HV says I am bf 11mo too much - no weight gain

[Jellybabie3]

I am just abit confused so asking for some advice. My DS has not gained any weight for about 6 weeks. He weighs 8kg, 9th percentile

When asked about his diet I explained he has 3x meals a day but sometimes hes just not that bothered i.e he will throw most on the floor. He also will not eat any kind of bread (bagels, wraps etc) which is a bit of pain. On average I would guess he bf 4x a day (6.30am 11am 4pm 7pm ish) then wakes 3x a night and wants a feed. I know this is probably habit but I dont feel compelled, as much as I would love the sleep, to push him by sleep training.

Straight away my HV said that it's the night feeds which are the reason hes not eating enough food and I need to stop it as bf does not have the calories he needs anymore.

1 measley attempt of shortening a night feed (i pulled him off sooner to try to eventually make it not worth it for him to wake) meant he woke 4x instead of 3!!

I then asked if i should give food instead of or before a bf and she said yes although then went on to say he should have an early morn bf before a late breakfast but for the remainder of the day give food first. This is despite me saying he wont drink from a cup. Water, milk, nothing (I am worried about dehydration here).

Should I really be doing this?? I am so confused as this doesn't really go with what I thought which was that bf comes first til 1 year old

I understand the hydration concern but it is inevitable that he will drink from a non-bf source. Don't give up. Persevere. Try different cups. Try letting him drink from bottled water. Anything you drink from basically!

Same with food. Just persevere. I had best success letting DS nibble and sample whatever I was eating. Providing a wide range of foods as purees at the same time. Basically variety seemed to help him eat more. Also other children eating always made him interested and want a piece of what they were having!

Is DH around? Deploy dad for some of the night wakings. In my experience a good cuddle with Dad is almost as good as a bf with Mum, so long as Mum stays well away in a different room. I couldn't have done night weaning without DH doing the majority of it in the end.

Most of the advice is correct,
Bf on waking, then breakfast,Snack, lunch, dinner, (No bf)
Offer all with water, don’t worry if he doesn’t take it just offer it anyway and just try to lightly encourage a splash on the lips.
Offer breast once lunch is cleared away.
I found this tricky, how to phase in a meal.
I found my DS would take to food earlier in the day more than dinner, he wanted boobs & cuddles in the evening.

But when you say he’s not gaining weight... this is based on how long?

Why is he being weighed so frequently out of interest?

Milk is the main source of nutrition until 1. In reality some children take to weaning earlier than others. In my personal experience both dds were bf on demand until much later than 1. My eldest was still mainly on milk until a good few months after 1 when she gained more interest in food, my youngest took to weaning quickly and cut down her milk intake herself accordingly.

Depends on whether there’s a specific reason for the weighing etc. At 11 months I’d be def giving food before milk (so breakfast then milk afterwards or mid morning, lunch then milk afterwards, dinner then milk and then milk before bed kind of thing). I’d be less worried about night feeds personally as if he were filling up overnight he wouldn’t also be having milk during the day and mine cut their night feeds when they started to eat more food

I would follow her advice tbh. At 11 months I would expect a baby to be pretty much fully weaned, so having 3 meals a day plus snacks if needed with milk feeds at bedtime and first thing. Is he walking yet op?

Limiting his feeds for one night won't suddenly change his expectations. It will take time. Give him fruit etc if you're worried about dehydration.

I had a Ds who didn’t want to drink water, wouldn’t drink from a bottle even expressed milk.

I had to try lots of different cups. I got a nubby cup in the end . No idea if they still make them .

I would also say reduce the milk in the day rather than at night .

Look at higher calorific food . Avacardo, cheese.

as bf does not have the calories he needs anymore.

What on earth? Your milk hasn't lost its calories! HV often don't know much about breastfeeding, TBH. Just keep on offering three meals a day and breastfeed on demand. Unless there are any medical concerns (some children have got to be on the lower centiles...are you/dad small?) I wouldn't be worrying about his weight. It's normal for weight gain to tail off at certain points anyway.

Eating more did seem to follow on from stopping night feeds for my daughter. She seemed genuinely ready for a proper breast feed in the morning and then breakfast and then it followed on from there.
Stopping night feeds wasn't too bad. I made sure I stopped after she'd eaten well that evening ( gave preferrred food) think it was necessary for my peace of mind to know she wasn't genuinely hungry and then I wore lots of clothes and just cuddled not fed- it took three nights and she had been waking to feed 3 times.
Good luck with it and only try when you are genuinely ready and resolute!

agree with @piglet81

I would stop weighing him every week. leave it a couple of months.

Is op weighing every week? She says that her baby hasn't gained weight for 6 weeks so almost 2 month weigh ins??

Has your DS just become mobile? My DD didn't crawl until 12 months - up until then her weight gain had been spectacular (despite entirely refusing to wean - that's another story). However her weight plateaued for 3 months once she started moving.

DD also demonstrated nicely that milk actually pretty calorie dense; 'refusing to wean' meant that at 15 mo she was eating pretty much nothing (I kept a food diary, which tells me that one day she at 1/4 of a cracker and 5 cherios). However she was drinking lots (and lots) of milk, but completely refusing water, even if served in the same cup/bottle.

