Low Birth Weight in Infants: Growth and Feeding Concerns

The Current Situation of Underweight Children

My younger sister was born on January 29, 2005, weighing only 2400g (at 36 weeks).
Before she was one month old, she was drinking 120cc of milk every four hours.
Now, at five months and eleven days, her milk intake has not increased; she only consumes about 140cc every four to six hours.
Recently, she has shown some aversion to milk and can only eat rice porridge and thin gruel.

At her four-month vaccination, her weight was 6 kg and height was 62 cm.
Now, at five months and eleven days, her weight is about 7 kg.
Is this considered normal, or is her growth poor due to insufficient milk intake? She can now roll over and, with support from her parents, can stand and bounce.
Is this growth development within the standard range? Recently, when she is lying on her stomach or crying for milk, she tends to swallow too much air while feeding, which causes her to spit up (and I can hear her burping).
Should we be concerned about any immediate issues that require a doctor's visit?

An Ma, 20~29 year old female. Ask Date: 2005/07/11

Dr. Cai Zhengxian reply Pediatrics

Dear Mom An,
Congratulations on your baby reaching normal height and weight! Since your baby was born four weeks early, this is medically classified as late preterm birth, which means the corrected age will be one month less than the actual age.
Generally, late preterm infants develop very similarly to full-term infants.
Please continue with the current feeding and care routine.

I would like to remind you that your baby may start to roll over, so it is essential to have adult supervision at all times or place them in a crib with railings to prevent any accidents.
Additionally, please pay attention to burping your baby and avoid vigorous activities right after feeding.
The Tainan City Hospital cares about you!

Reply Date: 2005/07/11

More Info

Understanding low birth weight in infants is crucial for ensuring their healthy growth and development. Low birth weight (LBW) is defined as a birth weight of less than 2500 grams (about 5.5 pounds), and it can be a result of various factors, including premature birth, intrauterine growth restriction, or maternal health issues. In your case, your daughter was born at 2400 grams, which classifies her as a low birth weight infant, but she was also born at 36 weeks, which is considered near-term.

Growth Monitoring
At five months and eleven days, your daughter weighs approximately 7 kilograms and has a height of 62 centimeters. According to growth charts, this weight is within the normal range for her age, especially considering her birth weight. The growth pattern you described indicates that she is gaining weight appropriately, even if the increase in milk intake has been gradual. It is important to note that infants typically double their birth weight by around 5 to 6 months of age, and your daughter seems to be on track for this milestone.

Feeding Concerns
You mentioned that she is currently consuming about 140cc of milk every four to six hours and has shown some signs of milk aversion. It is not uncommon for infants to go through phases where they may refuse to drink milk or prefer solid foods like rice porridge. However, it is essential to ensure that she is receiving adequate nutrition. If she is transitioning to solids, make sure they are age-appropriate and provide balanced nutrition. The introduction of solid foods should complement her milk intake rather than replace it entirely at this stage.

If your daughter is experiencing discomfort, such as spitting up after feeding, it could be due to swallowing air while feeding, especially if she is crying or fussing before feeding. To minimize this, try to keep her calm before feeding, and ensure she is in a comfortable position. Additionally, burping her during and after feeds can help reduce the amount of air in her stomach.

Developmental Milestones
Regarding her developmental milestones, being able to roll over and stand with support are positive signs of her growth and development. These milestones are typically expected around this age, and her ability to achieve them suggests that she is developing normally.

When to Seek Medical Advice
While your daughter appears to be growing and developing well, it is always a good idea to consult with a pediatrician if you have concerns about her feeding habits, growth patterns, or any other health issues. Regular check-ups are essential for monitoring her growth and ensuring that she is on track with her developmental milestones. If her weight gain slows significantly or if she shows signs of dehydration or persistent vomiting, it would be prudent to seek medical attention.

Conclusion
In summary, your daughter’s growth and feeding patterns seem to be within normal limits for her age, especially considering her low birth weight status. Continue to monitor her growth, ensure she receives adequate nutrition, and consult with her pediatrician for any concerns. Early intervention and regular check-ups can help address any potential issues and support her healthy development.

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