Breastfed baby has slow weight gain and fussing but don't want to be forced to give formula yet

[monkeygirl]

My 8 week old ds was a big baby at birth (10lbs 1 oz) but he has been gradually sliding down the centile lines from the 98th to about the 25th (he now weighs 10lbs 13ozs). He has been exclusively breastfed from birth. I feed him usually every 2.5/3 hours on demand although at night he has recently started doing 4 and 5 hour stints.

I am not a confident breastfeeder, and in some ways am a reluctant one, mostly because I have no faith in my own ability and milk supply (and I hate feeding in public, but that's another story), but I really really want to continue and not supplement with formula or give up yet, as suggested by the dreaded HV. I know, I know, take what they say with a pinch of salt but his slow weight gain is beginning to upset me and compound my own feelings of failure again with bfing (I had a similar experience with dd1 but managed to persevere to 4 months at least). What's making it worse is that my ds has always fussed slightly at the breast but he has been getting worse and in the past few days has been screaming and pulling away at daytime feeds (nighttime feeds done in bed are never a problem, it's like a different baby).

My ds is still a very cuddly, squidgy darling who is very alert and smiley when awake (although he does love his sleep but often has a problem in the daytime dropping off, again screaming if he can't - can this be connected?) and seems happy and laid back most other times.

I try really hard to get the latch right and although I'm not confident it is always good, I have never had sore nipples and ds often has milk dribbling out of his mouth. When I can wind him he also sicks up a fair bit so some must be going in.

Please please can anyone help or suggest what is going wrong as it is beginning to spoil my enjoyment of being a mum again and I want to keep the HVs off my case.

[hercules]

Is he happy and livel? If so just dont go to the clinic and get him weighed.

[musica]

monkeygirl - sympathies - both my babies did this - ds was nearly 10lb and dd was 10lb2oz. Dd at a year is just above the 25th centile, and ds is on the 9th. I have heard that birth weight is not a good indicator of their genetic size, and that it can take a long time for them to settle.

I think if he is alert and happy, then he is fine. The time to get worried is if he starts falling asleep a lot, and doesn't wake for feeds.

Hope this helps!

[Aero]

Also, is it possible for you to lie down and feed him in bed during the day? I also find it easier lying down and have perservered with bf my ds2 who is still rubbish at latching on properly. I also hate feeding in public as I need both hands and feel clumsy trying to be discreet! Also at the stage where you are now I didn't want to be railroaded into giving him a bottle. I'm a bit pig-headed that way and refused to give in despite various problems. He's almost seven mths now and still wriggles and pulls back, but I've never really taken him to be weighed and not worried about his weight. He's perfectly healthy and now (at last) on solids.

[Lisa78]

Oh monkeygirl, God do I know how you feel. DS2 is 9m and I went thru exactly the same thing as you, and he even started to lose weight - and I hated everything about breastfeeding, so that didn't help either. All I can suggest is if he is well in other ways, then relax - he won't let himself go hungry. You could check for reflux - I know I'll get shouted down by half of mn but my ds was just as yours and infant gaviscon really helped, even tho he didn't have the classic reflux signs
Sounds to me like you have the latch on fine, but if you are worried, ask NCT or similar to check for you
Most of all, remember that breastfeeding is only part of being a mum - and its your choice to do it.

[monkeygirl]

Thanks guys, I know you are right about the dreaded weigh in at baby clinics and ds is mostly lively and cooing and smiling (although like I said he does sometimes sleep a lot but so does his dad, or he would if he could so maybe it's genetic ). But it's that little voice at the back of my head that's telling me I must be doing it wrong. It didn't help that I was in a feeding room today with two other mums with perfect feeding babies (no squirming or screaming, lots of swallowing and guzzling sounds, no hands needed to wedge boob in correct position).

Aero - maybe I should try and lie down more, but don't know if dd1 will let me!

Lisa - how do I check for reflux - do I have to go to the doctors? Did your ds still get through all his feeds?

[Aero]

mg - my ds 1 had reflux and it showed on a scan - he was prescribed infant gaviscon too but hated it so much we discontinued. And I worried......he's now six and also pretty healthy (most of the time when he hasn't got a cough like he has at the moment!). Your GP should refer you if they think he has reflux.

[frogs]

Monkeygirl, this was me a few months ago! Except that dd2 was my third baby, so I thought I knew what I was doing.

The first two (8lb12oz, and 10lb) just followed their centile lines up the chart like good little porkers, so I was wrong-footed when dd2 (9lb 5oz) took nearly 4 weeks to regain her birthweight, despite apparently feeding like a textbook baby.

