4 month old baby slow weight gain, breastfed, I think he's starving!

[milkyjo]

Hello
Hoping somebody has any ideas for our situation. My 4 month old was gaining weight well up until 6 weeks when he dropped down to 25th centile from 50th, his weight gain was starting to get progressively slower and he has dropped down to the 9th, only putting on 150g or 5oz in 3 weeks.

I feed him every 2-2.5 hours in the day and he only takes 30 minute naps. He'll sleep all night from about 7:30pm until 6/7am. I give him 150mls of EBM for his last feed as it gives me peace of mind! He is very windy and always very unsettled at the breast but we persevere through the feed, he comfort sucks and I don't know when he's finished, I've let him feed for 1.5 hours before to see if he'll detach by himself but he didn't, he just fell asleep! He manages about half an hour to 45 minutes of playtime before he gets really grumpy and generally screams before feeds, after feeds, before a nap and after a nap, also after his bath when I get him into his pjs.

I gave him a feed at 3:30pm today and he couldn't get much milk from me because I gave him 150mls of formula afterwards at 4:30pm and he took the lot, became a lot happier and managed to stay awake (happy) until bedtime at 7pm! And he then had 170mls EBM at bedtime. I also express at 10pm and I don't have time to even make myself some lunch let alone express more in the day as he is very demanding - I do eat lunch though, prepared by my brilliant hubby before he leaves for work!

So, my questions are:
Has he been starving all this time?
Has my milk supply disappeared?
If so then why, when he is feeding every 2 hours?

I am seriously considering giving up the breastfeeding, although it breaks my heart, its worse to see my little boy miserable and hungry (if that's what he is!).

Sorry for the essay! Please help! Thanks x

[firsttimemum90]

have you checked to see if his latch is still ok? how long has he been having bottle of EB and formula, i supplimented with my LO and he started the reject the breast as bottle was eaiser and not so much work for him! maybe try going to breast feeding cafe to check latch to reasure yourself he is getting a feed whilst on the breast.
when expressing are you still getting the same amount you usually do it same sort of time? if you are supply will be fine, when mine started to decrease i would have to pump forages and the amount would decrease each time.
however the fact you say hes been sleeping through the night says to me that he must of has enough through the day as no baby would starve themselfs.
my situation bit different as i did switch for formula around 8 weeks, and from 12 weeks my ds weight gain slowed down was ine 2nd at birth went up to 25th then down to 9th so similar to yours, hes now back in 25th. i spoke to my Hv about his poor feeds some due to reflux but thats another story!, (somedays taking 20oz max! but still sleeping 12 hours at night) and she recommended early weaning, he now has rice and puree fruit mix with milk and is eaisly taking 25oz milk a day.
dont know if i've helped but your not alone hope you LO gets his feeds up soon i know how frustrating it can be and how you worry all day is he getting enough!

[japhrimel]

Do you always take him off yourself by detaching him from the breast? When you say comfort sucking, is it just brief periods of very fast, light suckling followed by a rest or are there deep sucks?

Extra sucking is needed for every growth spurt to increase supply. There should be a change in sucking pattern if he switches to comfort sucking. I would wonder whether you might have interrupted him trying to up your supply a few times if you always take him off mid-feed.

[fifitot]

You could do with seeing or talking to a BF counsellor. Can you access one or phone NCT? IME the 'comfort sucking' is about the baby increasing supply so go with it and don't worry about it.

Is his latch OK? Get it checked as if it's not great he will definately take longer to feed and not get enough milk. If his weight keeps dropping it is of concern of course so you need to seek proper medical advice on this.

I would forget formula and ebm top ups - just let him have his milk straight from the breast, it will help your supply.

Your milk will not have disappeared. you may just need to increase your supply. Feeding every 2 hours is not unusual even at 4 months. Also napping for short periods isn't that unusual either.

I would definately seek support at a BF group or similar and just get baby's weight checked to see it isn't dropping.

[bonkers20]

Hugs...it's hard isn't it.
Here are some things you can try.
Have a stay in bed day, where you just cuddle in bed all day, lots of skin on skin and cuddling. Have someone bring you what you need and just dedicate the day to feeding.
Carry him in a sling, the comfort of you might soothe him between feeds to allow your supply to build up a bit.
Eat well and drink to thirst. Relax as much as you can.
Check that you have BF growth charts not FF.

Could he be teething? BF will be a great comfort to him if so.

Your milk won't have disappeared, but you might need to build up your supply.

As other have said, do go and see a BF counsellor, they can check positioning and suggest different positions. I'd give up the formula and EBM and just let him take it straight from you, much less hassle.

It doesn't last for ever.

