Weaning early due to poor weight gain.....

[rachelvs]

My daughter was born 4wks prem (she is now 17w but less the 4w=13w) but weighed a healthy 7lb 13oz. She has been solely breast since and her weight has now plateaued. 2 weeks ago she was 11lb 3oz and today only 11lb 1oz. The health visitor has suggested weaning now. She won't take a bottle so this is best option. I am happy to do this but am still anxious about her lack of weight gain. She sleeps thru the night (has done for past 4wks) and I feed her on demand. I know it's all averages when they measure these things, some babies are above and some below but this doesn't make me feel any better!

I am no expert but I am not sure weaning is going to solve this - it may be that she needs more milk rather than other food but I am sure someone with more knowledge and experience will come along

It does seem VERY young to be weaning - don't really think the HV should be advising it IMO.

Weaning will only decrease her milk and therefore calorie intake. That is the worst thing you can do to help her put on weight.

13/17 weeks is awfully early (well, by current guidelines, I know it used to be 4 months). They do plateau - my DS certainly has once or twice - especially if she has had a cold or anything (as every child seems to have had recently)!

I would be hesitant to introduce anything other than milk at this stage, and (contentious comment alert) especially just on the advice of an HV.

Personally I would hold off for a bit if you can; as you say, they do vary and I'd evaluate her on her skin colour (I mean, does she look healthy, not are you black or white etc!), is she lively, her sleeping patterns etc. If she looks and acts well, she probably is.

But if you have doubts, go and see your GP, that is what they are there for.

I am slightly anti HV at the moment, I know they do good work but mine told me catagorically that DS had "dry skin", and "definitely NOT excema", and he's just been diagnosed with, you guessed it, excema. So I would go and see a doctor by preference.

Another dangerous loon on the loose!

Listen-THERE ARE MORE CALORIES IN MILK THAN THERE ARE IN SLOPPY BABY FOOD.
bREASTMILK IS THE BEST THING IN THE WORLD FOR HER.

wOULDN'T TRUST A gp EITHER.

I was happy to do breat and bottle but we have been having building work done and no kitchen now for 5 weeks so the routine of a bottle once a day went out the window as impossible to maintain any routine or sterilise etc. This is why she won't take one now.

She was also born with a minor heart murmur. We missed her check up last month because consultant was ill and couldn't make the trip (we live in Jersey) but we have one next Friday. When initially told about the murmur lack of weight gain was mentioned as a possible symptom. Until next week we won't know.

I wondering if perhaps to just add baby rice to her diet and keep up the feeding on demand. It's got to be worth a try.....

Any food which is not milk will fill her up and she will reduce her milk intake. There are more calories in milk than any other food that you could possibly give her.

MILK IS THE ONLY FOOD SHE SHOULD HAVE IF SHE NEEDS TO GAIN WEIGHT

Baby rice has no calories (well few anyway). It will fill her stomach, be hard to digest and prevent her from taking the milk she needs.

Breast milk really does have more calories than baby food.
I know it probably isn't what you want to hear, but have you considered waking dd for a feed in the night? Some people even manage to get a feed in without waking their baby (a dreamfeed) - never managed it myself, but could be worth a try.
You could also google "breast compression" which sort of helps the baby get at the fattier hind milk. (Not a completely accurate description here on my part, but just giving a general idea of why I think it might be helpful for you).

Here's some more advice

Don't forget that the growth charts are also not based on breastfed babies... see here

Thanks for all the advice. DD is happy in herself; alert, chatty, smiley and developing at the normal rate for a 17w old. There has been no indication that she was prem from a developmental point of view. Bearing this in mind I am going to continue to feed on demand, perhaps attempting to introduce a formula feed once a day (when I get a kitchen!) and take it from there. My husband is 6'5" and we are/were both slim as babies and children. DD could just have a high metabolism. She is certainly gaining in length if not in bulk!

There is no reason to give a formula feed either (unless you want to).Your milk is the best thing for your baby,esp. as she was premature.

