LONG POST - Slow weight gain and a bad day with the paediatrician - offload and confidence boost needed please

[annabanana169]

Hello,
After some early posts when ds was tiny, I've been a lurker but I've taken a great deal of info and support from this board over the last few months. But I've had a crap day today and shamelessly need a boost specific to me, I hope you all don't mind.

My ds is 5 months now, was 7 weeks prem and so corrected age is 15 weeks. He was 4lb 9oz at birth and is now 9lb 8oz. We had a very difficult bf start with a rubbish SCBU, HV and reflux until a wonderful bf counsellor got me sorted (latch and frequent feeding regime) and we discovered Gaviscon.

Since then, ds has put on basically 4oz a week. Its very hard when everyone else's baby is HUGE but my LO is developing well and when we saw a consultant paed 2 months ago he was very relaxed and said as long as he went parallel to that bottom 0.4th centile curve, to keep going, to ignore the 'get him on the bottle' types as breast milk was best for him particularly - as he was prem, had reflux and I've got a history of eczema and hay fever.

All was well, he carried on plodding on his 4oz a week and we had a follow up appt with the paed for today. Apart from minor moments of panic when GP said she thought ds had a big head (nonsense) and the HV randomly declaring he was FTT, I was doing OK!

But then today, we saw a different more junior paed, whose first question was ? how often does he feed and for how long - and when I said I fed on demand but it was about every 2 hours during the day and 3-4 hours during the night ? he said I should try to stretch his feeds out and that this would make him take more and get his stomach to grow. I knew it was going to be a disaster! I had to challenge this and was immediately labeled a nutty bf mother and he started to patronize me. Then we discussed when to wean and I said I?d like to do baby-led weaning ? he had no idea what this was and told me that for weight gain, I need to get ds on solids asap. I pointed out the WHO guidelines and my allergy history and he said I could keep exc bf until 6 months but then to get him on the baby rice and puree?

And finally, even though 4oz is just about ok overall and was ok for the consultant, he referred us to the dietician for weaning advice and recommended we get ds on breast milk fortifier. When I asked why, he said this would encourage ds to eat more and that it wouldn?t affect more supply? however I?m not confident this guy knows what he?s on about (see above.) SO, I?m just going to soldier on, doing my on-demand bf and wait to see the dietician, I know I?m doing the right thing but its hard in the face of a medical type? UGH UGH. Rant over. Thank you for listening!

Anna

[moondog]

Oh honestly,he's talking crap and you know that.

Ignore.

[determination]

Hi Anna,

Definately ignore, If your ds is still gaining 4oz p/week.. that is a good gain. I would definately stick by my guns and continue feeding on demand then at 6months start baby led weaning - which is great fun i may add .

You are showing obvious sign of having more bfing knowledge than the bloody dr! But then who is surprised?!

[MarsLady]

Twit!!!!!!!! (Him not you).

Ignore ignore ignore!

You're doing the right thing and clearly the twit has no idea how breastfeeding works.

DT1 barely registered on the centile charts. She still eats like a bird and yet flourishes and thrives. Honey... you already know from the posts here and from talking to the senior paed that the junior paed is talking out of his bottom. If you need to see them again insist on seeing senior paed.

[edam]

I'd be tempted to write to the senior paed quoting what the junior doc said and asking why you are getting conflicting advice... might mean junior is told to sort themselves out sharpish. And in the meantime ignore daft junior. WHY people who don't know anything about b/f dish out 'advice' based on bugger all, I don't know.

[seeker]

Ignore. And say "NO thank you" nicely to the dietician's appointment too! Say that you don't want to take a slot away from someone who needs it!

[bosch]

Support. Support. Support.

It's a shame that junior drs have to take a view but it's damaging that the one you saw seemed to feel the need to undermine the advice of his senior!

I got rubbish advice from a junior dr about when I had to have my c/s and he also rubbished my concerns. Fortunately, i shortly afterwards saw a MW who told me that junior drs might have had very very little experience. and that what I said was right, and that he was talking out of his ar*e.

I'd say keep going with your own views, as supported by senior paed, and consider asking to see senior paed again if you need a review given that wihtin the next month or so you'll be starting weaning. My ds2 started to lose weight when we (baby rice/puree) weaned him at 6 months - you need to have a strategy if blw knocks him off course (although, I wonder it he'll just carry on taking more milk...I know nothing about blw - good luck

[VeniVidiVickiQV]

Oh good lord it's scary isnt it?

