Poor weight gain at 4-5 months BF

[Christmastinsel]

Ds born 75th centile but dropped immediately to 50th week after birth. He(BF) gained weight fine for first couple of months going along the 50th c line.He feeds from 1 side only as previous lump surgery damaged the milk ducts of the other breast.
I then had a throat op with general anaesthetic and he dropped a bit following this reaching the 25 c by 3 months.Since Nov weight has basically flatlined with 3 weeks of no gain followed by 3 weeks gaining 1/2lb then no weight gain again this week.He is now 9th c.

He seems to have a permanent snuffly nose but GP says chest is clear.Only other health problem is red inflammed area behind knees which is being treated with hydrocortisone/clotrizomole.He is happy responsive baby.However generally he only feeds for 10 mins at a time (sometimes 15) - even when I put him back on he eats for a few seconds and then comes off again.I am expressing after 2 of his his feeds and can usually get 3-4oz out(less in evenings) which I give him as a top up after last feed at 10ish - he takes this very reluctantly and is not at all keen on the bottle.He wakes once or twice at night and is basically fed on demand at any time of day or night but just isn't gaining.
Have watched Jack Newmans videos and checked Kellymom and tried breast compression but doesn't seem to have made any difference.
My dd did have excema but mostly now grown out of it.Reluctant to wean early because of possiblity of his inflammation being excema , also the same re. formula although health visitor has suggested hypoallergenic formula from GP.
Don't really know what to do except start weaning/hypoallergenic formula - seeing GP again on Friday.He is now 20 weeks.
Any suggestions anyone?

Hi Christmas. My DD is 22 weeks old.
She was 5.12 at birth and 2 weeks ago was weighed at 11.4. She is just about to drop off the chart. Her weight gain is about 6oz every 3 weeks. So not a great deal.

I fully breast feed her as you do. Also she seems to have exzcema as well. I have been using hydrocortizone, oilatum and diprobase.

A lot of the time she will only feed for say 10 mins at a time. And she never seems to be really hungry. Quite happy grazing.

But she is a very happy baby, nice and alert, doesn't grumble (much). I am a bit put off weaning for the same reason really.

I cant really offer you much advice, just to say that if your lo seems happy and alert, then there is probably nothing to worry about. The Hv just keep telling me to keep offering the breast as much as possible (i am sure you are doing this anyway). As breast milk is more calorific then baby food anyway. Jazz has a cold too at the moment. Its that time of year.
I'm sure your lo is fine.

I am sure someone will be along to give you some better advice soon. Dont worry

Ok this sounds terribly familiar. My ds exploded with excema from 16 weeks following his vaccinations

Here is what I did. I took him to a cranial osteopath and a homeopath. I cannot impress upon you the difference the two in combination has made. DS used to look like he had been scalded from head to foot. It was raw and weeping and the hyrocortisone just kept it at bay. The cranial osteopath very very very gently manipulated his skull and body to relieve the compression and misalignment he had which was not allowing his organs to function as they should. The homeopath gave me some fab advice and very gentle remedies for ds. He now has beautiful skin and is a little angel.
It might come across as a bit 'out there' but please do read into it and dont rule it out. It really worked for me.

Bump for Christmas!

DD only gained 2oz between 13-17 weeks. I'm still bf mostly, but she has one or 2 bottles most days now. I'm knackered and I don't think my bod's making enough milk. It's really hard to know what to do as it's a vicious cycle - the less I make, the more she wakes up in the night, so the more tired I am.... I am really saddened that I can't feed my baby on my own, but mostly that's because it's such a faff making bottles.

dd is 23wks & has gained nothing over the last fortnight. like you I think it may be a vicious circle with milk production/being run down/feeding more frequently though other more knowledegable people say not.
BUT she is also happy alert & interested in everyhtign going on, wees & poohs well so am trying not to stress about it. I figure better to ahve a happy light baby than a chubbier miserable one!

Hi Christmas, does DS need weighing so frequently? Only wondering because he seems happy and healthy. My Dd was 75th centile born, down to 25th within a few weeks, HV freaked, I was pretty sure she was ok, plenty of wees and poos, etc etc, but eventually ended up comp feeding, only back up to birth weight at 10 weeks and then I stopped having her weighed. I did a sneaky weigh myself at 17 months and she was on the 9th centile, HV now not bothered as can see a very active and happy child...even said she was obviously never meant to be on the 75th centile (yeas I know I did try to tell you that I said throught gritted teeth!).

