4.5 month old, breastfed, and not gaining enough weight...

[DizzyDizzy]

I've had the health visitor out again, and my daughter of 4 and a half months, has put on about 1oz in the past 5 weeks. the health vistor's advised that i start giving her formula, but i REALLY don't want too. my daughter is very disinterested in food. she feeds often, but not for very long. she's always looking around, and generally not interested in feeding. i don't see how trying to feed her formula will help? if she doesn't take breast for long, why will giving her a bottle make her more interested? i suggest trying to start weening her instead, and she said yes, but to give her high fat content foods (obviously) but when she said potatoes and butter (?) and cream (?) or greek yoghurt (?) i was shocked, as i thought you weren't suppose to give babies cows milk until they're 1. she said it's ok, and that formula milk is adjusted cow's milk... which i thought was bullsh*t! has anyone else had a similar problem? if so, what did they do? and should i really be giving my child cow's milk based products at this age? please help!!!! i'm extremely worried about her now!!!

[ashleysilver]

Sorry but the health visitor is talking nonsense. If you don't want to give formula, you don't need to. Your milk is fine. More than fine. Also, nowadays the recommendation is to wean at 6 months and there are good evidence-based reasons for this.

How does dd seem to you generally? Is she happy and alert? Does she wee and poo? If yes, ignore the hv. If not, take her to the gp.

[DizzyDizzy]

yeaah, she's really happy, alert, sleeps all through the night, wee's poo's regularly. but she's just not putting the weight on. what can i say to the health visitor though? she comes back next week..

[sebsmummy1]

Oh gosh I had a similar problem and absolutely broke my heart over it. In the end I stopped getting my son weighed in with the HV, bought my own digital baby scales and weighed him regularly on those. As long as he was happy, alert and good colour and hitting his milestones I wasn't going to be detoured from what I was doing.

At one point he went down to the 3rd centile, having started on the 75th and then followed the 50th. He is now 10.5 months, eats like a horse, is climbing the centiles ( last time I weighed him he was just above the 60th) and larger than his peers.

[AnythingNotEverything]

I agree OP - I don't think formula is the magic solution here. Why would it, unless you were over feeding her to meet some target on a chart.

You can have dairy products before 1yo though. It's a little early to wean though if she's otherwise well.

I think I'd adopt a watch and wait approach if it were me. She's hardly wasting away.

[sebsmummy1]

I wouldn't early wean him, it really isn't necessary. The advice is that you can give cows milk as a food, not a drink, from 6 months. My son has unsalted butter, cream and cheese and thrives on it. Other babies though can have a lactose intolerance and need to steer clear, you will only really know as you start the weaning process.

Make sure when you are feeding you have the tv and radio off and aren't trying to conduct a conversation or multitask. They are very easily distracted at that age. I also used to use different feeding positions. One us called the dangle technique, which looks very wrong but is really effective for a strong feed.

I started doing it when I got a blocked milk duct, but basically you lay them down and dangle yr boob in their month which you prop yourself up over them. When I fed him that way he had no alternative than to get a big mouthful of boob and get a feed into him, using the more trad technique of feeding him across my lap just saw him twisting his head away all the time to see what else was going on.

The other advice I had was to express and feed him from a bottle so I could see the actual quantity he was getting. I didn't do that as I could never get much out using a pump and it just sounded more stressful than letting him feed naturally.

[5madthings]

Babies can have cows milk, yog, butter etc from 6mths in food but not as a main drink until one year :)

My only thought is that if she is not feeding at night maybe giving her a dreamfeed will help, she may feed better at night if she is distractable during the day.

Is she active? Weight gain can slow down particularly if baby is active. Was she weighed on the same scales? Has she grown lengthwise?


If she is well in herself I would be inclined to just offer bmilk lots and maybe try a night feed is at 11pm when I would be going to bed.

If she is well and meeting milestones I wouldn't worry.

[hettienne]

The HV is right that formula is cow's milk, but as babies shouldn't be weaned before 6 months they also shouldn't be having milk and yoghurt before 6 months.

If your baby needs more milk, and you have breastmilk, the most obvious answer would seem to be breastfeeding more often - have you tried switch feeding where you switch sides every time she starts to lose interest, so feed from 2,3,4+ sides per feed?

If she's not feeding at night then you can add some extra feeds in there.

[nickelbabe]

"hi HV, i'm sorry that your training and information don't seem to be up to date, but my child is gaining weight, and is also happy and meeting all her milestones. Weight is not the only indicator of health, and to focus on it in such a way is dangerous. My milk is sufficient for my baby, and by the way, if you ever believe that it isn't, your first comment should be "feed her more often", not "feed her something different". thank you"

[DizzyDizzy]

i've tried feeding her more often, and feeding her in the dark, no sounds etc. but she's still not feeding for long. i don't see why she would take formula anyway, if she doesn't want breastmilk

[hettienne]

Lots of short feeds are fine, you can't force her to stay at the breast (though I would try switch feeding) - how often does she feed per 24 hours? Has she crossed any centile lines?

[LemonBreeland]

The main issue is if she is dropping through lots of centiles. Also you don't have to see the HV.

[beginnings]

I'd also advocate bulking up your diet a bit. Cream, peanut butter, that kind of thing. Might make your milk a bit richer. A friend tried that and it seemed to help.

