baby weight gain, breastfeeding etc

[Focusfocus]

Okay so stats first - my baby is 16 weeks old, mixed fed at the moment but predominantly fed direct from breast about 6 feeds a day and one 5 is bottle of ebm. He also takes about 10 oz of formula in addition to this.

His current weight is 13.6 lbs. age is 16 weeks. Height is 66 cms and head circumference is 40 cm.

Why do I know his head circ you ask? Well he was measured on all these things by the HV today and she points out to me that -

1. A 50th centile birth baby has gone to hovering between 25th and 9th

1. His weight and height aren't in proportion (25/91 respectively)

1. His head circumference has gone from 50th to 9th and there is evidence that this coupled with less than 40% of birthweight gained in first month of birth apparently links to reduced IQ.

I asked her what she recommends. She says the decision is mine but he needs more calories into him.

Now - when he was exclusively BF (I was very tired very hungry very lethargic all the time) it was the same story of a slow weight gain. We introduced those two bottles but frankly it's an ordeal to feed him anything more than 3 oz. Even breastfeeding is an ordeal unless he is asleep or sleepy and lying down.

When he breastfeeds I offer him both sides at least. He refuses the second. Milk flows out of the breast as he stimulates the let down and stops and laughs and bats the boob away. I cannot get more calories into him by offering him more boob or more often as he shouts and bats it away.

It's the same with the bottles. If he's sleepy he will have a bit if not he laughs at the bottle and bats it away. It's all very draining and being told by the HV that he is not becoming proportionate.

At this stage I don't want to return to exclusive BF. I frankly don't. I am happy to retain his 5/6/7 bfs daily - 3 of which happen very early in the morning and are excellent solid belly filling feeds involving lots of milk. I also do compressions and his little belly fills up. Beyond this I need him to actually take the bottles (10-12 oz on a good day)

He is fine in himself nappies etc. His height weight situation makes him look "dinky" beside other babies (words of another mum at the clinic) or "puny" (words of my darling SIL).

So what should I do. I go back to work in April and the plan was to retain morning and night bfs till he is a year old but if he won't be interested in milk whichever source it comes form boob or bottle and laughs and bats things away and continues to gain slowly then what the f should I do?!?

[Focusfocus]

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[Elledouble]

My son fell right down the centiles from 10 weeks, it was horrible - I feel for you. I started supplementing with formula (which I hated doing but it was the best thing to do) and in the end had to wean him early, at 5 months, on the advice of the paediatrician. It turned out that reflux was the problem - he was (and is) sick quite a lot and the Infant Gaviscon he was prescribed helped a lot with that.

I'd suggest you take him to the GP, show them his graph and they'll check a few basic things. Ask for a referral to a paediatrician if things don't improve.

But try not to worry too much. "Normal" is a really broad spectrum and some babies (like mine!) just are tall and slim.

[cathpip]

Dc4 who is 6 months old is on the 50th for weight and 91st for height, head is on the 91st too, his weight started off the chart, he was delivered at 38+2 weighing 11.6lbs. Every baby is different, he takes after his sister, heavy at birth but turning tall and skinny. One was bottle fed the other was breastfed, you can't force feed them. Also for reference dc4 weighed exactly the same as dc1 at 6 months and dc1 weighed 9lb.

[tiktok]

Focus, this is a story of less than ideal HV communication and care, IMO.

She has worried you, and not given any actual recommendations of what to do. If she really thinks that giving your baby more calories (how? more formula? More breastfeeding? More ebm? Start solids????) would avoid a lower IQ than otherwise, then she has to speak up and tell you :) .

Or she should refer to a paediatrician and see if there is anything to worry about, and what to do if so.

I think it would be a good idea to see a paed, and ask your GP for a referral if necesssary, or if you have already seen a paed in the past, ring up for another appointment.

[Focusfocus]

Thanks all.tiktok do you think on its own this is a worry? A baby that's slightly under 25th centile but hovers on it as he gains weight - and height on 91st?

He's 16 weeks old gurgles laughs rolls over holds head up sits in his Bumbo and high chair very happily - just that he's grown taller so much faster than wider. We are already approaching then very end of the feet in the 3-6 months.