DD, now 6.5months, was born at 5lbs11oz, and while she gained weight really, really well for the first month or so - 8oz a week - since then she's put on about 3oz a week, except for a fortnight when we were abroad - she fed more when she was jetlagged, put on about 4oz. She's teetering on the edge of the 2nd percentile. She bf feeds for about 5-10 minutes, about every three hours during the day - something like 7am, 10am, 1pm, 4pm, 7pm and 11pm. She is a very content baby, and she sleeps really well. She doesn't fuss after a feed.

At the baby clinic, our HV kept on muttering that she wasn't gaining well, that I should give a supplementary feed, but DD just isn't interested in feeding often, and she won't take a bottle. So I just panicked, but a panicked mother trying to force a feed on a baby who isn't hungry isn't a great combination for stress-free living. I tended to get weepy and hyper-stressed, and it took me weeks to get over a visit to the baby clinic. At which point it was usually time to go back to have her weighed... I read all the Kellymom stuff, too, and none of it seemed to make a difference either.

Finally, we were referred to hospital for crossing 2 percentiles. DD was measured and weighed and examined, and the doctor asked questions like did she throw up a lot. DD doesn't. Anyway, the doctor said DD seemed healthy and there was no reason to believe there was anything wrong, that some babies just follow their own curve, and to come back in three months, once solids were established. Of course, DD isn't interested in more than four or five mini-tastes of solid food at a time.

Anyway, I think it's really hard to trust your baby to know what is right for him/her. But if you don't think there's anything medically wrong, then I think you just need to back down, take a deep breath, and try not to panic. I know it's hard, DD fed really badly today, and it was hard not to panic and try to shove her onto my breast. But follow your fears to their logical conclusion: does your baby have other symptoms that might suggest an underlying problem? Dry skin is really common. Is he going to starve? No. Is he failing to thrive? No.

It sounds like you've had a really tough time with the surgery, try to give yourself a break from worrying, things aren't as desperate as they might feel. Maybe your baby just meant to be small for now. A friend's baby only takes 2-4oz a feed, is on 9th centile. She was referred to hospital, too, but told her baby is just taking what she needs.

hi Christmastinsel I am wary of offering definite advice as firstly I'm not a bf counsellor and secondly I don't know your particular situation. But I would suggest you call one of the bf support lines as opposed to talking to your gp about it, who probably hasn't had any training regarding breastfed babies, and is offering formula as the 'solution' when it may not help at all. In particular, if the eczema is related to a food sensitivity, you can eliminate foods from your own diet rather than going onto formula - this is what I did with both of my sons.

I'm wondering what was the reason behind the expressing and offering it to him at night? Was it to give him higher fat milk to try to increase weight gain (and possibly get him to sleep longer)? I know I tried this with ds2 who had real weight gain problems, and the expressing was a real faff, and didn't really make much difference in the end. I also tried breast compression and offering one side only for each feed and didn't get much result out of either, although some people find these help a lot.

It turned out ds2 had severe reflux, but I didn't realise this for ages. And reflux babies really need to feed 'little and often' so I learned to just let him decide how much he wanted and not to try to force it. (This was after he was on medications to limit the reflux.) I'm not suggesting your ds necessarily has reflux, but just that there's probably a reason why he stops when he does, and that giving him more milk might not help until you've worked out what's going on.

I would recommend the La Leche League as they were the people who really helped me through it all when ds2 started to lose weight and we weren't sure what it was. The other thing was that other breastfeeding support lines I called seemed to be aimed more at mums of newborns, and when you have the basics covered (especially if your son is latching on fine) but are still concerned, they don't necessarily offer you any other suggestions.

The helpline is 0845 120 2918 and you can also check for local groups here . You don't have to be a member to go along to a meeting, and it can help for them to see how your son is and how he behaves on the breast.

I know how worrying it can be and so I hope you sort it out soon

Agree re. the weighing but HV keeps saying come back next week as we need to keep a check on him and it is hard to directly ignore.

Have just tried my expressed feed with him - he wouldn't take it.

