Am I being irresponsible by not weaning early

[lifeistooshort]

Following from my thread from last week, I went to the baby clinic again today and again, my 19 weeks son has only put on 3oz he is now 6.47kgs. The HV said you have to start weaning him now. I asked if I could give it another week and she said no. My son is very alert, very content, active, sleeps through the night and does sit ups.

I think he is fine and very content but at the same time I am being made to feel guilty and as if I am endangering my son's health. Don't know what to do

I don't know a lot about your situation and I'm in no way an expert (that's tiktok and others...) but if your HV told you weaning foods weren't lower in calories than milk, that's clearly wrong. There is the debate on baby rice explained above. But general weaning foods - pureed fruit, veg and the like - are clearly and demonstrably lower in calories than milk. If your HV doesn't know that, I would worry about her judgement and training.

Is there anyone else you could talk to? Another HV you could see at a different clinic? Another HCP?

Ribeana I saw two different HV. One this week, one last week and they both said "wean him" or "top him up with formula". I thought there was supposed to be more support for breastfeeding out there. There is another clinic on a Tuesday, perhaps I will go to this one after the Xmas break as it is an other HV team. I was surprised when she discarded my concerns that weaning food had less calories than breast milk. Also I don't understand why there are no breasfeeding counsellors at baby clinics, there advice would probably more useful that the "top up with formula" which seems to be the standard answer. As I mentioned on my other thread, I had mastatis four times with DS and he is a slow feeder and no one ever mentioned to me to check his latch!

I used the A5 Boys UK WHO chart and 3.5kg at birth is 50th%ile, 5.74kg at 10w is 50th%ile and 6.49kg at 19w is just under 25%thile. If your DS had stuck to the 50th%ile he would be just over 7kg. So not really a huge variation from 6.49kg. A birth weight of around 4kg is between 75 - 91%ile.

A month's bfing at every squeak should hopefully make some difference or it may be that your DS is just destined to be on a lower %ile to the one he was born on

It sounds to me, to be brutal, like there are some training needs within your HV team. Regardless of the issue of whether your child needs more calories (won't attempt to comment on that, I'm not an expert) not knowing about calorie contents is basic scientific knowledge. I would resist doing anything too dramatic based on the advice of someone who doesn't know that.

Are there any baby cafes, breastfeeding clincs or similar near you? They might be able to give some input.

What a shame you're getting such poor support.

It's silly they haven't explained why they want you to wean early.

My DD2 is coming up to 6 months and I've had pressure to wean early too. I waited til 6 months til DD1 and I really feel as though if I've waited with one it would be wrong to do it to early with the other, if that makes sense?

I think I said the same on your last thread, but my ds is exactly the same - 3.8kg at birth, 6.1kg at 16 weeks but healthy and happy.

My HVs haven't even mentioned his weight, let alone told me it's a problem.

My daughters were all born on or around the 50th centile, with measurements to match, and gently sunk through the lines until they were on or around the 2nd (0.4th for one of them for a while) by 4 months. They are all and have been perfectly healthy, just destined to be tiny in childhood. Thank god I have had enlightened HVs each time (two different ones) who have had the experience to notice that my babies were not wasting away, merely rejoining their natural centile being fed entirely on breast milk. I think that some HCP really do not understand centile charts nor the information they are based on, but instead treat them like the Gospel.

Your son sounds fine to me, OP, doing all the right things- ultimately though only you know your son and know whether he is well or not. You can actually refuse to see your HV entirely, or ask for a referral to a paediatrician if they really will not put you down. Being small is NOT life-threatening! It may just mean that he is a little thing through babyhood.

Sorry, forgot to say all three daughters born weighing 3.3 kg or near enough, did not reach 7 kg until about a year. DD2 was 6.93 kg at 12 months, not 19 weeks!

DS dropped from 25th centile to below 0.4th where he remained until after 1 (when they get weighed with clothes on!) weaning made no difference to his weight gain and I'm glad I stuck to my guns and didn't wean early despite some pressure from HVs from 17 weeks. DS was 33 weeks before he was the weight your is OP. DD is heading the same way but experience has taught me to stay away from frequent weigh-ins and trust my instincts

worth a read

But I would get your feeding checked to ensure good milk transfer. Try the local children's centre to find local bf groups, or see if your local NCT group has a bfing counsellor who could come and see you.

My motto is follow your gut instinct, you really don't sound as if you want to start weaning him and according to the advice here it doesn't sound as if your DS's weight is at such a level that you need to a) worry about it and b) weaning would actually address the supposed problem and help him gain weight any faster.

Do you have to see a HV every week and have DS weighed? What would happen if you said you weren't coming as regularly anymore? Sounds like it's causing you more angst than anything.

My HV told me that weaning would help DS gain weight too. I looked at her confusedly and said "But why... I thought that milk had more calories than any food?" and she just gaped at me and said "Well you'd be surprised. Babies always gain weight when you wean them. I've seen it."

I decided she was talking bollocks and didn't bother going back.

Op, can I suggest you look for some other venues of support in addition to your HV team.

Is there a Breastfeeding support group locally? Your Children's Centre or local NCT branch may be able to point you in the right direction.

You might find it reassuring to speak to other mum's who are breastfeeding and not planning to wean or move to FF at the moment.

Goodness, my baby could be your baby's twin weight, birth weight and timing-wise and there's no way I would wean him when to all intents and purposes he's doing so well - he's happy, healthy, active.

