Low weight gain in a 16 week old

[mrsbee]

Baby number 3 is nearly 16 weeks old. He was born on the 75th percentile but has been steadily moving down the centiles and today was between the 9th and 25th. He is still gaining weight just not as quickly as the health visitors would like. He is fully breast fed and is happy and alert and doesn?t seem to be starving. Any ideas about how to get more milk into him ? I really don?t want to introduce formula (as with two other little ones I don?t really have the time to be making up bottles, sterilising etc.). Or should I try not to worry about it and just assume that as long as he is gaining weight and is happy all is OK.

[Monkey]

Go and see your gp. Health visitors might be worrying you unnecessarily.

[Knomester]

Baby Knomester was similar. Started on 50th dropped to the bottom centile. I wasn't concerned because he fed well and regularly, slept well and was alert but the health visitor reacted like I was deliberately starving him and put us on weekly checks with the GP. He was absolutely fine in the end - now 17 months and just above the 75th for height and weight.

See if you can dig out the WHO growth / weight charts for exclusively breastfed babies. They are quite different to the projections given in the red books.

If you are concerned then do see the GP but if you're confident your little one is OK then try not to worry too much.

[Ruth_Baldock]

Best advice I ever got re: weight gain...

Watch the baby, not the scales.

Is he happy, alert, meeting milestones and having at least 6 wet nappies a day? If so, don't stress and continue to breastfeed as you are already.

[catgirl]

Both my (excl breastfed) babies started off high centiles (75 and 98) and both came down the centiles rapidly. I suspect no 3 is doing the same but have not had her weighed since shortly after birth. As the others have said, if your baby seems healthy and happy and is feeding well, sleeping well, wet and dirty nappies, seems alert etc then don't worry.

As someone else has said, may be worth seeing your GP as well, if just to set your mind at rest. In my experience, health visitors often seem unduly obsessed with babies following the weight chart, despite the fact that breastfed babies don't follow the same pattern of weight gain.

[chantelle]

i agree it's probably not cause for worry. but at some stage he should follow the trajectory of a centile band. Obviously not good if he keeps dropping down off the charts. My son was born 50th centile and ended up following the 9th centile band until he was on solids and put on a bit more weight. now he's 3.5 and totally normal sized.

[Jo'sEnglish]

Aren't the charts in the red books for breast fed babies now? I read somewhere that they were changed a couple of years back to breast-fed babies but can't find where I saw that now...?

And I agree with the others that if he seems fine, happy, feeding ok and having wet nappies then I'm sure he is fine. It's easy to say not to worry I know, but try not to!

[mrsbee]

Thanks for the advice and reassurance. He is happy, feeding and sleeping well and plenty of wet nappies so I'm sure he is fine. He is gaining weight just not as quickly as the health visitor's would like. I'll just keep going on as we are and get him weighed in a month or so.

Ruth - that is a brilliant bit of advice and so true.

[Yak]

Yes, I think the red books now reflect bf babies weight growth as well. Of course go to your gp or hv if you're in any way concerned, but I agree with the stuff about the the wet and pooey nappies being a good indicator of healthy gain.

Assuming a baby is going to perfectly follow a centile line, whether breast or bottle fed, is about as realistic as assuming we all have the same appetites and hunger levels (in my very hunble, unscientific and totally personal opinion).

[Fuschia]

I think if there s a concern about weight, see the go for a referral

The hvs aren't really able to interpret any weight gain issues, is the problem and almost see any

Variation as 'failure' which isn't very helpful

One thing you might consider is whether you feed often enough in peace... Whether the baby does get to feed properly on the hind milk or snacks, that sort of thing

[Fuschia]

It's from 4m the weight tend o plateau a nit, I believe

[mouseysarah]

Agree with most of the others, as long as there is steady weight gain and no other cause for concern, dropping down the centiles need not be a major worry. It is worth keeping an eye on but no more. Health visitors sometimes forget that the 9th, 2nd and 0.4th centiles are all perfectly normal and healthy places to be - the 9th just means that if you had 100 babies of 16 weeks you would expect about 9 of them to be that weight or less (ie not far off 1 in 10). Sometimes babies are born on a high centile because their mother had an efficient placenta and perhaps they were overdue and had carried on growing, but once born they settle to the curve they 'belong' on which is lower. Worth a think about you and your partner as well: if you are 5 foot nothing and your partner is 5'6, chances are your children are not going to be in the top half of the charts!

How big are/were your other babies? Again, if they were average to small then no surprise this one is as well.

If the HVs are panicking about it then I would either a)see the GP and tell him/her you are not worried, and chances are high s/he will confirm there is no problem and you can tell the HV it is all fine, or b) just don't go to the clinic so often!

[mrsbee]

Fuschia - I think you have hit the nail on the head as part of the issue may be that he is being distracted during feeds with the other two running about. I can't go and feed in a quiet darkened room as I did with baby number 1 as god only knows what the others would get up to if I wasn't there. I am just going to have to make more of an effort to make sure he is getting a good feed every three/ four hours - maybe put the other two in front of the tv for 30 minutes.

Thanks for all the advice - I'm not going to worry too much but will just get him weighed again in a month and see how we are doing. If still not gaining weight quickly enough I'll pop to the GP.

[Fuschia]

Let us know how it goes...

[mrsbee]

A quick update on this.

So it turns out that the baby moving down he centiles is because he is lactose intolerant and hence the reason for the poor weight gain. This was only diagnosed at six months so he is now having lactose free formula and I am on a dairy free diet (which is proving more difficult than I thought) as I am mixed feeding. So hopefully now along with weaning he will start to put on a weight.

[mrsbee]

A quick update on this.

So it turns out that the baby moving down he centiles is because he is lactose intolerant and hence the reason for the poor weight gain. This was only diagnosed at six months so he is now having lactose free formula and I am on a dairy free diet (which is proving more difficult than I thought) as I am mixed feeding. So hopefully now along with weaning he will start to put on a weight.

[Fuschia]

Cows milk protein allergic? Because your breatmilk will Always have lactose (human milk sugars) in, regardless of your diet... It's only cows milk proteins you can prevent passing in your milk by cutting out dairy yourself

Sounds like slightly odd advice... Think sometimes the two things get confused

[Fuschia]

http://kellymom.com/health/baby-health/food-sensitivity/

http://kidshealth.org/parent/medical/allergies/milk_allergy.html

[mrsbee]

Fuchsia - it is lactose intolerance as they did a reducing sugars test which proved positive so not an allergy (though that is still a possibility). Also I did double check with the GP (actually both GP's that I have seen) and they agree that there will still be lactose in my breast milk but if I cut out diary then the level should reduce so hence should help with digestion.

[Fuschia]

I suspect that they are a bit muddled about what lactose actually is, but all to the good that it's not deemed necessary for you to stop bf if you don't want to! Would colief be of help? Lactose intolerance usually to do with jack if the lactase enzyme which colief provides ...

[Mens]

I think many babies are lactose intolerant (or whatever the term is) for a while and it goes away. Basically I can feed my baby as long as I don't have any dairy, as soon as I do phlegm spews out both ends for a couple of days (yuck, I know).

All 3 of mine have dairy intolerances or allergies.

My first was always below the second percentile. She has severe allergies and even though these foods are being avoided she is still tiny (she's nearly six). She is super healthy and energetic. I no longer fret about her size.

My middle child is huge and always has been (even though she has allergies too).

So, not sure stopping dairy will cause weight gain to speed up. I think the pros of stopping dairy is that baby might feel better if dairy was causing any discomfort.

I wouldnt worry about weight or believe what health visitors say about it.