Older DD also dropped to 9th c but born on 25c - he was a heavyweight initially in comparison.

He has wet nappies at every change and did three big! poos today - generally goes every 3 or so days then all at once.But he does look slighter than the other babies I know born in the same month despite being one of the heaviest at birth.
He really is a happy baby generally though.

I am more worried probably because I feed one side only and therefore question myself as to having enough milk later in the day.

Thanks for all the reassurance and advice but as you can tell I still feel anxious about it all.

Thanks Mummypig,

Will try helpline tommorow.

BTW he does throw up quite alot - both fresh and curdled milk - much more than my dd did.He has to wear a bib constantly and we go through several muslins a day.

Going to try more frequent feeds .Although I do try him often now but he just turns his head the other way if not interested.

Mootie - he has now dropped 3 centiles but no hospital suggested yet.I think because he is alert and happy so far everyone medical is just on constant monitering.Agree re the panicking - trying to take deep breathes.

Thanks for your replies and help.

I think being constantly monitered is really hard-going - you can never relax or stop worrying. Maybe you can ask to be referred up? In the end, I was glad to be referred to a "proper" doctor, to get some sort of answer about whether or not I really should be worrying. I found the HV incredibly unhelpful, always saying DD's weight gain wasn't good and to come back next week - but not to worry. Talk about mixed messages.

I'm sure you've heard/read about bf weight-gain not being constant, and that early weaning probably isn't the answer.

Good luck with the more frequent feeds, and let us know how it progresses.

Tinsel,if he is not interested in breastmilk,then logically he is not going to be interested in formula is he?

Similarly,if anyone starts banging on about weaning,remember that milk has tonnes more calories than gloop like baby rice.

Also,what you can express is not necessarily what you are producing.This is really important to bear in mind.
I was useless at expressing yet b/fed for over a year each time.

I would be really wary of the formula especially with the skin problems too.

Chances are too that your GP has next to no training on b/feeding issues so is hardly the person to be offereing you advice.

Another good helpline is Assoc. for Breastfeeding Mothers

0870 401 7711

I haven't seen your name before.Are you new?

I'm sure our resident experts Tiktok and Mears will be along to to give you some bona fide proffesional advice.

Christmas, I can't tell from what you say if there is anything to be concerned about....it can be normal for babies to plateau in their weight, after all, and without frequent weighings you don't get to kow about it!

There may be an issue with having to feed one sided only. Most mothers can happily get a full supply for one baby with one breast, but some have more difficulty....it may be you need to feed more often than you are doing to really stim. the supply on that side, if your baby has a lack of calories (and as I say, I don't know if he has. You certainly can't tell simply from his weight history). There is no point in giving formula if extra breastfeeds have not been tried - see if you can fit in a couple more every 24 hours. The risk of giving solids, inc rice, wd be that calorie intake wd actually lessen, so that's a bit mad too

TikTok,

He was born a week overdue at 8lb 14oz and is now 13lb 13oz at 20 weeks.

Trying to feed more frequently today but he is only doing about 5 to 10 mins or so every couple of hours.At night he goes down about 8/9pm and wakes at 7/8am with a 3amish feed.However someimes wakes at 1am or 5pm also - not very predictable.He doesn't feed long at night either.I will wake an extra time at night also if he only wakes once - used to do this but he seemed then to have a disturbed nights sleep(and me) then sleep more the next day.

Moondog have posted before but not in this section - more about birth/ bad tearing and incontinence problems.Have used the advice given in previous posts here though but now feel I need more specific help.Sometimes feel I look at everything - think oh thats the answer - and he still doesn't gain.

Anyway back to feeding the baby.

hi Christmastinsel, did you manage to call a helpline today?

Spoke to La Leche lady - she was very nice but couldn't give me much more advice.Said to concentrate on evening feeding as much as possible - he doesn't have those all evening feeding sessions like when he was younger.

Ds checked by GP again today - examination was fine.GP said had never had ,so far, a failure to thrive baby without something detectable on examination. He didn't suggest formula or weaning.Getting a urine check done - baby not me.

Trying to stay morehomebound(difficult with Christmas fast approaching) and really concentrate on regular feeding.
Didn't manage an extra night feed last night - fed him at 12 and then he didn't wake to 7 and I just slept through with him.
Feeling more positive today ....until the next weighing!

