HELP! MCHN says night BFing is causing DD's weight to be "Borderline" underweight

Just had my DD's checkup with the MCHN. She's 19.5 months.
I mentioned that she wakes at night and can only be settled with BFing.
DD weighs 9.45 kg, but she has always been small.
She started off around the 25th percentile, at her last checkup at 8 months was in between the 10th and 25th, and is now just above the 3rd percentile.

I was shocked because she loves food and never gives trouble to eat.
MCHN said that I need to night wean her because this is what is causing the weight problem, and that "She should be sleeping through the night".
I was told I shouldn't listen to what other mums say about their children who still wake at night. i.e. It's not normal.

She didn't give me any techniques on HOW to night wean, except to just try and rock her, tap her, but not BF her.
And to deal with day naps without BFing first. (I dared not tell her that DD has day naps LYING ON MY LAP BFing!! Haha!!!)

Can anyone please give me some point-by-point instructions on how to stop BFing for day naps, and night weaning too? Would love to know how you dealt with it, and what I should expect....

If you are happy to continue then just don't listen to the health nurse! My 18 month old is still BF'd to sleep and I have no intention of stopping anytime soon. He also wakes through the night still. He has only slept through 3 times, ever. I have night weaned him though, I just started offering him water instead, but that's only because I'm due to have another bub soon and I didn't want to be feeding two during the night.
I'd like to know what the CHN defines as 'normal'!
You're doing a great job! Don't let anyone plant seeds of doubt xx

Um how would night weaning affect weight? Id brush off everything she's told you and keep doing what your doing if it works for you. My Ds was a night breastfeeder til he weaned at 13mths and still wakes during the night for milk................and he is 2.5 and a hefty 16.5kgs; even at 12mths and night breastfed he was a good 11kg.

If she is that concerned about your daughters weight growth she should tell you to see a paeditrician to investigate other issues.

OHHHH!!!! Forgot to say that she says I AM AFFECTING HER DEVELOPMENT!! Because if she wakes during the night, she is being sleep deprived and so during the day she won't learn properly etc!!
She equated it to being on a long-haul flight and being dead tired but not being able to sleep... apparently this is what I am doing to DD!! She wants to sleep, but I haven't taught her how to self-settle!

I tend to think that DD just needs to eat bigger portions, and have more meat, as her diet is mostly vegetables, fruits, grains. Maybe this could be the cause for the low weight?? And easily fixed too!

I agree ignore the mchn and if you are worried see a pead instead. If you wean and don't replace the feeds she would drop even more weight! Most likely she is just little, not everyone is at the top of the scales.

Forgot to add dd1 didn't get to 10.kg until she was 2 and even as a premmie it wasn't a concern.

Did she explain more about how night feeding was affecting weight gain? It isn't as though it can be displacing solid food calories if it is at night when she wouldn't be having other meals anyway... seems like it would be adding more intake?

My 27 month old still has a couple night feeds oops! She's little but I'm little so never really even thought about it.

ETA: I think it sounds like rubbish btw! Do what you feel is right :hug:

Thanks all! Yes Black_Rose, I agree.... DD has always been tiny - it's not as though she started off huge and suddenly lost weight! She's always been tiny!! I think I will just make sure she has more meat in her diet, and increase her portion sizes, and give her more things like cheese slices to snack on... what do you all think?

That health nurse sounds like an idiot babe, you're doing a great job. And I've actually heard the opposite about babies waking in the night - apparently they're smarter because they get more stimulation. :P

If you're happy with the way things are going, then why change them? My DD has gone from being around the 75th percentile to just over the 10th and she's still happy, healthy and meeting all of her milestones - and she wakes 2 hourly overnight most nights.

If it ain't broke, don't fix it. And those charts are a bit outdated anyway (and based on FF babies) - there are new charts on the WHO website which are for breast fed babies and plotting my DD on there, it's all good.

Hugs lady, you're doing great :)

Just realised you wanted some advice on how to wean - the ABA website has some wonderful information on there.

I have only JUST night weaned my DS, but he still wakes up, henow gets a guzzle of water then goes straight back to sleep.
I pretty much followed this Sleep, Changing Patterns In The Family Bed | Jay Gordon, MD FAAP, I really liked the way this guys stuff spoke to me, so if you decide that night weaning is what YOU would like to do, it sall in there for you.
Best of luck and I personally take everything the MCHNS say with A LOT of salt!

That's what we did, slowly increase her food making sure she had morning and afternoon snacks. She weaned her night feeds at 2.5.

You can also try a multivitamin as the iron can help with the appetite.

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Did she explain more about how night feeding was affecting weight gain?

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Apparently because she is feeding during the night, it's affecting her daytime appetite. Which, now that I think about it.... is just plain silly!!! She's not guzzling litres of milk every night! Most night she wakes once, and feeds for a maximum of half an hour.

I just didn't like being told that I am hindering my DD's growth and development!... DD is as sharp as a tack!

Oh jeez, I would be ignoring her too :doh: How is letting her have more feeds making her not gain weight??

