BF babies, sleeping through and weight gain?

[goosey123]

I'm feeling a bit gloomy as just had DD2 weighed and she has very nearly dropped 2 centiles in the last month, having gained weight really well (born on 75th centile, and stayed there until 3 1/2 months). She is now 4 1/2 months and exclusively breast fed.

It seems to have coincided with her dropping night feeds - in the last few weeks she only really feeds once between 11 and 7am (hoorah) and since moving her into her own room she has slept through a few times.

I guess my heart is sinking as exactly the same happened with dd1 when she started sleeping through at 3 months, both babies exclusively breast fed. And she got referred to paed team, tested for all sorts etc.And was absolutely fine. I really don't want all that hastle again.

Is it possible to keep a breast fed baby on their growth graph line if they are sleeping through? I guess she feeds about 3 hourly duing the day so gets between 5 and 6 decent feeds in 24 hours. I want to enjoy this spell of sleep without feeling guilty that I might be starving her!

is she being plotted on a bf baby chart or the old FF baby ones?

if the latter then i wouldn't be worried

breastfed babies tend to gain quickly and then plateau at atound the 4 month mark (ish)

if you hadn't had her weighed would you ahve been worried? is she meeting milestones? happy? plenty of wet/dirty nappies?

Is she losing weight or slowing down her weight gain. If she is losing weight then that definitely needs to be investigated. If she is just not packing on 8oz a week (or what ever was her usual pre-4 months) then please don't worry.

It's normal for breastfed babies weight to slow down at ~4 months. Kellymom has some good weight gain guidelines here. Basically between 0-4 month babies put on an average of 5.5-8.5oz and 4-6 month babies put on an average of 3.25-4.5oz a week.

If your red book has an older chart in it you will be plotting her weights against babies who are not solely bf (and I think most would have been ex.ff). Try plotting her weights on this chart from the WHO. It may make her growth look quite different. If it doesn't and you still have concerns re. her feeding is there any one you can see in rl?

Don't worry. I got referred to feeding clinic with DS2 who was IUGR and dropped below 0.4th centile at around the same age. The GP was keeping an eye on him and referred him just to be sure all ok only because he was so tiny to begin with. She said she wouldn't normally be concerned with a similar drop at that age in a bigger baby. Consultant said the same, she wasn't really interested as it is quite common for them to shift centiles and find a new path as it were - as long as baby is happy and healthy and developing normally it isn't a problem.

My DS still (at 10m) feeds about every 2-3hrs through the night too, so it isn't necessarily connected.

I also think that you should keep in mind that the centile babies are born on isn't often the one they end up on IYSWIM - eg my DS1 was on 9th centile at birth but is now, at 5 yrs old, around 45th.

Thanks for your replies and links - she hasn't lost weight but only gained about 5 ounces in the last 4 weeks so it looks like a very dramatic plateau if you know what I mean. It is one of the old FF charts, but I still think she has dropped a bit even on the BF chart.

i only got her weighed because I was slightly concerned about the amount she pukes - something I've ignored all along as weight hasn't been an issue and she is a happy little thing. I guess I am wondering if this is related to her feeding less or puking back her feeds. But I also wonder if you are right and this might be her finding her own centile... Its just been so nice not worrying about weight (compared to my last experience) so I feel a bit apprehensive..

If she's gained 5 oz in 4 weeks at least she's gained

Have you tried increasing the no. of times she feeds or increasing the amount of 'sides' she feeds from each nursing session? Could you try offering more often (which I know might ha will be difficult with another child) maybe not letting her go 2 hours with out offering during the day?

Have the Dr/HV discussed reflux with you? Whilst you might not want to go down the drugs route if she's not in any pain you could try the positional management route. Lots of time upright (bouncer/sling/car seat/pushchair) after feeds and propping up her cot at the head so it tilts slightly. Hopefully that could stop some of the puking.

Drop of two centiles is normal, so don't worry. If everything else is normal, she's alert, good wet output, then relax (though easier said than done). My DD only put 5oz in month 5, her weight always slowed down when she stepped her mobility. Mine dropped from 25th to just below 2nd, not once was any HV concerned with even she put on 1oz in two weeks.

As truthsweet said, maybe look to reduce reflux, but this is the age where they start to outgrow it anyway. There's load of info online for this.

Your previous experience with DD1 was fine so use that as reassurance. At the moment there doesn't look to be a cause for concern, apart from checking reflux option.

I plotted DD3 on the WHO charts last night and found her growth pattern very different to the old NHS charts. She's not on the 9th she's above the 15th and while the old chart has her following the 2nd for ages (after being born on the 91st) the WHO chart shows her as not even reaching the 3rd before heading towards the 15th. I feel much better

Should all the hv's be using the 'new' charts by now?

In my area they have just started (DD3 missed out as she was Oct-09) as they couldn't afford to train HCP how to use them for ages.

I remember plotting DD1 on the WHO charts a couple of years ago, Truthsweet, and feeling lots better - so maybe I will do the same with DD2! Some of the other local health centres here are using the new charts, just not mine. I will ask about it...