baby not gaining enough. what are my 'options'??

[cheapandchic]

I have not been to health visitor in a month because my baby was doing well despite breastfeeding issues (over supply/fast let down/fussy baby bad latch)

But from month 3 to month 4 she has barely gained anything! Now at 17 weeks, health visitor said she was not worrying yet but to come back in a month and if still not gaining then we can discuss our 'options'... She is currently on the 9th%. (started on 9th but went up to over 25th and has dropped and now moving downward)

What are the options? will she suggest formula? baby will then be 5 months, will she suggest weaning? I am not keen to do either. What do I tell her? I am dreading going back, and worried now about my little one. What can I do in this month?
Can I try to feed her more? Any suggestions?

This might help...

www.mumsnet.com/Talk/breast_and_bottle_feeding/417135-mighty-oaks-from-little-acorns-grow-slow-weight-gain-support/AllOnOnePage

is it ok that my baby only gained 0.1 kg in a whole month?!

Sounds like your HV is not worried about your baby's health, cheap, so that's reassuring.

If she thinks there is a weight issue next time, then this is easy enough to deal with - just breastfeed more frequently, with two, three or more breasts each time. You could do this now, if you wanted and felt worried - you won't 'overfeed' your baby.

Were the last weights definitely accurate? If it was just one measurement it may have been a blip, wonky scales maybe.

If she's still on the same centile she started on I wouldn't be too worried (although I'm not qualified in any way!). And if the HV is happy to wait a month for another weigh-in, she doesn't seem majorly concerned, just wants to keep an eye.

Meant to say also (blooming premature posting) - tiktok's advice is quite right, try to up the feeds if you're fretting. But make sure you still reach the good ol' hindmilk!

Do you have access to any breastfeeding support? If you know you've had latch problems, it might be worth checking that your baby is feeding efficiently with someone who has experience.

Otherwise I would maybe try offering the breast more often to see if she takes it. If she's otherwise happy and well though (and from what you have said) I wouldn't be worrying.

No such thing as 'reaching the hindmilk' , MrsN!

See kellymom for explanation.

Yes, if the HV was really worried, she'd be wanting to see you next week or sooner. They don't tend to wait around when they suspect problems. You mention that your DD is still on her birth centile. That's also a good sign.

Really, don't panic yet. Babies really do grow at very variable rates and the likelihood is that your DD will speed up again in the next few weeks.

Apologies tiktok - I show my ignorance.

Although I'm sure kellymom was where I learned about foremilk and hindmilk. I was totally ignorant with DD1 and I'm surprised it worked at all. I swotted up for DD2. Or at least thought I did! Do you not start with foremilk and gradually it thickens up to hindmilk? Am I way out?!

(sorry for borrowing the thread for a min)

And a basic question, are those the breastfed baby centiles? I spent hours agonising over tiny ds1 (also 9th centile at birth, bottomed along 2nd, until, miraculously, I found the breastfed baby centiles and he was 9th again.) If DD is happy and weeing/ pooing, don't worry just yet. could she have had a cold which slowed her down a bit?

Once again, posted before ready.

I thought the longer you feed the more fat is picked up in milk factory. Have I totally missed the mark?

Check kellymom, as I say, MrsN, for an explanation. Babies do not have to 'reach the hindmilk' - it's not like 'drilling up' into the breast for creamier milk. It's too simple to say the milk gradually thickens up/the longer you feed the more fat your baby gets - you have got half the story only :)

weary - charts in use in the UK are always breastfed baby charts these days. Previous charts were of babies whose feeding was not differentiated, but for a four month baby it would make no difference anyway, as the difference in weight between bf and ff babies only shows from about 6 mths onwards.

gaining no weight in a whole month still worries me. however I just looked at her chart and the 3 month weight was done at the hospital when she was there for a follow up at the feeding clinic.

the 4 month weight was done at my local gp baby clinic...possibly the scales were not exactly the same/correct??

well thats what I am hoping. but for over a week now she has been vomiting much more than normal. between feeds rather than just after. but she doesn't seem unwell. its strange. anyway I am going to a breastfeeding group friday to see what they say.

It's very possible that there was a discrepancy between the two scales - and when babies are so small, even a small difference will show on the charts. Could it also be that you'd given her a good feed before the first weighing and just changed a pooey nappy before the second weighing? DD loved to fill her nappy in the waiting room. Could it be that the first weight was recorded wrongly? Everyone is prone to schoolboy error.