Underfed Baby

(4 Posts)
fifi08 Thu 12-Jun-14 07:29:34

Please Advise! My friend had a baby 6 weeks ago tomorrow. The baby is exclusively breastfed apart from 2 tiny bottles of formula he had in hospital as his weight was continuing to drop 5 days after he was born. He was 7lbs when born, chubby cheeks, squishy, gorgeous little man. He had jaundice after he was born but the hospital didn't make a big deal of it. He finally got back to his birth weight at 5 weeks and put on another 160g the following week. I've had two babies myself, big 9 and 10lb ones so I've spent a long time really questioning whether what I see now is just a normal baby as opposed to my big fat ones.. but seriously, he has wrinkled skin on his forehead, his legs are skinny, he doesn't have the squishy cheeks or oopmhy little face. He's very unsettled, not sleeping and I know it's cause he's hungry! They're first time parents and I've been there, lost shattered from tiredness, not knowing what day of the week it is, you get lost and you can't see the wood for the trees.. in an effort to restore order they tried restricting his feeds a la you know who, GF, but when I discovered that I begged them to stop and take him to bed for a week for skin to skin non stop feeding.. and gave them a big handwritten note on boosting your milk fast. I don't know whether they took any notice of that.. at his last weigh in he was on the 0.4th percentile at 6 weeks having been at the 50th when he was born. Formula is absolutely not an option and to that I saw you go girl, but only if things are ok with the BF ing and I don't think they are! I'm a massive breastfeeding advocate but it's hard work and it's hours of lying down feeling like a milk machine but you can't commit to it in words and then not do EVERYTHING to be sure it's working. A lactation consultant has told them he needs even just one bottle of formula a day but they won't listen. They live somewhere, not in the UK, where baby clinics and health visitors aren't easy to find. They have a 6 week check up soon which i hoping if the GP is worth his salt he'll pick up on this problem.

Please please let me know if anyone has been in mine or their positions. The couple are so lovely and of course want the best for him but they seem to be putting their values before his needs at the moment and it's desperately hard to watch it happen. And I say that as as a woman who did everything I could to BF my own kids and would support someone else in that choice. They say there's no problem and that someone has to be in that percentile but with an over 6ft dad and average mom he's not the one who should be there. Please please help!

Spindelina Thu 12-Jun-14 08:59:59

I've sort of been in their position. 50th centile at birth, readmitted at day 3 (13% loss) to do formula top ups on which she gained, went back to EBF at day 10, no further gain until week 6 at which point she was below 0.4th centile and we started topping up again, which we did until she was nearly 12 months. Weaned at 18 months, so not all doom and gloom!

The BF advice I got from HV was crap, which is why it didn't get sorted sooner.

You are of course right to be suggesting skin to skin etc. Someone does have to be in that percentile, but it is unusual for it to be a baby born on a much higher one (we had friends whose DD tracked the 0.4th centile from birth - small but perfectly formed).

How is the baby in himself? My DD was skinny but still bright and alert. I would have been more worried than I was (and believe me, I was worried!) if she hadn't been.

I think all you can do is be there, provide (virtual if necessary) cake. You say you've given them a handwritten note - have you sent them to the Kellymom website (or similar)? No offence, but that is 'expert' rather than 'your opinion' (even though I'm sure it says the same thing!).

tiktok Thu 12-Jun-14 09:14:22

I would be very worried about this baby, too.

Of course some babies have to be on the 0.4th centile, but the healthy babies who are are not skinny and wrinkled. They are just small smile

It was a very, very bad move for them to start to restrict and schedule feeds - this may well have calibrated her supply downwards and it can be difficult to get back to normal after that (which is actually an assault on the physiology of breastfeeding).

Where are they? They can get in touch with La Leche League anywhere in the world, virtually.

Kellymom is a good resource, but I don't think she is that great on these crisis situations, when common sense would say this baby is underfed and needs some intense intervention (which might well include formula) to become safe. They have not listened to a lactation consultant - are they still in touch with her? Might she agree to expressing and giving the expressed milk as the supplement? This baby might be too weak to breastfeed effectively, so the bottle(s) of ebm might ensure more volume goes in.

In the UK, this baby would be regarded as an emergency, and would probably be admitted to hospital. If the parents continued to refuse to address the situation, social services would be called.

bakingtins Sat 14-Jun-14 20:05:23

I've sort of been where they are. My DD is my 3rd BF baby, born 2 weeks early and small (<6lb) I was adamant she wasn't having formula as my Ds2 was severely CMPI. The attitude of various HCPs doesn't help, they tend to advise formula as a first step rather than seeking a BF solution, it gets you on the defensive. I have had to make a complete PITA of myself to get her tubed with donor milk for a few days then have been BF, expressing and topping up round the clock to get my supply going and enough milk into her. Back at birthweight just before 3 weeks old and now gaining ok and phasing out the top ups.
One thing that struck me is that 150g/week is a respectable weight gain, have they changed something now? Your baby-moon making a difference perhaps?
I agree with PP that in the UK they would have had many people on their case. I have only just been signed off by MWs who have been weighing DD every 2 days. I'm also lucky that I have 2 paediatricians in the family so have had their less biased opinions and back up that baby appeared well and to persevere. Some of the MWs/nursery nurses I've encountered have been very patronising. Your friend needs to talk to someone who can be constructive about finding a way forward. If she feels supported in her choice to Bf then she will be more open to solutions to poor supply/ ineffective milk transfer/inappropriate scheduling of feeds. I think you need to raise your concerns with her, even if it's just asking how it's all going. Maybe you can suggest other ways the baby could be supplemented ( expressing, donor BM, formula via a nursing supplementer) whilst she resolves the BF issues?

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