Advice needed - slow weight gain in excl BF 16 week old

[Mog37]

Hello - I've been lurking on this forum for a while now and found it really helpful so I'm hoping for some pointers/advice...

DD is 16 weeks old and exclusively BF. She was on 9th centile when born and followed that curve until she was about 10 weeks old. Since then, her weight gain has slowed - I've only been having her weighed every 2 to 3 weeks but she's only put on 5oz in the last 3 weeks - an average of less than 2oz per week. HV weighed her this morning and she's now dropped 2 centiles. HV says "don't worry but take her to your GP for a check". Cue panicked first time mum fighting the urge to rush to the nearest A&E!

Now, my question is this: would I know if there was a problem with DD? She seems bright, alert, active, sleeps through the night, plenty of wet and dirty nappies etc and if I hadn't taken her to be weighed this morning I would have said everything was absolutely fine with her & wouldn't have dreamed of bothering the GP. What kind of problem could cause slow weight gain?

Perhaps I should also mention that I am well below average height myself as are both DD's grandmothers. Is it possible she is just going to be tiny?

Thing is, I've really loved BF and am concerned that, once the doctors are involved, I'll be pressured to try topping up with formula. Are there any other options I could put to the GP?

Long post - but thanks for reading and for any advice!

Mog - there are two main reasons why a healthy baby of your baby's age might seem smaller or have a slower growth rate

i) this is the physiological growth rate of this baby - how she is meant to be

ii) she somehow is not taking the amount of milk she needs to grow

Reason i) is not something you would especially want or need to do anything about.

Reason ii) is easily tackled - give her more breastmilk. Why would formula be needed? You have the milk in your breasts - she can have it more often if she wants it. She can have it as often as you want to give it! You can increase her breastfeeding by offering more 'sides' per session (not just two, but three or four) and/or offering more sessions. She might not want it, and by 16 weeks you will be in tune enough with her to understand her communication.

Also it should be said, that by the time a baby is four months old or so, the standard UK charts are starting to be of less use - it's round about this age that solely breastfed babies start to look slightly smaller on the charts...and how surprising (NOT) your HV was not able to explain this to you, and instead was more concerned with an arse-covering exercise.

If you're at all concerned, then offer more bf! You take babies to doctors when they are actually ill, don't you??

have you seen the tiny acorns/mighty oaks thread on this forum? it is FULL of mums who have been referred to medics by HVs for slow weight gain.. and their babies have been FINE.

GPs are not breastfeeding experts tho - mine told me to switch to formula "because my milk wasnt good enough" So if you get told this, do get a 2nd opinion from a well-qualified bfc eg via one of the national helplines. or LLL are v good.

my dd started on 25th centile and dropped to 2nd, she is now 10 months old, 16lb 12oz and perfectly healthy, standing on own already and cruising, everyone comments on how small she is but she is fine. still bf. don't worry.

Hi, sorry to butt in but I am most interested in this thread. My DS3 is 10 weeks old, started above 50th centile, now hit 15th. He seems healthy, alert, smiling, v good head control, lots of wet and dirty nappies, however ALWAYS unhappy, crying an awful lot and not sleeping any length of time day or night. I am exhausted (2 other children to look after aged 4 and 5) and I have started topping him up with formula. I do not know how to change things as he spends hours and hours and hours on the breast. I have no probs with sore nipples and only v occasional blocked duct (much less than when feeding DS1). Any advice much appreciated. And, Sally, you are so right: GPs are NOT breastfeeding specialists - in another life I am one and have no clue what to do .

Mummyfor3 - start a new thread, otherwise it gets confusing

Moq37 - I know how you feel! I wrote exactly the same thing ("if I hadn't been to the HV today I wouldn't be worried") myself a few weeks ago. My DD (20 weeks) started on the 25th centile and is now just below the 2nd.

First thing was advice by HV to top up with formula, although she didn't push this on me when I said I didn't want to. (There are very good reasons not to top up if you want to continue bf as it can affect supply.) Then we saw the GP (on advice of HV) who has referred us to a paediatrician. Both HV and GP agree that DD looks fine, is active and happy, produces lots of wet and pooey nappies and generally ticks all boxes except on that chart. I have decided to go along with the medical check ups so I can be absolutely sure DD is fine - I'd never forgive myself if there was a problem. But all my instincts tell me it's nothing.

I have also been down to my local Baby Cafe and would highly recommend you do that. I wanted reassurance that my latch etc was fine. The BF counsellor there looked at DD's growth chart and said it looked "regular" for a BF baby - she gained relatively rapidly for 8/9 weeks and then started to plateau. I felt much better having been there, got great support.
And lurking/posting on MN is also a big help. I read the slow growth thread which is v useful.

Please don't doubt yourself and your decision to bf! This is such a nasty problem, makes you feel that you are failing your baby in the most fundamental way. Please get help from bf experts for reassurance that all is ok (or pick up if there is actually a problem) and keep posting if you need moral support. Good luck!

Thanks everyone for all the advice and support - it's so easy to start doubting yourself when something as fundamental as growth & feeding seems to be going wrong!

I did take DD to see her GP this morning who has referred us to a paediatrician but who was supportive of the breastfeeding, which at least made me feel that I couldn't be starving DD...

Anyway, DH, DD and I are on holiday next week so the plan is that I shall spend the next week sitting on a beach while feeding like mad in the hope that DD's weight gain will be more respectable by the time she meets the paed!

Thanks again for all the support.