[smileymam]

i was the same with my son, only fed him for 3 weeks, finally put him on the bottle and he gulped it down so fast i though he must have been starving. Fed my daughter though for six months and she was really slow to gain weight aswell, she was under the chart all the time and only weighed just over 10lb at six months, was reallly worried as she was gaining a tiny bit then losing it, docs sent her for tests and all was well, but they prescribed a special milk to help her gain weight, i asked should i stop breast feeding and they said certainly not! so i did both, and she came on fine, very healthy 6 yr old now, she stayed on the special milk for a year and they aslo told me to add full cream to her desserts when she was weaning to fatten her up, they said if she had been shorter they wouldnt have worried but she was to tall for her weight.

[PenguinArmy]

Your feeding and weight gain pattern is exactly how DD was. I just accepted it. Lots of babies feed every 2 hours and since she was a slow gainer I was reluctant to try and extend her feeds so didn't. She was also a 30 min napper and fed 2 hourly during the night as well.

I (and the HCPs) had no concern as she was otherwise alert and fine (although mardy when it came to sleeping and difficult to get off).

I got the latch checked, did switch nursing and just carried on. She came back up to 2nd centile by her first b'day. She was mobile quite quickly (rolling at 11 weeks, walking at 8.5months) so figured she couldn't be starving if she was doing that. Is nappy output all OK?

If expressing is a PITA then don't do it.

[squiggleywiggler]

A v quick post to say BF babies will almost always drink from a bottle (as long as they'll take one in the 1st place) even when they've had 'enough' milk from the breast. Most bottles let out a small amount of milk without the baby doing anything and this stimulates baby to drink. Doesn't mean they are hungry.

Obv I don't know if this is the case with yours, but it's worth going to a BFing group asap. They could guve you some tips/ideas and may stop unnecessary top ups if you don't really want to give them.

[zayla]

We had weight issues for a couple of months, and if I did things again I'd pay for a lactation consultant as early as possible. I found that the free breastfeeding support out there was a bit hit or miss for weight issues. There's also a book called 'Making More Milk' that you might find useful if you can get hold of a copy.

Also rule out reflux/silent reflux/food intolerances as they sound like a possibility though as nighttime sleep is ok it seems less likely.

We mixed feed now (2 bottles of formula a day) and doesn't seem to have affected my milk supply for other feeds so giving up completely isn't necessarily the only option though whether you can get away with this obviously depends on the individual.

[CamperFan]

My DS2 is almost 6 months and until very recently would feed every 2 hours in the day and also every 3 at night! And he would sleep for 45 mins max in the day. However the last couple of weeks he has been going for longer, and his naps will be longer than one sleep cycle at times. And we are currently down to one feed per night. I have not had him weighed since he was about 10 weeks old and was worried about reflux (loads of puking, which settled around 4 months, still a little pukey), but he is big with chubby thighs, so I am not concerned. I sometimes think weighing them can make you paranoid and undermines the confidence a bfing mum has.

I completely agree with another poster that there is no way he would sleep all night if he is hungry - tbh it sounds like you are managing to fill him up nicely during the day! And yes, if they will take a bottle (my DS2 does not), then they will tend to drink even when not hungry. It does sound to me that you need top ups at all. And so few women actually have a problem making enough milk for their baby that you shouldn't worry about this.

If you could get to a bfing group you might find that lots of people have your experience. And if you can find a group with a trained MW there too, all the better. It can be hard knowing you are doing the right thing if no one you know in RL bfs. Are you and your DH quite small? Maybe the 9th percentile is where he should be? And you could just have a grumpy baby, and the afternoon with the formula was coincidence.

[CamperFan]

That should say "it doesn't sound like you need top ups" of course!

[milkyjo]

Thanks for all your replies. My son does have reflux, sorry forgot to mention, but it is under control with Omeprazole, he's not very sick now, just small vomits (about 3 for about an hour after feeding). I decided to let him feed for as long as it took this morning, we started at 6:30 and finished at 8:10! This wouldn't be a problem if I wasn't home alone all day as when he is settled feeding it's lovely, also this doesn't give us much of a chance to go out and about.

Some people have said about comfort sucking upping the supply but do I have to sit and wait for 2 hours for him to do this every feed? I don't mind him doing this but will he eventually stop? I had loads of milk this morning and he still fed/ sucked for 1 hour and 40 minutes.

Camperfan my husband is 6'4" and I'm 5'5" so we are not small, my son seems to have inherited my husband's extraordinarily long torso and he is a long baby, even 3-6 month vests are tight lengthways!

My plan today is to get dressed (!), feed only from me whatever the situation (could mean feeding every hour!) feed him his last feed from me, express at 10pm as usual, block my ears through the grumpy crying!

[MigGril]

If you've been toping up/limiting his time at the breast it may take a few days of just feeding/feeding/feeding to up your supply. Just go with it and it should setal down in time. BR babies offten change there feeding routine, nothing stays the same for long.