little weight gain

[zissi]

hi there,

my 21 week old DD has not been gaining much weight for the last 4 weeks. I weighed her on my scale which is only .1 accurate but it appears that she has gained only around 100gr in 3-4 weeks. according to the percentile table she went from being just below the 50th percentile to now slightly above the 15th percentile. until 4 months she was gaining steadily around 130gr per week. She is a dainty girl but doesnt appear very skinny. she is a very happy child, very active and reaching all her milestones on time. she has 4 wet diapers per day and one soaking diaper at night since she doesnt get changed at night. she also has normal poo´s.
I suppose her weight gain decreased when I switched from 2 hrs feeding to 3 or 3.5 hourly feeding (which is more age appropriate I think). she only feeds for about 7-8 minutes and I have offered only 1 breast at each feed. Today I started offering both breasts but making sure that she finishes the first breast first, so she fed today on average 15 minutes. Will I see an improvement in her weight gain? The reason I only offered 1 breast was that I had issues with OALD and oversupply of milk and my lactation consultation advised me to do so.

thanks for your opinions!
fran

[clazzat]

My ds dropped from the 92nd centile at birth to the 8th by about 4 months - I was very lucky that when I went to the hv to get him weighed, their attitude was that he was happy and healthy and reaching his milestones and therefore there was nothing to worry about. He has since bounced back up to the 75th centile (fuelled mainly by chips, I think ).

I think that you know in your gut whether there is an issue or not. If you are happy that she is thriving, then the numbers don't matter. There is nothing in your post that suggests that you have anything to worry about, so you should try to relax and not focus on the numbers which are only a small part of the picture. Do you think that she is satisfied with the amount that she is getting? You can try to persuade her to eat more, but if she is not desperate for a feed before it is time for it then she is probably eating enough in the first place.

[*Ali*]

I see you already have some good advice.  I agree it she is happy and meeting milestones and having wet diapers she is probably fine.

I wouldn't weigh her on your own scales since they are probably not giving an accurate measure. It is best to only compare weights taken from the same scales anyway.  Can you get her weighed by the HV if you are concerned?

If she is taking more milk at each feed then she should put on weight Yes.  Although mine both slowed their weight gain around this age as they started being more mobile and rolling,  sitting and such which uses more energy than lying still all the time. 

Is she sleeping well at night? Any feeds then?

[Fiver]

Agreeing with the others. Does the OS seem to have settled? Sometimes it's a balancing act with that of not going too far the other way! Sounds like you're doing the right thing to offer both sides again especially if she's taking both.

[zissi]

hi there,

thanks for the good advice. yeah as usual I worry too much. I live in ireland and the next health check is only at 7 months. I could visit the HV but breastfeeding rates are very low here and Im sure supplementing would be encouraged with her slow weight gain and I dont want to do this. she is generally sleeping well at night. for a few weeks she only needed one feed after 8 or 9 hours of sleeping (Im not doing a DF, not sure if I still should/could introduce it?) but she got very early up for the day so I decided to feed her around 6am and usually she would go back to bed till 7.30am. so I am happy to have 2 feeds as long as she doesnt get up that early. (BT is around 7pm).
after 2 days of offering both breasts I offered today a top up after roughly an hour after feeding since I want to make sure that she gets the fatter milk rather than drinking on both breasts only the fore-milk. she is of that age where she is very distractible and she gets impatient when the milk doesnt flow fast anymore. the other problem with offering both breasts is that I end up with an oversupply again. felt quite full again the last couple of days. what do you think about top-ups vs offering both breasts?

[*Ali*]

By top up do you mean when you offered the breast again an hour after eating? 

[zissi]

yes exactly. same breast again after an hr or so, she usually drinks only 2 mins then but it keeps her going for a little while longer...

[*Ali*]

Do you alternate the breast you offer first? Maybe try offering the same breast first for a couple of feeds. If top ups help you can do it. Have you tried doing it a bit sooner than an hour? I often found that after a burp and nappy change so about a 15 min break mine would go back on the breast and take a bit more.