I really don't see how he could possibly be considered as anything other than thriving, if a little on the light side - possibly because he's so active, you should see him in a jolly jumper!

Trust your instincts in this case - if he's started OK, and he's still OK, then stick to your guns and ignore them.

I'm really intrigued by the weaning and weight gain question. Admittedly my situation is different in that DS was born three months early - but the specialist pediatric dietician told me yesterday that one of the reasons he should be weaned very soon (at not even 3 months adjusted age) is so that he increases his weight gain. And she told me to start with pureed apple, not anything particularly calorific either. Admittedly there are other reasons to wean prem babies early, but even so I was surprised. But then based on her previous form she apparently knows very little about breastfeeding (according to her, it was ok to leave my son 5 hours between breastfeeds when he was only just past term and weighed under 3kg)

Sorry for slight thread hijack, but I find it surprising that there can be such extraordinary ignorance about breastfeeding from even specialist HCPs. Without commenting on individual cases, is this something that bf experts such as tiktok encounter regularly?

To go back to OP - from a position of no expertise whatsoever, I would trust your instincts! I almost had a nervous breakdown when my DD was refusing to take almost any solids at 9 months old, and various 'experts' were telling me she should be eating lumps by that point or else she'd have serious problems later on. Now she is nearly 3 and eats for England, with a willingness to try new foods that makes me blush with pride

libellule, the usual reason for weaning prems early is to give them more iron....a lot of a baby's iron stores are laid down in the later weeks of pg, from the mother, so they may not have as much as they need. This does not seem to figure in the dietitian's thinking - maybe ask her about this?

I too would be suspicious of any HCP who said it was ok for a very small, prem baby to go 5 hrs between feeds.

My experience is that lack of knowledge about bf and weaning is common in HCPs - one reason could be, as one paediatrician told me, 'we never see breastfed babies' and they extraploate from what they know about formula - which can be difficult to increase in volume. FF babies typically take increasing volumes of formula as they grow, and bf babies do not. There are reasons for this but whatever....if a baby is already taking huge quantities of formula, then it can be hard to 'make' him take more. So, wean, and add the puree to his intake on top of the mahoosive bottles.

Now, it cannot be literally true that no paed ever sees a bf baby, but in some areas it might almost be true. So expertise does not increase.

That said, it seems to me to be a tad dim to think apple puree is better for weight gain than breastmilk.

I breastfed my 3 children including tandem feeding of the oldest 2 so I knew I could produce plenty of milk. When my youngest came along, she was on the 50th centile at birth but slipped down to below the 9th. My HV wanted me to switch to formula but I ignored her. She (DD)always looked glowing and full of health. My daughter is now 10 and is finally catching up with her peers in terms of size. She has of course, always been ahead of them in terms of brains and beauty!

I think HVs only have a very short term outook because their responsibilities are confined to pre-school children.

Hmm, that's really interesting tiktok, thank you! DS is on daily iron supplements, which may be why she didn't mention it? She basically said it was all about weight gain (she said they keep up the same volume of milk but add the solids - from what you say, not what's likely to happen with a breastfed baby?!). And about not missing the 'weaning window', which given my experience with DD is a concept which I'm also a bit suspicious about.

It does seem that breastfed babies (especially, at a guess, fully breastfed 26 weekers) are rare enough that all the medical advice is tailored to formula-fed babies. But yes, dim is the word I was toying with - just seems quite surprising that a specialist neonatal dietician could be so ill-informed.

Again sorry for hijack lifeistooshort, but maybe this is added ammunition for you. My DS has had a pretty rubbish start to life, but he's looking blooming and nicely podgy now, and despite the catalogue of 'experts' in his life, I have no trouble with the concept that I'll start weaning him when I think he looks ready, not on the say-so of an HCP who I don't actually trust. And as it turns out, the consultant paed actually agreed with me, and said there was no rush if I thought DS wasn't ready - there is sanity out there

Thank you all so much for your reassurance and support. I have decided to stick to my guns and not to wean or give formula but to be mindful of his latch and do some breast compressions. I am 100% convinced he is healthy.

For those who recommended local breast feeding support group, last week after calling and calling both the mws who run the group and the hv and no one getting back to me, I finally managed to speak to one of the mw running the group. She didn't want me to attend the group as it was "for new mother" and when I asked her what I was supposed to do she said "call the NCT" (which I did and a lovely breastfeeding counsellor gave me loads of advice).

Last night my son slept from 23.30 to 7.30 I don't think if he was starving that he would sleep so long without calling for food.

life I have never heard of a bf support group turning away a 5 mth old baby and his mum 'cos the baby was too old.

Glad you feel better about things.

On the subject of fully BF preterm infants, I was recently told of a 24 weeker fed exclusively on her mother's milk from birth going home on her due date weighing 7 lbs and in the peak of health. I doubt that happens often, but even less often with formula.

On the subject of fully BF preterm infants, I was recently told of a 24 weeker fed exclusively on her mother's milk from birth going home on her due date weighing 7 lbs and in the peak of health. I doubt that happens often, but even less often with formula.

My DD was slow to gain weight, she was bf & I weaned her a 6mths, despite pressure from the MW's to wean about 4mths.

She is now a strapping (but not fat) 7 year old.

One MW was helpful & suggested spacing the feeds out so that she might drink more hind milk. This was very helpful to me, as it meant I wasn't constantly letting her have 5 min feeds & also helped her to gain maybe 1/2 lb a week.

FWIW it's not good for babies to be fat, you could try asking if there is a chart which uses their weight & height ratio.

HTH