9 months into breastfeeding, baby not eating or gaining weight and HV has told me

[mololoko]

...to stop feeding him at night as "breastmilk has no vitamins or minerals after 6 months" and should do "cold turkey" and let him cry it out. Then he'd be hungrier in the daytime for food. And I should be giving him vitamin drops.

I know that's largely rubbish but is there any truth in it? DS feeds twice between 7 and 7 and seems really hungry when he does. He breastfeeds 4-5 times during the day.

He isn't keen on food and it's a real struggle to get him to eat anything. If he was gaining weight I wouldn't be worried but he hasn't gained for 2 months and I'm at my wits' end. He's not good with a spoon and the only thing he will eat consistently is bread or toast. He won't take a bottle.

I don't know where to turn for support as I obviously have differing opinions to my HV regarding CC etc. FWIW I'm not bothered about getting him to sleep through yet, I just want to get him eating and growing again.

I am feeling so down because I had a rocky start to breastfeeding and 9 months in I still feel like I'm getting it all wrong.

tbh if you are feeding him up to seven times a day (four or five feeds during the day, twice in the night) then that does sound excessive and would almost certainly have an impact on his intake of solid food.

Think about it this way - you are feeding him pretty much every four hours (over a 24 hour period) and that is equivalent to the feeding routine of a newborn. So it's little wonder really that he's not wanting solids - he's filling up on milk.

While the hv's statement isn't necessarily correct, at nine months breastmilk alone is not enough and he does need vitamins and minerals from other sources - preferably from his diet rather than supplements.

So yes, I would cut down on a couple of milk feeds during the day and altogether at night and try to encourage more solids - think about what he does eat rather than what he doesn't iyswim and try to build on that.

I didn't get mine weighed past about 6 months (I just went on how he was/how he looked) but I seem to remember that at that age he really didn't eat an awful lot (and some days it would be half a mango for breakfast, others he didn't want anything so it was very variable). He was also an early walker/crawler and has tended towards the lean side because of all the extra activity I think.

It's just personal experience, but I don't see that starving him at night (of a fantastic food, she's talking rubbish about vitamins/minerals) will make him eat more in the day - you want food to be enjoyable, not a battle.

At about 11 months something clicked, and he suddenly wanted 3 good meals, plus snacks, plus feeds (2 or 3 in the day, 2 or 3 overnight) most days, and now at 16 months he's largely dropped the day feeds but not the night ones still.

Vitamin drops are your call though - probably won't do any harm, might help.

So hang on, has he actually stopped gaining weight or just dropped a centile? If you plotted his weight on a graph without centile lines, is it going up?

You getting distressed when he won't eat is only likely to put him off eating even more stupid HV! If it helps any at all, DS would pick at about half a meal a day until he was twenty-two months. I tried everything, witholding BF just made him eat less, I wasn't about to stop, at least he was getting something. He's now used to eating in front of the TV (distraction technique) and way bigger portions of junk food than I'd like because it was suggested that perhaps he was always so hungry that he didn't know his own hunger cues and so I should let him eat things like crisps until he was full for every meal so that he got used to the feeling if being full and knew the difference. Yeah, thanks for that Also had a HV insinuate I was starving him because I couldn't be bothered to feed him, the children's centre was getting extra bread in for us in order to offer him toast while we were there because he was "always hungry" (no idea why but his food aversion disappeared when other children were eating too) :(

The most helpful advice I had during this was from my LLL leader, she gave me an excellent leaflet about non-eating toddlers (which you can order from a group or online) and also recommended to me a book called "My child won't eat" - which is out of print and so quite expensive on amazon, your local LLL branch might have a copy, or there is a new edition out in February. From what she said to me it sounded brilliant. Worth getting hold of a copy if you can.

not excessive wannabe. well within normal. no evidence that this would interfere with solids. if she was ff this often wouldbe different. but she isnt.

Do HVs in the UK not know anything about breastfeeding? They seem to know far less than any mother who has personally BF.

OP, have you tried porridge made with expressed BM? Your DC might like that because it tastes of your milk, as a way of encouraging him to take up solids. DD1 loved porridge and it really helped her put on weight.

A healthy baby like yours doesn't need extra vitamins generally, but DD1 did get iron deficient at 9 months (tested by doctor), possibly because I was anaemic by that stage as well. I remember she got prescribed some baby supplement, but actually she still has a tendency towards it and needs iron supplements every winter and she's now 13. I believe vitamin D supplements are recommended for babies living in northern England/Scotland, because there isn't enough daylight there in winter.

after 6m brestfed babies are advised to have vitamin drops

is that really true? I thought this was only for formula, the old kind that didn't have the added vits

surely, it being the natural thing to do, with added food, this is rubbish?