I think your plan sounds good, i.e. more meat etc. If she needs more she'll eat more, if she doesn't she won't, simple!

And pfft on the sleeping through thing. I know A LOT of kids who didn't sleep through til over 2 years, it's NORMAL!!

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You can also try a multivitamin as the iron can help with the appetite.

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Can you recommend the multivitamin you use? And can you get them from supermarkets?

I cannot see how night weaning will help your little toddles gain weight. Your MCHN sounds a bit suss to me.

My DD is 19.5 months and still night wakes. I did stop night feeding her about 3-4 months ago because she wouldn't settle back to sleep and instead thought boobies were a play thing, she'd be up for 2-3 hours playing before going off to sleep again. I took the boob away and handed her nightly wakings to her daddy because I was just so sick of being a play thing for her. Daddy STILL gets up to her 1-3 times a night. Sometimes she just needs a burb and its straight back to sleep, sometimes she's cold and needs her covers put back over her and sometimes she'll wake right up for an hour or so ....... she ALWAYS make up for it the next day though if she has a really bad night.

I do think its a good idea to offer more food or maybe offer some yoghurt before bed? (along with her trusty BF to sleep) If she eats it great, if she doesn't then she's probably full.

We give DD food until we can see she is clearly full. then its her bath then a book then yogurt and another book then bed. there is a good 45 min from teat to bed time. We have chosen this from our own experience with DD not wanting to settle if her tummy is too full.

ATM she goes into her room for boobie and bed at 8.30 but this week its been after 10 before she will go to sleep for me. I take boob off her once she gets that real comfort sucking thing going and is not falling asleep.

I am also pregnant atm so I find bf for more than 10/15 mins rather painful.

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I pretty much followed this Sleep, Changing Patterns In The Family Bed | Jay Gordon, MD FAAP,

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Thanks so much Starrysky, that sounds wonderful!!

IMHO, alot of MCHN's don't know what they are talking about and should just keep their mouths closed.

My DS1 has always been underweight for his hight (right from birth). We also had a MCHN try to give the same advice to us. I mentioned it to the doctor, who was horrified - he needed all the feeding he would take, whenever he was demanding it!

I will be honest and say that DS1's weight (or lack of) has caused him health problems. He is much more susecptable to virus' and infections then his much heavier siblings; and we have had to deal with iron and other vitimin and mineral deficencies too. Nowdays he is on a childrens multivitimin, and despite his slender physic he's health is much improved. He will still only eat when he wants to eat (you cann't force feed him), but this is just how he is built.

If you are concerned about your child being underweight, talk to your doctor - not the nurse. You doctor will be able to run any test to ensure that there is not any underlying medical condition; and provided there isn't then it may just be a case of you happen to have a skinny bub. In which case the best thing you can do is just try to ensure they are eating a wide range of healthy foods and getting all the different vitimins and minerals they need.

Good luck.

One thing I will say is you are definitely not hindering your DD's development in anyway - breastmilk contains so many good ingrediants that support brain development! You're doing a good thing ;)

I use pentavite from the chemist but the supermarkets do have chewable ones just don't know if they have iron.

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Can you recommend the multivitamin you use? And can you get them from supermarkets?

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Multivitimins can only be take by children over 2yrs of age. IF the dr runs tests and finds a specific deficency they may prescribe a specific supplement, but I know our dr even then preferred to try and supplement with natural vits and minerals in foods and once we weren't breastfeeding, we had to go onto toddlers formula rather then just plain cows milk. There are some toddler multivitmin mixtures (like flavoured milk drinks) you can purchase (can be found in the chemist or in your local suppermarket) which you can use in addition to breastfeeding - we tried them, unfortunately the child in question didn't like the taste, so his older sister drank it all.

I could count on one hand how many times DS2 has slept through. He's almost 18mths.

He's just hit 10kgs with clothes on. (we weighed him because he needed ab's). He was a chubby bub but is so active and busy that he just shed weight once he started crawling and walking (and running and jumping). I am not changing his diet. He eats with the family, and sometimes he is hungry and sometimes not.

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I was told I shouldn't listen to what other mums say about their children who still wake at night. i.e. It's not normal

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This 'other mum' says it sounds normal to me! I would take a bet that 'other mum's' lie to her, just to get their appt over with and get home.

Can you visit a different MCHN?

Well I'm at the other end of the scale. DS at 16 months weighed 10.5 kgs and BF to sleep both at night and for naps and would wake for three feeds during the night, sometimes more. My milked dried up due to pregnancy about a month ago and my god what a nightmare.

I can't see how BFing would be causing your daughter to be smaller, when DS had the same habits. I'd say that's just the way she is!

This mchn sounds like an idiot!!!! Do not listen to her. How dare she aay bf ia hindering your dd's development! Boo.
Find a different nurse. Some kids are just small!! My niece is almost exactly a year older than my dd bur weighs only 1kg more! She is just little.
Like your idea if giving cheese etc as a snack,

Hugs!!


Sent from my iPhone so sorry for the spelling and punctuation!!

