Is my breast milk not nutritious enough?

[milkybarmum]

Am having a confidence crisis after my EBF little girl has dropped below her percentile at four months - she weights 12 pounds.
She was a dinky 6.2lb to begin with and steady plotting between the 9th and 25th percentile, but went below this month. She's on the 65th percentile for length though. She's not at all skinny and has chunky thighs!
I'd wanted to EBF until 6 months (allergies run in our family) and then try babyled weaning. But am now paranoid that my milk is not nutritious enough or she's not getting enough and I'm stunting her growth at this crucial time.
I feed on demand through the day - every 2-3 hours - and night. She NEVER refuses milk when offered! She was sleeping from 7.30pm until 5am, but this week is waking for feeds at 3am and 6am, which after being desperate for her to sleep through I'm actually happy about now as she's getting more milk!
Basically I'm wondering whether a bottle of 6oz of formula pre-bed on top of her normal breastfeed will help her grow/put on weight.
Two babies I know who weren't putting on weight with breast milk went onto formula and are now huge! It's not what I wanted to do, but don't want to stop her reach her full growth potential.
To complicate things I would use goat's milk formula for this extra feed until 6mths, as I was allergic to cow's milk as a baby and tolerated this better.
Can anybody reassure me to continue EBF or tell me if adding a one formula feed will help with weight/growth?

I don't think it's possible to get goats milk formula in this country anymore.

Lots of baby's weight gain slows down around 4 months. If you're worried she's not getting enough milk maybe you could just feed her more often? Do you offer both sides? If so you could try switch nursing where you swap back and forward between sides several times.

:( shame you're worried about this, milkybarmum.

First off, breastmilk is always nutritious, and differs very little from mother to mother in terms of its ability to nourish and have the right 'stuff' in it.

No baby has their own centile line - it is within normal limits to drop (or rise) two centile lines and it's only a 'sustained' drop that might need checkig out...and even then it's not usually anything 'wrong'. If you think your baby might need more milk, then you have the milk, right there in your breasts :) No need for formula.

You can

• feed more often (2-3 hourly is not that often, and it should be easy to up that, esp as your baby never refuses :) )
• always feed from at least both breasts and even three or four when you can, each session
• feed more at night, which you are doing

To be honest, adding formula to a potentially allergic baby's diet is a risk (goat's might make no difference - plenty of babies with cows milk protein allergies are allergic to both). It will also impact on your supply - 6 ounces is a lot for a 12 lb baby.

You could express your milk but there seems no point in this, when your baby is happy to breastfeed direct - no need for the hassle!

Hope this helps.

milky please don't worry it all sounds perfectly normal.

I understand from your post that she is still gaining weight, just not along the centile you want. Is that right? Is the HV using the right chart? Are you getting enough wet and dirty nappies.

As for waking in the night it sounds like classic 4 month sleep regression and doesn't mean she is hungry. There are plenty of threads on MN about 4 month sleep regression or have a read of what Kellymom has to say.

To me it does sound like your baby is getting enough milk. Really you shouldn't compare your baby to ff babies as they are usually fatter but fatter isn't necessarily better. Do you mix with any other Bfing Mums? Is there a local support group you go to?

Please give one of the Bfing Helplines a call too. They can talk you through your worries about your milk, discuss ways of topping up if that's what you want to do and talk to you about Goat's Milk Formula as I've sure I've seen someone post on here that its illegal.

Keep feeding and keep posting

x-posted with Moonunit and tiktok.

It is perfectly normal for some bf babies to drop percentiles; as long as they don't lose weight and are otherwise healthy and thriving, this shouldn't be a problem.

If you are offering breastmilk on demand, and she is healthy and content, there really doesn't sound like there is any need for you to give her any top ups of milk.

Babies breastfed on demand do reach their growth potential, without going over their growth potential. This is why breastfed babies are less likely to become overweight in the future.

As moonunitalpha says, if you really think she isn't getting enough milk, then breastfeed her more often.

Milkybarmum - tbh, I would stop weighing her! Easier said than done, I know. You say she looks healthy. I'm sure she is.