And BTW, he's 3 now and eats constantly, has since he was 22 months, he's hitting all the milestones correctly, exactly average height (although people keep telling me he's tall!) no idea how much he weighs because the stupid obsessive HV made him phobic of the scales by stripping him off (Which they're not supposed to do after 12 months ) and forcing him to be weighed. But I struggle to carry him for long these days.

It's also worth pointing out that before 12 months the majority of a child's nutrition should come from breastmilk, not from food. Some children are slower to switch to solids than others, maybe you've got one of these? I have known some babies who dont switch to solids until nearer 12 months and they are fine.

Also, my paediatrician comment was for if the child had not gained any weight at all in 2 months (so not even an oz). If the weight gain has just slowed that's normal.

Very glad that tiktok has arrived on this thread.

Why start solid foods?
Because there comes a time when breastmilk no longer supplies all your baby's nutritional needs. (This does not mean, as some uninformed people say, that there is no nutritional value in breastmilk after the baby is six months old.) A full term baby will start requiring iron from other sources by 6 to 9 months of age. The calories supplied by breastmilk may become inadequate by 8 to 9 months of age, although some babies can continue to grow well on breastmilk alone well past a year.

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Mandel and colleagues compared milk from 27 women who had been nursing for two to six months and 34 mothers who had been nursing for 12 to 39 months.

They report, in the journal Pediatrics, that the average fat content of milk from the shorter-duration breastfeeding group was just over 7 percent, compared to about 11 percent from the longer-duration group. A liter of milk from the women breastfeeding for a shorter period of time contained about 740 calories, compared to 880 for the women who had been breastfeeding for a year or longer.

"The results showed that the caloric contribution of breast milk to the infant diet is not negligible," Mandel added in comments to Reuters Health. "Hence, we can tell mothers that continue to breastfeed their infants that, from a caloric standpoint, their milk is of nutritional value."

They don't fill up on milk. DS would wake in the night at 13/14 months and feed, feed, feed, then sit up and sign "food" at me. He was hungry and the milk wasn't filling him up. Also, if he'd just had a big feed conversely he seemed to eat more at that meal, maybe because he was relaxed?

mololoko,

You must be feeling quite anxious and stress about the fact that your baby has appeared not to put on any weight. I had a very similar experience to you in that my dd dropped from the 50th centile to the 0.4 over the space of six months. It is really hard not to worry. It turned out my dd weight was being plotted on bottlefed charts and that God has destined my child to be small.

Provided that you are offering food, then I am sure that your baby is getting what he needs. I worried horribly with my son, but I now realise that children take food when they need it. The point where babies run out iron varies from child to child. When the iron in breastmilk is no longer enough then babies instintively want iron rich foods. Problems with breastfeeding anemia happen in third world countries where there is a serious lack of decent food.

These are good books which would explain what I mean better.

www.baby-led.com/

I went to a lecture by the author of the book below and read an old edition of his book.

www.amazon.co.uk/Child-Wont-Eat-Carlos-Gonzalez/dp/1780660057/ref=sr_1_1?ie=UTF8&qid=1323342602&sr=8-1

I realise that you feel that the breastfeeding support group is only for new mums, but I am sure the health visitors would be prepared to talk to you. In my experience health visitors who run breastfeeding clinics are more sympathetic to hippies who want to nurse toddlers. Or at least they are phased by an older baby still nursing.

It is well worth finding out which clinic they weigh babies at so that you can take your baby to someone who is not anti breastfeeding an older baby.

My DD is 9 months and breastfeeds about 8 times in a 24 hour period, including typically twice between 7 pm and 7 am. The WHO recommends that babies are breastfed frequently and on demand until 2 yrs and beyond, and so I see this as normal. You might also want to take a look at the complementary feeding info on the Kellymom website, which says iirc that by age 1 year, breastfed babies should be obtaining, on average, 25% of their calories from food i.e. most of their calories should still be from breastmilk.

If your baby will eat toast and bread, how about trying: avocado, banana or peanut butter on toast (maybe with butter as well for a few extra calories), cheese on toast, eggy bread, fingers of scotch pancake spread with fruit puree, or fingers of homemade muffin (either semi-sweet made with grated apple, sultanas etc or savoury made with grated courgette/onion and cheese).

And ignore the horrible HV- you could always see your GP to get a second opinion, if you are worried. :)

Absolute rubbish from your HV. Just follow your baby's cues and make sure you all eat together at least some times. Try to find an LLL group. The leaders will be well educated about feeding and weaning and nobody will tell you off for breastfeeding too much!
Incidentally both of my children bf way more than that at 9mo - I just didn't tell anyone :-). My 17mo DD has more (if short) feeds than that now (and eats plenty of solids, lots at times)

WannaBe I must disagree with you there. 4 hourly feeds is only a newborn routine if you artificially enforce it. Babies fed on demand as they should be will normally feed more often than that whether they are FF or BF. The number of feeds the OP is giving is not excessive, remember that BM is also a drink to BF babies as well as food.