What should I tell Gp exactly when I ask for paed referral?thanks in advance

[Focusfocus]

I should add he's dribbling massively and humming in everything including his dad's chin REALLY PAINFULLY HARD

[tiktok]

Honestly, focus, I have no idea! Your ds looks and sounds absolutely lovely and totally normal, but that's no good to you :)

Mostly, overwhelmingly in fact, these sorts of concerns about babies' growth turn out to be absolutely nothing at all - the babies are normal, grow normally and develop normally, and turn out to be not noticeably different in height or weight than anyone else of their age.

But sometimes, there is a real issue, and the only way for you to rule it out - given you can't look into the future :) - is to get a proper medical opinion.

The HV is doing her job, in keeping tabs on your ds's growth, but I think she is prob floundering here - seeing a little lad who looks and sounds and behaves like any other 16 week old, but whose recorded measurements just don't 'fit' so she just does not know what to do except say something about 'more calories'....even though she knows, from what you have told her, that he appears not to want them :)

[Focusfocus]

Thanks tiktok much appreciated :) I've been left feeling his 10 oz if at all he has it of formula isn't enough and I should stop BFijg him all day and move to formula completely. But perhaps not :-)

[daluze]

Focus, maybe you should talk to GP about how you feel and ask for support? From this and your other posts it seems that you cannot accept that your baby is fine, no matter what the facts are. I think at the moment the concern should be why you are trying to medicalize your baby. I am not an expert, but could it be PND? I would suggest going to GP, but not so much because of the baby, but because of how you feel about him.

[Focusfocus]

Excuse me? The post reported what a health visitor has said to me this morning, in no unclear terms. I suggest you refrain from diagnosing people online when you have absolutely no knowledge of their reality. My baby is just fine - and an absolute handle of joy. The health visitor on the other hand is sadly misinformed.

Personally, I think there is little point in looking through people's posting histories and trying to make it out that there is some internal struggle that they are going through - rather simply take questions at face value. Else you risk coming across as more "helpful" than is required, and create awkwardness and second thoughts for people posting on forums for (and with) discussions and advice.

[Focusfocus]

And medicalise my baby? I didn't know till this morning that measuring babies head circumferences was even a thing. There is a clear line I think that needs to stay clear between one's desire to help anonymous posters online - and one's ability to misinterpret, misconstrue and misdiagnose situations precisely because of the way anonymised online communication works.

[tiktok]

You're not medicalising, focus and it's a bit out of order for daluze to say you are.

The Hv was right to measure your baby. This is in line with usual practice when growth is slow.

I think she was a bit rubbish leaving you dangling like that :(

Hope you will get a doc's opinion and this will reassure you.

[daluze]

My appologies. I didn't mean to upset you in any way. Of course it is the right thing to measure babies, but if there is a problem, you should be referred to see specialists, not to online forums. What's the point of doing that if then a mother is left worried and confused? Since your baby was not referred, and you questioned what could you tell the doctor, it sounded as if the baby was ok.
Once more my appologies. I hope your little boy is doing well and please seek a second opinion if you don't trust your HV.

[lcoc2015]

Hi focus - going thru something similar myself (dd has dropped from 50th to below 9th) and is refusing bottles - its all very stressful so you have my sympathies!

As your son will take formula, isn't there a very high calorie formula that can be given if the hv advice is to get more calories into him? I'm not an expert but my paediatrician mentioned this as a possible course of action.

My hv has also been advising me to try get as much hindmilk into the baby as possible so to feed 1 breast per feeding and in the a.m. express first for an ounce or so and then offer the breast. I'm not sure how good this advice is though, perhaps tiktok could weigh in (i found my supply took a bit of a nose dive only offering 1 breast but offering multiplee times per feeding - however i do seem to have supply issues)

The other thing that reassured me was asking my mil about my dh's weight gain when he ws a baby and apparently he was a low weight / faltering weight gain baby too so i do think some of these things can just be genetic.

[tiktok]

Hv advice to feed one side only is the opposite of what you should be doing to get more calories into your baby, lcoc.

A very common misunderstanding.

The advice to express off your milk first is not totally pointless but what a hassle.

Might be good to get another opinion on your next move.

[tiktok]

To increase intake, switch nursing is best - repeated switching of breasts during the same feed.

[lcoc2015]

Thanks tiktok- unfortunately followed their advice for a week and only saw a 80g weight increase and a dip in my supply! Will go back to switch feeding immediatly.

Sorry focus ignore the crap advice then from my hv!! - but i guess the higher caorie formula might be worth investigating for the ounces of formula he does take!