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.

rik not really good info there sorry. its not that breastmilk is deficient in vit d in any way. it isnt. but the baby of nine months needs more vit d than can supplied by breastmilk. he gets it from his own diet and from sunlight. his mum"s vit d will not be enough at this age.

guidance in uk is based on concern that modern life styles mean some babies over 6mths could go short esp if they live in north and esp if ethnically dark skinned.

formula has vit d added to it but bf babies get it via supps. if they get outside a lot and have plenty of vit d rich solids then they prob dont need them but that's a judgment call.

Whatever, at this age the mum's supps are irrelevant.

Sounds like a really crap HV there. I can't add much to the good advice that's been given here, but just as a comparison at 9 mo my DD was having about 11 bf a day as we did blw and she was rubbish at it

So certainly don't get concerned that you're nursing too frequently.

And if memory serves me correctly at that age DD was generally waking 1-3 times a night for a feed but then miraculously a few months later started sleeping through the night. So don't get overly worried about the sleep either.

You sound like you're doing a fab job.

Sounds very like my DD - she barely ate a thing until she was nearly 12 months old (now 17 mo and still quite fussy but in the right mood will eat really well) and her weight gain slowed after 6 months so that she dropped a couple of centiles by her first birthday.

As an anxious first timer I was panicked by the HVs and ended up with paediatric and dietician referrals and blood tests for various conditions - with hindsight I wish I'd just relaxed, trusted my own instincts (she's happy, looks perfectly healthy and is developing fine), and the HCPs now think she's just naturally small (someone has to be!).

I tried scheduling feeds instead of BF on demand to reduce her milk intake, but it made no difference other than making us both miserable so I gave up; couldn't face cutting out night feeds and only stopped them 6 weeks ago - haven't noticed any changes in her appetite since though!

She is an idiot. What if you stop feeding him BM and then he gets even less. Woefully ignorant. FWIW my DS fed loads and ate loads. I think they are all different. Feed as much as possible, whatever! I would think about how much he eats over a three or four day period, rather than a meal by meal period as is more realistic. You would probably find he eats more than you think!

Your HV is talking rubbish ofcourse.

My DD who is 15 months, hardly ate anything till she was 12 months and started nursery. She was fine and well, thriving and growing. Now she eats like any other 15 month old, although maybe her portions are smaller, but she is great at eating a wide variety of food like meat, fish, fruit and veg. I used to get really stressed about her not eating. She refused spoons and she wasnt' interested in self feeding much either and I was worried. But what could I do? Sometimes I tried to offer her food when she is hungry rather than breastfeed her, but she would cry when I put her in the high chair, and I had to pick her up and feed her. Ironically, she ate better with a BF beforehand, like she was could relax into exploring the food.
Even now I BF on demand. If she eats she eats, if not, BM is still a great food for her. Withholding BF in the hope of her eating solids has never worked for her.

I can't add to the wonderful advice you have got already. Have you looked at baby led weaning since it sounds like your LO doesn't like the spoon but will eat toast? My DD won't let me spoonfed her unless it's fromage frais. But she will eat all sorts of finger foods. Also i havent forced her to eat more solids by witholding milk, she just started to eat more at her own pace. I just keep offering what we eat every meal and she just starts to eat at her own time. (We change what we eat to have more roasted root veg, toasts for breakfast, to make it more compatible with her).

IIRC the BLW book says that many babies don't really start eating solids till 9 or 10 months.

We did BLW with my DS and he took to solids enthusiastically from the dot of 6 months. But it was 11 months before he 'needed' a solid meal - up till then he could skip a meal and just bf quite happily.

He bf about 7 or 8 times a day, and about 5 x a night at that age. 8/9 months is in the middle of a HUGE sleep regression (another one at 11 months) so waking and wanting to be fed at night is totally normal at that age.

FWIW DS who was a rubbish sleeper, suddenly improved to only 1 waking a night from 13 m.o. without any intervention from me.

tiktok Most babies get more than enough sunlight to top up thier vit D, only babies kept indoors most of the time wouldn't. I know how little sunlight is needed to get enough vit D, I become Vit D deficient because I have a sunlight allergy in the summer months when the sun is at it's stongest, I only become vit D deficient in the summer months when I have to stay indoors or wear factor 40-50 at all times outside. Winter, autumn and spring sunlight are fine and I can go out without taking precautions and the 1 hour a day I am outside on the school runs is enough to keep my vit D up so a baby would need less. As long as you have some exposure most days it's fine. I live in NW England so lowish sun levels and an hour a day is fine. Mum should take multivits because what goes into her breastmilk comes from her own stores. Advising all babies need supplenting is wrong, because they don't, very few need supplementing and advising everyone to supplement when most don't need it is rediculous and worries parents needlessly that they are depriving thier baby who is choosing not to eat much.