The midwives were fantastic, keeping an eye on it in a very low-key way without making me feel there was a problem. I did have some muttering from the HV, including all the 'Oh, it's very difficult to bfeed exclusively to 6 months' stuff. I came on MN to whinge, and everyone told me to just stop getting her weighed. So I did.

I have no idea what she weighs now (age nearly 8 months). She's definitely on the dinky side, probably below 9th centile (which is odd, as I'm 6 foot) but she's plump and juicy, and very alert and cheerful, so there can't be very much wrong. She's also quite minimalist about her solid intake (a couple of teaspoons at one meal) but I decided I wasn't going to worry about that either, so I don't.

Take no notice of the HV, they talk pants. I've heard a theory floating around on MN that some babies that are very well-nourished in the womb are born weighing more than they 'should' for their body type, and will drift down the centiles until they reach their natural level -- that sounds sensible to me.

I don't understand why HVs seem to think that modified cows milk is going to be better for a baby than his own personalised supply of human milk. You know you're doing the right thing. Keep us posted, we'll root for you!

[monkeygirl]

Aw Frogs thanks very much. I did vow this time to not take too much notice of the HVs, even the nice ones, and so I shall but that carton of formula to the back of the cupboard for now (yes I did buy one in a panic 'just in case' ).

What's worrying me more now is that ds is still pulling and screaming at the breast this morning, although he did seem to take some in for a good few minutes first, and he was again a completely different baby in the night - no fussing at all. I had to stop feeding him out of frustration on both our parts this morning.

As he is completely 'normal' at night does this mean it's a 'behaviourial' or positional problem rather than a physical one? Can anyone help?

[frogs]

Yes, I've had that fussing thing too, with all three. It is a phase, and I never quite worked out what it was all about, but my guesses were:

With tiny babies, sometimes the milk comes out more quickly than they can keep up with it, and they have to keep letting go to splutter, which hacks them off (understandably enough);

With slightly older babies, they sometimes get cross at the start of a feed before the main flow of milk lets down. Of course the more they fuss, wriggle and fret, the longer it takes for the milk to let down, so this can be a bit of a vicious cycle. I found fairly vigorous rhythmic patting on the back helped. A bit.

Also as they become more aware of the outside world they can be distracted by what's going on elsewhere, which can lead to slightly erratic feeding.

All of these kind of fussing seem to fluctuate particularly by how hungry/tired the baby is at the time, and also by how fast the milk is flowing, which fits with what you say about it varying at different times of day.

Also, indigestion can sometimes present as apparent hunger followed by fussing at the breast babies can't always interpret their bodily sensations very well. I found it helped to remember that they are very small and inexperienced little people all this 'baby knows best' thing can sometimes end up making you feel as if any problem is actually your fault, when sometimes it's just one of those things. I never really got to the bottom of what was causing the fretting and fidgeting and let's face it, the baby can't tell us but it does pass.

The rule of thumb told to me by my very bossy but friendly GP is: if the baby's happy and alert, growing and putting on weight (in any quantity) and has little chubby bits at the tops of the legs, then there can't be much wrong.

hth

[edam]

Oh God I remember that embarrassment at the fact that other mothers could feed without holding onto their breast. I never could. Made it to 7 mos (with one bottle feed a day) before going back to work though. B/f counsellor did say 'now take your hand away' once I'd got ds latched on but if I ever did latch changed and it hurt. Guess I'm just not as perky as some women (maybe something to do with nature being a bit generous in the old cleavage department).
Ds went through a stage of fussing as well, about four months IIRC, but I think was getting distracted by everything around him.
Frog's ideas make sense to me.
HTH

[monkeygirl]

Thanks Frogs. I know, it can be hard trying to to attribute 'adult' reactions and emotions to these tiny bundles sometimes.

So I will try the patting, and not feeding with too little a gap which I do do occasionally, and also grit my teeth and hope it is a stage. It might just curtail my feeding in public for a while (which I hate doing anyway) as when he screams he sounds like someone's cutting him with a sharp scalpel, but it's his usual cry, honest!

[monkeygirl]

Edam - I know perkiness is not a problem I have! I was going to start a thread along the lines of 'I hate women who can go braless, lift their t-shirt up and quickly and discreetly feed their baby hands-free instead of having to wear reinforced scaffolding and prop up their breast'

[californiagirl]

If it makes you feel any better, DD is often a fusser, and she actually rose almost a centile. She got better for a while, and now at 5 months rarely seems distressed, but is still fussy and fidgety. I am back to requiring two hands, one to hold the breast and the other to corral flailing baby bits, and frankly it works best if I'm leaning back with my knees up and can use my legs to help! When she was a newborn it often required a minimum of three hands, as she was very big on flailing, and DH had to hold her arms down while I positioned her head.

