BF Baby Not Gaining Properly

[QS90]

I will go to the breastfeeding clinic and also ask them, as well as checking with GP, but does anyone have any insight into this? I'm beginning to get quite worried :-(

My milk was slow to come in, but after needing formula top ups, I managed to get to the point where I was EBF my now 7 week old. He was predicted to be born approx 60th centile, was ultimately born on the 97th. He only lost 7% of his body weight, but was slow to gain and didn't get back to it for a month - a Lactation Consultant suggested this might be "catch down" growth, which made sense at the time.

He cluster fed a lot the first few weeks, then settled to feeding about every 3 hours (give or take). Last week he had a few days of intense cluster feeding again, which I put down to the 6 week growth spurt.

HOWEVER, I hot him weighed today, and he's dropped from 4.65kg last week to 4.60kg today. I know it's not much of a loss, but the point is I was hoping for a gain, what with him having been glued to my boob for days. The HV said not to worry, as he's alert, content, smiling and looking around etc. But I do worry - he's now approximately on the 20th centile. Everyone both sides of his family is at least average sized, if not biggish and tall. I asked of I should be topping up with formula but she said no, the weight loss wasn't enough to recommend that. And tbf, I find if I do top up, he just goes longer between feeds, so not sure if he actually takes more in over a day.

He has been checked for tongue tie, his latch is good, and he has lots of heavy, wet nappies. I only change him 4 to 6 times a day, but nappies are usually very full indeed, and the wee is pale. He does only poo every other or every third day, but there is lots of poo when he does go (I think he gets a bit constipated). I can hear him swallowing when he feeds most of the time, although he does comfort feed in the evenings. He is a bit sicky, but not excessively so.

So what is wrong with him? Why does he seem to just not gain? Where is all the milk going??

Sorry my tired brain can’t work it out - what was his birth weight and how much has he gained since then?

So he started off at 4.40kg at birth, dropped to a low of 4.08kg at 9 days, and is now 4.60kg at 7 weeks.

So he's only 4.54% heavier now than when he was born.

Did you get his height measured? He may be using energy from the milk to grow in length rather than weight if that makes sense? That’s what I was told when I was in a similar situation

as long as he’s having good wet and dirty nappies, is alert and content when awake and sleeping well then honestly I wouldn’t worry too much about it

That's interesting to hear - his height hasn't been measured, but he has grown out of his newborn sized grows this week, so presumably he is getting longer.

@QS90 that might be it :) and really good sign that he’s growing out of his newborn size. I find weighing weekly isn’t helpful as it fluctuates so much! Could you do 2 weekly weight checks instead? Ask them to do height at the same time.

the reason why I tell you not to worry is because my baby was dropping down the percentiles whilst BF and so I decided to stop and put him on formula. Turns out he just didn’t have a huge appetite and was always going to settle on a lower percentile so I feel like I gave up my BF journey for no good reason!!

I would get a second opinion on the latch and try some breast compressions and switch feeding to get extra milk in - easier than topping up!
I would want more poo personally, and be wondering if maybe allergies could be an issue - CMPA can cause slow weight gain.
Did you have fluids in labour? This likely inflated his weight if so.

Also things like when they do a poo it fluctuates their weight! So try not to do weekly weight checks