Big baby, very fussy at the breast, not gaining weight well - should I persevere?

[porcupine11]

I'd love to hear what other mums of big babies did.

DS2 was 10 lb at birth, 98th centile, but at 12 weeks is almost down to 75th. He's breastfed and has always been very screamy/fussy during feeds in the daytime. Sometimes he feeds for just a couple of minutes, comes off upset and won't go back on.

If I try to offer the breast when he's not showing hungry signs he screams at it as if I've insulted him, and sometimes even when hungry I have to give him a few sucks on a finger to calm him down enough to accept a nipple. I do have a fast flow, but that shouldn't upset him before a feed?

Nappies etc are fine - he's recently started pooing once a day rather than once every two days - but the poor weight gain and the fact he seems quite miserable a lot of the time worries me (he does look healthy as he was so big to start with). His priority seems to be sleep, and he only wakes once or twice in the night to feed (though is more relaxed about it then and feeds better and longer).

In short - I have plenty of milk, but he doesn't seem that interested. The two times he's had expressed milk in a bottle, he has drunk it all without any fussing or screaming. But I can't express more than 1 bottle a day as I have a toddler who already isn't getting enough attention (and used my breast pump as a sand shovel today).

A lot of people have told me their big baby was miserable until put on formula, at which point there was a miracle improvement, but I'd feel quite guilty if I didn't offer him the same no of months breastfeeding as DS1 (which was 11 months). Is this silly? I can't work out which is putting his interests first - trying to improve his weight gain and mood with formula, or persevering with breast milk.

I'm sorry, I can't give very useful advice as my biggest baby was DD (11lb 10oz), 2nd baby, who did drop a bit, but, like your DS, this wasn't a concern as she was so healthy-looking.

Unlike your little chap, however, she fed like a dream; no fussing or 'snacking,' just a quick glug lasting usually less than 20 mins, then sleep for a few hours, waking up to repeat the pattern. She did have evening colic, though.

DS1 was 10lb 5oz, and didn't drop in weight, but seemed to feed constantly and also had the hideous colic, plus woke several times a night.

DS was different again but was only 8lb 1oz so doesn't qualify as a big baby afaic!

I suppose my point is that any problems your DS is having aren't necessarily related to his size; as I said, my most contented and easily replete baby was the biggest.

I'm hoping a bf expert will notice your thread, so am bumping for you.

I wouldn't listen to the 'experts' telling you to use formula without looking into other possible solutions first, though - maybe something in your diet is affecting him?

porcupine, sorry it's being a bit miserable

I think this is one of those situations that would benefit from a proper, full conversation and possibly face to face session with someone who knows what to look for and to ask about and how to listen to you.

I don't think the size of your baby is anything at all to do with this, BTW. In any case it is well within normal for a baby to drop from the 98th to the 75th and even quite a bit further, too.

However, his mood and behaviour need figuring out.

So not sure myself what might be going on here, sorry.

One thing I'd explore is the fast flow you talk about - and it's certainly possible for a baby to become tense and stressed with this, and to associate this with bf and to become fussy before he gets on...in anticipation, if you see what I mean.

Just wanted to say that I've struggled with a fussy eater and low weight gain (was 25th down to below the 2nd).

It is soul destroying when they seem to find feeding such an insult, but I've preserved and for the last week (17weeks) things have settled down nicely. I was just on the verge of switching to exclusively expressing. How is he with dream feeds, if OK, maybe try to do a few more of these.

None of the hcp's seemed worried. I just made sure that I ate enough (i was skipping meals and not drinking much, not on purpose just forgetting. This helps you to have at least enough energy to face the day), I didn't try to prolong any naps (if she woke after 30mins which is about 2 hrs between feeds, which was most of the time, she got fed and a new cycle started) and as long as she was producing wet nappies I tried not to worry. That didn't stop be from being really emotional about it, especially after a bad night.

Maybe a possible thing to look at is silent reflux, but I personally don't know much about this. He might have come to associate feeding with being in pain.

