Breastfed baby gaining too much weight

[elsbethy]

I have a 18 week old exclusively breastfed baby. He was 91st percentile when he was born, and his weight has been rising steadily since then. At his 4 month check yesterday he was over 21lb, so his dot was well above the top percentile line.

Each HV we've seen has expressed worry about his weight gain. I've repeatedly asked how they expect me to tackle this. I BF on demand and he's not had any formula. Pumped a few times when I had mastitis, but he wouldn't take a bottle.

Since he has now crossed two percentile lines, he is apparently officially 'cause for concern' and we have been referred back to GP, with talk of being referred to a pediatrician. The last time I asked my GP about it (at my 6 week check), she said any baby over 75% percentile was classed as obese, and that I shouldn't feed him every time he cried. Hmm.

I was so pleased that BF was going well, and personally feel that he's fine. (He's a very quick efficient feeder, sleeps well, is rolling over & holding his head up.) But all this concern is doing my head in and making me doubt myself. Any thoughts/experience welcome!

[hollie84]

I wouldn't see the GP again as the "over 75th centile" thing is bollocks. Take the Paed referral though just to put your mind at rest.

I know someone whose baby is very similar size to yours - I remember the weight because her baby weighed the same at 4 months as mine did at 18 months

[CelticPromise]

My understanding is that a bf baby will regulate their own intake and you can't over feed them. You can't make a baby bf in the way you can encourage them to finish a bottle. It is entirely baby driven. I would expect him at some point perhaps to slow down. What did he weigh at birth? Some babies catch up/down to where they are ' meant' to be. And centiles show normal distribution of weights- someone has to be the biggest! In the absence of any other concerns, and since no-one is giving you any sensible alternatives, I would carry on as you are.

[micah]

Agree with Hollie.

I had the opposite- an ebf baby who dropped the centiles but my gut told me she was fine.

My hv referred me to the GP, who agreed yes, crossed two centiles is a paed referral.

The referal meant a blood test, for liver, kidney, thyroid, endocrine and other disorders. Then I saw a paed, dc was weighed measured and assessed. Together with the blood results nothing obvious wrong, so after another quick assessment a month later, discharged.

I'd take the referral, just so you can get that ticked off and reassure yourself nothing's wrong. If everything is fine, I found the best way to avoid the worry was to stop getting them weighed!

[Itsfab]

My HV told me off for feeding my baby too much. She complained I was feeding him every time she saw me. Really helped my PND .

Carry on doing what you are doing.

My baby was chubby, not fat. He is now skinny and tall. I am not doing as good as him.

Don't know if it will help but I am happy to post his weights if you want. I fed him 2 hourly for about 6 months as well.

[Lweji]

she said any baby over 75% percentile was classed as obese

Ah, ah.
As in my skinny 9 year old, who got to the 90 something centile by the time he was 1.

He had been down to much lower than 50 (can't remember - 30s?) at 3-4 months and then steadily climbed.
If he is breast fed, I'm sure it's fine. Babies need fat for when they get ill.

[lettertoherms]

Some babies are big. You can't over breastfeed. I wouldn't worry. He'll have growth spurts where he gets leaner and taller, and eventually his weight will even out.

[Sootgremlin]

My ds weighed the same as yours at the same stage, no one ever commented, all told me how well I was doing! He started at 75th and went up to 98th at one point. He was huge at 8 months, then started crawling and turned it all into growth upwards. He is now a very tall but very slim 3.4 year old, who still likes his food but eats healthily and is fine, active and energetic. He's in size 5/6 clothes, but you can see his ribs and abdominal muscles.

I fed him at every squeak, and I'm now doing the same with my daughter, you can't force them to breastfeed, they take what they need for the size they are going to be. He's not big because you feed him so much, he needs to feed so much because he's big!

This obese over 75th centile stuff is nonsense. Some babies will have to be above that, just as some will be below the 25th, everyone's got to be somewhere.

Like lweji says, I was extremely grateful for his chubbiness when he fell ill with bronchiolitis at 6 months. He barely fed for a week or two, but his weight loss wasn't ever dangerous as he had loads in store, and he stayed hydrated due to the little and often feeding.

[Thumbwitch]

I wouldn't worry about it either.

My Ds2 was born somewhere between the 50th and 60th centile, at 7lb 11oz - and by the time he was 10 weeks old he had hit the 99th centile. That's a massive increase!
I didn't mind, the HV here (Australia) didn't mind, in fact I was quite relieved because his tongue-tie had meant that he appeared to be throwing up almost as much milk as he was drinking (gulping too much air, getting reflux etc).

