Mighty oaks from little acorns grow - slow weight gain support thread

[FireworksScareMossyPets]

Thread for those of us whose los are:

• Healthy
• Meeting developmental milestones
• Producing plenty of soaking wet nappies
• Producing several pooey nappies (quantity varies after first six weeks or so)
• Gaining weight...

but just much more slowly than the centile charts tell us they should.

This is a thread for help, support and understanding from other Mums who have "been there, done that".

It's where we can share links, share our stories and what if anything we have done to help our lo's weight gain - or whether we've just ditched the scales and looked at the baby.

However, we also don't want to lull other Mums into a false sense of security; if your lo is not meeting the criteria at the top then it is best to get help from a breastfeeding counsellor (or general infant feeding specialist - not all slow gaining babies are breastfed) or supportive health care professional.

Mossy xx

Hi Hadeda

so much sympathy..... know what you mean about the lying awake at night worrying thing. what a cow of a HV.

my ds is only 17wks and only just following his line now, with the aid of lots of galactogogues... but now is going to come the normal 4-month slowdown of ebf babies... can't wait to hear all the guilt trips people are going to give me over that...

Hi Hadeda

your story sounds so familiar. To cut a long story short, DD2 started off on the 50th centile but by about 20 weeks was off the chart for both weight and length. I persevered with the BF but by 25 weeks was ordered by the HV to start solids that day as she was "very concerned about this baby" despite the fact DD2 was meeting all the developmental milestones. OK she was maybe a bit grouchy towards the end of the day but no more so than DD1 and DS. I said I couldn't understand why she wasn't putting on weight. Then I was told "babies can get used to not being given enough" I felt like she was accusing me of starving my baby. Fortunately this baby is DC3 and I successfully BF the first 2 so I took her comments with a pinch of salt. Had this been my first baby I would have been beside myself with worry.

That was 3 weeks ago. I started solids that day and DD2 was weighed 2 weeks on - she had put on 800g and grown 3 cm in those 2 weeks . Looking back she was obviously ready for food and is absolutely loving it. However I stand by decision to hold off with the weaning and don't regret it at all. It is so frustrating that there is no room for manoevre with the charts. The fact that DH is tall and skinny and maybe, just maybe his offspring might just have the same build is completely dismissed.

Basically all babies are different and not all of them are going to follow the charts. So I reckon if you feel your baby is developing well just carry on doing what you feel is right.

Been for weigh in and in 3 weeks ds had gained 7oz, I think this is an ok amount but have no idea what babies his age are supposed to gain per week, I think I read it's supposed to be around 4oz a week but thats what ds used to gain in a good week before weaning. He's now dropped off the bottom line . It was the nice hv today, she just advised to keep trying to give him high calorie food and to see what the paed says when we see him (have got an appointment on 1st July to discuss his slow weight gain).
So, at the moment i'm just trying not to worry and trying to look at the positives which is that since I last had him weighed he's put on nearly half a pound. I thought he might start puttin on more weight once he was on the food but I had also read the weigt gain can slow a bit once weaning so guess that was a false hope.
Personally I think he's fine in every way, I just wish he'd grow a bit more so I could stop worrying about him!
He has 20 oz of milk a day plus fromage frais for breakfast, veg puree for lunch plus banana custard desert/high calorie creamy desert, and meat (chicken/beef/lamb) and veg puree plus the rest of his lunctime desert for tea. I think thats quite a good amount of food and a well balanced, varied diet so I can't understand why he doesn't put more weight on? Oh well, guess i'll just have to wait for our appointment with the paed.

We saw the paediatrician today who was great . Said that DD was fine (which is what I thought, so nice to have that confirmed!). Said that she recommended I continue to bf and actually said that the HV's advice to top her up with formula was, in her opinion, wrong. I am now going to bash any HV who raises the subject again with the paediatrician's view!! We will go back to see her in a couple of months to see how DD is doing weight wise so I think I'll avoid the HV weigh-ins for now.

