Here I go again...

[cinnamonbun23]

Hi everyone, sorry for the following long post. In need of some advice please, if anyone has any? I've had a few issues before regarding BF my DD, the lovely ladies of MN gave fab advice, as did LLL adviser, and things settled down nicely (DD gaining weight etc) Bit of background - DD born at 39 wks by ELCS at 2.8kg, got off to a shaky start, she wasn't gaining that well, then got help and she was suddenly gaining well.

However, we're in a doldrum again. 4 weeks ago, my Gran (who I was pretty close to; I'm from a really small family and we saw her every day) passed away after a short illness. This seems to have had a massive impact on both me and DD (in terms of BF) At the time my Gran passed away, DD was feeding more than normal, but I kept at it, feeding to demand. This has been the case since.

Then today I had the HV round who stated the DD was jaundiced on her face, but not her eyes or body. She then weighed her and said she was very concerned about her weight as she's now 3.8kg, so has dropped from 4.1kg 4 weeks ago. I explained the bereavement, and said that recently my feeding has gone back to 2-3 hourly as dictated by DD who is settled after feed, alert and active. HV said developmentally, DD is fine.

HV called the GP surgery and arranged an appointment this afternoon to have the jaundice checked. She then said that I really must give her at least one FF per day, that I had little or no chance of managing to get a hospital breast pump as the "list is long, and you're near the bottom" and that things must improve by next week.

So...off to GP's. GP examined her, said she's fine (not jaundiced etc) but that she was worried about the weight issue. She then said she'd want us to be seen by a paediatrician at the 'weight gain clinic' and that we might have to go to the urgent one over the weekend. She called the on call paed, who said to give DD 30ml formula after each BF, so 180ml per day. I got really upset in the office, and tried to explain that I feel like such a failure, despite obviously wanting to do the best for DD.

My DP is now saying that we have to do this, as is my Mum, so I feel that the cards are stacked against me. Does anyone have any experience of this, or any words of wisdom? I'm at a loss, and will feel gutted if I have to eventually give up BF because I introduce formula. Sorry again for the long post, and thanks for reading.

[crikeybadger]

Sorry about your Gran cinnamon, she sounds like she was a big part of your life.

I can't quite work out from your post how old your dd is now. Also, how many centiles has she dropped in the last four weeks? Are you confident that the figures from the weigh ins are accurate?

Is there any other way of getting a pump? Perhaps a friend could lend you one, or could you hand express?

[crikeybadger]

Ps: there's no reason why introducing some formula need spell the end of breasfeeding. You will need to protect your supply though, but you could think of the formula as a short term medicinal need. Does that make sense?

[Hedgehogging]

I'm afraid I have no real advice but I'm so aorry for your loss and the very tough time you're going through.

How old is your DD and what time frame has she lost the weight over? Your post seemed to say she hasn't gained and has in fact lost weight over the course of the last 4 weeks? If so I think I'd be doing whatever the paeds advised.

That said I don't think temporary formula top-ups necessarily spell the end of your BF journey! Plenty of babies end up having formula top-ups at one time or another and go on to BF very successfully.

Is there anyway you can access a pump yourself? Would renting a hospital grade one be an option for example? That way you might be able to suggest EBM as a top-up option when you go to the weight gain clinic.

Hopefully things will become clearer if the paeds/lactation consultants can figure out why your LO is losing weight but stay strong for a little longer and don't feel you'll have to hang those boobs up yet. Remember everyone (at home, in the hospital, on here) has your DD's best interests at heart. You've obviously done absolutely brilliantly so far so be proud and keep soldiering

[cinnamonbun23]

Thanks for the replies, and the kind words. DD is now 17 weeks. She was born on the 2nd centile, and dropped to the 0.4th 5 days after birth, and for a while was following her own curve just above the .4th (which everyone said was fine as some babies just do that) but has now dropped to under it. The last few weeks have been really hectic and stressful, and I'm a bit fuzzy on details, but she was 4.1kg around 13 weeks, dropped to 3.7kg and is now 3.8 at 17 weeks.

I've no one in RL that I can borrow a pump from, annoyingly, but I did manage to buy a Medela swing this evening (albeit on the credit card) so have been pumping. She's taken a good feed from both sides tonight, and is really settled, and the 4 year old is in bed meaning I can get some pumping in.

[MrsCookieMonster]

Hi,

Sorry for your loss and to hear how difficult things are.
I don't have much advice but just wanted to mention on the breast pump point you can easily buy one tomorrow morning from boots etc to at least give it a try, you will find reviews on here on which ones are best. I had the Medela swing and found it great but I'm sure there are lots of good ones. Also if you want a hospital grade pump I rented the Medela from www.medela-rental.co.uk but I think if you ordered today you would only get it Tuesday.

