Slow weight gain, fussing while feeding and pressure to wean...

[pinkpip100]

DS2 is almost 21 weeks and mainly breastfed, with the occasional bottle of formula if I want to go out. He has always been a 'snacker', not feeding for particularly long but very frequently. Even now he rarely goes longer than 2.5 hours between feeds, even at night which in itself doesn't really bother me. However, he has been very slow in gaining weight for around the past 8-10 weeks, slipping down from the 25th centile at birth, through the 9th, and is now on the 2nd centile. Also, for the past few weeks he has been really fussing during feeds, pulling and tugging at my nipple when the let down doesn't happen quickly enough, and then pulling off and crying after only about 3-4 minutes. I do try to keep putting him back on, but eventually give in and switch sides, where he will then feed for a further 3-4 minutes maximum before losing interest. I have always assumed that his latch and position were fine but am now worrying that he is not sucking hard enough and may not be getting any hind milk (is this possible?), hence his very slow weight gain. Or perhaps it's the quality of my milk that is poor? Either way, it is so frustrating as I am feeding and feeding him but he is still slipping down on the weight charts.
My HV has suggested early weaning (as in now), which I'm not keen on as he doesn't seem ready and I had hoped to get him to 26 weeks and then go down the baby-led route. But now it seems that I'm running out of options.
He seems healthy, active and alert but is definitely very long and slim. He has plenty of wet nappies but only poos once or twice a week, which I believe is not a big issue in breastfed babies.
So sorry for the very long post (its only about my 3rd ever on Mumsnet). If anyone has made it this far, any advice would be great.
Thanks x

[pinkpip100]

Oh, I forgot to add that the HV has also suggested giving him at least one bottle of formula a day to increase his calorie intake, but I'm not sure if want to do that just for the sake of it...and would worry about the possible effect on my milk supply.

[tiktok]

It's hard when you're faced with concerns like this, Pink.

I don't think your HV is well-trained on supporting good nutrition, though....if all we are worried about here is your baby's calories, then it would be better to increase and enhance his breastmilk intake, yes? Giving solids at this stage risks reducing his calorie intake, and giving more formula will impact on your breastmilk supply...all bad news.

He sounds healthy and delightful! It doesn't sound to me that he is under-fed, but a quick trick to keep everyone happy would be to fit in more breastfeeds (if he wants them).

The quality of your breastmillk will not be an issue - breastmilk does not really vary in quality and whatever you make will be top notch The fussiness might be worth discussing with a breastfeeding counsellor on one of the helplines.

HTH

[Firepile]

Hi pinkpip,

I've no expert knoweledge to impart - but my ds's weight gain tailed off dramatically at about 15 weeks or so, and he is now off the bottom of the charts. I was advised to give formula, which he refused, and to wean early - which didn't help - he wasn't terribly interested in solids and still gained weight very slowly. It was - and is - very stressful (he is still under paediatric supervision at 15 months).

Having said that he didn't show any signs of being unwell or unhappy. I suspect that I would be trying to find out why he is crying when he feeds - this might help you to tackle the problem directly rather than giving him solids before he's ready.

[glassslipper]

pinkpip100 - i could have written that post. My DD is the same age and started at 25th centile and is now on 2nd. She poos 2-3 x a week too but has lots of wet nappies.

My HV is not concerned at all as DD is happy and developing well. I have started weaning (I know early please dont shoot me everyone). DD loves it and so I have continued however it has made NO DIFFERENCE AT ALL to her weight gain (12lb the other day) so dont feel pressured.

[pinkpip100]

Thanks Tiktok & Firepile, I have left a message for a bf counsellor so maybe they can give me some advice on why he's fussing so much during feeds. I did think that the weaning/formula advice sounded a bit contradictory but its hard to be rational about it in the face of a 'concerned' health visitor..

[moondog]

Jeeezuz,once again a spectacularl ill informened health professional attempts to defy science by suggesting to vulnerable women in her care that wallpaper paste has more calories in it than full fat milk.

