Low weight baby, breast feeding, formula and weaning early - whats the best solution?

[Wills]

Hi,

Unfortunately my dd2 is currently sitting on the 0.5 percentile and is very likely to have fallen off the chart within the next fortnight. Apart from a low weight in every other way she looks perfectly healthy and the health visiters are being reasonably relaxed about this (thank goodness). However given that she's now 3 and half months they think they are going to recommend that I wean early i.e. at 4 months. Since dd2 is also showing distinct signs of allergic rhinitus I was told by my gp to not wean for as long as possible and definitely not to introduce formula - to stick to soley breast feeding as long as possible. She's recently recinded this statement and now feels that I could possibly feed with ordinary formula just not soya.

All in all I've had an awful lot of messages. DD2 is a healthy looking baby just not very chubby. DD1 was similar although never fell off the scale. I'm starting to feel that my milk is not good enough.

What should I do - I'm tempted with weaning at four and half months but going very slowly. Would be grateful for other people's thoughts and experiences.

I am no expert, so please this is just my view. I was told that my dd2 was dropping weight too, but I couldn't see how getting other food into her would actually increase her calorie intake - because her milk intake might go down without getting anything significant into her. Breastmilk is very high in fat, mashed banana isn't. So I didn't. She seems fine but I've not had her weighed recently.

I started solids when DS plummetted through the weight charts between 12 & 16 weeks, and it didn't make a difference. He just settled on a new lower line, in spite of baby rice, sausage fat, all sorts of high calorie foods he eagerly consumed. Remains short & slight, which is a very strong family trait for children on DH's side (they grow up to be taller-than-average adults).

If your HV is really good, could you ask to borrow her scales over the weekend and weigh your baby before and after feeds; then you would be able to document just how much milk is going in.

It might also be worthwhile to ask your Mum or MIL what sort of growth pattern you & your DH had; were either of you 'small' babies? Other question is whether your DD's weight percentile is similar to her length percentile.

I don't have any experience, but I would say that if your baby is happy and healthy then surely she is fine? Surely the nutrition and protecion she gets through breastmilk is worth more than calories from other food ? Most of what HV say is complete nonsense anyway!

If you, or the HV, think your baby needs extra calories (and that's all a baby of this age would need,as specific other nutrients are not needed at this age) then giving extra breastmilk is the most effective and appropriate of delivering them.

There is no point in giving solids at this age to increase calorie intake - it won't work, and in fact it could lead to fewer calories being used.

If you give veg or fruit, the calorie content of the tiny volumes a baby of this age would have is very low....but the baby might be too 'full' to take as much breastmilk.

Even if you give comparatively calorie dense food like rice, you still have to give a lot of it to make any difference. Read the packets - I think a teaspoon of reconstituted (with water) baby rice is something like 8 calories. How many teaspoons is a 3 mth old baby likely to have - five? six? so maybe 50 calories, tops? She'll use up calories digesting it, too! She might as well have a breastfeed instead, and take (probably) 70 or 80 calories, (for a 3 fl oz breastfeed, typically) metabolising it easily and economically.

The quality of your milk is just fine. Milk quality varies hardly at all, and certainly not significantly enough to make a difference to a baby's weight.

It sounds as though your baby is healthy, but if there is a question mark over her weight, then just offer her more breastfeeds!

Messing about with titchy bits of puree and slop is a chore....easier surely just to stick her on the breast

dd also fell down the charts steadily from birth. These charts, often used in isolation by HVs, are not a true indicator of health in a bfed baby as I'm sure Mears et al will tell you. They are based on formula fed infants and the studies from formula manufacturers, and most breast fed babies do not conform to them. To give you a flavour of their reliability I am in Switzerland atm and the charts used here are different to UK and a bit more generous. I'm sure someone posted a little while back a site which had several charts including one for breastfeeders. dd, now 2, is still at the very bottom but healthy, happy and petite. Both dh and I were petite children.

If your dd2 is otherwise largely in proportion (weight, head circumference, length), healthy, producing normal nappies, not dehydrated, developing normally, and feeding regularly and well, I would try not to worry. If however she is medically suffering as with a "failure to thrive" then perhaps it is worth following it up but I doubt that early weaning will help.

Have more confidence in yourself especially if your dd1 was similar. If you are happy with your dd2's development you are under no obligation to keep getting her weighed by HV. DS also slid down the charts but dd, despite having a higher bw, slipped more. I was so glad not to have had her in the UK because I could foresee myself in a similar scenario to yours.

