My son, Chase, was born IUGR at 28 weeks 4 days on September 30th. He weighed 1 lb 7 oz. Currently he weighs 2 lbs 10 oz. He's been on full feeds since about 5 days after birth. The nurses have been fortifying my breast milk with 24 calories for quite a while, but he hasn't been making good growth gains. He is below the third percentile for his gestational age. The nurse practitioner said that Chase should gain 210 grams a week. He's only gained 100 grams in the past week. Today the NP told me that I needed to decide if I want his feeds alternated with formula or change his calories to 26 instead of 24. I opted to go with the calorie increase. I feel like my breast milk is too important for him at this point and I'm producing an adequate supply. When I call the night nurse, I look forward to hearing what his weight is and then I feel disappointment when he hasn't gained anything. Right now, Chase has been having mostly good days and I want to keep them going. I know he needs to grow in order to make even more gains. Those of you with IUGR babies or VLBW babies, did you also experience roadblocks while trying to get your babies to grow? What did your NICU do to grow them?
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IUGR- Not Making Gains in Growth
- By oquinn27
- Posted November 4, 2009 at 7:39 pm · 5 replies
- In In the NICU/PICU
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- By beckhamsmom
- Posted November 4, 2009 at 8:35 pm
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Our VLBW baby too had / has slow but steady growth. He was born 1# 15oz. at 27.5weeks. He was on 30 cal breast milk with Neosure until 9 months actual. They started him on 30 cal while in the NICU. He does have CLD / BPD so he burns more calories. He is now almost 20mo/17 mo and is in between 21-22 pounds and almost 30 He hasn't been weighed in over a month as we are staying clear of the doctor's due to H1N1. So he is still small, between the 3-5 percentile for his adjusted age (17months). However what is very encouraging to us is when we look at VLBW or LBW growth curves. Our hospital's electronic medical records allow us to look at this at home. There are always disclaimers aa these are gathered from small data pools, but according to the VLBW chart he is about the 35% for weight and 10% for height as of last month (19/16months)
- By katek
- Posted November 4, 2009 at 8:59 pm
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Keep in mind that babies usually lose weight or plateau the first week or two. That's "normal."
I'm not sure that it is realistic to assume a baby born under 2 lbs is going to gain 30 g/day in the initial stages of NICU. At least in our NICU, they "hoped" it would be between 20-30 g, and then the bigger the baby got, the bigger they hoped the gain/day would be.
There is good weight gain and not so good weigh gain. My understanding is that you want some of it to be fat but some of it to be "real" growth in the limbs. As one neonatalogist put it, you want baby to have the "healthy" growth. Establishing that can take time.
I believe that my son's rounds of feeding intolerances were driven in part by the addition of the fortifier too early in his NICU stay (and he turned out to have a milk allergy). Unfortunately with a sample size of 1, I can't prove that. But looking at the patterns, I'm pretty sure that the extra calories ultimately hindered his situation b/c they overtaxed his system (he was diagnosed with NEC and then he had to be taken off feeds for a week and then it took a long time to get back up to normal feeding levels). That's just our experience.
Given the research on NEC and formula, I would definitely keep giving the BM as long as you reasonably can. Babies who are on formula tend to get NEC at higher rates than BM babies.
Best wishes to your son.
- By Teesa1221
- Posted November 4, 2009 at 9:04 pm
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Adam was low birth weight, IUGR, and it took him until 1 month adjusted age to really start picking up weight. There was about a month where he stayed in the 4 1/2 pound range. We were told he should gain 15-30 grams every day. That didn't happen. The doctors however were not concerned at all. They said because of everything he went through and that he was IUGR it just takes some time and eventually things start happening the way they should. Sure enough they were right. He was also on breast milk fortified to 24 cal.
- By beckhamsmom
- Posted November 4, 2009 at 9:23 pm
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I just wanted to clarify when DS started the 30cal, I believe it was when he was around 8 weeks old.
He too previously had NEC (at about 3 weeks of age) and was NPO for 10 days. Fortunately it resolved with meds.
I would encourage you to keep pumping, that is so great for your LO and you!
- By peanuts_mommy
- Posted November 13, 2009 at 6:04 pm
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I want to thank everyone for sharing their IUGR srories. To hear that babies way younger and smaller in gest. age than mine who are doing well really helps my outlook on things. Keep praying ladies!
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