To supplement or not to supplement?

[TrixieBelden]

In a last-ditch effort to not lose my mind, I thought I'd ask the Mumsnetters...

DS is EBF. His weight was in the 25th percentile when he was born, and now, at four months, he's down to the 2nd percentile. The HV, predictably, is alarmed.

Now, DD who is now 5 followed an almost identical trajectory when she was a baby. We were in the U.S. at the time, and she was subjected to a battery of tests to make sure she didn't have a thyroid problem. She didn't, but the paed instructed me to top her up with formula and start her on solids at 5 months (which is unusual in the U.S., where 6 months is the norm).

DD is still very small for her age, but very healthy: rarely unwell, very energetic, bright as the proverbial button. Her weight isn't even on the percentile chart.

DH, I should mention, was also very small as a child (we still have the growth charts his mum kept) but is now over six feet tall.

So my dilemma is: should I top DS up with formula now? He doesn't look skinny; he wets at least 6 nappies a day and does anywhere from 1-5 poos. He's happy, and sleeps well-ish (8pm-3am, then 4am-7am). I'm totally undisciplined about feeding him -- whenever he fusses, basically, which isn't often, and the feedings work out to be about every 2.5-4 hours (closer together in the evenings). I wouldn't worry, but on those rare evenings when he gets bottle of expressed milk, he always downs at least 8 oz, if not more, and I have no idea if I produce that much in an evening's feed.

I can't bear the thought that he might be hungry. But if he were, he would cry, wouldn't he? He's not much of a crier dream baby, really but given how much he'll drink from a bottle, and the drop in his weight gain...I can't stop worrying.

Advice? Thoughts?

Trixie, the usual guidance for being concerned about weight is when a baby has a sustained drop of two or more centile lines. All that means to the HCP (in the absence of any other signs of illness) is 'lets see what's up with this baby's feeding'. The majority of babies in this category (the ones who've dropped two or more centiles) are fine. They are just that way because that is normal to them

I am not sure why your HV is 'alarmed' - has she explained why? Your family history is reassuring, and it sounds very much that you are responding to your ds's need to feed, and that he is healthy, active and happy.

If it's thought your ds needs more milk, then he can have it - from your breasts. He's not feeding very often, really - about 6-8 times in 24 hours, from what you say, so it could be easy enough to consciously feed more often, perhaps offering him a third side each time, after he has had 2 breasts?

Can't see any reason to give formula, though but check back with your HV for why she is so worried.

I wish I could get a straight answer out of her! She suggested I see a dietician and asked me if I was depressed -- as well as telling me to top up with formula. I asked why and she said something like "We see a lot of busy mums who just need a little help," which is not only maddeningly vague but makes me want to ask her for some Valium and see what happens.

In any case -- thank you for your professional perspective! I can certainly try to feed him more. He tends to doze off when I feed him so I'd have to wake him up, which I hate to do, but needs must.