Good luck

Message withdrawn

Is she small generally? If she's not very 'tall' then she won't be very heavy.

To be honest Wills, if there is a real concern about your dd's weight gain then that should be investigated medically by a paediatician to see if there is a cause. Starting solids early is not the answer as Tiktok has explained. Is she gaining weight at all? How often is she being weighed? Can you offer more breastfeeds?

To be honest Wills, if there is a real concern about your dd's weight gain then that should be investigated medically by a paediatician to see if there is a cause. Starting solids early is not the answer as Tiktok has explained. Is she gaining weight at all? How often is she being weighed? Can you offer more breastfeeds?

I had similar problems with dd. Have a look at this thread I started asking for advice. I should probably have returned to the thread to let all the lovely people who gave me suppport know how things turned out: they turned out well. I persisted with the breastfeeding, it made no difference if I fed her more often unless (as in that last message) she demanded it. In other words, she was putting weight on at the rate which was right for her. I weaned her at about 5.5m, when she was showing signs of readiness (getting hungrier, putting things in her mouth, watching us eat and trying to take food from our plates) and she took to it straight away, and put on weight at an unbelievable rate. Though she didn't get much chubbier, except on her legs, she just grew all over.

So please Wills, stand your ground. If the baby is physically well and showing all the signs of wellness then your milk is all she needs. It is good milk - the best there is for her.

Wills - I think I'm in the same position, although I'm avoiding the scales - dd was 98th centile at birth, and is now below 25th. She is very very long, but very slim - she looks healthy and is alert, but I just know they are going to say something about the weight! I'm aiming for 6 months weaning, and just avoiding the baby clinic as much as I can.

I'm sure it's not your milk - but I do have the same anxieties! Maybe we can reassure each other!

Thanks to everyone for their advice and points its been an extremely helpful read and given me back my confidence. To answer aloha, yes dd2 is also small in length (but has a big head (on the 85th percentile) which appears to run in my dh's family ) so overall she's actually only in proportion hence why she looks fine. She doesn't look particularly skinny and certainly no longer has that newborn, doesn't fit their skin look. The health visitors are always surprised by her weight as she does look well. I shall continue breast feeding exactly as we have been and be content to simply look at her in terms of determining whether she is well or not.

Musica - I certainly will be grateful that someone else is sharing this.

Wills - interestingly I spoke to a friend of mine tonight whose grand daughter is 12 weeks old, breastfed and has been extremely slow to gain weight. She has never been pressurised to give formula but the baby was referred to a paediatrician. She has been diagnosed with a ventricular septal defect ( small hole in the heart) and has been started on diuretics which will encourage the hole to close. I must stress that I do not think that your dd has this problem. The point I am trying to make is that breastmilk is the best food for babies, and if there is concern about a baby's weight gain when feeding problems are not present, a review by a paediatrician is warranted. That ensures there is no underlying cause for poor weight gain.
If your HV does not think that the weight gain is slow enough to warrant a paediatric review, then I would give the scales a wide bearth. Your milk is the best food available

Thanks mears. I'm due to see the hvs again in a fortnight when both my daughters are due to have their hibs (dd1 is due for her booster). If dd2 is still falling and they start to push for early weaning then at that stage I will suggest a paedatric review instead. The other factor that might possibly be involved is that dd2 has had a blocked nose pretty much from the day she was born. As she also sneezes a lot this has been diagnosed by my gp as potential allergies (she also gets allergy spots). I've asked for (and just got) drops for her nose to try and clear it, hopefully she will then feed better. But all these things aside she does still look like a well baby which suggests to me that nothing is actually wrong.

Good for you Wills.....
Mears you ARE right.... I hear too many women blame their milk for a baby's poor weight gain

Sorry I shouol NOT say "poor" but "low" - as it may not be poor but just lower than "average"..... babies are not averages!

Feeling v. blue today. DD2 has been classified as "Failing to thrive" (wonderful term - NOT!). Even the hvs are a little shocked by the strength of my gps reaction. She's even hinted at asking me to forego our holiday which we're supposed to be going on next Saturday to Florida! Thankgoodness my work provides me with health insurance meaning that I will see a paediatrician next Thursday. My gp basically hinted that she felt that I couldn't be feeding dd2 enough. When I said that dd2 was going through most nights she was horrified, saying that at 3.5 months a baby was too young to be going through the night. She seemed surprised that I had no routine when I said that I fed on demand every two to three hours. Kept telling me that some babies don't let you know when they're hungry - well that's rubbish! When dd2 is hungry nothing other than food will content her. Surely a hungry baby will not lie on her mat contentedly playing and cooing at her toys! I've now started to question everything I do and am feeling like a bad mum.

