Slow weight gain - I have the HV's advice, now need advice from MN'ers!

[thomasina1]

I know that lots of you have been here before!

DD is 4 months and has gradually dropped from 50th to 25th to close to 9th centile. She is very alert, seems very well, lots of nappies etc. Slightly depressed fontenelle if that means anything?

She has 4-5 feeds during the day, I wake to feed at about 11pm then she sometimes wakes for another night feed but sometimes sleeps through until about 8am. So 5-7 feeds in 24 hrs. HV has suggested fitting in another feed - perhaps waking her earlier in the morning . I'm reluctant to as she's in a good routine now (not imposed by me!) and also I'm not convinced this will encourage her to take more milk overall.

Any advice/reassurance would be very welcome!

I've been there before, so know how you feel. I think that if it were me, I would try to fit in another feed if you can during the day. I don't think it has to be early in the morning by any means, but more feeds can't be a bad thing and during the day must be easier for you. At that stage, I think I was feeding every 2-3 hours or so?

Hope that helps.

My DD and DS were similar piled on weight till about 3 months then slowed down to the 25th/9th centile and they were both fine. If she's got lots of wet nappies there probably isn't much to worry about.

A depressed fontenelle can mean dehydration though- are you breast or bottle feeding? If you're bottle feeding maybe you could give some water- if breast feeding maybe an extra feed when you notice it- this is what I used to do if mine had slightly depressed fontenelles and it sorted it out.

Thanks violeta, I will try and fit in an extra feed, even though she rarely cries for the feeds she is having at the moment!

bordergirl, I am excusively brestfeeding. That's a good tip about feeding when I notice the fontenelle to try to get her hydration levels up. I don't think I am drinking enough myself - could that be affecting my milk does anyone know?

I don't know if that could affect your milk supply but my hv said it was a good idea to get a big drink of water or squash before I sat down to breast feed and that was good advice as I'm not good at drinking enough.

It sound like your milk supply is fine though if your dd is alert, well and happy.

HVs can sometimes be a bit obsessed with weight gain I think. The centlile charts are based on bottlefed not breast fed babies. Apparently breast fed babies don't gain weight in such a steady way and have more ups and downs in their weight curves.

Fontanelle thing is misleading - healthy babies' fontanelles go up and down for no real reason at all, and a truly depressed fontanelle is a sign you would not see without other signs of serious illness.

If the mum drinks according to thirst she will be fine - whatever, it makes no diff to her milk supply either way, just to your own comfort.

Charts in the UK are based on babies whose feeding was not differentiated, and they only differ from the soon-to-be-introduced 'breastfed charts' from about five months onwards.

Thomasina - maybe your baby would benefit from more breastfeeding. Some laid back babies jog along quite happily, but 'ask' for less milk than they could do with. 5-7 feeds in 24 hours is not a lot. If you really don't want to fit in another feed, can you offer a second, third or fourth breast at most feeding times?

Thanks tiktok and starlight. Yeah, I know what you mean about the routine

• it is probably more habit now (for me!). She rarely does "ask" for food but I will try and feed more. I think I will do more "cluster feeding" from late afternoon onwards as that is a time when she is awake. I will also try an extra feed in morning before she goes down for her nap I think.

Thanks for the comment on my fluid intake not affecting supply - I thought that was the case.

I always offer (and she usually takes) both sides, but will start offering 3rd & 4th breasts too. Like the idea that I have 4 breasts