Childhood Diseases

Question
Posted by: nix | 2012-02-15

Q.

4 MONTH OLD SON LOOSING WEIGHT AT CRECHE

I have a 4 month old son who is at creche for the last 4 weeks.

We had him weighed before he went and he was 7kg and 63 cm tall.

Yesterday we weighed him again at the baby clinic and he has lost 300g weighing now 6.7kg.

He sleeps most of them time that he is at school and only drinks 1 bottle of 240ml Isomil formula, some rice porridge in the morning and pumpkin in the afternoon for lunch. At night when he comes home he has breast milk and falls off to sleep again and sleeps right throught the night to awaken at 4am again or a feed.

Is this normal? Last night he ate 2 bowls of porridge and looked like he wanted more, When he sees food he stares at it continuously and I swear if he could he would try to eat it.

He is a very content little boy who never cries and is always smiling. What should I do, its really worrying me now!

Expert's Reply

A.

Paediatrician

The average weight for a baby boy of 4 months is 7kg. Your baby was doing well until he started at the creche.It is not the solids that are important for a 4 month old baby,but his formula. Why is he on Isomil? Is he definitely allergic to cow's milk or does he have lactose intolerance? If he does not then he should not be on a soya formula such as Isomil. I would prefer him to be on a regular cow's milk formula if possible, especially one for hungry babies such as Lactogen1.Please let me know why he is on a soya formula and if necessary I will advise you about the way forward for your baby.

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5
user comments

C.

Posted by: Purple | 2012-02-15

You don''t pass on bugs through your milk, you pass on the antibodies to help your child fight off any bugs that you have had or that they catch from you.

OK, so he has a runny tummy - that is probably the cause of the weight loss.

The formula can make the tummy bug worse, rather stop the formula and leave him breastmilk as it means he will get sick less often and will recover faster when he is sick.

Lactose intolerance is very rare, and generally only starts in toddlerhood when the body is making less lactase because children are drinking less milk. Green poos are usually a sign that mom is not finishing one breast before offering the next and is trying to give both breasts at every feed. It can also happen from mom having lots and lots of milk gushing out and baby getting in lots of foremilk from that. To resolve, lie back when you feed so that gravity helps the situation.
The other reason for green poos is a tummy bug or from the iron found in formula - as there is too much iron in formula becuase the body can''t absorb it all that well in that form (whereas breast milk has the right amount and most of it is absorbed).

When a baby reacts to formula, it is usually to the milk proteins and not to the lactose.

Yes, the cows milk based formulas like S26 can be a cause of exzema. Breast feeding will help as it reduces the risk of exzema.

I think that if you increase your breastfeeding a lot of these problems you are having might go away, as the formula seems to be the problem.

Reply to Purple
Posted by: nix | 2012-02-15

I put him on Isomil as he was having tummy problems, cramps and green poos.

His brother ( 3 yrs old ) was lactose intolerant and was scared he was going the same way. My baby also has eczema and thought that the formula I had him on S26 Gold was affecting him.

Reply to nix
Posted by: NIX | 2012-02-15

He has had a very loose tummy lately and I gathered that my tummy was upset about 2 weeks ago and he probably picked up what I had through my milk.

Reply to NIX
Posted by: Purple | 2012-02-15

Sorry, in addition to the reasons given above for more frequent feeding, the more frequently you feed, the more of the hindmilk is present in your milk, the hindmilk is more calorie dense (its the cream or fat in the milk) so helps a low gaining baby or a baby who has lost weight gain it back again.

To have lost 300g is quite a big weight loss, and not due to different scales or a vest being on and so on.

Its probably a good idea to cotnact a lactation consultant (an international board certified lactation consultant) or La Leche League for some help, because you need to resolve the feeding issues so baby can regain the weight and start thriving again. You should probably also visit your peadiatrician to give baby a thorough check. It might just be coincidence that this happened with the start of creche, he might have lost the weight anyway if he is getting ill.


Reply to Purple
Posted by: Purple | 2012-02-15

He is not getting enough milk.

AT this age he should only be having milk, anything else has fewer kilojoules and is not nutritioius enough fo rthe rapid growth.

Some babies at this age do " reverse cycle"  meaning that they don''t take much milk while apart from mom in the day and then make up for it by frequent feeding at night.

Breast fed babies feed small amounts often - as opposed to bottle fed babies who take large amounts less frequently.
The creche need to offer him bottles of your expressed milk at least every 2 hours. They need to stop giving him cereal and vegetables as this is resulsting in him taking less milk than he needs.

He will take between 60 and 120ml per feed. You need to express every 2 to 3 hours at work to keep your supply up.

You also need to feed him in the morning before you drop him off, you can offer breast again at the creche when you drop him (or in the car outside as well), as soon as you fetch him feed him at the creche or int he car outside, again when you get home, all through the night (co-sleeping can help with this as you and baby both essentially stay asleep through the feed so you are less tired than if you have to get up at night to feed - but not everybody is comfortable with a baby in their bed - its a matter or personal choice). Over weekends, be sure that you are demand feeding and if baby is not asking, offer him a feed at least every two hours.

Another thing to watch for is if he is losing weight because he is getting sick and off his milk from that. Unfortunately babies in creche get sick a lot. It helps if they use their own bedding and its not shared bedding and if the care givers wash hands often, but these practices still don''t eliminate illness entirely.

Is there any way you could find a day mom (where he will be around fewer children) or a nanny for at home?
Another option is a creche closer to where you work so taht you could try to go there at lunch time to feed him and help with his weight gain.

Some moms who work find that expressing at work is difficult and they leave formula at the creche, this is also fine, but if you want to keep on breastfeeding, keep on feeding when you are with baby and keep the feeding as frequent as possible and stop the solid feeding as it is going to cut your breastfeeding days down.

Reply to Purple

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