EBF 3mth old dropped 2 centiles, can I do more?

[TriciaMcM]

EBF DS is 3 months and has dropped from 75th centile at 4 weeks to just under the 25th now. He was 84th centile at birth. Dropping 2 centiles is an automatic referral to a paediatrician here, so want to do everything I can before they mention formula.

He's a happy baby, lots of smiles & starting to giggle, very, very little crying at all. He's very strong and had good head control from the beginning, and the nurse at his 3 month check said she'd never seen a stronger 3 mth old as he was showing off his push ups! He looks lovely and chubby too. He also sleeps for a 6 hour stretch at night. He NEVER cries for food - when I hear him stirring during the night, I know it's time for a feed - for example I know if I put in his dummy he'd probably turn over for an hour. During the day I offer every 2 hours at most, unless he's asleep. In the mornings/evenings I usually offer more frequently.

His feeds have always been short. DD who was DC1 was happy to sleep feed, and feeds could last forever. His longest even as a newborn was 20 mins. His average one now is 6 minutes. If his weight was good, I'd accept he was an efficient feeder. He's exceptionally windy - you could burp him for 90 minutes straight and still get burps. If he gets grumbly it's inevitably wind.

He spits up a good bit - DD was similar and we saw a specialist who pretty much said she was perfect, just to wear washable clothes until it sorted itself out. She tracked the 75th centile almost perfectly though, and still is there at age 4. It's not really causing him concern - he grumbles if he has wind but no screams or crying. It did seem to bother him for a while & we tried Gaviscon (GP suggestion) but it made no difference except to make him constipated. If he started and stayed on the 25th centile, I wouldn't be worried, it's the drop that's concerning. I'm smallish - 5'3 and slight, but DH is tall and DD looks like being tall too.

So - I'm offering regularly and always offering both sides now no matter how quickly he's done after I saw a post from tiktok to someone with a similar query.

He doesn't seem to feed for longer if there is longer between feeds. He was 4 hours the other day between feeds as we were in someones house who didn't believe in using heating - I was cold with my winter coat so didn't want to take him out of his cosy footmuff unnecessarily. He didn't so much as grumble for food, napped and smiled away. When we got home he fed for maybe 8 minutes.

I'm reluctant to wake him for a feed during the 6 hour stretch as if we don't burp him after a feed he wakes 30 mins later anyway so it would disturb his sleep. He's also not a great napper during the day - he seems to prefer sleeping at night (opposite to DD).

I'm not anti-formula entirely - if I believed it would help his weight, I'd already be giving it to him. He feeds so quickly that I can't see him finishing a bottle much quicker anyway.

I also EBF DC1 and BF her until almost 2 so I'm used to BFing and very confident that I don't have a supply issue. At the end of his feeds if he's sleepy and stops swallowing, he spits out the milk in his mouth! So there is milk coming even at the end.

Is there anything else I could be doing?

[tiktok]

It's good you are seeing paed.

I think it's def worth exploring getting more milk into him.

Sounds like he might be a laid back baby who's happy enough ticking along without demanding much. That might mean you need to be proactive. That means not ignoring any cues to feed (dropping the dummy esp at night).

Forget about whether he is windy or not. All babies - all humans- take in air when they eat. It's pointless winding for 90 mins ( you don't really do that?! Do you?).

It's also pointless timing feeds. This gives you no idea of volume of milk taken. Frequency of feeding drives supply and intake.

Hope things go well with paed. All might be well.

[TriciaMcM]

Hi tiktok, thanks for reply. Dummy is only for naps/sleep, he never has it otherwise but I take your point. I agree that he's such a chilled baby that he doesn't look for much. I'll offer even more often, it's just that after feeding, nappy change & winding it's nearly time for another feed again! We don't wind for 90 mins but when spit ups were very bad I was keeping him upright for almost an hour after a feed so indirectly sort of was.

Just watching him here, he's on his baby gym rolling onto his side with such concentration & then chatting to the animals hanging down, it's hard to think there could be anything wrong with him. My mum thinks there's a problem with my milk, logically I don't agree but logic flies out the window when it comes to a baby so I've that awful niggling worry constantly now. I keep waking during the night & stressing

[tiktok]

Reassure your mother. Breastmilk varies hardly at all in quality between mothers. I can't think what could be, 'wrong' with it. She is opining on something she knows very little about and it's undermining you. She should zip it.

[OhMjh]

Exactly the same story here! Was your LO overdue? DD was just above 75th when born at two weeks over and is now on 25th. Had her weighed today ( 3 months) and she's stayed on the 25th so they are happy as long as she stays there. Overdue babies often have 'catch down' growth because they were bigger than intended at birth, IYSWIM, so maybe that applies to you.

You can't have 'bad' milk, no, but they quality of your milk is affected by your diet. My milk was rarely creamy looking, and I lost more than my baby weight with no effort, so I was told to introduce more stodgy foods and my milk is no longer watery, also DD seems more content. It may be worth looking at your own diet to see if you could be eating differently.

[YiIKEA]

Ohmjh honestly your diet is largely irrelevant, milk is synthesised primarily from your blood - you have to be malnourished to see differences and even these don't knack the quality or calorie content. You can diet, eat crap and bf.

The only way to get more milk in, if more is needed, is to feed more often and to offer more sides.

[CultureSucksDownWords]

Ohmjh, I don't think you're correct about diet affecting the "quality" of human milk, except where the mother is near starvation or extremely malnourished. As I understand it, your milk is prioritised so that your baby gets what they need. I've never heard of anyone being advised to eat "stodgy" food to help with producing breastmilk.

[PotteringAlong]

We had this! DS was seen and it was decided he was a 'banana baby' (how they described him!) a decided that he had just tracked down to his weight - in our case though it was 50th Centile to 9th centile.

The dr looked at my DS and decided that he saw lots of sick babies and he wasn't a sick baby! He decided to start feeding more naturally at about 4 months and is putting on weight and tracking his line now.

[PotteringAlong]

That's feeding more but naturally decided it by himself, not that his feeding was unnatural!

[anothernumberone]

Spits up makes me wonder if there might be a tongue tie, particularly a tricky to spot posterior one.