Slow weight gain after good start - bf, what to do?

[FortunateHamster]

Help!

DS is five weeks old. Lost a bit the first week, then gained 7oz then 9oz in the two weeks after that - great! At four weeks he'd only gained 5oz and this week it was 4oz.

He's dropped a centile (was on the 50th) and I'm beginning to worry that I'm not doing something right.

I'm exclusively breastfeeding and have been doing so on demand. There's no routine whatsover - he's hungry, I give him boob. I'd like there to be more of a gap between feeds as when I'm on my own it tends to be every hour or so unless he has a rare nap, and in the evening he cluster feeds. So with all this feeding, why isn't he gaining more?

The health visitor suggested I actually try to space out feeds in the day so he feeds better at each one, but to make sure I wake him at night after five hours - does this make sense? I'm not entirely sure how to space out feeds if he's crying - he's so small and he won't settle on me for very long as he can smell my milk.

Have been to a bf group and they thought latch was ok.

Lots of dirty nappies - a couple of isolated green ones so have been trying to make sure he gets enough hindmilk.

He's crying so will have to come back later. Any ideas?

Have you tried doing a nappy change when he seems finished with the feed to wake him up a bit? Then if he's not drained the first breast put him back on that one then swap. Might get him taking more at each feed and more hind milk into the bargain?

Stick with it and try not to let anyone persuade you to use formula to "fill him up". Sounds like you're doing fine.

correction: was on 25th centile, now on 9th.

HV wasn't actually that concerned but I am. I was just about coping with constant feeds knowing he was getting decent amounts at least - now I'm just not sure.

He does sometimes fall asleep during a feed, but then I usually wake to wind him and then put him back to the same breast for a bit. I try not to put him to the second unless he's definitely fed up of the first because of the foremilk/hindmilk thing.

Spacing out feeds and waking him up doesn't sound that sensible - hopefully some expert advice will be on here soon though cos your HV doesn't sound like one... :)

Surely you'd want him to feed more not less often if worried about weight gain? I agree - keeping a wee baby crying wouldn't be my cup of tea either.

Congratulations btw :)

( I am sad cos I just looked in my DS's red book and his weight gain varied a bit too - 12oz one week, 7oz the next then only 4.5 between 6 and 7 weeks, I think as long as he is gaining weight, having plenty of wet and dirty nappies and is healthy and alert this is generally considered good :) )

Just quick as I have to get on with something else.....

• anyone who tells a mother that she needs to space feeds in order for her baby to gain more weight can safely be ignored. They don't understand about breastfeeding and about babies' needs

• babies gain weight by taking in more milk, more often, more effectively - it is volume of milk that provides the calories that lead to weight gain

• it is normal for babies to drop up to 2 centile lines in weight in the first months. Even the ones who drop further than this are usually fine. Your baby has only dropped one - well within normal

• weight is only one aspect of a baby's well-being and should only ever be assessed in that way

• young babies who cry need attention and, very often, feeding, and it is unkind to make them wait for either

• green nappies are of no concern at all in a healthy, thriving baby (which yours sounds like)

foremilk/hindmilk is widely mis-understood. Offer the second side at every feed when your baby is still young - it does not matter if he takes it or not, but he should have the chance to take it. It is normally not necessary for babies' feeding to be engineered to 'get the hindmilk' - this happens without any messing about when a baby's feeding needs and cues are being responded to...what you are doing in your post of 14.17, hamster', sounds fine, though.

Whoops - don't know why or how all that last bit was BOLD

Thank you everyone, knew I'd get better advice here :)

I did think her advice was a bit wonky about spacing out feeds. From a personal point of view I'd quite enjoy more space between them, but I certainly don't want to enforce that on him.

He is generally a very alert and happy baby and I've never left him to cry (apart from trips to the loo etc!).

My concerns were just whether he should be gaining more I suppose, especially considering he feeds a lot in the day, but if people think he might okay I feel a bit more relaxed about it.

He has been a bit more unsettled his week generally - he's seemed windier, has woken up flailing his little arms about a few times, and has been very hard to settle for bed (we rarely get him down before midnight). Could any of this impact his weight gain? Yesterday it was very hot and I don't think he liked that either.

Once a baby has got back to birthweight, good practice is to weigh no more frequently than once a month (unless there are obvious health problems, clearly) for the first 6 mths, and no more freq than every other month for the second 6 mths. It is actually poor practice to weigh more often as the info you get back from such frequent weighings is not helpful at all and could be misleading.

This is official - part of the training backed by the Royal College of Child Health, Health Visitors Association and who knows who else, connected with the rolling out of new weight charts.

So no need to have weighed baby hamster at all, really, until now :)

Ah, you see the first health visitor I saw told me to go every week for 'about a month' (last saw her in my home when he was three weeks). It's a bit confusing - maybe I won't bother next week, though it'd be nice to see an increase in the gain at some point and/or make sure it isn't slowing down further.

I think spacing feeds can be a good idea of your baby is comfort sucking rather than feeding. My first son gained weight very slowly (it took nearly 5 weeks for him to get his birth weight back) and I found that giving him a dummy helped him to stay asleep once the feed had ended. On the whole your baby's weight gain sounds good and I found with my second baby that his weight gain slowed after the first month as he was awake more. Hopefully as your baby gets bigger he will naturally space his feeds out as his tummy is able to take more at one time. Good luck!

moajab - if a baby is comfort sucking and not effectively feeding very much at all, then this needs to be sorted out, I agree, but not by spacing feeds. It is normal and fine for a baby to suck for comfort and it helps support milk production as well.

Hi
Your baby is weeing and pooing and gaining weight-enjoy this special time and try not to worry.
Sounds like your doing a great job x

lol I was a bit like this. HCP were all fine with weight, I was the one being paranoid (though my LO put on a lot less weight than yours, 3oz was a good week for the first four months). 4oz is in the normal weight gain bracket, so don't think its small. Its just smaller than the numbers your used to.

Also don't stress about the odd green poo.

Obviously you've got sound advice already so am only echoing what others have said. Try not to correlate increased feeding with increased weight gain, they don't go directly in hand. The week my LO had a feeding frenzy she only put 1oz in two weeks.

You know if LO is fine, trust yourself (though you'll still worry, its we do).

I found it a bit tough switching to one per month weigh ins after weekly ones, but try and hold your ground