3 month old not gaining enough weight...desperate for advice

[Bobby30]

Hi everyone...

I'm new to the forum and desperate for advice and help.

My 12 week old boy has been EBF since birth but has now dropped two centiles in the weight charts. He was 9lb1 at birth, dropped a pound and now weighs 11lb.

I'm feeding him every hour and a half (or he screams blue murder) for around 30 minutes a time, he goes maybe five hours at night without a feed then it's back to every hour and a half til around 8am (putting to bed at 9pm). He goes down at night with no problems.

He rarely naps during the day unless I take him out in the pram or car, and cries lots instead. It's driving me mad and I feel totally helpless.

I was referred to a bf support group by my HV since he's not been gaining enough weight and I've been advised to pump off whatever is left after a feed and give it to him all in one go at the end of the day in a bottle. They checked my latch and positioning, all fine. So since yesterday he's had two bottles of 85ml and 100ml in addition to his usual feeds...but this just seems to be making the problem worse and if anything he seems to want to feed more. And he's been extremely unsettled.

A bit more info: I had mastitis when he was 6 weeks old and since then have had a blocked duct on two occasions on the left hand side.

Any advice would be amazing...I'm at a total loss as to what to do. I really don't want to top up with formula unless I absolutely have to, last resort.

[~ Vik ~]

Have you looked into the possibility of reflux or intolerance? The crying and lack of sleep, more food making it worse, makes me wonder if something else is going on... Feeding every hour and a half may be comfort feeding (milk soothes the burn from acid reflux).

How's night sleep? What's your routine like? How are poops (frequency, consistency)? Is crying worse laying down or sitting up?

Check out the colic reflux and crying board (under health medical) for more information to see if anything rings true for you.

[Bobby30]

Hi Vikki...thanks for the reply.

Night sleeping is generally ok. Goes down at 9pm wakes about 2 or 3 for a feed and then again at about 5am, which I guess is normal for bfing.

As for routine, we don't really have one. I feed him when I think he needs feeding, then let him play for a bit and then try to get him to nap but that never really works and we get into a vicious cycle of crying and feeding.

Loads and loads of wet nappies, about 1 or 2 poopy nappies a day, consistency is quite runny and yellowy colour. Crying definitely worse laying down on back.

[Erin M]

Here's the reflux info that Vicki mentioned -- have a read and see if any of it rings true for you -- http://babywhispererforums.com/index.php?topic=654.0

I've not had babies with reflux but the frequent wanting to feed, low weight gain, crying on his back all sound like reflux to me. 

When you feed for 30 minutes is he actively feeding the whole time or is he comfort sucking for some of it? 

[Bobby30]

he does a lot of comfort sucking, probably half the time, but if I take him off he protests...

[Bobby30]

I've looked at the reflux link and dont really think that applies to him...he never spits up - all he does is the frequent feeding. He is a poor napper but mostly sleeps ok at night (up twice for feeds).

[Fiver]

I know this won't seem all that relevant, but did you have an IV fluids/drugs during labour/delivery?  They can inflate birth weight and subsequently make it seem like LO has lost a lot of weight when, in fact, they've had fluid in their system and are just getting back to where they "should" be.

Did the BF group/HV check out anything else apart from positioning and attachment?  Hopefully they tried to get a bit of history to see if there were any issues around his delivery that might be having an impact or whether there is anything awry in his mouth (tongue/lip ties, for instance).

Only other thing I can think of right now is that perhaps he has wind and he's feeding to try to get rid of it, but in doing so it's giving him more and you're getting stuck in a cycle.

[Hedgehog17]

Sounds very like silent reflux to me!

My DS had this, and his was caused by MPI (cow's milk protein intolerance) from the dairy I was eating. Very runny poop, particularly if it explodes up his back, is a sign that this may be the case.

Unfortunately HVs are not very well informed about this common problem, so you'll have to get your information online and try to diagnose it yourself. If you suspect MPI, take all dairy out of your diet for 4 weeks and see if there is any improvement.

Many of us here have been through this, so you are not alone 

Don't worry about your DS either - mine dropped off the bottom curve at 3 - 4mo, but has been around the 50th since 7mo and is a healthy, sturdy little boy. There are dairy-free options for milk and food 

[Bobby30]

Thanks for replies....