OP - the number of Bfs you are giving is fine, carry on. Keep doing as you are doing with solids, offering a range of things and he will get there

DS didn't get into solids with three meals a day until 9 months.

Before that he sort of had breakfast and lunch but not every day. He was a milk fiend (I fed until he was 2).

I remember around 9 months, he started wanting a snack in the afternoon instead of milk (but still fed loads at night).

As we got closer to 1, I introduced more snacks as better than giving meals (DS was always and still is a bit of a snacker).

As someone said - if the HV hadnt said anything or he hadn't been weighed, would you be worried?

Do try and have mor finger foods before one or two feeds a day (mid morning or mid afternoon) to see how it goes and gently encourage self feeding etc.

NHS link to breast fed babies over 6 months (and formula fed babies who have less than 500ml formula a day) should have drops of vitamin D)

thanks Nannyl - i'm really surprised at that advice.

Some great advice here, thank you all so much. I will contact the breastfeeding helplines (why didn't I think of that?!) and I will get some vitamins just to be on the safe side.

I will also try to reduce some feeds, but not if he's distressed. I can't face stopping night feeds yet. It's not a problem for me - we co sleep from when he wakes at 4am or so and I barely wake up whilst he feeds. If he cries, he wakes up dd and I don't want that.

Thanks again, I feel so much better to have a plan of action.

My gp referred ds3 to a paediatrician for this.
He was about 7/8 months old, weaning was going terribly, I was at the dr's for me, when she looked all concerned and asked if Ds was always pale. I said that he was, but was very similar colouring to dd, but she carried on quizzing me about his crap weaning, how much he was bfing etc. I left the dr's feeling utterly useless and spent the next four weeks panicking about how much he was feeding, and how little he was eating.
When we saw the paed, she took one look at Ds, crawling like a chubby rocket, then pulling himself up on a chair and cruising round it, did a rolly eyes thing and asked if any of his siblings were similar colouring.
Her advice was "If you are happy that he is ok, then he is fine."
She also said that she was seeing more referrals from GP's and HV's because BFed babies weren't thriving. All that meant was that weaning was taking longer than expected, but it is completely normal for BFed babies to take 6 months or more to get the hang of eating, and stressing a mother out by suggesting her baby is anaemic or not thriving is a sure fire way to introduce feeding battles into the baby's life.
She told me to go home, relax about his eating, and do it at his pace, because you can't force a baby to eat, and in any case, he was perfectly healthy.
Ds is now 10 months old, eating well, and still feeding 4 or 5 times during the day, and at least twice at night.

Sorry, that was really rambly
I suppose what I was trying to say was, don't stress about it, he'll get there in his own time.
And health visitors know bugger all about breastfeeding

OP, I won't add to the wonderful advice you've already been given. It's a real shame that your HV knocked your confidence when it sounds like you are doing so well.

My child won't eat has recently come back into print and now no longer cost £150 on Amazon Might be worth a read? My eldest wasn't keen on solids until she was over a year old. Fortunately I had a very sensible HV who was unconcerned as DD1 was perfectly happy and healthy. You know your baby best, you will be able to tell before anyone if he seems ill, tired or out of sorts :)

New one not out until Feb unfortunately, hohoh, but still definitely worth pre-ordering, OP, or check your local library or La Leche League library.

How about offering a wide selection of finger foods. if he doesn't like the spoon.

At nine months I offered a finger buffet at 5pm of steamed veges, sweet potato, toast with spreads soft fruit and just let them get on with it as I wasn't interested in battling with the spoon. I think milk can take the edge of appetite so would offer solids first.

I imagine the HV is worried about iron levels?

You have done a great job BFing so well done to you.

mololoko - Here is the WHO's guidance on complementary feeding for children aged 6-24m. The most relevant page for you is probably pg 18 where it actually specifies the amount of kcals from bm/food for the 6-8m, 9-11 & 12-23m age groups (and has allowances for industrialised/developed countries so applies to the UK).

I hope that helps and it might be useful to wave under the HV's nose next time you go.

OP it would be more beneficial for you to take multivits, your body will always prioritise your breastmilk, it's you who will become deficient, not your baby. Babies who are born at full term don't need supplements as long as there are no health issues with baby. I was vit D and calcium deficient, it didn't affect dd3 at all, I on the other hand felt like crap but was fine after taking vit D and calcium lozenges prescribed by the doctor. All nutrients in breastmilk are very bioavailable and easily absorbed which is why despite bm being low in iron compared to formula anaemia is very uncommon in breastfed babies as they absorb a huge amount of what is available.