If you wanted to introduce a bottle once a day though, you could try expressed? (sorry for stating the obvious if thats what you were doing before you lost your kitchen)

I like giving an ebm feed once a day cus at least for that feed, i can see how much is going in. I know the whole "wet/dirty nappies, happy, developing baby" should be enough but i also find comfort in the number of ml on the side of the bottle

I will admit for the last few days we've tried giving one formula feed a day because DD seemed hungrier and is waking up every 2 hours at night - she's 18 weeks now so not far off your DD's age - and i can definitely state its made no difference apart from giving her low tummy ache only alleviated by farting. FWIW we will be knocking that on the head and going back to bf/ebm and keep trying to hang on for 6 months to wean...

I would only introduce a formula feed additional to any breast milk and just to add calories. I have previously expressed and bottle fed but to be honest I can't be bothered for the sake of one feed. She doesn't need any extra food to settle her because she is sleeping 12hrs a night and has been for the past 4 weeks. I am reluctant to attempt to feed her at night and wake her as she seems happy with this new routine which she dictated and to be honest suits us all! I'm going to see how she fairs this coming week. We're seeing paediatric cardiologist on Friday and will ask if plateau in weight could be sympton of murmur.

Poor weight gain can be an indication of a heart problem rachel but if she's otherwise well try not to worry too much. Good luck on Friday, my dd has heart problems so if there's anything I can help with give me a shout.

Although I am a fan of early weaning (16 weeks for both my two) I wouldn't in this case. She is still v young by edd, and also will get far more calories from the milk. I found one bottle of formula helped both mine sleep longer and I think it helped with DD2s weight gain. I know not everyone does experience this, but it worked for mine. Their weight can plateau for no apparent reason, and I would also check with the consultant re the heart murmur/weight gain before following the HV advice.

When it comes to weaning 6 months from birth is ideal and you don't need to readjust for prematurity. It's a shame to see such anti health professional comments but I do think your HV is wrong in this instance. Some babies do plateau and there is good advice in what has alreadly been said. I would also wait to find out what is causing the heart murmur as some are much more innocent than others and there are a few instances where a fortified top-up are warranted. This would be on the advice of a paediatrician/ paediatric cardiologist not a HV though. I've no problem with early weaning if your baby is showing that they are ready, but at such a young age there is evidence to suggest weaning can be harmful and poor weight gain is not a sign your baby is ready for solids.

I'm keeping my nose out of this - because I'm still in the thick of my (healthy, full term, bf, 18 wks) ds 'plateauing' - so I think it is early for me to act as world authority.

However,my frantic browsing of archives on this subject suggests a bit of plateauing is not that unusual.

bf is great for your babies health, development and growth - don't let your hv scare you into a sudden change of direction.

Your DD sounds as though she is breastfeeding beautifully - I would not introduce formula as it alters the gut flora of a breast fed baby and can prediscpose them to allergic responses such as asthma and eczema. It isn't at all unusual for breast fed babies to plateau at this stage. My DD did the exact ame thing and HV advised solids. I knew I wanted to exclusively breastfeed until 6 months so just carried on with breastfeeing on demand. DD didn't gain a lot of weight but she didn't gain a lot once she started solids at 6 months either.

First 2 babies had heart murmers by the way that were found to be 'innocent'. Disappeared when they were toddlers. Good luck for Friday.

Do not wean her. Your hv is talking rubbish. Food given at that age is not for eating more taste as they don't eat enough. The food does not have as many calories as milk so in fact your daughter will be getting even less calories. Please do some research first and don't wean. She'll also be at risk of having allergies and bowl conditions if you wean this early especially with her being premature. Weight gain is not a good indiction of how well a baby is doing either, if she looks happy, healthy an alert then that's a much better way. I wouldn't even bother seeing the hv again.

My daughter was born at 36 weeks weighed 5 lb 14 and a half and was in scbu for a week. Looking at my red book for her she weighed 10 pound 7 at 13 weeks and 11 pounds 6 at 16 weeks so not much different to your daughter. She was a tiny thing and took ages to grow, that's jsut the way she way and now she's a happy, healthy and tall for her age 5 year old. At 22 weeks she was 13 pound 4.

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The thing is that why will food give her more calories? It doesn't because they dont eat enough so the logical thing to do would be increase milk NOT introduce solids, it's easy to look that up to see it's true as well. The food taken in is such tiny amounts that it wouldn't give the calories needed.