Between Rock and Hard Place! 3 month old underweight and milk supply low. Don't know what to do

[mum2fred]

My 3 month old recently clocked in underwieight, in the 17th percentile and dropping. He seems to be happy and healthy and never goes wanting for food (although it was hard to convince my HV I wasn't starving him! grrr!). In fact, becuase we were keen to make sure he was getting enough we often give him some expressed milk from the bottle after his feed (as he has never been an attentive or thorough feeder on the boob).

Over the past month my milk supply has been decreasing (for a few reasons) and I am keen to get this back up. WHich I understand involves not giving him the bottle/pacifier and feeding him more regularly than the current 3 to 4 hour rota.

BUT I am anxious to get his weight up and dont want to spend time fiddling around with his fussing over my boob, so i'm not too sure which road to take: my milk supply or his weight?

THe HV has suggested that I start supplementing him with formula. Im keen to stay on breastmilk as much as possible but as im currently not really producing enough to keep up with his feeds (as he refuses to stay on the boob longer than 10 minutes) we more often than not need to use frozen expressed milk - of which we are almost out. So if I concentrate on feeding him to get his weight up, I will inevitibly have to start supplementing formula. But if I focus on getting my milk up, I think it will be such a trial to get him happy using my breast again that he will actually lose weight as opposed to put it on. And I desperately dont want that to happen.

Hopefully these ramblings made some sort of sense.

What do people think I should do? I am changing my mind ever hour abot which road to take...

(note: i dont know if this is relevant, but DS's dad is a small man, and apparenlty was never the chubby 3 month old - so I'm not suprised DS is on hte small side. The fact is that someone's baby has to be on the 17th percentile, so why do the HVs need to make me feel like I'm neglecting my baby? Perhaps he is just a wee little man... Comments from mum who have had underweight babies would be much appreciated)

I don't understand why the 17th percentile is underweight? Has he ever lost weight?

The important thing is if ds is in proportion, same centile for weight and height. So long as ds is putting weight on imo id try to give bf a go, you can always change your mind if it doesnt work. Like you say someone has to be on the 17th centile, my dd3 has just reached the 9th!

What's wrong with being on the 17th centile? If he is actually losing weight, then this needs to be invesitgated, but a baby who falls to the 17th from a higher centile may simply be finding his own level. It's called catch down growth.

However you may need to protect your milk supply. Feeding 3-4 hourly is not enough to increase a milk supply, you are right - you need to breastfeed and/or express at least 8 times in 24 hours including at least once at night. Anything less and the increase will not happen. Keep your baby skin to skin and close to you, and he will feed more often - that's almost certain. It's the frequency and effectiveness that counts, not the length of time he feeds, so feeding often is great.

If you need to use formula while you are building up your milk, you need to breastfeed/just as often - using formula instead of bf will reduce your supply.
Hope this help

Ditto what tiktok says: my DS was born on the 75th, shot up to the 91st and now is just below the 50th. He was fully BF until 6 months and carried on until he was 17 months with BFding.

But he's never technically lost weight - just gains it at different speeds. And that is totally normal.

Don't panic! My neice was born on the 9th centile and has remained there ever since - yes, she's small, but she's in proportion and she's just going to be a petite thing all her life and that's fine!

As others have already said there is nothing wrong with being on the 17th centile in itself, the centiles are calculated on average weights and lengths etc. It works something like getting 100 babies and plotting their weights on a graph - more babies will fall towards to middle of the graph and less towards the top and bottom.

My DS was always towards the bottom of the chart and I tried not to worry about it. Some babies will be off the bottom or off the top of those charts. The charts used to be based on bottle fed babies so breast fed babies tended to be towards the bottom anyway but the charts may have been updated now.

Anyway, in terms of your milk supply / getting your baby to gain weight. I had similar issues as DS lost tons of weight to begin with as wasn;t feeding properly due to tongue tie which also had an effect on my supply as he wasn;t getting enough milk to boost my supply. I got totally stressed out about it which made it all much worse so it is very important to chill out and keep calm as I found that worrying lessened by supply when I was trying to boost it!

I just fed him almost constantly and had lots of skin to skin. I did take brewers yeast and nursing tea etc etc and to this day do not know if that made a difference or it I FELT that it was making a difference, therefore relaxed and the milk increased!

After a very rocky start I sucessfully BF DS for 14 months. The last time he got weighed he was on the 25th centile woo hoo

So just do your best and do not stress out - babies find their own curve and so long as your baby is not losing wieght steadily or getting dehydrated do not worry

Thank you everyone. It is reassuring to read all of this, I really needed it, thank you. I?m glad I?m not alone!

I guess I was feeling a bit anxious because of the way the HVs treated his being on the 17th percentile. I?m a pretty laid back mum and it never really concerned me that he wasn?t the typical 3mo butterball - until I went to the HVs and they made me feel like I had been neglecting him. So of course I have been obsessing about it ever since.

DS was born just below the 75th percentile (ouch!) and has steadily dropped down to the 17th. He?s never lost weight (since the first couple of weeks) but has never put it on very quickly.

After being an absolute cow the first couple of months, I seem to have dried up significantly this past month. To the point where I got my period (argh! I had NOT missed them this past year). And you are right idereamofclooney ? I?ve been obsessing a bit about it., which probably was not helping at all.

I think what I?m going to do is spend the next week relaxing, not worring about his weight and trying to get my milk up. It his doesn?t work (no reason it shouldn?t) and I feel like I?ve given it a good go, I might think of supplementing formula.

DS is not very good on the boob ? he often screams after 5 minutes and during those 5 minutes will frequently pull off. I regularly burp him (as he was a big fan of vomiting when he was a bit younger) so I don?t think it is wind ? rather complacency and a preference for the easy bottle. Any suggestions with how ot improve this? Or is simple persistence the key?

(BTW ? I told DP about posting this on here and got him to have a look ? he is much relieved at the prospect of me not calling him hourly to obsess about some breastmilk detail ? and he was most taken ablack that I had called him small. Tee hee)

Glad you are feeling more positive.

YOur health visitor is a bit naughty! Surely she/he should not make you worry about the weight of your baby unless there is actually a problem. Not all babies can be on the 90th centile (obviously!)

I sgree that the best plan is to relax and do your best and see what happens. Chances are your milk will increase and your baby will settle and fit his/her curve.

Good luck!