slow weight gain

[amyce]

I have only given ds breast milk but he is not gaining weight as he should - was 6lb12oz at birth, is now 9lb10oz at 13 weeks and has only gained 1oz in the last 3 weeks. Because I'm concerned about allergies (family history) and don't want to introduce formula unnecessarily my GP has referred us to a nutritionist at the hospital to discuss our options. Obviously I'm v. worried and only want to do the best thing for my baby. He already has eczema so I don't want to do anything to make it worse. Has anyone else been in this situation? I've seen an NCT breat feeding councellor and I don't seem to be doing anything very wrong. Has anyone got any suggestions / advice. Please tell me I'm being an over-anxious 1st time mum...

This is a slow weight gain, amy, but it could be normal for your baby.

If it's thought your baby needs more calories, then (of course) the 'best' calories are in breastmilk - so feeding more often, and checking that milk transfer is optimal, are the obvious steps. Effective bf happens when the baby is well-positioned and able to get the milk efficiently.

Tell us more about how often your baby feeds and how you feel the feeding has gone since the beginning.

Tiktok's the expert, so the extra info she's asked for I'm sure will help in getting you the best advice.

For what it's worth, ds was EXTREMELY slow to gain weight, although he never actually lost weight (apart from the intital and very large dip at birth): I think he was about 6 or 8 weeks old before he regained birth weight and he was 6 months old (I think) before he doubled his birth weight.

Reiterating tiktoks' point: we eventually worked out that he was following his OWN growth curve. He was always happy, healthy and alert, with plenty of wet and dirty nappies. At the end of the day, that is the most important thing.

With the help of the breast feeding support group and the midwives who ran it at my maternity hospital, I had the confidence to continue to b/f for the full 12 months.

What helped me was being encouraged to give him EBM - for a while, for every second feed. That way we could see that he was having plenty, and the fact that he was still only gaining weight slowly just meant that he must have a fast metabolism or whatever! We did have some problems with the latch, which we worked on, and with the little tike only pretending to swallow, but the supply of EBM gave me the confidence that he was definitely getting enough.

In the end it was the consultant paediatrician who told me to stop "having the faff with all the expressing" and go back to plain b/f, as I had a healthy baby who was just following his own chart. (I actually kept going with the expressing as I was going back to work when ds was 4 months old and it was useful for us both to have the habit and to have the stocks in the freezer).

If they've taken blood tests to rule out anything more serious and if your baby is happy, healthy and alert, plenty of wet and dirty nappies, not dehydrated (skin is plump and soft and doesn't wrinkle when you pinch it), then you should try to stop worrying. Ideally you should consider STOPPING getting him weighed and use your own observation as to his state of health instead. I never actually succeeded at that (until I went back to work and it got increasingly difficult to take him along to be weighed): I claim I wasn't WORRIED as such, but that I had a morbid curiousity about his weight. But at the end of the day, what does knowing his weight achieve??!!

Ds is now nearly 2 and half and I don't have a clue how much he weighs. But he's healthy!

Thanks for your comments, it's wonderful to have your support!
I've been keeping a careful eye on him. I think his problem might be that he's a lazy feeder - he loves being on the boob and would be there all day if he could, but doesn't actually feed for all that time, just messes around. He's v. difficult to settle for daytime naps and because he's so small I think I have fallen into the trap of offering the breast whenever he's upset / won't settle in the hope that he'll take an extra few calories. So today he's hardly slept at all and it's been really difficult to keep him awake to take proper feeds. Maybe he's fallen into a snacking habit that means he's getting too much foremilk. Does this sound sensible? How can I change this pattern? He has a bath and goes to bed at 7pm and goes to sleep on his own very well. I usually wake him at 10pm before I go to bed for a feed and he'll normally wake for another at around 4-5am. Again though, he's pretty sleepy for these feeds. Should I wake him for more feeds?
The NCT counsellor says that the position is okay.
I was reassured to hear from you, JanZ and I'm glad your son is doing so well. Mine does seem quite 'normal', and has plenty of wet and dirty nappies. All the same, I'd rather see some meat on his bones!

Actually, I thought doubling birth weight at 6 months was supposed to be norm.... I know that DD just scraped in. And she's a pig; eats like a horse.

Amyce: if your DS had too much foremilk he'd have lots of green poops & nappy rash with it. All that "messing" about you describe could be good; it means he's hanging about, latching on here & there to get the drips of fatty hind milk that are made slowly when your breasts otherwise feel empty (unlike the voluminous foremilk that fills up breasts in the morning). That he sleeps so well suggests that he is satisfied; his body thinks it's getting enough. I guess there's a chance of a metabolic disorder, but that would be so extremely rare. Otherwise, I wondered:

1. Is he generally happy?
2. How long is he? Is his weight percentile close to his height percentile? You can guess by looking at his clothes sizes.
3. what is his weight percentile? I guess his birth centile was around 9%? My husband's family has small tiny runt children who grow into big adults. Do you or the babe's dad have a similar family history, or are you or your DH petite?

