Breastfed 6 month old not putting weight on, help!

[Eliza34]

Hi everyone, hope this is the correct place to start this thread. Just looking for your experiences and/or advice really. I have a nearly 7month old who has weighed 6.7kg for the last 3 months, she has totally plateaued and is now falling below the 25th percentile having been sat at over the 50th at 4 months.
She is exclusively breastfed but I have experimented with expressing into bottles and also formula at certain points. She was prev a long feeder (30 mins per feed, would sometimes take from both breasts but usually only 1) Now she is so distracted that her feeds are less than 5 mins and she rarely if ever takes both breasts. I feed her in a darkened room with no noise and wear interestingtops/jewellery or hold an object up for her to look at whilst she feeds all with limited effect. We have started solids 4 weeks ago and that is rocky - she is not keen on a lot of stuff and seems to prefer to do baby led. In addition to all this malarky she seems to have a bit of an intolerance to dairy (red rash around face after eating and eczema worsens).
I am so worried and my GP nice as she is has been of limited help - and said that they don't refer to paeds until she has crossed 2 percentiles.
Is there anything I can do to bolster her feeds and get the calories in? Anyone with similar fussy babies who are generally arsey with food and milk?!! Thanks in advance.

I should add that when she has a bottle of formula she rarely takes in more than 5 fl oz, i'd say the average is 3 fl oz.

Firstly, it's not usual for a BF baby to only take a little formula. Unlike formula, BM changes over tome so BF babies don't need to drink ever increasing quantities to grow, they average around 1 floz on hour.

If she's got eczema, have you tried cutting out all dairy?

If she's only feeding for a short while, could you try breast compressions? They might keep her interest a little longer.

Does the GP know about the rash too?

Hi, thanks for the reply @JiltedJohnsJulie !
I know that BF babies do tend to get more effective at feeding as they grow so wasn’t really concerned about the shorter feeds per se, it’s the complete lack of weight gain.
I did try cutting out all dairy for about 2 weeks and it made no difference but I probably should have persevered a bit longer perhaps! I have cut dairy out of her solids now though so maybe that will help.
I began weaning at 6 months as she was showing the signs that she was ready but she is taking next to nothing, is really cautious about food and I just feel like tearing my hair out!

I didn’t know that BF babies don’t necessarily take a lot of formula so that’s good to know.

The GP knows about the rash but then started confusing lactose intolerance with cows milk protein intolerance so I feel it might be a bit pointless asking for another telephone appointment really. Especially during these times.

I have just expressed and am getting 7floz so I think my supply is still good at least!
Will try the breast compressions though, thanks for that.
Difficult to know if I should be switching breasts early on in the feed to attempt to keep her interest or keep on the same one to reach the elusive hindmilk - any ideas on that? TIA x

Dairy takes about 6 weeks to completely leave your system once you give up (I was diagnosed with dairy allergy 3 years ago and was told this.)

Has she just started crawling/crawling more? Weight issues could partly be due to increased activity, but I would be concerned at no weight gain at all in 3 months.

At 6 months, they're not expected to do more than play with their solid food. It's then a gradual change until 1 when they are expected to get most of their nourishment from it.

Do you have a contact number for the local health visitor?

@Bubblysqueak yeah I knew that I read that somewhere, loathe as I am to give up cows milk in my teas and coffees I will give it a go. Thanks
@FireflyGirl no I don’t have the numbers anymore and I don’t know what kind of appointment/advice they’ll give at the min as I can imagine almost all face to face apps will be cancelled? I’ll maybe ring the gp again.
I can’t really think of what else to do, and don’t want the problem to become worse. Thanks for the advice x

If she's having only short feeds she could just be taking foremilk and no hindmilk which won't be helping her hunger or weightgain as foremilk is pretty much water. Have you tried expressing before feeds so theres more hindmilk when she does feed? What is your own diet like as that can affect milk quality too ? With DS i express before each feed as i have a large supply majority of which is foremilk which just gets poured away and he has the hindmilk once i started doing this his weight rocketed and he's a lot more satiated between feeds now. I wouldn't recommend FF personally as that dries up your milk supply

Hi LucaFritz, I keep reading conflicting things about hindmilk and foremilk - my HV told me after she was born that this wasn’t correct and it’s all just milk - but I know a lot of other sources do distinguish between the two! I will give that a try for definite.
When I gave her formula I pumped and stored it to keep up my supply so hopefully it’s all still okay. One thing is though that my DD never seems to get that hungry unless l leave it 4 hours say least between feeds. Was your DS noticeably hungry very often before you started focusing on the hindmilk?

I think this article from Kellymom explains the hind/foremilk thing quite well. The breast Compressions should help to release the fat

How to increase weight gain is a useful article too.

Can you give us an idea of the foods you are offering too?

Sorry, forgot to ask one last thing. What’s her height doing? Is she getting longer or has that stopped too?

Hi @JiltedJohnsJulie,
In the morning I offer fingers of sholemeal toast with dairy-free spread or peanut butter, and then weetabix or porridge mixed with fruits which I feed her. It’s made with breast milk. In the afternoon I have been offering veg sticks with puréed veg (eg lentils, carrots and parsnips were yesterday’s meal) I’m veggie so haven’t bought any meat for her yet and was hoping she could be too but it looks like the weight and intolerances might force me to.
Thanks for the links - interesting reading and I started breast compressions last night
Her height has never been measured previously but I measured her this morn and found that she’s on the 75th centile for length and 75th for head circumference too. Weight is now just above the 9th

Thanks for the replies x

Has she always been on these centiles for length and head circumference? I’m just interested as my BFs son has always had difficulty keeping weight on, but he grows like at weed. At 16 he’s now 6’6”.

Could you add olive oil to her purees and try her with something like Banana-cado for calories?