Lots of jokes about me producing "gold top" milk - but aside of that no one was worried, all that happened was he plateaud at about 6m and didn't gain any weight (or very little) for some time. He's back on around the 60th centile again now. :)

[Thumbwitch]

Sorry, should have said he's now nearly 23mo :)

[Thumbwitch]

Oh and utter bollocks to the "any baby over 75th centile being classed as obese" - what a load of shit! Some babies START at over 75th centile; a friend of mine had 4 babies, all over 9lb, 2 over 10lb poor thing! Granted she had gestational diabetes as well but that's not the point. All her boys are slim, healthy and not remotely obese.

[elsbethy]

I really appreciate the replies. I just wanted to hear it from someone else really, as I was worrying. I'm confident I'm not overfeeding (if that's even possible), because he makes it very clear when he does/doesn't want feeding!

He was 9lb 7oz at birth, I forgot to say. He's a big baby, no doubt. But the way I see it that'll change as soon as he starts crawling/walking.

Micah, interesting to hear what the referral entails, so thanks for that! We're due to see GP tomorrow, so I'll see what she says.

[NotQuiteCockney]

Ok, first of all, the rule is, a baby crossing two centile spaces (not lines) downwards is cause for concern. (But may be absolutely fine) A bf baby who is fed directly (no bottles) can't be overfed.

[Thumbwitch]

I don't know if your baby will do the same as mine, elsbethy - my DS1 was a little thing, born on the 9th centile and stayed on it - and he was walking at 10.5m and running by his first birthday! But DS2, being so much bigger, was much slower to walk - he was 13mo before he started taking steps, and took longer to progress to running as well. I think, and was told by other mums whose DC had been similar in size, that this might be because he was that much heavier - his muscles needed longer to develop enough to hold him up!
He did have superbly chunky thighs (still has!) but that made it harder for him to move rather than easier, I think.

[eatscakefornoreasonwhatsoever]

Just to reassure you still further - I agree with what these other lovely ladies have said. You obviously just make gold top, jersey cream, gorgeously fatty milk. Well done you. You're doing a wonderful job.

Take the referral if it will reassure you, but I bet he's just fine x

[leedy]

Your GP is talking complete arse (or at least doesn't understand how percentiles work) - my DS1 was born on the 98th percentile and stayed on it (I think he went slightly above it for a while before he really got moving). He is now a tall, skinny five year old.

[MustHaveMoreTea]

Echo what others have said = an 18wk old cannot be obese in any one's book!!! I think they referred you because of people overfeeding on formula, and they don't want to get in trouble if someone looks at the numbers without taking into account the context. Take the paed referral but more because they are difficult enough to come by when you have serious concerns anyway, so it is a bonus really, and use it as an opportunity to ask any other questions about DC as well! :) My bet is the paed is going to say: 'My! What a healthy, bonnie baby! Growing so well! Excellent work on producing such excellent milk!'

[CultureSucksDownWords]

Just being over the 75th centile cannot mean that a baby is "obese", as it depends on how long they are as well. A 75th centile baby for weight and length is in proportion. A baby that is 75 centile for weight but say 2nd centile for length would be more concerning as they would be short and heavy.

Agree with PP that you can't overfeed a bfed baby, and hopefully the Paed appointment will be reassuring.

[micah]

Can I just butt in and say the "quality" of the milk not likely to have anything to do with size…more probably genetics.

Like I said my baby went the opposite way- but it didn't mean my milk was of bad quality or inferior (as repeatedly suggested by my mum, and other pro-formula mums). I had to battle quite hard against the theory that my milk wasn't "good enough"- in fact I was told by paeds the absolute best thing for my baby was to continue breast-feeding, as formula could artificially pack on weight and mask any real issue, and affect natural development.

Mine just gained differently- her chart is a series of steps, no gain for a couple of months, then a couple of lbs in a very short space of time, usually coinciding with a developmental gain.

[Sootgremlin]

Agree micah, I had comments the other way, meant positively of course, but my milk wasn't better quality, I just produced a lot of it, because that's what my baby required. The excellence of breast milk is that it completely suits the needs of the individual baby it is produced for, as and when

[hollie84]

I have 2 children, both with the same birthweight, one a massive fatty and the other a slim baby. The milk "quality" is just the same for both!

[MustHaveMoreTea]

Sorry, Micah, didn't mean to imply to OP that there is 'poor' vs 'good' bm. More just a light-hearted thought on what the paed is likely to smile vs the HV 18wk old obesity rubbish!