She suggested that when we start weaning at 26 weeks, I give her some high fat things (e.g. cook veg in butter, give her yoghurt and fromage frais). Dalrymps, I guess I might have a similar experience to you at that point...
Can definitely second your wish they'd grow so we can stop worrying - but for today I'm determinedly optimistic!

Also, thanks for all the sympathy after my previous rant!

Hadeda - So glad to hear your news! Must be a massive weight off your mind to know she's totally fine . Bet you can't wait to tell the hv where to go! I suspect ds is fine too but i'll not rest until I hear the paed say that, hope that is the case. Glad you're feeling optomistic, may it carry on. Yes, ds has fromage frais for breakfast every day and has butter in purees and whole milk mixed in to things when I can and custardy deserts, have tried him with cheese sauce but wasn't too keen , did the paed give you any more high fat suggestions for food??? Hope you have a lovely weekend with your perfectly fine dd

Hadeda hurrah for a sensible paediatrician
Makes a lot of sense to avoid the HV for a while too!

Hello, another quick weight update from us. Had DD weighed today and she has put on another 2lb 3oz in 4 weeks! She's now 14lb 11oz at 30 weeks! - bizarrely she has gone from just below the 0.4th, to touching the 9th centile in that time - the first time she has been on the chart since about 8 weeks! It's just possible she might be turning into an oak, you know .

The flipside being that she has now stopped sleeping at night and insists on up to 4 feeds between 10pm and 7am, despite having her normal milk feeds, plus 3 solid meals + pudding during the day. All of which does not make for a happy DW (or a happy DH, for that matter). This parenting lark isn't easy, is it?

well done with your NOT so lo. We have our weigh in next week but dont think we will reach your dd weight. At 13 mths 13lb 10 at 14 months??? gonna guess at 14lb 2 and we be if we are heavier than that. Glad all is going well as for the night time feeds why should I be the only one

Great news ILoveDigestives! May it long continue!
soremummy - Hope the weigh in goes ok.
We saw the paediatrician and paediatric dietician about Dylans slow weigt gain yesterday. The doctor said he looked fine and like a healthy little chap and he wasn't concerned about him, said he was all in proportion and following the bottom centile nicely so he didn't feel the need to do any further tests at the moment and said he woud see him agian in 3 months . The dietician said he was fine but could do with being a little heavier as his length is on the 9th centile and weight on the 0.4th so ideally they'd lke him to be on 2nd-9th centile for weight. She looked at his food diary and said was all fine and that the amount of milk he's taking is good so she has prescrubed some high energy/calorie formula to build him up a bit, just a short term thing to see if we can get his weight matching his length. She also gave me a few more tips on how to make his food more calorific eg making him cereal with the high energy milk and mashed potato etc.
As you can imagine, we are relieved that he is ok, even though we suspected that was the case this is a huge weight off our minds

ILD - way to go on the weight gain!
dalrymps - glad the Dr was happy with Dylan, must be nice to be reassured by the specialist!

Well round here we are doing ok. I have finally given up the triplefeeding (bf-pump-EBM bottle) as it was doing my head in not being able to go out. So I slowly weaned myself off the pump and DS off the bottle and his weight gain stayed a steady 4oz/week.

Then we hit 4mo.

Since then his weight gain has slowed right down. He's still only 20wks so it's early days yet but despite plenty of night feeds he's really not gaining as fast as he was. (Not losing either) it's 2oz/week at the moment. I am going to monitor the weight for another week ot two then seek advice from a bfc over the phone. HV answer was of course "wean early" not entirely happy with that plan!! esp since want to try BLW.

hi all
sallyforth i can't believe she told you to wean early. Print this off to show her the fat content of breastmilk!!

Well we (whispers)....are almost at the 50th centile!! From 0.9th and below! Is dd an oak yet?! I'm whispering because we're about 3wks into BLW and she's not eating much, plus teething so off her Bfs too...I don't think the next weigh-in will be so positive.

But we got to at least the 25th on BF alone by 6mths so it CAN be done!! Stand your ground ladies and gents.

Have just filled in a questionnaire for our local NHS trust re infant feeding and have totally slated their BF support...

