Baby not gaining enough weight

[outnumbered4]

My 8 week old girl is exclusively breastfed, she has gained weight very slowly and has only gone from 7lb 3 at birth to 8lb 13 today she has dropped nearly 2 centiles on her growth chart.

The health visitor has been today and is happy with her development and that she is healthy and not lethargic or dehydrated. She is pooing and weeing normally and is very smiley and happy. We don't know why this is happening as there seems to be no problem with her feeding, she is fed on demand and the latch is good. No pain for me and she is clearly swallowing through every feed so definitely drinking.

There was mention of a need to top her up from a bottle if her weight gain doesn't improve. Has anyone got any experience of this? And is there a bottle that is good for mimicking the breast if I have to do this? I would ideally want to top up with expressed milk.

Hi OP, sorry to hear you're feeling stressed. Do you have any breastfeeding support groups in your area? Would you be able to pay to see a lactation consultant? I have not had this problem but know others who have and often with the right support, there is no need for breastfeeding to end. Even if you need to top up with ebm or formula for a while, it is still very much possible to keep up the breastfeeding too. As for bottles, babies really do vary in their preferences! I know lots of people who really like Dr Brown bottles and have heard good reviews of the medela bottles too. Good luck!

Thank you, I will look into the breastfeeding support, the health visitor was really lovely but I'm feeling a bit deflated and worried now as I really want to breastfeed as long as possible

Hi, I'm in a similar boat with my 10 week old, it's a horrible feeling when they're not gaining weight well, isn't it?
Has your DD had a cold at all? Mine's had 2 (courtesy of her nursery-attending brother!) and it's definiately effected her feeding.
Don't feel formula is a necessity either. I've been pushed in that direction by HV, but my GP has advised me to just keep BF on demand and to keep an eye on her weight. Absolutely get yourself some BF support - sometimes there can be issues HV and Drs miss, but if she's feeding well, coming off satisfied and pooping/weeing regularly my understanding is it's unlikely to be a supply issue....
Maybe make an appointment with your GP too? I've found mine much more knowledgable and holistic about weight gain issues - sometimes HV seem a little obsessed with numbers and charts in my experience!

Also, I'm not 100% on this but my understanding is:
a) Movement of up to 2 centiles on the weigh charts isn't neceasarily a cause for concern, and
b) It's more accurate to take it from the centile they settled on once they regained their birthweight, rather than the centile they were on at birth, if that makes sense? As various factors around the pregnancy/delivery can effect their birthweight, so that centile may not be a reflection of where they'll naturally chart

That's really interesting about the centiles, she has dropped less than one since getting back up to her birth weight so maybe not as bad as it looks? She hasn't had a cold or anything although me and the other children have a nasty one at the moment so I am expecting her to get it any time now which won't help! Sorry to hear your little one has been poorly it's horrible when they're so tiny isn't it

Hello @outnumbered4.

I have experienced very similar with my 7 week old. She was born 91st centile and now on 25th! Gaining slowly, took 5 weeks to return to birth weight! Been feeding lots and no signal of low supply like you lots of active feeding/swallowing. HV kept asking to top up with formula and I've found giving her a few extra oz (of expressed breast milk) in the evening when she tends to cluster feed helps her gain better (i trialled this as stopped for a week and she only gained 20g!). I offer her both breasts before and after (to make sure it's 'extra' she is getting and pump when she's having the bottle, she Only has a bit but seems to make a massive difference to her weight gain! If it's expressed milk and you pump when say your OH is giving the bottle it shouldn't affect your supply! I use the Lanisoh bottle with slow flow teat and she takes it fine, no confusion yet! Hope you find a way to manage, your not alone!

@outnumbered4 also if you pump after each feed, even just for 5-10 mins then add these up you can use this to make up a bottle each day! Saves time as I found it a nightmare trying to pump between feeds as more often than not baby would wake up early and then get frustrated that i had just expressed her feed!

That's interesting thank you, so perhaps if I try topping her up with a bottle of expressed milk in the evenings this week until she's weighed again next Thursday and see if that makes a difference. I am a bit wary of trying a bottle in case she doesn't want to breastfeed anymore it's so worrying isn't it!

Unless your baby has tongue tie she will be a lot more efficient at getting milk from your breasts than any breast pump will be.

Don't get me wrong, expressing milk can be helpful, but it's not always the magic solution, and I wouldn't put a lot of time and effort into expressing milk and bottle feeding without getting specialist advice - that is, from a lactation consultant or experienced breastfeeding counsellor.

Please look up breastfeeding drop-ins and support groups near you and go to a couple.

Thank you, there's a breastfeeding drop in at the clinic I'm taking her to be weighed on Thursday so I'm planning to speak to someone then.
The health visitor advised me to just keep breastfeeding as I am now until Thursday but I've convinced myself It's not enough for her now and feel a bit like I'm letting her down not doing more.

She's my 5th baby, I really didn't expect to feel like I haven't got a clue what I'm doing with her

Please don’t worry. My son measured small throughout my pregnancy (measured 28 weeks at full term) and when he was born he lost a good 2 pounds of his small birth weight.

Weeing & pooing & happy means baby is okay! All these statistics & things make you panic but I do hear they’re quite outdated?

Have you had her checked for tongue tie? Mine had this, and it wasn't picked up on until he started losing weight, as his latch appeared to be good and he was having wet/dirty nappies. Might be worth getting it checked just to be on the safe side.