I guess I'm saying that I'm not sure DS's food refusal is why he isn't gaining weight.

Agree with @piglet81. In my experience, children just take to food at different ages. With ds aged 12 months, getting a few teaspoons a day of food into him was a win. Suddenly at 15 months, he got it and has been eating well ever since. He was breastfed on demand and it never occurred to me to cut back on breastfeeding. My understanding is that, other than iron, milk is still a good source of nutrition.

kellymom.com/nutrition/starting-solids/solids-how/

Kellymom is really good in terms of breastfeeding advice. At this stage, his main source of calories should be breastmilk (he should be getting no more than 25% of calories from solids by 12 Months).

Breastmilk contains a lot of calories and if you are feeding him on demand (including at night) he shouldn’t be struggling with weight gain because of breastfeeding, even if he’s not eating much.

Breastmilk is a fantastic source of nutrition. Have a good read up on breastfeeding toddlers, breastfeeding at night, etc and then make an informed decision on what you want to do and what you feel is best for your DS. Obviously if there is a medical issue surrounding weight gain then this needs looking into but I would say if this is the case then breastfeed him more not less!

One of the good things about breastfeeding as they get older is you don’t have to worry if they don’t eat much tea/lunch one day as you know they can make up for it by breastfeeding and still get the nutrition and calories.

You could phone NCT or a lactation consultant to discuss with them and hopefully reassure yourself. Unfortunately it isn’t uncommon for HV to give really poor advice in relation to breastfeeding, particularly older babies.

Oh and purely anecdotally, at a similar age one of my DC used to wake up at about 6am and have masses of milk, literally feed non stop for ages then get up and have a huge breakfast (2/3 pieces of toast and weetabix) so it’s not necessarily the case that feeding at night stops them eating.

Thanks all. He has reflux so is weighed by the doctor every 8 weeks minimum. At his last appointment the doctor raised his concerns that he thought DS would cross a percentile curve for a second time since birth soon and if he did he would be referred to a pediatrician. He asked for a urine sample on the meantime to rule out a kidney defect which came back negative.

I can work on the food in the day I just think the night time will be difficult.

And how would I have known this? I am a ftm and feel like I was well and truly talked down to about this by the HV...like 'duh...why havent you stopped bf on demand'....i feel so stupid

Breastfeeding is recommended by WHO for 2 years and beyond. Stopping feeding on demand is a form of weaning (as is ‘don’t offer, don’t refuse’).

WHO don’t recommended you wean at 11 Months. Stopping feeding him on demand would be a form of weaning him.

Honestly, NHS advice when it comes to breastfeeding is often so poor. Please do your own research before making a decision to breastfedfeed him less.

Have you tried giving him something to eat immediately before bed? Even if it’s fruit purée and baby rice - just something as heavy as possible to help him to sleep through? (Ds2 is 13 months and we find we have to fill him up before I BF him before bed)

Sorry, I meant something from a spoon rather than a BLW approach?

Surely breastmilk has more calories than fruit purée or baby rice though. If his weight gain is a concern then you would be better to give him milk through the night if he’s asking for it (providing you are happy to continue doing so).

What sort of solids are you offering him? Breastmilk is very nutritious, but has approx half the calorific content of avocado but twice the calories of carrot.

He has muesli for breakfast with full fat milk (aptamil stuff) and maybe some fruit if he.can manage it. Lunch is usually a mix of fruit/veg (like carrot stick) cream cracker with peanut butter/cream cheese, yoghurt, maybe a few of those carrot wotsit things if i can get em down him. For tomorrow though I've made pasta that I will mix cream cheese and tuna in to.

Sorry, to answer an earlier question, no hes not walking yet but hes cruising

They told me to only give him fruit ot veg as a treat now after hes eaten something else. They think hes cherry picking fruit and veg which is lower calorie because its brightly coloured 😕

Often at that age, food is all about exploring and experimenting with textures and different flavours, encouraging chewing to help muscles in his mouth develop for speech.

As per Kellymom, no more than 25% of his calories should come from food at that age so over 75% of his diet should be breastmilk. Obviously, some will eat more than this but lots will eat less too.

You can’t force any baby or child to eat. All you can do is provide him with a variety of healthy (high calorie if his weight is an issue) food options. The last thing you want to do is create a strsssful environment around food as it can easily lead to a poor relationship with food as he gets older. They pick up more than you realise when you are worried over something.

Sometimes at that age they can go through a phase of demanding breastfeeding less. Are you also offering him breastmilk at other times as well as feeding him when he asks?

If he’s not the best eater and struggling with weight gain, I would try to get as much breastmilk into him as possible as well as offering him food whenever you eat.

I'm sorry you are getting so much mixed advice here op. Our children are smarter than all of us so I would continue to follow their lead unless there is a health issue. Bm is very calorific so I would be inclined to offer more breast during the day. Solids and milk are not mutually exclusive. For example, if I drank a pint of milk before my dinner it might take the edge off my hunger but I'd still want and eat my dinner. I nurse my toddler frequently throughout the day and he still has a great appetite BUT he only really started eating well around the 12m mark, even then he had good days and bad days.

Also.. everything that littledinaco said 👏