Hello - I feel a little bit of a fraud for joining this thread as I've been lurking for a while so know my problems are not quite as bad as everyone else's because of where my DS started. But I've been having a few issues with DS's weight gain, and HV are now starting to question it.

DS was born at 9lb/4.1kg so between 75th and 91st centile but at 13 weeks old he has dropped to 25th centile. He's 12lb10/5.75kg now. He lost 10% of his birthweight (although I actually think it was more because that was based on midwife using balance scale and weighing with nappy so he'd probably lost more) and took 4 weeks to get above birthweight. Since then he has gained every time I've taken him in, but has only gained near the 'average' 6-8oz twice and the rest of the time is at about 3-4oz although his worst gain was just 10g when 3 weeks old. He is now dropping down the charts fairly rapidly (in the last 2 weeks he's somehow gone from just under 50th to bang on 25th)

I know i don't have as many problems as lots of you on here, because he is still gaining a few oz per week and started at a big weight but I know that the HV are going to start questioning me about it soon and I just want to be forewarned about what they may say and what my responses should be so wondered if I could join in the conversation and benefit from all your experiences. He is breastfed apart from one bottle of formula at night, and we had a lot of problems establishing supply due (I think) to my blood loss and anaemia and I therefore have very little confidence around my ability to breastfeed him as it took so long to establish supply so when he gains only a few oz I feel terrible and usually end up in tears on my DH.

On the plus side, he is more than meeting his milestones - smiled at 4 weeks, could support his head perfectly at 8 weeks, rolled at 12 weeks etc. and is a very happy baby so I know in my heart of hearts that he is just a slow gainer and that there is nothing really wrong with him. But I am just trying to find out a bit more about slow weight gain before I have to have a fight with the HVs because I feel so fragile about it that I'm likely to capitulate and go fully formula if I'm not prepared.

Hope it's okay to join in.

Hi! And of course it is!!

There are people on here more expert than me so just bumping for you and saying hi....but to me your ds sounds fine!!

Have you had RL bf support? I just ask because I know that part of the problem for me was poor latch=poor milk transfer=slow weight gain and supply issues - having someone help me with the latching etc improved things. They could also go over how often you are feeding etc - again just my experience but in the early days i don't think my dd was feeding enough.

I think the key thing is that he is gaining all the time never losing? That sounds good to me!

Also maybe the thing about "catch down weight" could apply to him?

Good luck!!

Is he weeing and pooing aplenty?

Are you and your DH small/ very slim - could he just be "catching down"?

Could he have been born heavier than "supposed" to be due to gestational diabetes etc?

If not..........

Why do you give him a bottle of formula at night? is it because you doubt your milk supply, or for convenience (so he will sleep longer, or so your DH can share feeds)?

You make most breastmilk at night, could you co-sleep and feed him lying down so that he can breastfeed as much as he wants overnight? If he does not wake at night could you reduce the anount of formula he gets by half an oz every few days until he starts waking? If you do it nice and gradually your milk supply will have time to increase in response to his increased demands.

Hi sallyforth - thanks for replying

He poos and wees just fine (although the past week DH has noticed that his nappy isn't wet when he changes him around 11pm - but other than that he wees for Britain). I'm average height and a size 16 so he doesn't take after me, but DH is tall and slim just like DS is (75th for height, 25th for weight) although DH was actually a big fat baby and a podgy child and didn't get slim until puberty.

On the formula, it's a long story. I lost 1.5l of blood at birth after a 43 hour labour so was very anaemic and beyond exhausted. Felt okay in hospital (adrenalin I guess) so doctors agreed I didn't need transfusion (in hindsight wish I had). Consequently I was absolutely shattered in the first few weeks, and found that I couldn't physically cope with DS's cluster feeding from 2.30pm-9pm and then also deal with night feeding as well and so found it mentally very very tough because I was too tired to think straight and was convinced I wasn't making enough milk for him. In the end we introduced a bottle to save my sanity in the hope I would be able to continue bf the rest of the time, and also so DH could feed him and if i'm honest also because I hoped DS would sleep better so I could get some rest. Bottle started off being part bm - only on the occasional day could I express 3-4oz so was never able to be fully bm - but there was a soul destroying few days where I couldn't express more than 1oz so I ended up deciding it should just be formula rather than upset myself more. He didn't get above birth weight until 4 weeks so the rocky start coupled with that mean I've never been a confident breastfeeder and it's required a lot of effort to not introduce more formula.