I was weight obsessed with my DS (my first baby) and, tbh, I ended up weaning him too soon to maintain the magic line. He's now on the chubby side and I bitterly regret messing with EBF. With my DD, I went by what I could see - a healthy, happy baby - and didn't get her weighed unless I had to.

Like the others say - the lines are based upon mainly FF children.

DD did have a bit of a feeding frenzy around the 3-4 month mark - she seemed to jump a clothes size in about 4 weeks and I remember having rather sore nipples. I think that's relatively common (although by no means applicable to all), so perhaps prepared to increase night feeds if she goes that way.

I've just checked DD's red book - she was 6lb8oz at birth and 13lb6oz at 18 weeks.

She sounds perfect to me! I second stopping weighing her as they go all over the place.

FWIW my son is intolerant of cow's milk (by proxy, so I'm dairy free) but also sheep and goat so it's not always better tolerated than cow's milk. And as mentioned, goat's formula isn't available in the UK as it's not allowed to be sold so it won't have the right mix of nutrients. Big risk IMO.

It's easy to get paranoid but just look at her - as you say she looks perfect!

My DD was 6lb 12 1/2oz at birth and followed a v. similar growth pattern to yours. I weighed her only occasionally at the standard development checks and when we visited my parents' house (we don't own any scales).

Yes, she was easily the smallest kid in her age group when she started nursery at 6 months but she was also the only one EBF'd to that point.

She was always v. healthy, happy and reached milestones early or on time. Given this, I saw no reason to worry.

Also, I remember noticing that DD was 75th centime height and 25th for weight ... but she didn't look thin. She looked perfect. My son, who followed a 90th Centile line throughout, looks ENORMOUS in the photos from his first year.

I'm not objecting to fat babies - I had one! - but neither is it unhealthy for a baby to carry a lower proportion of fat.

We are a nation of fatties and there is a definite causal link with this culture of producing fat babies; well, artificially fat babies. Some are naturally big, but others are simply overfed.

When my friend took her older daughter to the Paediatrician, she mentioned being concerned that she thought her DD was underweight. The Paed asked her why she thought that and my friend said it was because all of DD friends were much chubbier.

The Paed said her DD was perfect and to never compare her weight or anyone elses with those around you as the other children are probably unhealthly fat!

So my advice is to stop looking at the other babies and have faith in what you are doing

Hi milkybarmum

If it makes you feel any better my dd was weighed 2 weeks ago and was 12lb 12, that was at 6.5 months. She's just above the 2nd centile, she was 25th, then dropped to the 9th then 2nd. She's remained on the same line since 4 months. My hv told me to get her checked out by GP, I went and the doc said she'd never seen a healthier baby. Also went to a bf group and they were happy with dd's latch etc.

Babies come in all shapes and sizes just like we do. Your dd sounds like she's doing very well and she's just found her natural line on the chart :)

Can't comment on the weight issue but I saw goat's milk formula in a local health food shop a few days ago.

If it is definitely illegal to sell it in the UK, can someone please PM me to tell me how to go about getting it removed from shelf? I don't want to hijack the thread more than necessary!

Oh, I would add that my niece was a skinny baby and was at a ridiculously low centile for weight but she was always bright and healthy and is now a lovely but still skinny 8 year old. So OP, please don't fret too much.

Was it follow-on milk? It's possible if it's for 6 months+ it's not illegal.

yes, it might have been. I know one of the tins definitely was follow on formula.

My fully BF girls were always tiny. The 16 mo is now in age 6-12 month clothing, but at a year she was in 3-6 m size. She didn't really eat anything much until recently, was definitely still to all intents and purposes fully breastfed at 10 m. She went from the 50th centile to somewhere between the 2nd and 9th by 4 months and has followed that ever since. I will go and look in her red book in a minute to find out how much she weighed at 4m. Her older sisters were just the same and are now fine young women, still growing at 15 and 13, and very healty.

ANOTHER thought is that, when you actually quantify the weight difference between centiles, it is usually very small: a few ounces at that age. A big feed could be anything up to 8oz in weight. A big poo - who knows?!