I do remember there being quite a big section on fussy eaters on the kellymom website, but I did find a lot of contradictory information out there. Some saying giving a bottle is the start of the end, others saying getting food down them is a must. I just went with, if producing wet nappies, then food is getting there and preserving. Depends on how you'll think you'll feel if you switch to ff.

Otherwise, good luck either way. hth

Just a thought, but maybe the ff babies were happy because they were on bottles and not due to the f content. (my completely untrained/unqualified opinion though)

Thanks for all your messages, I looked at fast flow issues on kellymom and I've had some success in giving more relaxed/longer feeds over the weekend by lying down for each one.

I did think about silent reflux, especially at first, but it doesn't seem to make sense if he didn't have it at night, so maybe the fast flow is the thing.

Quite a bit of this sounds similar to my experience with DS (now 7.5 months) who was born 9lb 8oz: screaming if offered when he wasn't hungry, and crying during the letdown. I finally concluded it was almost certainly due to a strong letdown, and I must say that I found it very hard going. I often felt I was forcing him to breastfeed. Although he dropped some centiles, he was always above the 50th and couldn't have been any healthier.

Some things that helped: feeding him the second he awoke from a nap (when he would eat properly) and walking/ jogging him almost to sleep when he started crying and then latching on again.

Now for the good news: it gets better. Since about 5 months (long I know. It's quicker for other people, like ClimberChick above), everything has been FINE. No problems and still an extremely happy healthy baby. I'm really glad I kept it up

Thank you zackles, I will definitely try the feeding straight after a nap, as he feeds so much better in the middle of the night. At the moment I have to trick him back on to the breast several times during an already short feed by getting him sucking a finger/dummy then quickly transferring to nipple.

It's so good to hear they can improve at 4/5 months - maybe they get better at coping with the letdown when they are bigger.

I was almost on verge of cracking open the formula this morning but will reset my deadline from 3 months to 5 months I think (and assuming weight doesn't suddenly plummet)

Might sound a bit odd but would you consider wearing no perfumes for a few days? That includes deoderant and scented soaps. DS seemed to like it when I was a bit stinky and feed better then - i.e. at night rather than in the morning when I was freshly showered.

That's interesting - no deodorant I can do now the heatwave has gone

I think DS just liked to smell the milk / my armpits ... !

I just washed with water a few times each day - and used a pitroc instead of deoderant

FWIW my DS was 10lb 6oz and 'only' dropped from the 98th percentile to 92nd

But remember many of them 'catch-down' with the average baby so it's not a problem. But it would be nice for your DC to seem happier...

Oooh and do you find he fusses more with one boob than the other - I had 'reliable' right boob and 'lovely' left boob. Right boob he could always latch on fine but didn't seem to enjoy the milk as much. Left boob was harder to latch on but seemed more delicious

The only point when he got really grumpy about my nipples was when I developed thrush - but it doesn't sound like you've got that. it was on my right boob and suddenly got painful again. Biocidin forte tablets sorted that out for me/us...

Honestly sounds like the fast let down which is the problem rather than being a big baby.
You could try feeding laying on your back with him tummy to tummy on top as this helps babies to feel more in control amd gravity slows the flow. One other trick you could try is direct and strong pressure on the breast above the areaola during letdown, it can help to slow things a little, but make sure to take the pressure away once the letdown has slowed a little.
If you have an abundance of milk, then the weight thing may be because he is getting more foremilk, so you could also try block feeding to make sure he gets plenty of hind milk. Explosive nappies which have a greenish tinge and have few or no milk curds can be a sign of more foremilk.
Most babies do have a change from a frequent to less frequent stool pattern around 6-10 weeks, so may just be that.

Faddle I tried this for last feed yesterday night and it worked very well, he emptied the breast more than he's ever done!

And yes! His nappies had absolutely no milk curds until 10 weeks old, when he started to settle down a bit during the day. I think the fast letdown/foremilk must be the thing - thank you all for helping me get to the bottom of this, and all the tips