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Children's Health

My 2 month old baby gaining poor weight

01/27/2009

Question:

hi i m really upset mom, Dr told my 2month son is with heart murmur and told me to have an appointment with heart specialist. my son was born with 9 point jaundice now jaundice is ok, he is on zantac becz he has reflux he is gaining poor weight he was born with 7 pounnds 20 inches now he in 2months age he is just 9 pounds 21 nd half inches is it poor weight that he gained plzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzzz repl me as soon as possible i m much upset

Answer:

You have certainly had a stressful start to motherhood with your son! Your son's growth measures were good at birth his weight at the 25th percentile, meaning that he weighed more than 25 of 100 baby boys at birth. His length was at the 50th percentile, meaning that 50 of 100 little boys were shorter than he was and 50 were longer. He was exactly average in length.

Looking at his weight and length at 2 months of age, both are at the 5th percentile, meaning only 5 of 100 2-month-old term baby boys weigh less and are shorter than he is. He has also crossed two major growth percentiles downwards in weight and three major growth percentiles downwards in length. So these are important changes that your son's doctor have called to your attention. He or she is being a good and careful doctor for your baby.

Many babies have reflux in their first year of life, although it is most common in the first 6 months of life. This is because the top opening between the esophagus or food pipe and the stomach is lax in infants. Research shows that almost all babies have some degree of reflux. For those babies who have reflux with back arching and crying, Zantac is prescribed to stop the production of stomach acid so that the reflux will not burn the tissues in the lower part of the esophagus. Other measures include elevating the head of the baby's crib or basinette to prevent pressure on the top opening after a feeding or placing the child in a reclining infant seat and giving thickened feedings. There are new formulas that thicken on contact with stomach acid, but since your child is on a medication to stop stomach acid flow, the traditional method of adding rice cereal to formula is the better way to go. Before doing this, discuss it with your baby's doctor. The usual recommendation is 1 tablespoon of rice cereal per ounce of formula. You may need to enlarge nipple holes to make it possible for your baby to suck in the thickened feeding. If you are breast feeding, pumping the breast milk, then thickening it with rice cereal, and feeding it from a bottle works well for many babies. A lot of spitting up, even with Zantac, may be the cause of your son's poor weight gain.

If your son has a heart murmur, it is possible that there is a problem that needs treatment by medication or surgery. Most heart murmurs are what we call innocent flow murmurs. The baby's chest is so thin that you hear additional flow sounds but nothing is wrong. However, other murmurs mean that there is something wrong. This could also explain why your son is not gaining weight. The problem in the way the heart formed or the way it is working may be stressing his body with lower than normal oxygen levels and that may be preventing good weight gain. Fixing the problem usually improves weight gain. So your son's doctor is very correct in suggesting that your son have a good evaluation of his heart.

Anxious mothers may also upset their babies' ability to eat well because babies sense their mother's worries and become anxious too and feed poorly. If your baby's heart is fine and he is taking in enough food and not spitting up much, this may be at the root of his poor weight gain. Being a mother is a big responsibility. It is no wonder that many mothers do feel worried about how they are doing as a parent. Your baby's doctor can help you relax and feel more confident as a mother or recommend a counselor to work with you to gain confidence in your parenting. It just means you care a lot about being a good mother.

The bottom line is that your son is lucky to have a good and smart doctor who recognizes when additional care is needed and he or she is being careful to assure the well being of your precious child. That's what you want too.

Take each day one step at a time and don't hesitate to ask for information and support from your baby's doctor. He or she knows you and your son best and really wants to be helpful. 

You may want to purchase the American Academy of Pediatrics's (AAP) book Caring for Your Young Baby and Child: Birth to Eleven Years" or Penelope Leach's excellent book "Your Baby and Child: Birth to Five Years." The AAP's book focuses more on health issues. Penelope Leach's book focuses more on parenting and developmental issues. I highly recommend both and they are both available at major book stores such a B. Dalton, Borders Books, and Barnes & Noble. I hope this information proves useful to you.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University