Just ignore him. I'd certainly take the issue up with his senior. He obviously needs more training....

Look at it this way - if the paed consultant was worried, he'd not have left you in the hands of a junior, would he?

Sounds like you are doing just fab on your own.

[magicfarawaytree]

two of my three children were midway between the 25 and 50 centile normally closer to the lower. same a a friend who was told her childs head was 'small'. funnily enought child started walking at 6 months and she was even lighter!

[mummypig]

oh Anna what awful advice, especially if your little one has had problems with reflux! But clearly you know what you are doing and your little one is growing well without you having to listen to badly informed people like that. If you have the energy, it might be worth complaining, otherwise this junior doctor will become more senior and will carry on giving crap advice to people who might take more notice.

It's annoying how, even though you know they are wrong, it still puts you out having an appointment like that, though.

Fwiw, ds2 had severe reflux and I kept on breastfeeding him and I did baby-led weaning which was wonderful, despite some very bad advice/opinons from various healthcare professionals (including dietitians). I seem to remember the HV at the surgery even wrote in his book 'will start on baby rice twice a day' when he was about 5 months old - and I had no intention of doing so! Then the dietitians all seem to focus on increasing the calorie content of a baby's food, in order to bump up their weight gain, without acknowledging that highly calorific food with lots of protein or fat in it is likely to be harder for the baby to digest and make the reflux worse. It just seemed counterproductive to me, and so we kept on with the breastfeeding and baby led weaning and let him choose when and how much he had. I found the La Leche League helpline good when I needed a reminder that I wasn't crazy and my approach had a sound basis. Also the Yahoo! group BreastfeedingReflux which I think I've linked to in other messages. And www.kellymom.com of course.

Also if it helps, ds2 kept on breastfeeding a lot until he was over a year old: although he liked a lot of different kinds of 'solid' food and rarely rejected anything, he just didn't eat large amounts of it, and I knew that my milk was his main source of nutrition. This was even more evident when he was slightly ill or his reflux got worse. So you'll probably get comments later on about how much he's breastfeeding or how little he's eating, and it might help to plan responses to those... the best are probably along the lines of 'yes and I am so proud to know my milk is still helping him' or something like that, although if I wasn't feeling confrontational I used to just quietly ignore any comments and get on with whatever I was doing.

[tiktok]

anna, here's my suggestion: write to the senior guy and tell him what you have been told. Explain how undermining it is to be told confusing and confused things, and politely ask if his junior colleague might be interested in some training.

Paediatricians rarely see a breastfed baby of your baby's age - I mean it. Paeds deal with sick children, and bf babies are not sick as often as ff, and you are already way beyond the UK average for exclusive/predominantly bf, you will have been an oddity in his clinic.

Many of them literally do not know that the introduction of other foods and milks to a bf baby may have an impact on the breastfeeding - I mean they do not know...they assume that anything extra is in addition to whatever bf the mother is doing, not understanding that when solids/formula is given early, then it reduces the amount of breastfeeding the baby does, and his intake of breastmilk.

It is entirely possible that if you follow his advice your baby's intake of food overall will lessen....which is mad.

Breastmilk fortifier is from cows milk, by the way, just in case you didn't know.

Can't see why you need to see the dietitian. I am no more confident in dietitians than in paeds when it comes to supporting bf!

Hope you will write to the doctor.

[annabanana169]

Hello

Thank you so much for the support. I am going to write to the consultant we saw first and ask that the follow up is with him and make a complaint basically.

My biggest immediate problem now seems to be my dp who told me last night that he was embarassed by me in the appt and thought I was defensive and evasive and that I don't have his support on this one. I really don't know how to convince him, I can understand that its hard to ignore the paed but ugh, what can I do to get him back on side?

Anna

[tiktok]

Can you show your dp this thread, or explain the gist of it - that the junior paed's understanding of breastfeeding and your baby's needs is poor? You did your job as a mother - challenging the doctor because you have your baby's interests at heart, and because, frankly, you were better informed than the doctor. If it had been his (dp's) health in question, and dp was unconscious, and a doctor or nurse said something that showed they had misunderstood the situation, you'd have challenged that, too.

I mean, think about it....the doc was crazy! Feed your baby less often in order to get him to eat more.....it doesn't make sense!