Slowish weight gain, frequent night waking & HV recommending baby rice at 20 weeks...help!

[WindUpBird]

DS is 20 weeks, breastfed, born on the 75th centile, steadily dropped to 50th, now dropping slightly more. He's 98th centile for height. For the past 6 weeks he has been waking AT LEAST 3 times a night, which I'm finding a real problem, but don't take it as a sign he needs baby rice!! HV said: 'I know the WHO/NHS state waiting for 6 months, but I, as a children's nurse and health visitor think that if you wait till 6 months his weight will drop even more and he won't thrive.'...She's mad, yes??
Are there any instances where it's necessary to start weaning onto solids earlier than the recommended 6 months??
BTW, I also have a 2 year-old who perfectly happily waited till she was 6 mths old so she could take the BLW route. She followed a completely different curve though: started on 75th, leapt to 98th for weight and height and stayed there.

So, comparing the 2 children I just feel that something isn't right with DS' feeding (and feel a bit disheartened that he keeps dropping through the centiles). I wouldn't mind the endless night feeds if he was putting on loads of weight, but he's not.
Have also posted similar on the weaning board.

back in the dark ages the rule used to be 16 weeks lol. rules is rules and all, but if he's hungry, feed him.
mad? nah. holding out because the rule book says 6 months and you may have a solution in weaning a couple of weeks early? that might be mad...
just my opinion.
perfectly au fait with the research about early weaning, thanks. but not so glued to the rule book that i realise the 'advice' changes with the fashion. give it another 10 years and it'll be 4 months again.
nb. even weaning at 16 weeks ds1 fed 2 hourly day and night, so i'm not so daft i think it's a miracle cure, but sometimes you have to try.
oh, and blw wasn't invented then lol.

you could also contemplate a bottle feed last thing at night.... if you were desperate to hold off on the weaning?

20 weeks is prime growth spurt time

a spoon or two of baby rice is not going to be as filling or calorific as more milk

so purely in temrs of volume, baby rice is not going to help much

if he is night waking, he needs more milk, and feeding more at night will hlep boost your supply

my bottle fed DD dropped from 50th to 25th centile , and stayed on there even after weaning at 25 + weeks

some children are smaller than others

if he is happy, content and weeing and pooing as he should , then leave him to guzzle as much milk as he will take

Hmm! As a HV I have to disagree with your HV.
I'd ask:

Is he producing lots of wet and dirty nappies? (always a good sign that adequate breast milk is going in)
Is he otherwise well?
Is he teething? (and therefore not feeding as much so waking up at night to catch up).

Firstly - growth charts are often not worth the paper they are printed on (IMHO of course). I just feel they are a tool for winding up parents of perfectly healthy babies into early weaning.

Secondly, the growth line that a baby is on at birth often bears no resemblance to the growth line they on at a year. Your DS may be heading towards being one of those tall and slim children.

Personally I'd be led by your instincts here. Baby rice is all very well but not especially calorific (and nowhere near as calorific as breast milk). Your HV displays her ignorance in thinking that weaning is the only and right answer. I'd be saying you are doing a brilliant job and don't worry too much if all the answers to the first questions regarding wet/dirty nappies etc are okay - just keep feeding.

Your DS might be gaining weight normally for him. The chances are that if a paediatrician saw him he/she would say one of two things:

Healthy baby - what's your HV going on about - just carry on. OR

sadly more likely

Healthy Baby - give him food with loads of cream and butter to get his weight up.

Lots of parents in my area wean very early - I've had someone in today telling me that she is going to start weaning her 14 week old (she is a Mum of six and weaned all her others at the same time - all fit and healthy of course). The chances are if you DO wean now there will be no adverse problems. But you'll end up having to go the non BLW route.

Go with your instincts.

From what I have read on here (happy to be corrected)....

...I understand that babies are ready at some point between 4 and 6 months are ready to take in solids. But as we can't x-ray a baby and have a look at their gut lining, we don't know which babies are ready at 4 months and those who aren't. Hence it is better that you wait until 6 months to be on the safe side.

