Concerned about breastfed baby's recent drop in weight centile

[cakefairy7]

Hi I have a baby who was 16 weeks yesterday. He’s been ebf and all had been going well with his weight until recently. He always maintained on the 25th centile until the health visitor weighed him at 14+4 where he only weighed 5.56kg dropping him to the 9th. This was almost 11 days ago and she is due back to visit him now in about 2 weeks time. I weighed him myself today (not incredibly accurate) and he came up about 5.8kg. I’m just concerned that when she comes back he may have dropped to the 2nd centile and what she’s going to suggest. He’s happy, has had a fair few sicknesses but has a brother in nursery so they can’t really be avoided. He looks a good weight with small rolls on his legs and arms and is meeting all developmental milestones. Is there anything I can do to help increase his weight over the next few weeks? He feeds on demand throughout the day and still wakes anywhere between 3-6 times a night for a feed and he won’t take a feed if he isn’t hungry, he’ll get quite frustrated and absolutely won’t latch at all. I would love to try and avoid formula if at all possible and haven’t topped up with breast milk to this point as he was tried with a bottle a few times when he was younger and refused every time and to be honest I’m just not keen on adding pumping if I can avoid

I think as long as he’s not underweight and he doesn’t continue to drop you don’t need to worry just yet. Obviously if it continues to drop drastically then you’re going to want to check with your doctor and investigate. But if he’s not fussy and crying a lot I can’t imagine he’s hungry.

Is he having plenty of wet nappies? Yellow poos?
If he is happy between feeds and feeding well through the day and night you don’t need to do anything at the moment apart from carry on feeding him as much as he will take. See what his weight is first before panicking, he will probably have gained since his last check and if not you can make a plan then - although the plan might still be feed as much as possible and see how he goes

Yeah he’s always had plenty of wet and dirty nappies even when unwell and been feeding less and he’s happy and content between feeds. Could it be a case of he’s burning it off? He loves spending time on his play mat and lying and kicking, could that be burning extra calories?

In previous generations babies started on solids around 3-4 months. So I would imagine that was to top up the breastmilk. Presumably they are more active too & so need more & more food to fill them up. I wouldn’t have coped with so many night time wake ups & so gave hungry baby milk at night & a bit of baby rice in the evening from 16 weeks. But I can see why people don’t nowadays as it’s against guidelines.

I imagine HV will advise formula, or as a pp above suggested, say that it’s ok to wean.if you want to do this that’s up to you but please don’t feel pressured.

3-6 wakeups doesn’t sound like a huge amount to me for a breastfed baby, if it feels manageable to you don’t feel like there’s anything wrong with that. Do keep offering as much as you can, id be tempted to offer even when he thinks he doesn’t want it. and I’d be tempted to pump to get an idea of milk supply - though it’s not always a good indicator. This might be a novelty from a bottle too and he may be willing to take a top up since it’s a bit fun.
it sounds like he’s maybe gaining but just not as much as you’d hope, he might just be active like you say. I’d look for a breastfeeeding clinic nearby though for some in person support, they may have some ideas for you.

He could be burning it off yes if he’s particularly active, my eldest was a bit like that, started rolling everywhere at 5 months and she never had that chubby baby look. It could also be because he’s had a few illnesses and needs to catch up.

He sounds fine to me.

If he's about 5.8 kg now at 16 weeks, I think that puts him still around the 9th centile – pretty good going if he's been ill.

You could have a look at https://kellymom.com/health/growth/weight-gain_increase/. I had two who dropped centiles, and I remember doing breast compressions to try to get that bit more milk in. They were also very active and never got particularly chubby, but did eventually start following a centile (more or less!).

Sounds like you’re doing great to me OP and he doesn’t sound hungry- sounds happy and well fed! Maybe he’s just finding his natural growth curve and will stay around that centile now, which is fine!

Thank you so much for your help, my first baby was never particularly chubby and he was ff and still had the same night wakenings if not more. He seems happy and healthy to me so if she tries to push for formula I could just say no I’d like to stick it out if I wanted? I need to try finding another local support group to go and ask someone in person, my closest one only ran one group since I had him and stopped them

Is he very sleepy? Dropping centiles along with a baby that sleeps a lot is a red flag for other health conditions, not just not feeding enough. Keep a close eye and you can always ask for an interim weight check at your GP if you want

No he only has his 3/4 naps for about 30/40 mins each during the day and then he’ll sleep for about 12 hours at night with all his wakenings. Sometimes he’ll wake 3 times for feeds and other times he’ll sleep maybe a 4 hour stretch at the start and then it’s every hour or hour and a half he’s up. During his wake times he’s alert, active and wants to engage with someone

My 5 were all ebf. They all moved up on the centile charts in the 1st few weeks then steadier before dropping off. My last dd dropped below her starting point at around the same point as your ds. One young health visitor suggested early weaning or adding a bottle, which I refused. She was happy healthy and active and following the same pattern as her brothers so I wasn't concerned. An older health visitor I spoke to later was quite happy that she was doing well. If your baby is happy, meeting developmental milestones and not lethargic or having insufficient wet or dirty nappies then I would say it's fine to stick to breast only feeds.

If he is gaining weight (even if he is dropping centiles) and feeding regularly and effectively, and his nappy output is good, I’d not worry. There’s no need to give solids (he can’t digest them yet anyway so it’s pointless) or formula, but you could try breast compressions when he’s feeding to see if that bumps his intake up a bit. Is there a breastfeeding support group you can go to? A chat with a trained, experienced breastfeeding counsellor who can check his latch etc might be really helpful, not all health visitors are clued up on breastfeeding, so it’s often better to seek support from specialists.