If she’s still drifting down the weight centiles, was the link on increasing weight any use?

My DS (now 19 months) starting drop weight around 6 months. He was exclusively BF until6 months and then I gradually introduced formula (pumping didn't work for me) as I had to return to work at 8 months and I couldn't easily leave work to BF. I continued BF at home. I kept getting him weighed and the HV kept telling me it wasn't a problem until he had dropped 2 or more percentiles. We were eventually referred to the paediatrician and it turned out that DS had low levels of iron (something I also have problems with). I was recommended to persevere with weaning and he suddenly got it and to introduce a high iron content diet. He now loves broccoli and spinach in everything. I did give him beef too but not as often. I'd recommend weighing your little one regularly but perhaps try adding more iron as it might help. My DS is at the same percentile for heigh as he always has been and his weight was back to his usual pecentile line 5 months after seeing paediatrician. We are still under his care but haven't had any more concerns just regular blood tests to monitor his iron. Good luck x

I came on to suggest CMPA or another food allergy. DD2 struggled to gain weight until I cut all 4 of her allergens (that we know of so far) out of my diet. Not fun! Speak to your HV or ask GP to refer her to a dietitian.

Thanks for all the replies!
@JiltedJohnsJulie she’s never been measured (except I presume at birth) so will have to dig out my maternity notes and see if she Is on the same trajectory. I hear what you’re saying about your son but I’m a bit of a small fry and my hubby isn’t particularly tall either so I doubt she’ll be towering over us you never know I suppose!
Re: banana and avocado - she’s intolerant to one or both ( gave her both in the same meal and she reacted) so they might be out the window. Olive oil is a great shout though. Also seems to react to tomatoes (honestly she was sent to try me)!
@niclw
Thank you for sharing your DS’ story - I’m thinking I will need to go down the paeds/dietitian route to see what’s going on. I’ll keep preserving with the weaning and pray her tasts buds develop ASAP. Good to know your son is gaining weight now
@goodthanks yeah I think the allergies she seems to have are definitely not helping! The input of a dietitian would be v helpful. Did you really mean that you had to stop eating the allergens as they came through in your milk?! That sounds hellish - especially since as a veggie tomatoes form the basis of a lot of my meals

Yes, if you are BFing, you definitely need to stop eating anything she is reacting to.

What centile was she born at? Was that in line with you/your DH height and build?

My DD1 had reflux/various intolerances and barely gained any weight between about 5 and 9 months. I assumed it was related to her dietary issues but with hindsight I think she was experiencing catch-down growth. She was born on 98th centile which surprised us because DH and I were both small babies. I am average height, small build while DH is average height and medium build. By 9 months DD had dropped from 98th to 40th centile. She has remained around this centile ever since and is now 10.

At the time it was recommended to me by the dietetian to add oil/dairy-free spread to meals. I also made a lot of custards etc with a dairy-free formula. With DD2 who was also CMPI, I was able to use the Alpro soya milk for toddlers which has added calories but DD1 wasn't able to have soya. Peanut butter is also an excellent high-calorie food.

Sorry, I didn't explain very well. In my Dd's case it seemed like she was born at a size bigger than she was naturally intended to be and then gradually dropped centiles to where her natural height/build should have been.

If she’s allergic to milk and you think she might be to tomatoes too, I would definitely talk to the GP again and ask fir a referral to the Allergy Clinic and a Paediatric Dietician.

This article from Allergy UK gives advice on how to talk to your GP about CMPA and here are the NICE guidelines the GP shoukd follow.

If you are unsure about the difference between ige and non-ige, this article from Kellymom explains it quite well.

That’s a lot of reading I know, but you’ll be glad you read it all

Yes I really cut out all allergens, her allergies are very severe so it comes through my milk. You get used to it. It's a pain at times as some of DD's are relatively obscure but it's worth it because it's for her wellbeing. She has been in hospital due to her allergies/weight gain and I'd do anything to avoid that happening again. Good luck OP.

@DippyAvocado she was born on the 9th centile then went up to 50th, and now has drifted back down to the 9th. A few weights have kept in line with the curve on the 25th though, so I have a feeling that’s really where she should be. In any case no matter what percentile she’s at she should be gaining some weight month on month. I will definitely start adding some oil and spread and your tip about the soya milk is great too, thanks! (Hoping there’s no soya allergy

Sorry posted too soon! @JiltedJohnsJulie thank you so much for the pointers, had already refreshed my knowledge on ige and non-Ige allergy (I’m of a medical background but babies are not my forte!) and will read the NICE guidance as well. Was going to try and see if we could do without dietitian etc for a while but after hearing all your replies I realise I’m probably in over my head.
@goodthanks sounds so tricky but of course you’re right there’s nothing I wouldn’t change or give up just to see her thrive! It’s all doable I’m sure with the right planning. Hoping you’re through the worst of it with your DD.

Thanks to all, you’ve been immensely helpful.

This happened to us around a similar age. From 5-7 months she only put on a couple of oz. Nobody seemed too bothered but I was a little worried. She wasn't very interested in solids and was moving a lot more than usual. Now at 9 months she's like a different baby, she loves her solids and has done for about a month and we weighed her yesterday at home and she's gained 3lbs since she last got weighed a couple weeks before lockdown. She's still only on the 13th percentile according to a google search but I'm so happy she's making proper gains now. Hope it gets better for you, it's hard when you don't know where to turn, sounds like you're doing all the right things.

@GiGi18 that’s really good to hear right now, thank you! Hopefully she’ll catch up and we get to the bottom of any underlying problems.

Hoping there’s no soya allergy. I hate to bethe one to bring bad news, again, but around half of people with CMPA are also allergic to Soya as the proteins are apparently quite similar.

It’s really not recommended that you give a baby with suspected CMPA Soya Milk.