Is my child underfed? . Baby not gaining enough weight

[VioIetMoon]

I've attached kendamil feeding guide.
My baby will be 3 months next week. He's 11 weeks currently weighing 8lbs11.
I'm giving him 120ml 6x daily. he's getting more feeds than what is stated on the tin as they state 5 feeds in day. I know its just a guide. At 3 months they suggest 150ml 5 x a day of formula plus I put him on my breast for a while a few times daily , In between feeds although he's not getting much. Probably 10 or 20ml as I can't produce much BM due to medical condition.
My health visitor has told me he's dropped off the charts and I need to feed him more 6oz and he needs weighing again in 2 days time. I feel this is unrealistic target giving him 2 days to gain weight? She said if he doesn't gain weight shell have to refer him. 6oz seems to be what kendamil is advising for a 4-5 month baby . Is this correct ? Although a guide, seems significantly more. He has alot of gas issues, and I worry feeding him more than what kendamil are advising, would this be too much for his tiny stomach? Giving him the same feed as a 4-5 month old baby. He was only 6lbs when born and was always measuring small and scan showed he hadn't grown in the 2 weeks prior to birth. Could he be a slow grower or am I just not feeding him enough. Would like some advice from other mums . Health Visitor said I'm not feeding him enough milk. She made me feed him more in front of her , despite the fact he was fed 1 and half hours before . How much did you feed your little one ? I want him to gain weight but I also don't want to upset his tummy as he has alot of issues with gas . Should I be giving him this 6oz 180ml in one feed or should i break it down into smaller feeds? for his tummy and gas issues as this seems alot of milk per kendamil guide.
I feel rather upset with myself to be told im essentially underfeeding him as I was following the feeding guide on tin.
Any advice appreciated

There's a difference between a small baby and slow weight gain. A small baby will be on a low percentile but will follow that percentile line, so they're still growing at an ok rate.

Slow weight gain can indicate a problem of some kind if they're not gaining weight as expected (whether a big or small baby). They need the calories for brain development as well as growth so that's why you might end up being referred - to check whether it's that he's not getting enough milk or if there's anything else going on eg a problem metabolising the milk.

I agree with this. Offer more and know that he is truly full which will aid growth and weight gain.

You should feed your baby what he wants to eat, as many times a day as he wants to eat.

If he's draining a bottle, offer a little more. If he's been draining bottles then you haven't been offering enough. Most babies eat around 6-8 times a day at this age.

It's normal for a baby to initially not finish an increased feed, he's used to small volumes and he needs to slowly increase

Ignore the packet.

If a baby who is eating what he wants to eat then struggles with weight gain he needs investigation but it sounds like he has been underfed if he's only getting five feeds and draining them completely. I'd try offering more before a referral. That's why the HV is suggesting bigger feeds because if a baby is offered more milk and won't take or takes and doesn't grow you've got a bigger issue than if they grow when offered a bit more milk.

@Sunnycolours in my follow up posts I've mentioned he can't finish the 6oz HV is requesting . We've increased him by 30ml per feed but he's struggling sometimes even with 150ml and won't finish it. He hasn't finished one feed today

If he's not finishing feeds then you can be sure he's having enough.

This is spot on advice!

I would also suggest offering more frequent feeds, at least during the daytime. Mine preferred more frequent smaller feeds at that age and didn’t manage 6oz at a time until 6 months +. She was also a low weight for her height but that just seems to be her natural build.

He really is tiny… my DS was on 4th centile at one point he had CMPA so once we changed milks she stabilised at a low centile and we weaned early as the milk is vile.

I’d want a referral he is really not gaining and I would be concerned.

In the meantime if he is finishing the 120ml he could be drinking more…
I would also make and offer 150 or 180 feeds even if he doesn’t take it all you can be sure he is having as much as he wants. I’d also offer more frequently so maybe offer it 7 or 8 times per day

The aim is that baby never finishes a feed.

Finishing a feed is not good. There should always be some left when baby is naturally done. That shows you're offering enough. If baby finishes the bottle, it means you are limiting the babys intake by deciding how much to give.

Baby not finishing any feeds is what you want. Did you not realise this?

To get even more calories into baby, feed sooner than you have been. Try feeding full bottles every 2h. See what happens.