The Baby Led Weaning studies suggest that if your baby is ready to sit up, pick up, chew and swallow a piece of food than that child's gut lining is sealed and they are ready for solids.

That said my own opinion is...there is no advantages in weaning early and there are risks hence I waiting for 6 months with my DD and I intend to do the same with my DS.

I can not understand how a teaspoon of low calorie gulp (Baby rice) could help a baby sleep, plus the reports of many baby rice having high levels of arsensic in them I wouldn't use baby rice.

As for the suggestion about introducing a bottle of forumla.

1. Why bother with the risks of formula and the hassel of preparation and the cost of buying it. Just adding another breastfed to your day will give the baby the same additional calories.
2. I read a study last week which showed that exclusively breastfed babies slept 40 minutes longer at night on average than breastfed babies who had a bottle of forumla at night. So one bottle of formula equals less sleep at night.

I would go with offering more breastmilk feeds and co-sleeping (if you don't do it already) to minimize the effect of the night wakening.

Have you checked his weight gain on the 'breastfed from birth' charts ? Breastfed babies do follow a different shaped curve to ff babies

Baby rice won't get extra calories into him, and its not like he's plummetting through the centiles or loosing weight, so I'd hang on till 26 weeks.

This is such a crucial stage in the gut and immune development that its not worth gambling with imo

windupbird Do you have the same HV as me? I posted a thread on weaning a couple of wks ago about my hv who told me I should wean dd (who was then 18wks) as she had dropped from 50th percentile to 25th and is on 91st percentile for height. What was worse about my hv was that DD is not hungry and at the moment, sleeps through from the dreamfeed. DD puts on 4 oz every wk. HV told me to wean her on to baby rice to help her put on more weight per wk than 4 oz . When I quoted the WHO guidelines at her, she told me it was rubbish and aimed at 3rd world countries.

Needless to say, I ignored her.

babieseverywhere really? thank f i didn't bottlefeed ds1 then. not heard the bf babies sleep longer thing trotted out ever. not advice as such - wasn't providing advice , just the next thing the HV will suggest - didn't ever do it myself as ds refused point blank to have plastic near his face lol.
we saw a dietician with dc3, but i only bothered going once. firmly of the opinion that you need to make up your own mind. but i do stand by the 'fashion' line in advice to new mothers. it is of course all backed up by research, but it's reasonably likely that eventually someone will come up with some research that blw babies are at more risk of x and y in their early teens, and so annabel karmel circa 2012/15 will be in vogue again - probably sponsored by a manufacturer of cute little freezable/ microwaveable pots linked to discounts with abel and cole.
initially, blw would kill babies because of the choking risk, you know.
baby rice is only really useful for thickening stuff that is too sloppy anyway. arsenic or no...

blw could kill babies? okaaaaaaaaaaay

fashion and history have usually dictated much later weaning than we have seen the last few decades.

anyway, erring on the side of caution would make me think waiting until around 6months or when a baby was exhibiting real physical signs of readiness rather than being hungrier than usual

the more i read and learn and experience, i think some babies just sleep more than others regardless of how they are fed

no no - that was what was said initially by HVs...

Thank you so much for all the posts (couldn't reply earlier as DH was hogging the pc).
Haha pudding25, maybe we do have the same HV, maybe she's on some evil early-weaning mission?!!
Yes, my instinct is to wait til 26 months (and just hope that DS is sitting up by then so I can do BLW). I did ask the HV why would I give rice when it's not as calorific as breastmilk, she just said 'it bulks them up and helps them sleep'!

He does wee loads, has dropped to 1 or 2poos a day (so don't know if this is 'normal) since I cut out dairy as he was pooing 8-9 times a day! I've always been concerned about his feeding, as I've never felt he's fed enough (and I always seemed to have loads of milk)

I don't think he feeds enough, I've been wondering if he possibly has silent reflux, though I guess that is another thread!