[SwallowsInSpring]

The charts are usually based on formula fed babies, who tend to follow a neat curve, some BF babies go in steps so it can be that they plateau for a bit, then have a growth spurt and 'catch up'. The WHO website has some BF charts/tables if you want to look, but really if she's happy and alert she's fine! My DD wasn't gaining well but also had other issues like diarrhoea and agitated feeding etc at that age, then started having blood in her poo, they think she's probably got a cow's milk protein intolerance, but the lack of weight gain by itself wasn't a concern. The consultant pointed out that in the red book it suggests not to weigh them more often than every two months at this age (as long as they're ok in other ways) to allow for individual variations.

[ashleysilver]

It seems to me like it is the hv who has the problem, not your dd. As LemonBreeland says, you don't have to see the hv if you don't want to/don't find her helpful.

[sebsmummy1]

One other piece of advice I had was to allow the HV to refer you to a paediatrician if she is particularly concerned and you wish to continue ebf yet feel it is against advice. They seem to be very good at assessing the child medically, recognising everything is as it should be, and letting you go on your way.

[5madthings]

The charts were changed a few years ago and are now for bfed babies.

[sebsmummy1]

5madthings that's correct, however I still don't think it accurately represents the weight gain pattern of a breast feeding baby. It might represent some, but not all, and I know that if I hadn't been so bloody determined to keep breast feeding I would have been swayed onto formula by the HVs.

As it is I am still bf my 10.5 month year old and plan on doing so until he self weans, or I am no longer practically able.

[SwallowsInSpring]

I didn't know the charts had changed, doh. Thanks for clarifying.

[DizzyDizzy]

i don't want to completely ignore the health visitor, it's my first child, and obviously i am worried about the fact that she's gone from 75th centile at birth to 2nd centile now. i offer her breast a lot, but she feeds for a short time. she's no drowsy, very alert, giggly, smiley, generally well, never been ill. you wouldn't notice anything out of the ordinary, it's literally just that she's not putting on enough weight. i REALLY don't want to formula feed, but what do i do if the health visitor comes out next week, and she's not put the weight she was supposed to on? tell her to stuff it??? just feel like i haven't been given any information, and can't wait for things to get worse...

[NaturalBaby]

My 2nd baby was a bit like this and the HV wanted me to wean early but I refused. He was growing but going down the centiles at each weigh in. I said I'll try feeding more often, she gave us 2 weeks to re assess (same story) then I basically fobbed her off and missed the next weigh in after that. She didn't specifically ask if I'd started weaning and I didn't tell her that I hadn't started.
When he hit 5 months he took a big adult sized rice cake out my hands and ate it . I was waiting till 6months but he had other ideas.

[NaturalBaby]

Mine was also a very alert, smiley baby but always smaller build than his brothers and very very active which didn't help his weight gain. The other night he had 3 plates of chicken and potatoes and he's just turned 4.

[DizzyDizzy]

the HV hasn't suggested weaning, that was me, instead of giving formula. but i was thinking potato, salmon etc.. not dairy products.. to eat along side what she's breast feeding.. so she'll get the same amount of breast milk and solids. she might take more of an interest in solids i thought.. as it's different texture / tastes / smells etc.

[MigGril]

Ok you do have an issue hear. Your HV is right about one thing that formula is modified cows milk, but you shouldn't give solids at this age it won't help the problem.

She's drop thorough several percentiles this is worrying. What I am surprised at is that this should have triggered a referral to a pediatrician to check that everything is well with your baby health wise. It could be that this is normal for your baby but it should defiantly be checked out. When the HV come's next ask for this I'm am surprised it's not happened already. Most babies who are referred are just slow gainers and have no health problems but best to get it checked out.

Another thing you mention in your post is that she sleep's through, if she isn't gaining weight then one of the big things you can do is feed through the night. I'd be giving a dream feed at lest maybe even one more in the early hours of the morning.

Time at the breast is not an issue all babies take different time's to take a full feed so it tells us nothing. It's far more important how often she is feeding. I would say you want to feed at lest every 2 hours during the day and at lest both breast each feed. As someone up thread suggested also switch feeding is a good way to get them to stay interested in the feed and take more milk.

Other thing's to check for are the latch have you had this checked by a breastfeeding supporter at all? If not see if you have a local breastfeeding cafe or drop in group to go along and have a chat to them. If you have not local group then one of the helplines should be able to help. Also having her checked for tongue tie would be a good idea and this can prevent effective milk transfer. I've also come across babies with low weight gain who turn out to be cows milk protein intolerant, if this is the case then adding dairy to her diet would just cause more problems.

Hopefully there is a few things for you to try and have a look into and hopefully things will improve. Good luck

[MigGril]

The problem with adding solids is that it will make her take less milk. So it's not really a solution. One of the reasons for changing the weaning age is that babies weaned early often slowed down in weight gain to much. There really is very little that is as high in fat and as easily digested for a babies gut as breastmilk. They can't digest solid food very well.

[ashleysilver]

What do I do if the hv comes next week and she has not put on weight?

Ask for a referral to a paediatrician. If dd does have medical issues, you will want to address them straight away. If everything is fine, it will put your mind at rest.