Fiver what you said is interesting. I got severely dehydrated during labour and went into ketosis, so had to be put on a drip. There's no problem with tongue tie, but DS came out face first so his lips were absolutely huge and his face very swollen when he arrived. I also lost 3 pints of blood and as a result didn't feed him properly for 2 days after the birth. I might mention this when I go back to the BF group because they didn't ask me anything about my labour.

Hedgehog17, the nurse at the BF group did suggest cutting out dairy and I do eat a lot of milk and cheese, plus, yes, DS' poos are very runny. I'm going to give this a go and also mention it at the BF group too.

Thanks

[Roseii]

((hugs)) that sounds so tough. I highly recommend trialling the diary free diet (or at least cutting down) It made a huge difference to us (oh and dd2 has silent reflux) x

[Fiver]

Yes, please go back to the group and keep going back until you've got things sorted.  Online help is great, but IRL support is vital. 

[SILLYFACE]

Hiya!
Well I could have written this post 9 months ago! It is so so hard.
My LO feel a centile during the first month. After that she never lost weight but was so slow to gain weight (3oz every two weeks) and breastfeeding was always to blame.
We tried lactose free milk and meds for acid reflux but I don't think either had a massive impact so I decided not continue. By 4 months life became easier which leads me to think she had severe colic with reflux/lactose problems.
The day I decided to give up BF and switch to formula (about 3 months) I had a phone call from the breastfeeding support adviser at the hospital. I had a long chat to her. She told me to look at my baby - was she happy/content? Was she sleeping at night for at least 4 hours solid? Was she feeding well (do not measure this by time but whether she was drinking)? Was she producing wet nappies? Was she reaching her milestones? Was her head circumference a similar centile? What were mummy/daddy/relatives like as babies?
Just because your LO was born on a centile does not mean he is destined to remain there.
Due to all the supplementing, I had to work hard to get my supply back and it was not easy. Do not let anyone bully you into thinking it is breastfeeding. The milk diet is such a small period of his life and before you know it he'll be on solids.
Google Jack Newman - he has a website dedicated to breastfeeding and advice for common problems. He will also convince you that weight does not always indicate a problem with breastfeeding. I don't know where you live, but if you are UK the NCT Breastfeeding advice line is fantastic and will be able to support you further.
Sometimes breastfeeding groups have a weigh-in which means you can be amongst people who understand and can offer decent advice .
I really hope you keep confident hun. Get advice and keep strong. Seeking advice was the best thing I ever did.

[clazzat]

My ds was born on the 90th centile and now hovers between 10-20th - he plummeted down the charts in his first few months, and I was really lucky to have a good hv who made me look at the bigger picture as pp said. Ds was happy, developing properly, meeting his milestones etc and therefore the early months just seem to have been him finding the right place on the curve for him. Genetics does play a part - although dh and I are both fairly tall, my ils were tiny, and now ds is not quite on the bottom of the chart for height! Looks like he is taking after them.

I also have to second the reflux - even if he is not spitting up, he seems to have a lot of the other signs of reflux. I would talk to your gp - again, I was very lucky that my gp was extremely understanding when I went in and gave me gaviscon to trial straight away. The difference was incredible. I have also had to cut out dairy - a common issue with reflux babies - and it has made a massive difference to how contented ds is. Also, it can be the case that cutting out dairy can help with weight gain.

[Bobby30]

Wow thanks for the suggestions.

He constantly increases in length and head circumference - hence he is very long and skinny. I go to a baby massage group and he is the same length as 6 and 7 month olds - just much thinner! He's meeting his milestones - rolled from tummy to back at 11 weeks, babbles and smiles lots (when not crying!) and hits out at toys on his gym mat.

Plus I'm fighting genetics - I'm 5ft8 and size 10, my other half is tall and thin and actually lost weight as a baby. My MIL stopped taking my partner and his siblings to weigh ins when they were babies as she got so much grief over their skinniness.

Maybe this is just the way he is meant to be, but HVs, doctors, nurses etc don't see it that way do they? It's like, if they're not fat, you're doing something wrong!!

Weigh in Friday at bf'ing group...hanging tight til then until I make any more decisions.

PS He has been more settled since my OP - I think the bottles were giving him terrible wind and I've been working really hard to get the burps up!

[Erin M]

Some doctors, etc do seem to be weight obsessed.  Are they using the WHO charts?  It does make a difference sometimes.  http://babywhispererforums.com/index.php?topic=63598.0