Breastfed baby is underweight pls help

[melissa1215]

Hi everyone

I have a 13 week old baby boy, I took him to be weighed today assuming he would be a healthy weight as I've had no concerns...

He was 10lb 1oz born, dropped a significant amount of weight and was jaundice so I was feeding on demand and he had been regularly putting on weight since. At my discharge from the midwife at 6 weeks he weighed 10lb 9oz.

Over 7 weeks later he is 11lb 4oz and the two health visitors at the clinic that weighed him were very concerned, questioned my feeding routines and said he is underweight

He's very alert, very strong and hitting all of his milestones. Honestly I thought they were going to say he was overweight if anything.

I feed on demand throughout the day, I also express and store milk and know my letdown and supply are really good. He has his last feed at 23:30 and will usually sleep until 5:30, sometimes he does wake up for a feed but the majority of the time he sleeps through, I was told this is wrong and he should be waking up more

I'm really scared. All I seem to do is feed him, the clinic gave me no other advice other than to come back again next week. He has regular wet and dirty nappy's and latches on really well, though we've been told he is teething so he is getting fussy now and then but generally feeds well (or so I thought)

Anyone have any ideas where I'm going wrong?

I wouldn’t worry about it (easier said than done), it sounds as though he’s fine.

Much of it could be "catch down" I had 3 large babies starting around 90/95th centile by 3 months they were each on completely different centiles and by 9 months they were on 25th/60th/98th - all tall/long though.

The youngest was just incredibly lean and as a teen still is.

@RandomMess thanks for the reply! He's super long, we were all talking about how long he is. It's just really discouraging and worrying, all of my family said there's nothing to worry about but I felt so scared. He really didn't seem underweight and I'm feeding him so much already I can't see how he hasn't gained much

@funmummy48 thanks for the reply, it's just a shock. He really looks perfectly in proportion but I'm panicking now

Does he sleep in long stretches?

My only thought would be to wake up for an extra feed but I never did that, I think youngest probably only got weighed 3 times - birth, 6 months, 12 months didn't have time with 4 DC, she was my skinny ones, never got chubby legs!

I have two tiny babies, both only a little bigger than yours at 20 weeks (so sitting around the 2nd and 9th centiles), whose weights no one is super bothered about. We just assume they are small babies. We are keeping an eye on it with fortnightly weighing.
Six hours is a long time to go between feeds for such a wee baby. One of mine can go down at 8pm and wake at 5am happily, so I will wake them to feed at 12 am or 3am.

Is your baby following a growth curve? Has there been a drastic drop of centiles?

@Isawthathaggis they said he dropped 2 centiles? He had steadily been gaining weight and I hadn't changed his routine but somewhere along the last 7 weeks it's slowed down. I'll start waking him for feeds through the night

When i was pregnant my baby was on 99th percentile. He was born just before due date at 9lbs 4, really long and lean. He dropped weight and the HV were really scaremongering to me. He ended up settling on 50th percentile, he's just tall and slim. Perfectly healthy at 11months. Everything you're saying sounds like he is healthy - just carry on as you are. You're doing fab!

Don't worry. I was hounded by hv with my last one. Told me she was too small etc. She was petite, but in proportion. Eventually I gave in and took her to the pediatrician who was really frustrated at the hv for wasting her and my time with a perfectly healthy baby.

If your baby is hitting other milestones and seems healthy then just do as you are doing!

My son was underweight according to the hvs. He was exclusively breastfed and diagnosed with a tongue tie at 2.5 weeks (missed by hospital and community midwives and diagnosed by a private lactation consultant) which was divided at 4 weeks. Up to that point feeding was torture but after that it settled. Like you I thought he was doing well but was slow to put on weight (it took about 3 months for him to reach 10lbs, starting from 7’13). Same as your son, he was extremely alert and hit all his milestones but his weight gave the hvs palpitations every time I took him in. I think the only difference is that my son was a terrible sleeper and was up most of the night. Eventually they told me to make an appointment with the gp who referred me to a paediatrician at around 5.5 months who told me there was nothing wrong with him 🤷🏻‍♀️🤦🏻‍♀️. It was a lot of stress and anxiety for me up to that point, especially as I felt I was being hounded by the hvs and he wouldn’t take a bottle so it felt like there was nothing I could do right.

I would suggest that you see if there’s a breastfeeding group in your area that you could go to and they can double check your latch and make sure there’s no issues there, or if funds allow maybe make an appointment with a private lactation consultant. More for your peace of mind than anything else.

I was feeding my son on demand too and when I took him to the paediatrician she suggested that I space out his feeds a bit to make sure he was drinking plenty and feeling full rather than having lots of snacky feeds that weren’t quite filling him up. I had fed on demand up to that point as recommended and my son was older than yours so might not be appropriate for you but have to admit it did make things easier for me.

The nappies, him being alert and content are all good signs though so would echo the pp and say it’s probably all ok and he’s just found his line. I have to admit, my 2nd child is 13 months and she’s been to see the hv once!

All the best.

The HV don’t know what they are talking about. A baby born at a percentile doesn’t magically stay at that percentile.
So long as the baby is growing, gaining weight and hitting milestones it is fine.
My first baby was much like yours. Long (still has long legs) and lean. Born at 56th percentile, also breastfed. Over the first year, dropped to 5th percentile. My DH is tall and skinny and I am teeny tiny skinny minty too. The pediatrician said that it is quite often that healthy babies are born big and then genetics takes effect. So because the parents are slim (and I’m tiny), the baby was simply starting to take after us. The pediatrician also mentioned that the growth charts are based on all babies, the majority of which are formula fed and it is a fact that formula fed babies put on weight faster than breastfed babies so pretty much all breastfed babies, while perfectly healthy, will go down a few percentiles.

Mines slept through from about 12 weeks maybe just over (definitely does not do this now unless in bed with me ) and I had to do dream feeds as she would have slept from her last evening feed til early morning time.

Theres so much contradicting advice. My close family said not to waken a sleeping baby etc but others were saying it was too long for a baby to go without a feed. I was a bit overwhelmed with everyone's different opinions and advice so I can relate to your post.

Do what works for you both! Its horrible you're feeling that pressure!

I believe when a baby crosses two centile lines it’s generally suggested that an action plan be put in place to make sure that the baby is well fed and adjusting to their weight.
That’s probably why it feels like the HV’s are worried.
So as the other posters have said OP, while you shouldn’t be too worried, it might be wise to not let the baby go over four hours. So if you wake the baby as you have said you will, that should give the hv peace of mind.

It felt to me like there is this massive competition to see how quickly you can get your baby to sleep through, and when you do? Then it’s not right because they need feeding.
Damned if you do, damned if you don’t.

The charts have historically been based on formula fed babies who do gain more weight faster than breastfed babies. This had led to generations of women being told their babies were underweight & they were not producing enough milk.

Read up on "catch up" and "catch down", birth weight doesn't reflect their weight as older babies at all.

My DD was 10lb6oz, my niece was possibly under 7lbs - DH and SIL both very tall etc, I am tiny but was the one that grew a healthier baby.

When they were both 12 weeks old they were pretty much the same weight, both 98th centile and off the chart height wise. The. My youngest was down at 25th centile for weight despite being just under 10lb.

Milestones being met, plenty of wet and dirty nappies, alert not too placid/sleepy it does sound like catch down to me.