lack of weight gain in exclusively BF baby

[mamd]

my 19 week old dd is exclusively bf and although is meeting developmental targets is not gaining weight quickly and in fact has lost couple of ounces in last week.advised by health visitor to top up with formula. of course priority is dd but feel i have been doing the bf bit to no avail and wonder why i haven't been able get her weight up - what is wrong with my milk? has anyone else had a similar problem?

Nothing is wrong with your milk and you dont need to top up. Personally I'd stop going to get her weighed if she is otherwise alert, wet nappies etc.

Was she weighed by teh same scales, same clothes, same time of day? Was she rechecked on other scales?

Hi mamd - can't really offer any advice but just to let you know that you're not the only one. I've been there too. DS2 is now 8 months but from birth to 16 weeks he gained weight beautifully (often 9oz per week!) and then from 16-23 weeks he gained a grand total of 3 oz, after which point I started weaning him and his weight started increasing again. That said during the time when his weight plateaued he dropped from the 9th centile down to the 0.4th and has stubbornly stayed there ever since! Personally I find it quite upsetting when people make comments about his small size and I understand your feeling about doing bf to no avail as I really felt I had let him down. That said, the hv's etc are so keen to recommend formula but I don't really think it helps since my DS2 actually drinks less from a bottle than direct (as determined by weighing him on accurate baby scales pre- and post-feed). I'm interested to hear from others though too.

WHich graph did they use? Ones for breastfed babies or the mixed one?

was there anything unusual about feeding this past week? Are you feeding on demand? Is your DD satisfied after her feeds?

The experts will be here soon, I am sure, but I should think it can be normal for weight gain to slow around now. (though I don't think it's normal to lose.)

If you think your supply is an issue, there are ways to boost it, such as expressing and taking herbal supplements like Fenugreek.

I think by now your supply should be pretty well established though.

There is probably no real need for formula top-ups but it's really up to you if you want to try that or not.

My 24 week old DS is a slow gainer and I always think it's to do with my milk, but I guess I'll never know for sure. (though am convinced he'll gain once he is well onto solids ...)

Please don't feel that your breastfeeding has been to no avail - it has been the best food for your dd and will continue to be so if you want to continue.

mamd Your baby probably needs more milk that's all. It's stupid to give formula, - why not just give more bfs?

How are you feeding? Routine or demand fed?

Are there plenty of wet nappies?

Your little one having lost 2oz is a ridiculous reason to top up. There could be a whole host of normal reasons for this.

Did the same person weigh your lo? Were they the same scales? Was your lo wearing the same things? Was it the same time of day? Was it before/after a feed for any of them?

If worried call a bf helpline BEFORE topping up with formula.

Good suggestions here - if all we are worried about is calories (and there could be all sorts of scale-related reasons for the weight loss anyway) then you have them in your breasts

Feed more often using at least two or even three or four breasts at a session if your baby accepts them.

Your milk will be fine, by the way. Quality of milk does not vary between women.

Agreed there are some good suggestions. Mamd, I felt I had to reply to your post as my ds lost weight between weighings sometimes, and has always been low on the centile charts. He was also exclusively breastfed like your dd. I resisted advice to give him some formula and I want to reassure you that he is now a strapping one year old.

It is such a normal time for their weight to plateau and 2oz is tiny....easily affected by scales/nappy/feeding/cold that day or the week prior. I had no idea top ups were suggested at ths stage, BFing is obviously established and going really well

thanks for all of your advice and comments. dd is fed on demand and nappies are always wet so I did feel that things were going well. its sometimes hard as first time mum when HV giving advice to know what to do even if it goes against your natural instincts. was not aware also that the weight charts could be for formula fed babies so will look into that. thanks again

Charts in use in the UK track the growth of babies using data sets from breastfed and formula fed babies, whose feeding was undifferentiated.

I don't think the chart is relevant here at all. On a breastfed only chart your baby's growth since birth might look even slower - it's not until 5-6 mths that there is any real difference when the breastfed babies' weight tends to slow down.

Being ruled by the chart is a mistake whatever the chart!