4 mo, EBF, not gaining enough weight - help?

[Flingmoo]

DS is 4 months old this week and has dropped from 75th to below the 25th centile... HV is concerned and has referred me to GP, going tomorrow.

He's EBF and seems to be developing well in all other ways... HV suspects possible reflux, but I'm not convinced - he pukes a fair bit but not every feed and not what I'd consider a worrying amount. When he's well-rested, he seems a contented baby.

The only concern I have is that his feeds seem very short - apart from a long, dozy feed at bedtime, he normally only feeds for less than 5 minutes, and then he either gets distracted (starts smiling and cooing at me) or agitated (starts writhing around fussing and refusing to have any more).

At night he has a teeny dream feed at 10ish and he's just started sleeping through the night until 5ish for the last few days.

Any ideas why he's not gaining enough and whether I should be concerned? :(

Has he actually lost weight or just not gained? How often does he feed typically in 24 hours?

Have a look at the Kellymom website for info about increasing weight gain in bfed babies - she has lots of useful info.

I have no advice but just posted something similar earlier today. My 5mo ds has only put on 7oz in 4 weeks. You might want to read that thread as very reassuring. But do check with someone in real life if you're concerned.

Thanks - I did see your thread but decided to raise the same question again anyway. I'm hoping our babies are just healthy but naturally lean!

It's tempting to begin weaning early despite the fact that all the advice says milk is actually more nutritious at this point...

Oh and to answer Embarrassed's question - he hasn't lost weight, just not gaining fast enough. Dropping centiles.

Feeds at least 6 times a day, I offer much more than that, before and after every nap and he usually takes 3 naps a day. But he just seems to have short feeds. I don't feel that there's any issue with my supply. Doesn't feed between 11pm and 5am anymore.

Presumably the nappy output is still ok?

If you don't already, you could try feeding in a quiet dark room to see if that helps him focus on feeding. Also try skin to skin to see if that helps.

6 times 5 minutes isn't a lot over the course of a day. I would say you either need to encourage him to stay feeding for longer or give him lots more feeds. Some babies go for a relative few long feeds whereas others like to graze on an off all day.

Thanks Embarrassed, I tried your suggestions when he was fussing yesterday and it did help him feed.

I also tried keeping a log of feeds today so I didn't have to just guess! He had eight feeds between midnight last night and midnight tonight, if you count the dream feed I'm about to do. He was less distracted today so they all lasted a lot longer than 5 minutes!

I've now got a mild case of mastitis though for some reason, which is not fun :(