Also just wanted to mention my experience: my baby was premature and jaundice and had to be given formula as well as breast milk for the first week and I then went on to EBF for 4 months after that. I think it is unlikely that giving a little formula for a short period of time will affect your ability to go back to EBF but I'm no expert on this just basing it on my experience and the experience of people I know.

Good luck whatever you decide and no matter what you are in no way a failure and are doing a great job.

[cinnamonbun23]

Snow, I'd love to have any advice, especially since you weaned your little one off of formula. I know deep down that I have to bulk her up a bit, but I'm terrified that it'll be the death knell of BF, so any advice you have to offer would be amazing!

[MrsCookieMonster]

Sorry cross posted, great you have a Medela pump already and hopefully that will help :)

[Hedgehogging]

Well that's progress! Sounds like you've had a really crap few weeks. Hopefully things will improve with a bit of help. We all need it sometimes (offers thanks to MN for support during multiple wobbles). Thinking of you and sending lots of chubby baby vibes. x

[cinnamonbun23]

Thanks so much for the link and help, Cookie. Have been pumping like mad tonight, so hopefully I can keep up the supply. Thanks also for sharing your experience, I'd love to get her weight up and then go back to EBF.

[DebH1975]

Hi OP,

I'm currently bfeeding my DD aswell as giving her formula top ups - she is just over 6 weeks old and I've been doing both bf and ff for about 5 weeks now, she was 2kg when born and struggled to put on weight. So far it hasn't affected her bfeeding - although she feeds using nipple shields so that might make a difference.

[MrsCookieMonster]

No problem, best of luck with the pumping. I pumped all along and it made my life so much easier for many reasons but the best thing about it was that it gave me assurance that my dd was having enough milk because I could see what she was drinking.

[cinnamonbun23]

Snow, that is such a great success story! Thanks for sharing, it's much appreciated I can sometimes get a tiny amount if I pump after feeding her, and to be honest, she used to have days when she'd be looking for more (but that was a couple of weeks ago) but now she'll feed from both sides, and happily sleep or coo and gurgle if she's not sleepy. I've offered her formula after each feed, but apart from twice, she's refused it.

I've really not had to top her up since Friday, apart from twice, when she took less than 20mls each time, and one one occasion, she was sick after taking it which made me think she was full? No one has suggested tt, nor has she been checked for it. I keep getting totally conflicting advice really, one HV on Thursday at the breastfeeding group I occasionally manage to get to said as long as she's gaining now & that her weight isn't static is a good thing and I've to "keep up the good work". She also said that health professionals are trying to have less emphasis on weight gain now, and looking at health of the baby as a whole to be a better indication of things. Then mines comes out on Friday and says she's concerned, and that things must improve before she's out again on Wednesday

On a brighter note, I've fed her at every available opportunity, as well as pumping when I get a chance, and even having had only 40ml formula, she's gained 300g since Friday. Perhaps I've managed to increase my supply after it becoming low. I just hope that she's on the up now!

Thanks again for all your help

[makeminea6x]

The "oncall paed" is probably not the most useful source of advice on bf I'm afraid. I say this as someone who once was them. In general that describes a junior doctor, forgive me if I'm wrong in this case.

If your little one is losing weight you need a referral to a paediatric consultant to rule out other causes and then they will likely recommend you are prescribed special high calorie formula for a short period. You can use this in conjunction with bf.

Well done on expressing and persisting and asking for help.

I would try to see your local bf specialist HV asap.

[makeminea6x]

Oops now RTFT and can see baby is gaining! Well done!

[cinnamonbun23]

make, I'm not sure if the paed was a junior dr, but in my experience any on call medic always has been a junior here in our NHS trust, so I think it was probably the case here too.

Got in touch with a lactation consultant who came round today. That was one of the best pieces of advice I've had in ages! She was truly great, just sat and listened as I went on about our BF saga, and then said that from what I'd said, I was doing things just as I should, and that seeing DD, she could tell that there's nothing else going on with her apart from the weight issue. She said that she didn't think there was a lot she could offer in way of advice, as I'm doing well, which was really lovely to hear. I did tell her I keep getting conflicting advice, to which she replied that I'd be astounded at how often that is the case with BF mums.

She has boosted my confidence loads, and has given me more drive to keep going. She did say that perhaps in the past my HV has had to deal with an ill and underweight baby and that she is just trying cover her own bum to do things by the book, which is fine, but a bit 'one size fits all'. She had me in a right panic, especially with the "things have to improve by Wednesday" or else...

DD was weighed again today, and seems to have put on again, so hopefully we've turned a corner.

Once again thanks everyone for your kind words and great advice!

[crikeybadger]

Well done cinnamon, so good to hear you've got your confidence back and things are going in the right direction.