluten free until we feel he's at a "safe" enough age to test him on gluten for 6 months, and then run a celiac test. I am guessing we will do it around age 5, for various reasons.

If you are gluten free and breastfeeding, and you are feeding your dd gluten free food, there should be no risk of active celiac in your dd. If you start feeding her gluten, and she is one of those kids who would get diagnosed as a toddler (remember, many of us weren't those kids), she would start showing signs ???I've heard average trouble starts around 9 months - of course that all depends what and when you are feeding her table food.

Personally, I wouldn't want to risk glutening *myself* by feeding and cleaning up very messy baby eaters, yk?

There is great research and evidence that support breastfeeding to create healthy infants, even research that shows the longer a mother breastfeeds her child, the less likely the child is to get celiac! In fact, I think the www.kellymom.com site has a growth chart for breastfed infants.

Please do check out the websites I listed. They contain lots of useful information. My guess (from talking with many many new mothers) is that your dd's weight is just fine, and the pediatrician is just looking at the charts and saying to fatten her up, without really looking at *her*. How does she look to *you*?

Warm wishes,

Merika

(upfront about being anti-formula)