have to top up 3mo - slow weight gain

[Liz79]

I have posted a couple of times previously about my now 3mo DD who has been slow to gain weight. On friday she crossed a second centile (down to 25th from 75th). I was given the choice of domperidone, formula top ups or EBM top ups. I chose EBM top ups. I have been expressing and offering since friday evening and now have almost a pint of useless EBM in my fridge which she wouldn't take. I am going to make a rice pudding from it later today . I first tried tommee tippee bottle as she has been having this once a week and was ok with it. But on the first top up she jsut played with it for 45 mins. Was about to give up and decided to pour it into avent bottle and try that. She took 50mls. She was offered avent all night and refused and then refused tommee tippee again yesterday morning. So of I went to mothercare to get their orthodontic teats (which they told me wouldn't fit avent bottles but they do!!). DD will suck on this teat merrily but bugger all comes out, the bottles I had to buy came with nuby teats and she seemt a little more interested in this than avent, plus it comes out easier than the orthodontic ones. The problem I have is she plays with all the straight teats and pushes them out with her tongue, unless she is quite hungry (friday evening bf wasn't very good). She will suck the orthodontic teat but nothing comes out of it.

What will I do? Do nuk teats flow faster than the mothercare ones and do they fit mothercare/avent or tommee tippee bottles or do I need to buy theirs? When I shake the orthodontic bottle upside down, nothing comes out. I found I have to squeeze it in a very particular way to get any out.

DH thinks this is all pointless and its just winding up me and DD and we are going to be knackered because of night time expressing and messing with bottles. He thinks its pointless as he thinks she eats till she is full and won't take the bottle as she isn't hungry. We both think she is fine and just doesn't have a big appetite.

Also I have been doing weight watchers, started shortly after the first time she didn't gain much. I have lost 10.5lbs in 5 weeks. when I took DD to the gp as told to after crossing the centile, I asked him if i should stop ww and he said no immediately - your milk supply is your bodies first priority, it won't be affected. I think I might have an extra couple of points a day as I have lost weight quite quickly I think? Will decide after mondays weigh in. Good weight loss isn't normally a concern for me!!

anyone?

I have no idea as I bottle fed mine but am bumping for you - someone will be able to give you advice

How fast did she cross the centiles?
Get a second opinion from a bf counsellor - get in touch with La Leche League or the NCT.

my dd was born on 75th centile, 25th by 3 months and finally came to rest between 2nd and 9th centile between4 + 5 months where she has stayed ever since. She is not a chubby baby but is happy + healthy. Perhaps your baby is similar?

Try to look at it holistically - were it not for the charts, would you be concerned? Is she making lots of wet + pooey nappies? Does she seem happy in herself?

Good luck, HTH

hi liz, fellow mum of tiny dd here - we also did top-ups for a while, and the whole feed-express-bottle cycle is exhausting. dd took tt bottles at the time but will no longer take them. (we've stopped giving them anyway as she is gaining weight, albeit along the bottom centile).

I have been recommended Nuk bottles and teats and also Dr Browns. I was also told to try to use a cup but dd was having none of it, but you could maybe try? we used these:cups

i don't know why the domperidone was an either/or thing, could you not try it too? i got it on prescription as motilium, have to say though i felt no difference. currently trying "more milk" herbal thingies, but just started so i can't tell you if they've had any effect.

i don't think weight loss will have any impact other than you might just be a bit more knackered than normal? someone who knows more will be able to help you soon hopefully!

is your dd actually gaining weight, although dropping centiles?

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Women staffing these lines have had extensive training + can offer real help

also - what chibi said!!

Hmm, I was doing WW and had slow weight-gain baby around the same age.

My GP advised me to express after each feed to give me a top-up bottle for the evening. I did this and stopped WW. After a week or two her weight began to follow a line.

She was on the 98th at birth, and went to between the 9th and 25th.

We were referred and she was checked over by the Paed Consultant at the hospital who said she was fine (which both the GP and I knew anyway). She did mention 'catch-down' weight.

I'm a bit sceptical about different teats etc, but then I've never had an issue with it so don't really know about it. It does sound like you are stressing out about it. Its very important you relax, drink plenty of water and eat properly.

GP did suggest I started to eat cream cakes!

when you say 'I was given the choice of...' by whom? Have to say this raised my hackles on your behalf... I have made no secret of my disdain for weight gain as a measure of health. I'm sure it is important in certain circumstances but it's not unusual for weight to level off in some babies AFAIK. is she otherwise healthy?

And why those choices? Why not a babymoon for a couple of days to see if you can just increase your supply?

Are you eating the full points range offered to exclusively BF mums on WW? I know in theory dieting shouldn't affect your supply, but my experience with DS2 was that it did when I tried to eat fewer points than suggested...

Your DH sounds quite sensible to me. If it's your HV/GP giving you the advice i would suggest you get a second opinion from a BF counsellor...

