Slow weight gain and reading baby’s cues

[starryeyed13]

Hi all - I have a 17 week old baby who was born on 50th centile but dropped to 9th in the days after birth and has tracked that line ever since. I am trying to express to give her top ups but only manage 20/30ml except if I power pump when I may get 70ish. Although she is tracking her line and doesn’t seem overly hungry, I can’t help but worry her weight gain is too slow and that I should maybe introduce some formula? She is a very content and chilled baby, she rarely cries for food or nappy changes so I am worried I am starving her! I really wanted to get to 6 months of exclusively breastfeeding and feel so confused about the right thing to do. I’ve fried breast compressions and switch feeding but if hasn’t really made a difference. Any advice would be gratefully received x

Hi OP, have you been able to talk to your health visitor about it? I can understand your concern but it could just be that the 9th percentile is the right line for her. My dd was following a bigger percentile in the womb to the one she did as a baby. Now as a toddler she is still slender.

Hi, I had a similar situation with my daughter who’s almost one now. Born just under 50th and dropped through two lines and tracked just above 2nd Centile From about 10 weeks until 6 months. In our case, she did have a tongue tie which affected things early on but even after this was snipped, I still felt I had to work hard to keep her On that line. I gave expressed top ups of 3-5oz a day which I got from using a haakaa a few times a day and had to make sure I fed her every 2 hours in the day. I do think that if I’d have purely followed her cues and not known about her weight gain issues then she’d have dropped further down the chart as she was completely content with what she was having, nappy output was fine, meeting milestones etc. How are her nappies, Meeting milestones etc?
Definitely a good idea to speak to someone face to face locally if possible to put your mind at ease. But personally, if she’s tracking along the same line roughly, then I wouldn’t worry at all. I too was told that they sometimes settle on a different line to the one they were born on. Plus, if she’s following that same line then her weight gain isn’t slow, it’s perfectly proportional for her size. I also measured DDs length at one point and it was bang on 2nd centile too so her height and weight were exactly in proportion, she was just dinky. Since weaning, she has chubbed up a bit more and I think is between 25th-50th now. It did really worry me early on though so didn’t want to read and run! X

It is not uncommon for a baby to be born on a higher centile then drop down and follow a lower one. It is called "catch down weight". Have you measured her length and head circumference? I think it is reassuring when the are also on similar lower centiles, however not everyone is completely in proportion. My second child was born on the 50th, and dropped to the 0.4th until puberty. He is now a slim adult.

You aren't supposed to take their centile at birth any more as this can be distorted for all sorts of reasons. You wait for them to regain birth weight first, then you follow whichever centile they are on using 2 weeks old as a starting point.

So 9th centile might just be where she is :) Sounds like you don't need to be topping up and defo no reason to introduce formula.

Her weight gain is fine. You don’t need to do any of this faffing, just feed her on demand.

My DD went from 50th at birth to 0.4 centile and tracked that way until weaning, then with solids tracked up. The lines don’t matter, as long as they are healthy and growing.

Thank you so much for the responses @Pantheon @BrokenLink @BertieBotts @Megan2018

The health visitor has been less than helpful. I did see a lactation consultant who suspected I might have a condition called hypoplasia which can cause low milk supply, though she couldn’t be sure.

I have thought about using a Hakka however my LO has to feed from both breasts every feed (think I have quite low storage capacity). She does a reasonable amount of wet nappies however they are not that heavy in the afternoon/evening. She has recently been going several days between poohs which is making me wonder if she isn’t getting enough.

I haven’t measured her yet but will do, good thinking.

@Almond791 thanks so much for your response and very reassuring that your LO increased once weaning started. The anxiety is real and I honestly thought I’d be so chilled!

Is she consistently tracking the 9th centile? If so I wouldn’t worry at all.

I have hypoplasia and classic hypoplasia weight loss is late onset, often 7-14 days rather than excessive early weight loss and tends to show consistent drop below the centiles. The actual weight may show a slight gain or static but it drops off on the chart. My babies certainly don’t track the 9th centile without supplementation.
Why did the LC suspect hypoplasia?

Infrequent stooling is normal in older breastfed infants and not a cause for concern and at this stage weight gain and the look and behaviour of your baby are your best guide. Wet nappies are of course important but a lack of them is such an ominous sign you’d no doubt notice your baby was not doing well before that.

It sounds like she is getting enough to eat and everything is going well. Pumped volumes tell you nothing especially at this stage.

I would add though that it’s wise to be cautious and babies who gain weight better with solids (as my own youngest did) probably weren’t getting sufficient milk and are doing ‘catch up growth’. It’s unclear whether this has any long term impact and whether formula supplementation is better than catching up once they start solids. I do think my youngest was hungry with milk (and she was supplemented freely but was a rubbish feeder) and had a lot of food insecurity when she started solids but at 19mo seems to have overcome that.