Christmas (and all!) - so encouraging to hear all your stories because I too have little one that has slow weight gain. She is exclusively BF too - she was 6lbs at birth and now 10lbs 8 and 4 months old. She is very alert and developing well - HV seems fine about it all and said as long as she is following the centile (even though it is the lowest and only just above the line!) then that's fine - but you do worry don't you! She feeds about 9, 12, 3, 5 and 7 and then usually about 1ish but has now (for three nights) woke up at about 10ish for a feed - that means I will need to leave expressed milk if I go out! Has anyone else found that their baby's routine has changed around this time? It might go back to normal, just thought it would extend to her sleeping through more. She then feeds about 1.30, 4.30 and then awake at 6.00. I wondered if it is because she is moving lots and using energy and wanting more milk. She does tend to snack a bit now! Thanks for all your messages - great to read for encouragement!

Christmas (and all!) - so encouraging to hear all your stories because I too have little one that has slow weight gain. She is exclusively BF too - she was 6lbs at birth and now 10lbs 8 and 4 months old. She is very alert and developing well - HV seems fine about it all and said as long as she is following the centile (even though it is the lowest and only just above the line!) then that's fine - but you do worry don't you! She feeds about 9, 12, 3, 5 and 7 and then usually about 1ish but has now (for three nights) woke up at about 10ish for a feed - that means I will need to leave expressed milk if I go out! Has anyone else found that their baby's routine has changed around this time? It might go back to normal, just thought it would extend to her sleeping through more. She then feeds about 1.30, 4.30 and then awake at 6.00. I wondered if it is because she is moving lots and using energy and wanting more milk. She does tend to snack a bit now! Thanks for all your messages - great to read for encouragement!

sorry, posted twice by mistake! x

thanks mojomummy - good to share stories, she too only put 3oz on over the past two weeks. Before then put on 10oz but that is so rare, usually only a small amount each week. You get used the comments when people see her 'oooh, so small for her age!' - she too is filling out, just lovely and petite!

Hello, just to say my dd has dropped from 75th to 9th centile too, she's 8 months now but that happened over 6 months and she's only 16lb now. I dont worry about it except when i go and see the HV who always seems to imply/make me feel that i'm starving her though she's bf on demand, alert and happy. The best thing anyone's said to me is that some babies have to be on that centile! If he looks well and is active dont stress about it, i have spent far too much time worrying about it. If it helps look at the WHO chart for breastfed babies, they always come out a bit higher on there!

Hello - I'm not quite new but it's been a long time since i've been on this site! Anyway there is quite an important issue missing from this thread:
the growth chart that all newborns are measured against is incorrect! Yes indeed - WHO have released a new growth chart this year, based on 100% breastfed babies, which is currently NOT IN USE in the united kingdom. The charts currently in use reflect formula fed babies from about the 1970's (most of whom are now obese americans). So - before panicking about your baby's weight gain, do check out www.who.int/childgrowth/standards/cht_wfa_girls_p_0_6.pdf for girl babies and www.who.int/childgrowth/standards/cht_wfa_boys_p_0_6.pdf for boys.
I was bullied into topping up with formula by my HV due to poor weight gain some time back - I only wish i had been able to stand my ground by having access to this information that I am now passing on to you.

Bellybee - you have pressed my buttons! The info you have about the charts used in the UK is wrong. UK clinics (or most of them) use the UK 90 chart which is certainly not based on bottle fed babies in the 70s.

There is a lot of discussion and shared information about this in the mumsnet archives. I am forever trying to correct the myth about the UK charts!!

As it happens, the WHO charts do not differ all that much from UK 90, at least for the first months. They start to diverge after about 6 mths.

The issue with charts is not what they say, but how they are interpreted and used with the individual baby.

My DD was 8lb 11oz when she was born, and was on the 91st centile. She is now 8 months and weighs 16lb 12oz so she hasn't even doubled her birth weight yet. She is currently sitting on the 25th centile, having recently crepped up from the 9th.

She put on a lot of weight the first 2/3 months and after that only ever gained a maximum of 2oz a week. She is fine though, and thriving (she is short as well so she doesn't look thin) so my HV has never worried about her slow weight gain.

btw she was exclusively bf for the first 4 months, and still receives at least 4 bf's a day now.