feeding a low birth weight infant RE: Feedback via the Ask Health Query to Dr SK. Get answered for free.

My daughter is born at 37th week with weight 1.75kgs. And Doc has done so many tests to find why she is so small for her gestational age. and everything came normal. so we just thought it is just genetics.
===common cause of low birth weight is poor maternal weight gain. other cuasess are some intrauterine infections and some genetic syndromes. even problems of placenta and mother's hypertension may at times cause low birth weight. whatever the cause, that cant be reversed right now, so we should concentrate on treating.
 
 i will pump milk and gives her through bottle. she used to cry for hunger untill she finishes her 2 months. At her 4months oppintment she weighs 3.37kgs.
======= she has remained as a intrauterine growth retarded baby, so as per that her growth potential will be relatively slow. she may remain smaller on growth charts, but should show a consistently rising birth weight, to catchup with other kids of same age by one year. if she doesnt gain weight consistently, we need to evaluate. She has almost doubled the weight by this age, so i feel .. thats no bad. you did enough efforts to have good growth. many enzyme disorders get ruled out when one documents a progressive weight gain.
>
> At her 2 months oppintment doc thought she is not gaining much weight and she put tube in her nose to feed. we kept > untill 2 weeks and she was vomiting a lot so we thought its not good idea and we removed that.
== feeding by tube is always a more reliable option. in many cases i even recommend putting a gastrostomy tube.. with a small operation till weight gain is adequate. if the weight gain is not enough, it may cause further growth failure and child may succumb to many infections and morbidities.
 
 from then on doc advised us to add infant formula to breastmilk.
=== a calculated supervised feeding is always preferable when weight gain is crucial.
 
And now she doesn\\\'t even cry for hunger anymore even if we wait 4 hours. So we feed her every 2 hours. and she takes 40ml in half hour.
=== good. she may not have energy to cry. but do burp well after each feed. keep her semierect or held on shoulders to avoid aspirations/reflux. max feed at one time over 30 minutes should not exceed 60 ml for 4 kg body weight.
 
  
she only sucks while she is sleeping. she doesn\\\'t suck while she is awake
=======suck reflex starts disappearing sooner by this age. in addition she may be getting fatigued with prolonged suck. this classically is  observed in many neurological waeknesses, underlying heart diseases etc all need not be picked up with investigations easily each time.
 
 and she only swallowes what ever drips from the bottle.
===use a smaller spoon or dropper that a botle. save the infants energy wasted in sucking efforts, weight gain will be better.
 
 
 we repented a lot going with that tube option.
===why do you feel so, if you face any probs with doc, discuss with me and we can sort soem solutions. learn the correct method of tube feeding when you opt for it.
 
 from then she doesn\\\'t like milk at all.
=== she does drink.. as you said she swallows drops. if she is alert and active she has least reasons not to drink. common reasons at this age being cheek/ throat infections like fungal candidiasis, inability or weakness to suck.  check again.. she should take better with a small spoon. feed slowly and for long time.
 
 and it is very hard for us to feed when she is awake.
===id it that cos you feel she doesnt suck? whatever trickles from the bottle, she surely will be swallowing as she does in sleep. its another indication to try spoon feeds in propped up posture.
 
 And doctor in USA keep on insisting us to put tube in her stomach to feed. We don\\\'t know whether it is a good idea to go with that option.and doc always asks us to visit so many specilists all the time.
=== its good idea to get rapid weight gain without hassles and other feeding related issues.
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> she is able to lift her head and she smiles when we smile and her eyes will fallow us. she poops and she is having wet diapers.
======== good.. keep a close watch on milestones. many low birth weight abbies have delayed milestones. its important to pick up earliest as then only it can be modified. so visit a developmental therapist at least 4 times in next 2 months. have the development periodically assessed.
>
> Doc put her on prevacid for acid reflux at 2 months oppintment as she is vomiting once daily.from then on she is having gagging and once in a while cough.
===all this can avoided by feeding her in semierect posture holding her in arms.. and trying feeds with dropper or small spoon and letting the feed trickle along cheeks form the angle of mouth.
>
> 1. can you please let us know whether she is fine with her weight for that age?(she doubled her weight by 41/2 months).
=== she is just ok but needs a close supervision and weight management with feeding.
> 2. when can i start semi solids and fruit juices to her?do we need to go by months or weight to start these?
===by 6 months should be fine.
> 3. what are the foods that make them gain more weight? semi solids? or fruits? or milk as i want to go with only more calories food.
> calculated feeds.. like say well prepared formula feeds.
>
> I would really appreciate all your help.
=== read further details at http://infantfeeding.blogspot.com

>
> Thank you so much
> Ji
> ---------------------------------------------------------------------
> Visitor Ip: 170.35.224.63


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HELPING YOU UNDERSTAND CHILDREN, THEIR HEALTH , THEIR ILLNESS, BEHAVIOUR, TREATMENT AND DOCTOR ! Arvhives 2006
yes! the easily approachable,
friendly and understanding paediatrician.
MBBS, MD, DNB and FCPS
from Seth G S Medical college Mumbai.
Currently working as Lecturer in Pediatrics.
drpeds.blogspot.com
Arvhives 2006