wills, try not to worry (easier said than done of course), i'm sure the paediatrician will put your mind at rest. on what basis did your gp classify her as failing to thrive? if your dd has plenty of wet and dirty nappies, is lively and alert and seems satisfied after her feeds, the chances are there is nothing to worry about. good luck.

wills, try not to worry and at least you will have an answer soon, but probably the gp is covering herself. dd went through the night from 8 weeks and I'm sure that did to contribute to a lower than normal weight gain, as she had dropped that feed so early, but at the end of the day you cannot force feed a bfed infant. It took until around 6 months before I felt we had a routine.

Take comfort from the fact that she is obviously happy and contented, feeding regularly etc and hope that your gp's fears prove unfounded. Good luck on Thursday.

Wills - I know you know this but hopefully the pead will look at other criterias then weight.... length and head circumference.
Good luck....

P.S. Bioth mine slept 10PM to 7AM at 9 and 6 weeks ! And dd was 7 to 7 at 3 months old.... she was centile 2 but I am tall and thin and so is DH - it never worried anyone.

Oh thanks pupuce. Sense tells me that dd2 is fine. She crys when she's hungry or tired. If I suspect tired I put her to bed and after a couple of "I'm not going to sleep without a nipple in my mouth" complaints she normally goes off for between 1 to 2 hours. I just can't believe that if she were hungry she would do this. DD2 could poo and wee for England - I'm currently trying out real nappies and one of my issues is that I have to change her half to hourly because they get soooo wet. During her play times (after feed) she's extremely alert, playful and currently attempting to roll over. To me she doesn't look anything like "Failing to Thrive" but it was horrendous to sit there whilst my gp basically questioned everything I've been doing. I came out feeling like a completely incompetant and failed mother. On top of this I think the surgery are going to try and associate dd2's lack of weight gain with me being on fluconazol! I phoned up the BFN yesterday to talk to them and I know they've consulted with the researcher "Wendy". Also dd2 had started to drop down the percentile chart long before I persauded my gp to put me on Fluconazol. Finally although not exactly the same dd1 also had issues with weight gain. She didn't regain her birth weight until 8 weeks, but from there she "blossomed" and now happily sits between 40 and 45 - so near perfect! However my gp is adament that she wants a second opinion and I can't refuse. Am seriously hoping the paed basically asks me why I've bought her! Honestly she looks fabulous but now I've found that I've started questioning everything and doubting as well. ugh - roll on next Thursday.

Hi Wills! I'm sorry you're feeling down. That does sound a bit extreme.

My ds had a lot of problems putting weight on, and something I was advised to do, although I don't know if it helped or not, was to express milk, and use it to top him up after each feed. It's reassuring because you can see the milk going in, but also doesn't compromise milk supply. He was one for sleeping through feeds, and falling asleep during them, so I really had to take responsibility for how much he had. I never really cracked it, and ended up mixed feeding, although I did manage to bfeed a bit until he was 13 months.

Actually, I'm dreading Tuesday a bit, as dd has her last lot of jabs, so I'm sure the HV will want to weigh her, and she has been rapidly slipping down the centiles!

Hope things improve - remember you know best if she's ok!

Glad you found this thread Musica. Didn't want to put the same thing on two different threads but had hoped you join this one. I wouldn't wish another child to be dropping in weight but is good to have company with someone experiencing similar things. The suggestion of expressing and then feeding from a bottle has also been made to me but I don't understand the logic. DD doesn't often fall asleep on the breast (except when she's tired rather than hungry) and I have no problem with leaving her on the breast for as long as she wants to feed. She gets to a point where is mainly fluttering with the occassional gulp. At this point I normally remove her from the breast - burp her and put her onto her mat for a play which she often will do for between 1 to 2 hours. Recently I've left her on the breast to see if she would come off of her own accord. The answer is no - she will continue fluttering for hours with occassional gulps. She gets to a point where she becomes overfull and throws up whilst still latched and then re-latches (not nice). At this point she normally gets a really distented tummy and is obviously in pain and also has green nappies - to me she looks "over full". Everytime you move her she sicks up - honestly its like picking up an overfull cup that keeps overflowing. Because she's in pain she wants to stay on the breast and is very difficult to get to sleep. The point is that I don't feel that I'm having any difficulties getting food into dd2 - its easy, so I don't understand why she is not putting weight on at the "required rate".

er, wills, ahem, hello....????

bossykate??