I am confident that he is meeting milestones etc. Other people with babies comment on how alert and sociable he is for his age etc., and he is such a happy, easygoing little boy and he does have chubby thighs And I've got over most of the guilt of giving him formula at night, not feeling I was making enough milk etc. But if the HVs start to question his weight gain (they gently raised it at last weigh-in which makes me think next time they will be wanting to discuss it in more detail) I might find that the guilt comes back - I've such a fragile confidence about it that I'm not sure that I woudl stick to my guns and I might end up capitulating by adding in more formula. So I was hoping to find out a bit more about slow weight gain so that I feel prepared to stand my ground with them if necessary.

Sounds like you had an awful time in the early days. Anaemia really does affect supply in some women - have you had your ferritin rechecked and are you taking iron tablets?

I'd encourage you to trust your instincts as a mum. If he's weeing for Britain, that excess fluid he's getting rid of can only be coming from your breastmilk! So you must be making enough milk! He should be doing 6-8 soaking wet nappies per day (or >45g if using disposables). Don't worry too much about the pooing because there is so much normal variation in how often they poo.

Ask the HVs about catch down growth and whether your LO could be doing this. But generally, I wouldn't get into an argument with them. All they are doing is making recommendations and as the mum it's up to you to weigh those against your own views / feelings / instincts and make the right decision for your baby. HVs often are not very helpful on bf issues. A proper bfc, even over the phone, can be much better - I'd encourage you to ring one of the helplines as I'm just a mum not a trained bfc.

All adding formula will do is reduce your own supply as it means your LO will take less from you. If your own supply is lessened this could also reduce the flow rate at let-down which could make your son start preferring the bottle to you - a vicious cycle.

If the HVs do feel you need to add extra feeds, they are almost certainly wrong, for the reason above - it is a quick fix but not a long-term solution. But you could compromise by expressing 2-3x per day, after feeds (this helps build supply; it is normal to be able to express only 1oz at a time) and offering your baby whatever you express as an extra bottle every day after one of his regular breastfeeds. This is what I did rather than give formula long-term. Bizarrely, it worked - not sure why - and after a few weeks I stopped expressing and the weight gain continued at the same rate. The HVs were happy as they thought I was giving an extra bottle of formula because I would refer to it as "making up a bottle", "giving a supplement" which sounds like formula but could equally well mean EBM.

You could wean him off the formula if you like, but do it very slowly. He will behave as if it is a growth spurt (feeding often) in order to build your supply back up to what it needs to be.

As far as slow weight gain is concerned I found these links helpful

look at the baby not the scales
thinking about milk flow

And I wrote some of my own thoughts here

sallyforth - thank you so much! that is really really helpful, particularly about expressing and offering it as a top up - it may certainly help with the pre-bath/post-bath feeding as he feeds for ages and I'm never convinced he is getting all that he wants.

DS just gone down for his nap so I'll have a read through your links now. I've also been making a list of things the last few days to talk through with a BFC so will definitely give one of the orgs a call - I feel fairly confident with bf at the moment but it swings hugely depending on how he feeds so I just think I need to talk through all of my issues from the early days so I can let go of them and focus on now.

Hi HQ,

Just wanted to add a few words of support.

I think getting some RL help is a big plus - made me feel SO much better when I was being pressured by HV to top up with formula. Either ring one of the helplines as Sallyforth suggested or, if there's a Baby Cafe in your area you could go along there (see Baby Cafe). We have one near us and I've found them to be fabulous. Or maybe there's another similar bf group you could get to?