Check out Kellymom on fussing for loads of practical tips.

[kbaby]

why dont you ring your local hospital and see if they have a bf counsellor. we have one at ours and she is fantastic, you can visit her as often as you like and she helps with all sorts of problems. even if she just gives you the confidence to carry on it wouldve been worth it.

[kbaby]

forgot to add. she often deals with lots of babies who arent gaining weight and finds a way to help without formula.

[tiktok]

I don't get it.

HVs (and others) say a baby isn't gaining weight. So the baby needs more calories. Why do the calories have to come from formula? Breastfeeding more often would do the same thing - get more calories into the baby - as well as actually stimulating the breasts to make even more milk.

However, monkeygirl, your baby is probably showing 'catch down' growth - a perfectly normal and recognised phenomenon, whereby babies born unphysiologically heavy (though healthy and normal) tailor-make their own intake so they reach a weight level and size that is right for them.

The fact your baby is bouncing and gorgeous shows this.

His occasional screaming and pulling away are something many babies do from time to time. He will stop doing it at some point soon, I would think.

Your milk sounds fine for him, but if you are freaked into thining he needs more, just put him to the breast more often....if he doesn't want it, no big deal.

It doesn't sound to me that regular weighings are doing you any good, or giving you any useful info or support.

[pesme]

Hi, not much to add. Agree with everyone on this thread. My dd dropped through the percentiles like yours and I really got upset. Luckily my hvs are fantastic and barely commented on it except to say that she still looked healthy and was thriving to relax. DD was v. fussy at the breast as my flow was too fast but she is alot better now. Keep up the good work and trust yourself.

[monkeygirl]

Thanks very much everyone.
CG - I've only read the fussing bits on the website you linked to but it has some great info on it. A couple of their suggestions make real sense about my ds.

Kbaby - I did go to a bf counsellor first time round with dd1 but unfortunately it didn't really help me, or rather a similar thing happened then - I guess my dd turned out fine.

Tiktok - what you say is very reassuring, so I will persist in bfing and try to ignore that little voice in my head which is telling me I am doing something wrong. I know bfing is a 'natural' thing but it does not come naturally or easily to me.

Pesme - you must have some of the only hvs that do not try to worry you at the drop of a hat. Next in line after weight is that my ds's head is a bit big and 'we must keep our eye on it'....God but they're out to get me this time.

[californiagirl]

What are you supposed to do about the size of his head, anyway? I suppose it's useful to know when buying hats.

[Bozza]

I'm glad you posted this monkeygirl because I had been considering posting something similar. DD has dropped slightly from her above average birth weight (8 lb 12) to being on the 50th centile exactly at 12 weeks. But DS who was 9 lb 10 and is now a healthy 3.5 yo was under the 50th at 12 weeks so I'm OK on the weight thing. Agree with them being excessive sizes when born (DH 5 '10 and about 10 stone - me 5 '4 and pre-preg 8 stone 12).

Its the fussing thats bothering me - it makes me feel as though I'm not satisfying her. And she's always fine at night, very alert and content for most of the day, and has the leg fat folds and a most impressive double chin. So why does she fuss so much?

[monkeygirl]

Bozza - from what others have said it sounds like the fussing is often just a phase lots of babies go through. But have you looked at the website linked below by Californiagirl? There's quit a comprehensive list to go through. I think that my ds might be doing it cos he's finished feeding, but wants to continue sucking to send himself off to sleep and may not like the fact that my milk is still coming out. He still does it so I take him off now cos it's just not worth the screaming and pain for both of us and let him suck a dummy for a bit which seems to then calm him.

If your DD was hungry she wouldn't be so content at night and other times surely?? This is what I am hoping and although I will try and stay away from the baby clinic mostly I think I will just check this or next week that my ds is putting on some weight still.

[kbaby]

Bozza, My DD also fusses a lot at feedings. She feeds for a few minutes and then fusses. I took this to be a sign that she wasnt getting enough milk but now I think it is more of a case that she doesnt want it but I keep putting her back on. If I offer the other breast she fusses on that almost straight away, which makes me think it cant be that theres not enough milk.

[Bozza]

kbaby I think you're right - I do that with DD - ie swap breasts and she is just the same and then I end up going back to the first one. I know logically that she's fine but just wish that feeding could be a calmer, more bonding time. Off to check out that website monkeygirl.

[Bozza]

Very informative website. The bit about milk supply and expressing was particularly helpful Californiagirl - thanks.

[californiagirl]

You're welcome -- I like the Kellymom site a lot.