I have never ever been told to give my babies any additional supplements apart from my first baby who was prem and needed iron for his first 6 weeks to top up his natural stores. I live in an area which has the one of the lowest bfing rates in Britain where most GP's and HV's think bfing is no good past a few weeks old... Vits have never been mentioned in the long list of reasons I've been given to stop bfing and switch to formula or wean early. I worked closely with a bfing consultant at my local hospital, she runs the mothers milk bank, I donated there while exclusively bfing my baby past 6 months (she was 32 weeks when she started eating solids) and she didn't mention giving my daughter supplements when she knew she was 10 months old and eating only a few bites a day either.

The OP's baby sounds fine and very normal, most babies weight gain tails off at that age, they are alot more active, sleeping less, growing more in height so they don't gain in bulk and slim off a bit, thier legs grow loads in length at that age in readiness for walking, I've never seen a bfed baby not slim off at that age. She's worried because her HV is crap and telling her that her baby is being deprived of vitamins is awful, because he's probably not unless she keeps him in the house 24/7 and uses sunblock on him all year round.

Rik, it's a world-wide controversy, this Vit D thing. I really don't think we know if 'most' babies get more than enough sunlight to top up their Vit D, and actually, a lot of babies are indoors a lot of the time especially in cold weather, especially in northern climes. When they are out, they are wrapped up and inside prams and pushchairs, or cars. You may be right that at least some exposure, every day, for a baby is ok, but not everyone agrees with that - check out the literature. In Norway, almost everyone (literally) is supplemented with cod liver oil every day - to good effect, apparently.

We evolved as a species outside, and people in the far northern hemisphere (like the UK) would have a diet higher in Vit D than most of us have now.

The multivits taken by a mother are simply not sufficient to top up the levels of a baby who needs Vit D - a baby who needs Vit D either needs to be outside a lot more, and/or have Vit D solids, or a supplement.

I am not advising people to give their babies supps - I am just saying what current UK guidance is and has been for a while. I can't comment on why you were never told to give your baby supps - but that's absolutely normal because despite it being official guidance (with some evidence for it, too), I would say few mothers are actually told it.

Whatever - all I wanted to do was to point out that you were not right in saying that it would be sufficient or better for a mother to take supps herself, because if a baby needs Vit D, it would not be enough.

Of course the HV's knowledge on this sounded rubbish and undermining :( :(

I was never "told" about vit D supplements for me / my baby

in fact when i asked the HV (who then asked the other HV and nursery nurse in the clinic) none of them actually knew the answer and they got out a book to look up the advice and check

I hadnt realised at all the I should be taking vit d so for 7 weeks of BFing I wasnt cause i didnt know, and was never told. (Until they looked it up, it seemed my HV hadnt realised that either)

and if it wasnt for mumsnet i wouldnt have known either

We didn't do VitD supplements - what we did do was ensure at least 10 minutes outdoors every day regardless of weather.

I read that ricketts was becoming a problem because mums weren't allowing their children to get any sunshine whatsoever, i.e. wrapped up too much, in cars all the time, etc.

rik this has already been linked up thread, but NHS recommends vitamin drops for all bf babies and ff babies who take less than 500 ml a day.

As for the sun in the uk, we don't even put suncream on in the summer and we are on the south coast. DH and I are from NZ and we always have a laugh when people put on sun cream here. The summer sun is weaker than our winter. Back home if you are pale skinned you burn in 10min outdoor. The weather forecast tells you burn time because it's important to put on sun protection. Neither of us has burned or indeed put on a tan here even in summer. Like tiktok says with the weak sun and the amount of clothing we wear, I've made the decision to use vitamin drops.

PS I was the only one without sun cream and a parasol in summer for my April baby. I'm sure I have a big neon sign screaming foreigner haha. DD didn't get burned once even with walks on the beach.

How interesting, lilham - I always burn in summer if I don't use sun cream or stay in the shade. It's only been the past year or two that I've realised what sunburn actually feels like, I hadn't been able to identify the difference between that and just being hot, before. So I tend to use that as a guideline for myself and DS now and move us into the shade or put cream on if I feel myself starting to burn.

BertieBotts, are you quite pale skinned? It's interesting you said you only discover the diff in the last few year about sunburn vs just feeling hot. Growing up in NZ we have lots of bad sunburn stories. The funniest was a friend went on a boat trip without suncream. He came back so burnt he had pockets on his skin that trapped water when he showered. It's funny but it must hurt so much!

According to DM, I was exclusively breast fed for 11 months with no solids offered at all. I know this isn't the norm now and back in the 70s she was made to feel a complete pariah!

Whilst her approach wasn't text book, it's comforting to know that I didn't starve and I now eat pretty much everything. Babies will take solids when they're ready. There are many battles to have and I've decided food isn't going to be one of them.

That sounds horrific! Yes I am quite pale.