How many WW points are you on? Should be about 31 if you are bf.

oh yes, agree with HCMB - we got a 2nd opinion from a BFC then a paed, who both said stuff the top ups, she's fine!

I get 33 points at ww. I think I will try 35.
It is a midwife who runs the bf group who has been weighing her, the actual bf midwife is coming tomorrow. She has been gaining weight each time but at a slower rate than is desirable, which means she has crossed the centiles. All started about 6 weeks ago. We have an appointment with the consultant in 6 weeks . GP, midwife, DH and I all think she is fine and is just going to get to a centile and settle there. Without the chart we would not be worried. She seems happy and healthy, she has yellow/brown nappies, lots of wet ones, she can smile and hold her head up and has started making a wider range of noises! . I hope the consultant will say she's fine and as long as she gains something and develops normally - no problem. Think bf midwife is going to try and hurry up the appointment. Wouldn't mind expressing so much if she would take it, but seems a pointless faff otherwise. Going to get nuk bottles now and then thats it.

Maybe I will do the ww "how many points quiz" and say I want to maintain rather than lose weight and see what happens for a couple of weeks.

Thanks for all your help

liz i don't know if it is do-able financially, but we scraped together and paid to go privately to the paed - meant getting an apt in 5 days instead of 5 weeks and gave us peace of mind sooner. cost a bloody fortune but worth it

Here's a support thread for slow-weight gainers. Caz is on it, I was earlier on. Lots of lovely people with the same worries. Little acorns

The midwife is going to try and hurry up the appointment on the basis that I work there, I don't like doing it and normally I wouldn't but this time I will let her do it.

We think she won't take the top up as she just isn't hungry, she has been satisfied by the boob. To test this, I am going to offer her the bottle first this time. If she takes it we will know she refuses the bottle because she's not hungry - not because she is confused and doesn't know what to do.

As long as she develops properly and is well otherwise I don't mind if she only gains small amounts. Thanks again everyone.

I am going to order an indian take away tonight - the baby needs it!!!

Well, it sounds that you might not need to top up at all. Definitely decide on this issue first. I have found that DS refused avent newborn teats at 12 weeks, but was happy to take them once I added additional holes. I also bought NUk teats which work great. Good luck!

I am sorry you are being worried and unsettled by centiles. She sounds fine to me too! You should look at how much she is gaining on average and not where she is on any charts.

see here

IIRC the La Leche book says 4oz a week (on average! not every single week) is fine too.

In the last 7 weeks she has gained 26oz, so just under 4oz a week on average. I just tried her with an avent teat and a nuk one, before and after a (small) breast feed. It was more a snack than a meal. Refused bottle, took breast, then cried when offered more breast or the bottle. I am thinking there is no point expressing, I don't think there is a problem with supply and she obviously won't take a bottle. I have just put in the oven a rice pudding made with 350ml EBM, rice, sugar and butter. No normal milk. I will not be counting the ww points in it ;)

Liz, I am mystified. Here is a baby who is gaining weight, who appears healthy, who's happy (apart from when someone is trying to get her to eat/drink more than she wants!!)...I don't see the problem! It can be perfectly physiological to have a period of 'catch down' growth, and this is more common in babies at the top end of the weight range, as with your dd.

Your own sensible and supervised weight loss will have no impact on this at all.

If there is any concern about your dd's weight (and why on earth there should be, I don't know!), occasionally offering her another 'side' when you bf is the easiest way to address it.

Waste of your time, and public money, to see a consultant, IMO

I agree -- this sounds like a classic catch-down growth pattern. She is gaining weight, and she's doing it at a steady rate, and she seems perfectly well and happy. I don't see the need for top-ups at all.

hi liz. our dd has been gaining 6oz a week lately and we're STILL getting hassle. we're not topping up though. but it feels VERY scary to be going against the gp's advice...paws really reassured me, hope yours does too.

just had good bf and took 10ml with nuk teat - but slowly and somewhat reluctantly. Still it is progress! will be interested in what bf mw thinks tomorrow. going to bed now with thermos,chill bag, 2 breast pumps and other paraphernalia. was much easier when i only had to take my breasts to bed.

caz - that is just silly. weight gain should be 4-6oz a week! I wouldn't be topping up if she was gaining 6oz. I'd be pleased!

night night xx

Liz, I hope the midwife tells you taking 10 ml from a bottle and taking all the paraphernalia is not 'progress' but a whole lot of unneeded hassle

My ds was a classic "catch down" baby - I didn't realize it at the time and had never heard the expression until a few weeks ago when I heard it from tiktok. He was very big at birth, and gained weight very slowly, He was healthy and happy, peeing and pooing and hitting his developmental milestones and feeding well. And he was gaining weight - he was just doing it very slowly. The health care people tried to worry me, but because he was number two i was confident enough to just stop getting him weighed. He is now an average sized 7 year old. If your baby is fine in all other respects and, crucially, is gaining not losing weight, I would relax and carry on with whatever you are doing. It's obviously working.