Help! 15 week old bf ds slow weight gain / formula top up?

[lactomum]

I'm usually a reader rather than a poster on mn, but am desperately in need of some advice re my 15 week old exclusively bf ds.

He weighed 3.74kg (8.2oz) at birth and is generally a good (if easily distracted) eater. However, his weight gain has slowed quite a bit over the last few weeks so that he is now just on 6kg and is on the 25th percentile rather than the 50th percentile that he was on at birth.

I am in South Africa for 7 weeks visiting family and am worried that the busy last few weeks before arriving here have had an impact on my supply / his weight gain. I have been feeding him on demand every 2 to 3 hours, but it is quite difficult to get him to stay on the breast for more than 10 minutes, and perhaps I should have been trying harder. Should I think about giving him a bottle of formula in the evening to top him up? I enjoy bf and would like to bf exclusively to 6 months, but am worried that the poor thing is not getting enough to eat (although the hv didnt seem too concerned when I saw her two weeks ago). Also not sure whether the formulas available here (Nestle NAN etc) are available in the UK and whether this would be a problem when I go home.

Sorry for long post. Any advice sincerely appreciated!

Also meant to add that while he does quite a bit of finger sucking, he is a very alert, smily little baby and doesn't seem hungry or very thin.

If he is healthy, developing normally, plenty of wet and poo-ey nappies, then I see absolutely no reason why you should top up, ans no reason why you should worry about his food intake.

The weight gain of a bf baby does usually slow done after the first three or four months, and it's very normal for a baby to drop percentiles as long as they are still continuing to gain weight (dropping percentiles is normal for an otherwise healthy baby; losing weight is not normal).

All of my babies started off at about the 5Oth percentile, dd1 went down to the 10th percentile by 6 months,; dd2 went below the 3rd percentile by 6 months.

Feeding every two or three hours is fine - you can trust your baby to take as much milk as he needs.

Agree with belgo - perfectly within normal for a baby on the 50th to slow so he is on the 25th. Nothing wrong with that at all. It would be a shame to give formula when your baby shows no signs of needing it, when your plan is to bf excl.

Guidance in the UK is that babies who show a sustained drop of 2 or more centiles need assessment. Most of these babies are fine, as well! But no one normally need worry about a baby dropping one centile (50th to 25th is one centile ie one line on the chart).

Babies who are established breastfeeders dont need to be encouraged to stay on for longer - you can leave it up to them

Not sure if this is relevant but they are now changing the centile growth charts in the UK so as the growth curves follow breastfeeding growth patterns not bottle fed ones.

I am a volunteer support breastfeeding consultant and when our group of supporters re-plotted our childrens growth on these charts we were amazed. All of the "worrying" cases were fine and those that had topped up had pushed their children up a centile!

As long as the baby is happy, alert, gaining weight and still producing wet and pooey nappies I would not worry.

allstarprincess - yes, the charts should be in use everywhere now. They became available in May this year. Babies' growth starts to look different on the charts from about 5 mths on - at 15 weeks, the OP's baby will be more or less the same on both.

I remember those charts were already available on the internet a couple of years ago when my dd2 had just dropped off the bottom of the standard charts. Fortunately the doctor looked up the new charts and plotted dd2's weight, and she was just about within the healthy range for a bf baby:toddler.

It was stressful time though, especially when I compared her to all the cherubic babies around; now at age four she's still very slim but perfectly healthy.

Thanks for all the responses! He is happy and still gaining weight (although a bit slower), and has a lot of wet nappies. Recently he only has one (admittedly big) dirty nappy every other day, but the hv said that was okay - do others agree with this?

The info re the charts is helpful, but I got a bit worried when I looked at the WHO charts on Kellymom which seem to say that breast fed babies should have doubled their birth weight by 3-4 months, and we are somewhat off that. It is pretty stressful, especially if you compare to formula fed babies, which all seem so huge, and their mums that come sometimes seem a bit self congratulatory on the size of their babies. Guess I just need to try and reign in my alpha tendencies and focus on him - if it weren't for the results of his weighings I wouldn't be worried as he seems pretty contented.

lactomom- it sounds like your ds is doing fine! As you say, if it wasn't for the weighings, you wouldn't be worried.

Many mothers are very congratulatory about their baby's weight but I've come to the conclusion that babies like mine are just not supposed to be 'fat' and bouncy. All three of mine took a year to double their weight, and all three are healthy.