Yes, cmotdribbler he is on the breastfed charts (whereas 2 years ago DD was on the old-style charts).

dd2 had that as well lol, but i won't bore you
i find cultural differences in childbirth and childrearing endlessly fascinating - mine were born in 3 different countries, and each one is certain they have got it right, whatever the WHO guidelines say.
whatever works for you and ds is the right way to go.

windupbird my ds dropped centiles from just under 25th at birth, then up to 25th then from about 4months down slowly to almost 0.2, now on solids (meals not babyrice, he is 8months - I don't do blw btw) he is up to 2nd (well that was a month ago, have a feeling he is on his way to 9th).

He has always been lively and super active and alert, but i too had the feeling he was not eating enough. specifically i felt that he did not increase the amount he took as he got bigger. he has never fed for more than 10mins at a time. he is efficient,butI think he needed a bit more. He turned out fine though, so do follow your instincts.

the final drop to 0.2 was in what I call the hunger gap: milk not enough but solids not et giving enoug calories. incidentally the infant feeding expert at the John Radcliffe in Oxford (who weighs ds before he sees his consultant there) advised squirting breastmilk in everything rather than butter and cream, which worked for a while. Not needing it anymore.

Windupbird,

My DS1 started life on the 98th centile for height and weight and by about 8mo, he was still on the 98th centile for height but had dropped to the 50th for weight. I wasnt living in the UK at the time so wasnt subjected to any cripcrap about failure to thrive... When all said and done, he was a long, thin baby who has now become a long thin child. For all the fuss they're making about child obesity, you'd think they'd be glad to see that some children are naturally very slim.

Has he actually lost weight WindUpBird or is it that he just hasn't gained much?

Weight gain in exclusively breastfed babies often plateaus around this stage.

If you didn't know about the weight/chart, would you be otherwise worried?

MY ds did exactly this. Something like less than an ounce a week from week 16 to 22 (IIRC) and then whoosh, it shot up in the last couple of weeks on breastmilk alone before I started BLW with him.

I waited 6 months with my DS (bfed) and this was no problem.

My DD however - when we got to 20 weeks (bfed) she had a major growth spurt, up 7-8 times a night for bf. I resisted weaning and carried on just bf. By 6 months, she was only up about twice a night so basically the frequent waking reduced without weaning. I have now been weaning a week and I will admit that this has lessened the 2x waking to 1x or 0x per night.

I would like to add that my DD has not been weighed since when the HV used to visit at home when she was v young. I have never taken her to baby clinic, I just look at her myself and think she is OK. And my mum looks at her and thins she is OK.

Are you or your partner long and slim? Mine started way up on the charts but started dropping/going up when their natural body shape took hold (2 started up and stayed up, they are way above average in height, 2 started high up, went a long way down, they are both teeny now, i'm 5ft, dad is 6'4)

I can understand a month either way in regards to weaning if hunger is problem and solids will bulk up and satisfy for longer, esp in a ff fed baby

BUT if it is just slow weight gain, then you can't get any more calories than with breastmilk, veg/fruit/rice calories are minimal and pointless

As said before, if without the chart you aren't worried, then I doubt there is anything to worry about

I've got a complicated breastfeeding situation (see post about committed boob-striker) and have been advised by the paediatrician to put my 19 wk boy on solids. I've been very slowly introducing vegetables (he hates the rice) and only use this to supplement feeds - so I give one tablespoon a day after a milk feed. My point is that I would much rather not do it - I'm only doing it because I'm really struggling to feed him at all. He wets 3 nappies a day, 4 if we're lucky, and has dropped to 25th percentile in both weight and height. I followed my instincts and feel that this is the right thing to do my circumstances even though my ideal would be to have him thrive on breastfeeding only. It's so hard to know if a breastfed baby is getting enough - only you can read the cues and assess if early solids is necessary. We know it's not ideal, but unfortunately babies don't always follow the instruction manuals.

THank you, all your posts are reassuring. I guess he is just going to be tall and slim (and not a little handsome ) . I used to be tall and slim and so did DH...
I suppose my main gripe is that he is feeding so often at night, not so much in the day and not really gaining much. He is now gaining about 2.5oz a week, so he is gaining, just not lots, so that's reassuring, mawbroon