Where I live there are breastfeeding drop ins several times a week, so if there is one near you on Monday I suggest you go to that for peace of mind - it would be good to avoid having to worry about it until Thursday.

I have only scanned other posters' comments so sorry if this has already been suggested, but I was told that the birth weight itself may be inflated by fluids given to you in labour/surgery (drips, IV fluids). Depending on how you delivered this can skew the birthweight meaning that your starting point might not be quite accurate and it might make it look as though the baby is dropping per centiles when they could be finding their natural place.

I'm sure a health visitor or BF specialist can provide more advice specific to your circumstances, but 8 weeks in is still fairly early in BF supply terms and I was told not to worry too much at this point and to look at the picture over a longer period. It sounds as though you've done really well and your baby is content otherwise so I hope you can access some good support.

I haven't had her checked for tongue tie, I will ask about that as well. I have no experience of that at all so I really don't know what I'm looking for there
There is a drop in on Tuesday as well but I can't make that one. I'm really hoping for a better weight this week so I can stop worrying.

It's worth checking for tongue tie but from what you've said it doesn't sound likely, I think there would be other signs. If you want to check there is a good list of signs here:
www.tongue-tie.org.uk/Mobile/m-tongue-tie-information.html
Anyway if you go to a breastfeeding drop-in they will be able to advise on tongue tie as well as other possible reasons for the slow weight gain.

Did you have IV fluids during your labour? This can affect birth weight.
It takes some breastfed babies up to 6 weeks to get back to birthweight too so I wouldn’t think your babies weight gain is too bad.
Wet and dirty nappies are a much better indicator of whether babies are getting enough milk. It sounds like your baby is doing well. Trust your body and maybe see a lactation consultant if you are really worried. A LC will make a plan for you whereas some other healthcare workers are often quick to push formula top ups.
Congrats on your new baby!

Oh really thats reassuring, her weight gain isn't bad really in comparison! I had an elective c section so no iv fluids until during the op and she was out within half an hour of them starting those.

My 4th baby was born a lot bigger than all the others and quickly lost a fair bit of weight before staying on the centile she had ended up on, little like the others. Perhaps thats just what's happening here

Hi, my baby (DD 17 weeks exclusively breastfed) was born on the 91st percentile and dropped down to 60th over her her first 10 weeks (never lost weight even in the beginning) but just didn’t continue on the 91st line as she wasn’t putting on weight fast enough to stay on this. I was really worried but now she has stayed on the 60 percentile for 7 weeks and therefore the doctor said she should now be expected to track on this-not the 90th. She is hitting all other mile stones etc.

I would only be concerned if she doesn’t stabilise on a percentile and continues to drop down. Remember also, if you have to crack open the formula it is not a bad thing, a happy baby is a fed baby!

I've had this. My baby dropped from 91st to below 25th. He has some feeding issues due to a very high palate but I got some advice on positioning from hospital bf clinic which helped a bit. I supplement by offering a bottle of formula in the evening but he's not particularly interested in it. He's started following the curve of his centiles now. We were referred by gp to paediatrician who thinks the main issue is he was just born bigger than he should be be so has been finding his proper size. It's been very stressful though, sorry you've got the same thing happening!

My first baby was similar, she was exactly on the 50thcentile st birth, dropped to below the 9th and stayed there. She was EBF. She didn’t go down further particularly, however she was hungry and I couldn’t keep up so I introduced bottles of formula (couldn’t express enough) and she shot up to 75th centile which increased further over the next few months (she was and Is very tall). She wasn’t fat but had quite chunky thighs but was very much more contented. Funnily enough when had her letter from school to say they’d been weighed (the ‘fat’ letter) she wasn’t fat by the way, they said you could look online to see their weight on the graph and randomly she was exactly on the 50th centile - exactly the same as she was at birth ! (This was when she was around 6 ish)

I’d suggest express and bottle feed and if you still have problems don’t fret too much if you need to formula top up

My baby was born on the 25th centile and has dropped to just above the 2nd, however 3 of my other children chart on the 2nd centile still now so I'm now hoping maybe she is just going to settle at around the same size as her siblings. There's a lot of really reassuring advice on here so I'm feeling a bit more positive!

Does anyone know if being unwell will affect my supply? I've just been up all night with a raging toothache and what appears to be a chest infection (after this horrible cold I've had) and have started bleeding extremely heavily in the night which I'm guessing is my first period I didn't think that was supposed to happen while breastfeeding! I am not feeling well at all this morning

I don’t want to scare you but think it’s important to share my story. With DD2 she was also very slow to gain weight. Then at 4 week I started bleeding heavily. Turned out there was some retained placenta which definatly impacted on milk production.
I had to have surgery and my supply improved pretty much immediately, we’re still breastfeeding 2 years later.
I wouldn’t just assume it’s a period, would be very unusual at 8 week if youre breastfeeding.

Your period would be really unusual. I would definitely head to your local walk in clinic if your GP surgery isn’t open.

Oh no that's awful! Glad you're ok now. Could that happen with a c section? They were very thorough as it was the 5th one and they were expecting complications. Maybe I will ring the gp in the morning and check. I haven't got any pain or anything just heavy bleeding like a period I hadn't had any bleeding for about 4 weeks until now.