Thanks again all. My self-confidence has taken yet another beating :(

I've decided I won't be going back there. This MCHN spends a lot of time telling her own personal anecdotes! Not helpful.
Funny though, when I told her that my DD started sleeping 11-12 hours a night at 17 months of age (and I didn't change anything, I was still BFing her to sleep at the time) she had no answer for me!!! Unfortunately it only lasted for just over 3 weeks, but still, it debunks her theory that kids "can't" sleep through the night if BFed to sleep.

My DD weighed barely over 3 kgs at birth - I'm pretty sure this is lower than the 25th percentile, so I think the marking on the weight graph thingy is wrong...

Still a bit sad, but I'll get over it.... I think I need to remind myself that my DD is NOT underweight. Looking at her without clothes on, she has the same rounded belly as other toddlers, and chunky thighs.... she's just little. And she's very healthy!
She has had exactly 2 colds in nearly 20 months.

It sucks she has shaken your confidence :hug: honestly, she really has no idea! My DD is 27 months and feeds to sleep still and often wakes for feeds overnight but she has slept through plenty too (usually a couple of nights a week) and I've never done anything but wait. She also sleeps over at her Grandparent's house and her Dad's house and manages fine, gets to sleep and is just cuddled if she wakes, there have never been tears! I was always told she wouldn't be able to settle for anyone else if I kept feeding to sleep but babies/toddlers are smart enough to realise things are different with other people!

She does sound healthy! Sounds very like my DD, she was 2.9kg at birth and always been smaller but she has a rounded belly, there is fat on her thighs - definitely not wasting away! Some people have to be the little ones :hug:

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Can you visit a different MCHN?

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As Onyx said. You are perfectly entitled to visit a different MCHN. It was common in my neighbourhood - we had one terrible MCHN, and a really well liked one nearby.

Where are you? Maybe someone can recommend another nurse nearby? Or just don't bother with them. She certainly doesn't sound very helpful.
My DS was dreadfully sleep deprived for years and is sharp as a tack. He'd be starting school by now if he'd gotten enough sleep (according to her illogic).
I night weaned my DS at 14 months and I did notice him eating more during the day. However, he also ate food during the night to replace the milk and his weight gain did not increase. (he's also fairly slight, though a bit bigger than your DD).

Dd1 was 2.5kg and off the bottom of the chart so it wouldn't surprise me if your dd had been on the bottom. At almost 4 she is still in the 25th percentile for her weight but she eats a lot and looks healthy.

I honestly can't believe you've been given this advice!

My advice would be to direct your MCHN to the WHO website. Then to find another MCHN. I changed mine early on because every time I saw her I left feeling like crap. Started seeing another one in the same centre (recommended by a friend in my mothers group) and haven't looked back.

Also, if you are concerned about her weight (which by the sounds of things is pretty normal given her size) then I would be looking to add a bit more fat to her diet, rather than cut back on BF. At this stage fat is essential for brain developments, so cooking with butter and adding a little to her veggies etc won't hurt.

Anyway, that's my ten cents worth. But at the end of the day you're her mum and you know what's best for her, so do what you're comfortable with, not what some MCHN (or me) recommends. AFWIW I think you're doing a great job! BF'ing to 20 months is fantastic :clap:

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OHHHH!!!! Forgot to say that she says I AM AFFECTING HER DEVELOPMENT!! Because if she wakes during the night, she is being sleep deprived and so during the day she won't learn properly etc!!
She equated it to being on a long-haul flight and being dead tired but not being able to sleep... apparently this is what I am doing to DD!! She wants to sleep, but I haven't taught her how to self-settle!
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Sorry but that mchn is full of ****. My 25 month old still doesn't sleep through the night and she hasn't had boobie since 3 months old. Just last night I was in her bed all night getting woken every 20-40mins. It's a stage she's going through or possibly just how much sleep she needs.

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My advice would be to direct your MCHN to the WHO website.

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Thanks, I looked at the WHO growth chart yesterday, which puts DD above the 15th percentile! ... How come we don't use those charts?! Is it true that the ones the MCHNs use are based on formula feeding?

From what I have heard it depends on how old the charts are that your area are using, the very old ones I believe were based on formula feeding, the more recent ones used by MCHN are based on a mix of formula and breast feeding (so better but still not the best for assessing BF babies). I always just used to go home and check out the figures on the WHO charts after each appointment.

:hug: DS only night weaned at 30 mnths (cause he was really only feeding once a day and that was at night :D ) and that was still hard.

DS still wakes once/twice a night most nights lol When DS was little I did a lot of reading and read a great site that explained night waking in another way.... When babies are born a lot of thier nural pathways are still developing and through touch it helps those pathways to connect so in fact you are doing your little girl a favour by responding to her night waking and helping her brain to develop.

As you said she is well proportioned and if she is active and healthy that is all that matters

You may want to take some action if it seems that your DD is unable to go to sleep by herself (i.e. she is waking every couple of hours). But if she is just getting hungry in the night then I wouldn't bother night weaning.
good luck!

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