[pinkpip100]

And thanks glassslipper, its great that your HV has been so supportive and that your DD is enjoying her food.

[mears]

I understand how you will feel concerned as you are being advised by HV. Is there a reason he is being regularly weighed BTW?
If i had my babies over again I would not go to the clinic for a regular weigh-in so that I could fill in my little card.

Agree with Tiktok to speak to BF counsellor about fussiness.

My DD did not gain weight in the 6 weeks before she started solids - HV was pressurising me but I said I wasn't doing it until 26 weeks. Babies do plateau with weight gain - it isn't necessarily a sign that they are underfed.

I have friends who had poor weight gaining breastfed babies. Changed to formula and the weight gain was the same.

It may well that he was born heavier than he was meant to be. These babies lose weight until they achieve the line on the chart that nature intends.

[percypig]

I too could have written your post pinkpip!

I wasn't feeding on demand, but DS's weight did go down by a similar amount. He started feeding for shorter amounts of time, which I came to understand was quite normal as he became more efficient. He also sometimes fussed - looking back it was probably teething. Could this be a factor for your son? I never gave formula and held off on weaning till 6 months. His weight gain didn't actually really improve post weaning, as others have said, milk has more calories. He eventually self weaned a week after his first birthday.

But - he continued to be happy and healthy, really took to BLW, and over the past couple of months (he's now 13 and a half months) his weight gain increased slightly.

[pinkpip100]

Mears, there wasn't a reason for him having regular weigh-ins, I just took him to clinic every 4 weeks or so and he also got weighed when the HV was doing DS1's 2 year check. Maybe I shouldn't have bothered! Although to be fair he is slim looking rather than a chubby baby, but maybe that's just his build...

Thanks Percypig, its so good to hear from someone who managed to do BLW despite having a "low weight" baby.

[ib]

Don't want to contradict the professionals, but this sounds very like ds with regards to the crying while feeding. Ds was really extreme, though, and fell right off the charts pretty early on. Tried formula which didn't help, in fact was a disaster; tried feeding ebm thickened with baby rice which did help.

In the end he had a pH probe done which showed he had really extreme reflux (every time he pulled off crying was a wave of acid, poor mite). Now he is on meds and started on solids (19 wks) as the solids help keep everything (including the bm) down...for the first time ever he is now bf properly as it doesn't hurt, so is finally putting on some weight!

Not what I would have chosen (I wanted to bf exclusively for at least 6 months and then do blw), but definitely what my ds needed.

[tiktok]

ib - your situation is not like pink's, though....pink's baby is 21 weeks old and his weight gain has been slow only in the past 8-10 weeks, which can be physiological.

I am gad you found out what was up with your little one....must have been a hard time.

[kiskidee]

tiktok, is it ok to cat you?

[tiktok]

OK.

[ib]

I know, each baby is different, and I'm not really trying to suggest that that's what pink's ds has, but I found that when searching bf forums for slow weight gain the advice is always 'bf more'. When you are feeding 20x per day that can make you feel pretty lousy. I just feel that occasionally the advice to find out whether something might be wrong with your baby would be good to have out there...

Not at all trying to knock what any of you do, btw. I think the support you provide is fantastic.

[tiktok]

Fair enough, ib, and sometimes, there is something that needs checking out, you're right.

[pinkpip100]

Thanks Ib for posting your experience and Tiktok for your advice. DS1 had quite severe reflux and DS2 has always been fairly sicky so we did think he may also have it, but I wouldn't say that the fussing and crying whilst feeding seems like he's in pain, more like he's frustrated. And this has happened fairly recently (3-4 weeks), before that he was feeding fine, if a bit 'snacky'. Because he won't feed for long on either side, the HV warned me that he wouldn't be getting enough hind milk...not sure how true this is though?

Hmmm, I'm spending the next few days with my SIL who is OBSESSED with feeding and weight gain in babies, and will be horrified that I haven't weaned DS2 yet (even without knowing about his slow weight gain). I'm really not looking forward to it. She'll probably be giving him baby rice when my back is turned!