EBF baby -HV pushing weaning at 5months

[Candinha]

I have a 5 months old who has consistently not put on weight quickly and recentely has slowed down and started to go down his centile curve (9th). He has never slept through and I BF almost everytime he wakes up. HV is not overly concerned but keeps suggesting we start to give him solids, I am concerned he will take even less milk from me. (He wont take a bottle, so formula not really an option).

He is a happy baby and very activite already turning onto his tummy.

I am confused about the weaning as advice is conflicting from difference sources! Anyone out there with similar experiences?

Thank you

Yes, my HV tried to get me to wean early due to having a small baby.

I pointed out that surely breast milk would be more calorific than pureed carrot- but she didn't really grasp that concept.

Anyway, I stuck to my guns and did blw from just short of 6 months.

DS loved it and I made sure I gave him loads of high fat foods (avocado, cashew nut butter and cheese) and his weight shot up.

Oh and at 15 months he still doesn't sleep through the night- but that's something you probably won't want to hear!!

Does he seem ready in any other ways? Such as sitting us quite well? Putting things in his mouth? Looking interested in food?

I think you have to trust your instincts which I appreciate isn't always easy!!! I'm not a fan of the 6 month rule as I don't think one age fits all babies IYSWIM?!

My dd was bf and struggled to gain weight, I started weaning at about 5 months went very slowly just a few mouth fulls of baby rice for first few weeks and gradually increased. I have to say for us it was the right thing as my dd loved food and to this day (she is now nearky 5!) isn't a big fan of milk.

Is your DS actually losing weight or just gaining v slowly? I was a slow gaining baby myself, and looking at the photos I was fairly slim for a baby (although round cheeks). My mum was bf, and under HV pressure started introducing solids at 4 months - she was quite proud at holding out and not starting at 3 months! I'm afraid it didn't make any difference to my weight at all. I am now a tall slim adult, seems to be just the way I'm built.

I'd do BLW myself as you can guarantee that he'll eat when he's ready - whether that's before 6 months or after.

I think before 6 months most of the solids people give have fewer calories than milk, so that could be counterproductive.

crikey, there was me thinking the sleep regression thread had solved all your problems.

FWIW, my 13 m.o. doesn't sleep through the night, although that isn't necessarily indicateive of a feeding issue. At 6 months DS was waking 6/7 times a night and was fed back to sleep most of the time. After working on his sleep, he woke once for food at around 7 months. He ate loads of solids in the day and had frequent daytime bfs too.

Actually, my friends HV was telling her to put her 16 week old EBF baby onto solids at her last appointment.

So I didn't finish properly, I just felt it was a bit odd. The baby is gaining weight and is generally doing quite well. I did wonder why she was pushing it TBH.

Thanks ladies that is really reasuring. In answer to some of your questions. He is not sitting up yet, seems to look at food when we are eating and is frantically taking toys to mouth constantly. He is not loosing weight just gainning very slowly 6g in 8 days on last two weightings. I want to try blw and can't do it if I wean now. I am going to try and get second opinion from feeding spc and see what she says. I am so confused and due to lack of sleep struggled to make a decision!

Have you tried all the techniques for increasing the amount of milk he's getting?

Add extra feeds in, switch sides multiple times during each feed, breast compression for instance.

Second opinion sounds a good idea. Hope you get some good RL support.

plus is he becoming more active as well?

Well, the current NHS guidelines (following the WHO)

How come he was weighed twice within 8 days - is it because of concerns about his weight? The WHO says 'it is recommended that babies should not be weighed more often than once a month from 2 weeks to 6 months of age... unless there are special reasons.'

The WHO fact sheet for parents on weighing babies is useful.

If he's not losing weight and seems healthy & active in other ways, I'd wait myself.

Oops, that should have said: The current NHS guidelines (following the WHO) recommend waiting till 6 months unless the baby is able to sit unsupported & pick up & eat finger foods before then, in which case you should allow them to eat finger foods.

If you're not sure, why don't you ask them to explain to you the research evidence that they think suggests that starting solids early will help his weight gain? That would allow you to make up your own mind.

does he seem alert, happy and is he developing normally otherwise?

I personally would not feel concerned about a slow Wight gaining baby that is healthy in every other way. As someone else has already pointed out, the foods that you can introduce before 6 months are much less calorific than breastmilk and if he truly needs more calories, he needs more breastmilk. However, it isn't even necessarily the case that he needs more food anyway. He most probably is just a skinnier or 'banana' baby. Babies (like adults) come in all shapes and sizes.

I wouldn't have him weighed so often if it's stressing you - they shouldn't be weighed more than once a month anyway. Look at your baby, if he's content and healthy then the numbers on the scale aren't important.

I started weaning at 5 months - ds wasn't sitting unaided (still isn't at 6 months though) but he was grabbing things and putting them in his mouth. I put some banana in front of him and he picked it up, bit a piece off, chewed and swallowed - I took that to mean he was ready!

However, once he started eating more he did drop a milk feed, and it took a month and three meals a day for his weight gain to increase. So I wouldn't necessarily wean early to improve weight gain.

Some HV's can be funny about weight gain and weaning - my friend weaned her 91st centile 16 week old on the HV's advice, as her weight gain had slowed slightly

You are weighing way too often! Over 8 days, the difference between having a poo / not having a poo would be significant enough to appear to throw him off whatever growth pattern he is following.

If it was me, I would wait a bit longer to wean. Can the HV explain why her recommendations go against the NHS guidelines? I know you said that he has moved down the centiles, but you didn't say by how much - for example IIRC then moving down a centile line is well within the range of normal.