I found 3 key things helped me with the weight gain issue:

1. looking at my DD as a whole person and not just a number on a scale. She is just like your DS, meeting the mile stones and generally a very happy baby. Which means she just can't be starving otherwise she'd be unhappy! Luckily for me my mom was very supportive on this. She formula fed both my brother and I so is no big bf guru, but she kept saying "there's nothing wrong with that child, anyone can see she's perfectly happy and well", which was great for me to hear.

1. information on the Kellymom website, which gives evidence based info on bf - see especially weight gain issues in bf babies

1. when pressured by the HV, I agreed to see the GP who then referred us to a paediatrician. A bit of a faff to see 3 different people, but it was useful to me for two things: firstly, I know there is nothing medically wrong with DD so I am not "harming" her by continuing to bf and secondly, now the paediatrician has given us the ok to bf, I can bang the HV over the head with that when she goes on about topping up.

I found expressing to be a bit of a pain, and it is a bit demoralising when you get 1oz out at a time! I got over this by setting myself a limit - I only expressed for 10 mins each side and whatever we got in that time was it. Slowly I got more and more out until some days I got 5/6oz this way. (I had to go in for a small operation a few weeks back so was building up a supply of EBM for DD for while I was away. After doing this type of expressing for 2 months, I had about 90oz of EBM in the freezer!) Perhaps express for a few days and then give the "bits" all together as a feed? Kellymom also has some good info on expressing here.

Seriously, if you think your DS is doing fine then he more than likely is. I know bf is a really personal and sensitive thing, and sounds like you've had a tough start to everything, but it sounds like you're doing just fine

Oooh, while I'm here can I ask you all about weaning? DD has now hit the magic 26 week mark so we are starting the Adventure of Solid Food.

Did you do BLW? I'm really keen to try that as DD has already helped herself to a few things - amazed both DH and I when she gnawed on a raw carrot and bits turned up in the nappy! But, rather like bf, you're not sure exactly how much your DC eats and how much gets thrown on the floor/mashed into their hair. So, if you have a baby with weight gain issues, did you do BLW or just stick with the old fashioned puree method?

We did a bit of both with the food - offering finger food from the start, but also offering DD a wide selection of pureed (and now mashed up) food. She's 7 a bit months now and eats like a horse - a mixture of textures too.

DS only 21 weeks and not ready for weaning yet but I am really keen to try BLW. Reason being that milk (breastmilk/formula) is so much more energy-dense than any puree, I'd rather he had lots of milk, a little taste of "proper" food and stimulate his oromotor development than fill up on Baby Goo.

If it is a dismal failure then we will try the purees, though.

sallyforth,

I do agree with the milk-having-more-calories-than-food thing, I do! However we've found with our LO that she was having lots of food (much of it pureed stuff - not just fruit, but meat and various high calorie stuff) AND also having all of her milk feeds too (she's only recently started to drop one or two feeds).

Consequently she's been putting on lots of weight because she's been taking in extra calories, rather than simply replacing some.

Obviously, it worked for us and it may be different for everyone else - but for some reason our DD just didn't seem to be putting on much weight on milk alone, and solids seemed to help.

I don't know why she needed the food to put on weight - and we've been trying not been think about it too much - but it's no coincidence that she's jumped from wayyyyyyyyy below the 0.4th centile to over the 9th in 6 weeks of taking in solids - in part, we believe, cos we left it till 6 months to start, and then when we did she was developmentally ready for it and took to it really well.

She still has plenty of finger food too, I should point out - and she loves it! But even the spoon food can be fun; DD insists on feeding herself with the spoon most of the time with only minimal help from mummy and daddy ;)

Hi all

Hope those babies are all piling the weight on. We are hanging in there with a weight gain of 2.5 oz this month..........

Now we weigh at 14 months a whopping 13lb 12.5 0z. Heres hoping that next month will be better gain for her maybe I need to tie her up to keep her still im sure she burning off all the calories now she walking

I got the who chart from vlc for girls weight but does anyone know how I can get the height one from I cant seen to get on the site properly but im sure someone might be kind enough to do me a link thanks in advance.

ILD thanks that's really helpful I wonder if my LO will alsso pile weight on with weaning. His weight gain has slowed lately

for soremummy