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DD has dropped below bottom centile. She is 7 weeks. We had been bf on demand.

After being checked out at hospital they could find nothing wrong with her or my milk supply.

We have been sent home with instructions to stop feeding on demand and to start feeding every 3 hours for a max of 20 mins...

They say on one hand she isn't getting enough calories as they say she falls asleep on the breast ( she does as she also comfort suckers but this is at the end of a feed or an additional visit to the breast) on the other hand they say she is expending too much energy sucking for so long.

Seems very contradictory as an explanation.

The advice seems counter to how I want to parent. I feel sick having to take my tiny baby away from the boob and for so long.

I have been to a local group and they said my latch and her feeding were good.

Lost.

Additional...

DD is happy, alert and seemingly healthy in all aspects except weight. She has gained every week since initial drop after birth but is just slower than expected.

Hi Teacup, just wanted to say well done for not giving up bf, my DD was slow to gain weight during the first 4 weeks and I remember how demoralising it was.

Have you tried feeding off just one breast for a few feeds, then switching to the other? That way DD would get more fatty milk. That was the thing all my MWs said would help, as the latch was fine.

Do they mean a minimum of 3 hourly feeds? so no taking her away from breast, just making sure she is offered it regularly? Otherwise I agree, it seems counter-productive.

Just carry on. Friend of mine had similar with her baby and HV started talking about "failure to thrive" scaring the shit out of her. She will feed when hungry. If she is developing, she's getting what she needs. FTT baby is now a big for her age rampaging 3 year old who is happy, healthy and smart as a whip!

Bumble - tried that but seemed to cause my milk production to drop so had started to switch feed.

Smile- no I was doing that already. They want me to take her off after 20 mins and repeat every 3 hours

didn't want to read and run.
It does sound counter intuitive to me. At that age I thought that the idea was to feed at every pip and squawk to ensure supply and get lots of milk into baby. I remember feeding DS every time he turned his head just in case he was rooting for the nipple.

I'd suggest ringing one of the helplines
nct 0300 330 0771
ABM 08444 122 949
LLL 0845 120 2918

Also some info from [[http://www.kellymom.com/babyconcerns/growth/weight-gain_increase.html kellymom] on slow weight gain.

I hope this helps.

KELLY MOM LINK

(Bumble what you were advised to do is block nursing.....totally wrong for low supply/low weight gain, and should only ever be advised for women who have a problematic over supply )

Teacup - sometimes small babies are put on a timed schedule, because the worry is they are gaining so little, too long on the breast means they expend more calories than they take in.

I don't know if this is the case with your little one, but they seem to think it is.

Usually, this is with babies who are showing clear signs of being underfed, with static weight or weight loss - can't remember your history, sorry .

It does sound very prescriptive to me, though - and is likely to mean your baby gets less milk and you make less milk.

Is there an infant feeding specialist at the hospital you can see to check this out? You may even be able to speak to her on the phone. I do think you need a second RL opinion.

Hi tiktok

Never been static and no loss just very slow

Think I pretty much saw everyone they had available...

There are breastfeeding councellors at my local group I can/have seen

She now seems to expending much more energy crying

Hi Teacup I think you know me from the local group. I am glad to hear your DD is still gaining. We are trainee BFCs with the ABM and our mentor is an hour away. I can get you the number of the breastfeeding counsellor in York (who is our mentor). She can give excellent support telephonically and will be happy to see you, if you are able to travel. We are also always present at the drop in to support you.

tiktok we do not have any truly qualified feeding specialists in the area. The local hospital/trust has a Infant Feeding coordinator MW who is lovely but is sadly under qualified (has had less breastfeeding specific training than peer supporters)

Hi (yikes I knew I would out myself!) I will definitely be down on Tuesday thank you. I can travel to York if you think that's a good idea too.

Poor DD, we just want her to be well and happy.

I'm so outed, I'll have to nc for any sensitive subjects.

Why don't I PM you the phone number and you can have a chat to the BFC. Also, I feel from your history and knowing that your DD has a good latch and is drinking effectively at the breast, that scheduling her feeds is counter productive. Especially if she is crying to feed.

There is good argument for her not to go any longer than 3 hours between feedseven at night.

Thanks TheRealMBJ that would good.

It feels so wrong to take her away from both food and comfort.

The night time schedule I can understand and is very similar to what we had started to do. Soul destroying to take her off after 20 minutes though and very hard for her as we are cosleeping so milk is right there next to her but she can't have it!

do they definitely mean 20 mins total? or do they mean switch breassts after 20mins? liike 20 mins on each side?

I've seen that advice on keyllmom - you do 20 mins, switch, then 2- mins, switch, 20mins, switch, 20 mins.

2- = 20

If she is alert, happy and actually gaining weight, albeit slower than The Powers That Be would like, is there actually a problem at all?

You have had good advise already and I always think its best to go with your instincts if in doubt.

My DD used to fall asleep when feeding ALOT so I used to rub her feet when feeding and it kept her concentrating on her food then drop off later.

Yep they mean 20 in total!

Soup - exactly. In all other ways she seems just fine!

blimey.

I do what cowboy does - if she drops off or stops, i rub her habds, or the side of her head.

hands (this child is very heavy)

Teacup, from what you say I would be concerned that the hospital is using ancient and discredited bf advice because they know no better - years ago mothers used to be told to feed '10 minutes a side' but no longer (usually).

You definitely need a second, informed, opinion.

Teacup how are you doing today?

Well we are trying to do feeding every 3 hours but not in between (feels very very wrong) but we are ignoring the 20 limit and are usually feeding for 40 or so.

My breasts often feel harder than before and don't seem to "empty" as much. Bit worried about the effect on my supply...

Getting DD to sleep last night was a bit traumatic without the breast.

Can't help worrying that I am damaging her. Everything I read about breastfeeding stresses the importance of demand feeding.

Just weighed her on our scales and reading very close to her last weigh in.

Feeling rather lost with it all.

Tried the number you gave me but no answer. Don't want to disturb her Sunday so will call tomorrow (weigh day with HV!)