My own DD was born on 25th, moved down to 2nd by about 6 weeks (slow to get back up to birthweight) and then dipped below the 2nd, before starting to move up again at about 5.5 months (BEFORE we started weaning) - she's now 11 months and on about the 50th. They don't all follow the centile lines, they're averages and not all babies are average!

Candinha - Have you seen this before?

It's normal for bf babies weight gain to slow down past 4m and then slow down further still at 6m.

Babies can't grow at the same speed through out their first year - a baby who gained even 6oz a week (the average amount a week for 0-4m) for a year would put on 19lbs 8oz so given the average birth weight is 7lb 8oz they would weigh 27lbs at 12m!

As you say your son gain 6g in 8 days - if he had done a big poo and wee after the 1st weigh but done a big poo and wee shortly before the 2nd weigh you could easily hide even a really huge weight gain.

A big wee could be 90g+ and a big poo could weigh equally as much if not more so you could be looking at a variation of 360g+ given a big poo and wee waiting to come out before weigh and poo/wee done before a weigh. Plus if baby has had a big feed just before the weigh in that could be 200g or more so that could be 1lb/500g variation just in the poo/wee/milk in the baby.

That is why very frequent weighing is not recommended - you can't see the weight gained because so many variables affect the actual weight of the baby (amount of poo/wee/milk in baby) rather than the bone/muscle/fat gained in the space of a week.

It's just too short a period of time to 'see' the weight gained. Weighing monthly allows for a trend to emerge rather than bouncing around the chart as weight gain isn't constant, it goes in fits and starts not a nice smooth curve except if you weigh infrequently enough to see the trend not the nitty gritty of daily ins and outs (if you pardon the pun).

Sorry for the rant/lecture but it gets my goat that I, as a mum (Maths ed. only up to GCSE level too), can see this but a trained HV can't....

Ins and outs, tee hee!

Gosh ladies so much information - very, very helpful. Read a few bits aloud to DH as he is a bit 'obssessed' about the centile curves. We have two other children and they were bigger so I guess DH expected the same, but I am small and he probably just takes after me! I love truthsweet post, tx for that will make sure to mention it to HV. I'll try and answer all questions; yes I am taking fennugreek and doing breast compressions, I had good BF support in the beginning as he had a tongue tie. He is an active baby and has started to move onto his tummy now, he is only 5 months and already I am having to pin him down to change his nappy . Thanks angeldog for the information will have a look a it. I had him weighed so close together because last time we weighed him he was dropping off the centile so I rang her to come back after a week, so my fault really. Because he struggled to feed in the first 6 weeks of his life because of the tongue tie I worry about his weight a lot and topped with the fact that he has never slept well at night!

Sorry for long post will keep you posted

Oh forgot to say - I think I will try a couple of tea spoons of baby rice at tea time mixed with EBM just to see what happens but wont start the 'root vegetables' HV recommended yet, as I am really worried he will reduce his milk feeds since he has never been a big feeder anyway.

Thanks again!

You know, that could have been me writing that post 2 years ago. Some good advice from others but just wanted to add my experience.

DD was born on the 50th centile and at around 3 months her weight gain slowed. By 5 months she had dropped down to the 9th centile. Like your boy she wasn't sleeping through (nor did I expect her to be) but was only waking once or twice for a feed. She was healthy, contented and very active so I wasn't worried, however, the HV was and insisted I go back to get her weighed weekly. On reaching the 9th centile she referred me to the GP who also had no concerns, by which time I was getting mightily pissed off. The final straw was when I was advisedd to stop BF'ing as my milk supposedly wasn't good enough.

Luckily I'm made of tougher stuff than that and ignored the advice. There's little enough support for BF'ing IMO so I decided that that would be the last time I took to the HV and we've not been back since.

So, 2 years on DD is still a healthy, contented and very active child. She packs in a tonne of food and has always had a good appetite. Her weight is now on the 25th centile (as is her height) so I think she'll always be below average but someone has to be.

Those charts are a blimmin' nuisance - they are not a benchmark for success of failure but are simply a guide that should be used in conjunction with an overall assessment of the well-being and development of the child and a hefty dose of common sense.

I hope that gives you a bit of encouragement. As has been said already, trust your instinct....mother knows best so don't let them bully you into something that goes against your intuition and values.

Thanks cluckykate your post nearly made me cry! I am fedup of HV and DH and others giving helpful advice such 'give rice', 'give formula', 'give potatoes', sod the lot I have BF 3 kids and my other two are a picture of health. DC3 is so happy and active there's absolutely nothing wrong with him apart from adults around him having the expectation that he should be on a particular curve rather than what he is! Despite my previous post I am not ready to wean and will wait until we are both ready. DH wants to start now as he thinks DC will sleep better but I am totally not convinced and will stick to my guns for now... Better go as he just woke up and needs a feed. Tx again ladies

truthsweet That was a great post! Reminded me of when DD was readmitted to hospital after losing 13% of birthweight. They ended up keeping us in because she had lost 5g one day. She'd had a massive poo (after a week of no poo) literally 5 minutes before being weighed. It was so frustrating - I was tempted to get the nappy out the bin and weigh it!

Candinha I had a consultant who wanted me to start weaning at 17 weeks. I flatly refused. With your DC being 5 months old you could just spend the next month fobbing the HV off by saying you're not ready to make a decision yet, still doing your own research etc. I agree with all the other posters. As long as you are sure your DC is happy and healthy don't worry too much. And some babies just have to be on the lower chart lines otherwise the lines wouldn't be there.