I have a bit of a theory that children find their own curve, which may be unrelated to birth weight - ds was an elephant at birth - nearly 10lbs, but then lost a lot of weight, and didn't put it on for ages. He didn't double his birth weight until he was 1, and as for tripling it by first birthday which is the other guideline....well he still hasn't. But, he has progressed very nicely just under the 25th line, so I think he was just born at the wrong weight! I tend to think that if the baby has lots of energy and is alert and doing the other things it should do, then you shouldn't be too hung up about it (oh how easy it is to say - I remember when I saw baby scales on special offer in Mothercare - I was SO tempted, but knew it would turn me into a neurotic wreck!!!).

Just a note...

I agree with all the below, but I noticed that when I was rushing around everywhere, my milk was not as good a quality as to when I was well rested. eg. sleeping when baby was sleeping.

Best of luck

'Snacking' - short, frequent feeds - is a normal way to feed. Forget about foremilk/hindmilk. That's only a real issue if there are other symptoms (colicky crying, failure to thrive, never being satisfied on the breast). You can maximise your baby's creamier milk intake by experimenting with keeping him on one side only for several 'snacks' on the trot instead of switching him, but that's just an option, not a necessity. Most babies happily sort out their own 'balance' of the feed without 'engineering' it in this way.

Yes, you could offer him more feeds if there is time!! But again, nothing you say makes me think this is a necessity.

There's no evidence that not rushing around has any effect on the quality of the milk, sorry, Hunniebunnie! It might have an indirect effect on the quality of the feeding - if you aren't rushing you are more likely to give your baby time on the breast. But direct relationship to the 'goodness' of the milk? No - not a jot

My ds also had very slow weight gain, we were referred to the hospital for blood test etc which all came back fine. He was a happy content little baby, just didnt put weight on very quickly, but did everything else he should have been doing. I too was pushed into feeding early, which I didnt. I also was against giving formula. Needless to say I have a very healthy, happy, intelligent little man (now 2.6yrs).

Please dont worry if you feel everything is ok. If you want to go for the tests for peace of mind (I did) then go but do what you feel is right. I know it is hard when you are a first time mum, I had everybody on at me. One thing to keep in mind is how you were as a baby, my ds was the same as I was as a baby, and my sister and brother, we were all small with slow weight gain. When I was a baby and my mum had all the same worries a doctor told her not to worry, a baby can only develope in stages and not all at once and it may be your baby is developing in different ways and weight gain will come, I have always remembered this.

I now have a dd who is different from ds and gained weight slightly better but I was determined not to go down the same road and dont go and get her weighed, even though the hv is always trying to get her on the scales.

God I think I have rambled here but I do get annoyed when all they seem to care about is weight.

Good luck

I know you are worried, but your baby sounds great. A wonderful sleeper and contented. Is he alert when he is awake but not crying? In that case I would guess he isn't hungry or dehydrated and that's all that really matters, surely? He might just be a naturally slim baby - my skinny friend (still wearing size ten at 9months pg) and her skinny husband had three skinny babies, totally breastfed and her HV etc went on and on at her because they weren't putting on enought weight. She now has three skinny kids all at school, all terrifyingly full of energy and top of their class.

I'm really relieved to hear from you all. DS does seem pretty cheerful in himself, and has plenty of wet and dirty nappies so I think I should try not to worry too much. His length and head circumference are on the small side of average but he is growing and is in proportion which is encouraging too. I plan to stay close to home for a while and really concentrate on my baby, making sure that I pay him plenty of attention and spend loads of time feeding and playing together. I do tend to rush around and try to achieve everything I used to before I was a mum! Hopefully the doc at the hospital will rule out anything serious and he'll be fine. Thanks again.

So there are other slow gaining babies out there. I felt like CS was the only one. 7lb 1 at birth then at about 6 weeks her weight gain slowed down. I think it was because she stopped comfort feeding as much. The HV was using thrive charts and I kept thinking of changing to formula. I'm glad I didn't. She's 1 in a few weeks and still breastfed. Shes a small 1 mind you, must be around 17lb now but she's almost walking and into everything. I could quite easily have swapped to formula for peace of mind but in the end I don't think it would have changed her weight gain. Thank you for showing me she's not the only small baby ou there.

My friend's son (bf) was born a little small, but then had real weight gain problems for almost a year staying on the 10 % line. My son (bf) was born average and got super big and fat almost immediately and went up to the 90% line. My son is now 27 mo. and hers is 32 mo. and they are now totally average and caught up with their age and you would never know that either one had ever been super big or super small. We feed them similar foods and have similar attitudes to upbringing. I think that there is far too much fuss about weight in the first 6 mo. and it makes mothers over anxious about something that is really not worth worrying about.