6wo ebf baby failing to gain weight

(74 Posts)
blonderthanred Wed 12-Dec-12 16:42:18

I'm so upset and don't know what to do for the best.

My DS was born by CS after a failed IOL at 38wks due to GD. He was 8lbs0 at birth or 3635g and had lost more than 10% of his birthweight at day 5. On day 7 he had lost a tiny bit more and I was put under pressure by the mws to top up with formula but I asked for a few more days. At day 9 he had put on 20g, since then he has gained weight slowly (80-100g/wk) but has not yet returned to birthweight.

Last week the mw referred us to the paeds and said we should hear from them in the next few weeks. I've not heard anything yet. We also saw the GP for the 6 week check who was also concerned in case he wasn't strong enough to withstand catching a cold but said she thought I was 'doing the right thing' by continuing to ebf. She ordered a urine test which came back clear. Everyone we have seen says he looks healthy, alert and is meeting his milestones (lovely smiles this week). He has big feet, hands and head circ like his dad who is 6'3.

This week I was so hopeful as he seemed chubbier but he had only gained 10g. He is now 3.57kg. The HVs were very concerned and keen for me to start topping up. I asked them to check on how soon the paed appt is likely to come through so they are doing that.

I am bf on demand, average every 3 hrs although it's not as regular as that. He seems to have a good latch and I can hear him sucking and swallowing, although he is fussier during night feeds and sometimes in the latter stages of a cluster feed so I sometimes have to help him more with compressions etc. I try to offer both breasts although he prefers the left. If he is sleepy I remove a layer of clothing or change him, unless I think he really needs a nap.

He was checked for tongue tie at birth and we were told he was fine. He sticks his tongue out with no probs, maybe a very slight heart shape at the end.

I've worried about supply (as anyone would) as I have never felt really engorged but he comes away with milky chops and doesn't seem hungry or dehydrated. The HV today said maybe the milk wasn't good enough quality and asked a lot of questions about my diet (which I didn't think affected milk). He has plenty of wet nappies and generally at least one full dirty one (apart from 5 days when he didn't go but he made up for that after) although they are sometimes on the greener side of yellow. I don't get much from expressing (only a few ml from 15 mins each side) and find it quite stressful although I'm willing to stick at it if needs be.

I just don't know what I am doing wrong. In every other way motherhood is fantastic, exceeding all expectations. I am just so scared I am doing my son a disservice by declining to top up. But my instinct (and understanding) has always been that ebf is the best start for him.

Sorry this has been so epic but I've tried to include everything. Thanks to anyone who has read this far and for any thoughts and advice.

hillyhilly Wed 12-Dec-12 16:56:40

My dd was very similar, though perhaps for a slightly shorter time than your son, once she regained her birth weight she gained weight really quickly and I have spent most of the 7 years since worrying about her being overweight!!!
It sounds like you're doing everything right, is there a drop in breast feeding clinic you could go to? They helped me a little, more on my confidence than technique & I have to say I was so glad that I stuck it out, we fed for 22 months after such a shaky start.
Somehow, something clicked with her (it felt like she got hungry!) around 4 weeks old

blonderthanred Wed 12-Dec-12 17:25:29

Thank you hilly, yes I have been going to bf sessions weekly and the latch seemed fine, they could see & hear the milk going through. I keep hoping this is the week we've turned a corner as others have said once they've regained bw the gain is much faster.

I've had a lot of mixed messages about fore/hindmilk as mw & hv both said I should stay on the same breast to get the hind but the bf counsellor said it was not relevant and to switch feed. I did wonder with the greenish poo if he was getting too much foremilk though.

SamSmalaidh Wed 12-Dec-12 17:41:15

Switch feeding is better if you are trying to increase supply and the amount of milk he is getting - keeping to one side will reduce your supply. BF counsellor is trained in breastfeeding, HV/MW aren't (or may have done a 3 day course).

I would increase feeds - 3 hourly is pretty infrequent for a 6 week old so there is definitely scope to get more feeds into him. Switch feed at every opportunity, keep offering the other side every time he comes off until he refuses any more.

Can you get someone else to check for tongue tie as well? Again, MWs aren't trained to spot them.

blonderthanred Wed 12-Dec-12 18:02:14

Thanks Sam. I was told 8x in 24 hrs so I thought 3hrly was ok but am going to aim for every 2 hrs.

Who would be the best person to ask about tt? I asked the hv today but she said she wasn't an expert.

I just had the hv on the phone, she said the paed won't do anything unless we've tried formula first. I said I wanted to speak to the paed myself so please could they chase up the appt. She said yes but they will just say top up (so why refer?) We went round in circles for a bit but she is going to speak to the GP tomorrow and ask her to speak to the paed.

SamSmalaidh Wed 12-Dec-12 18:06:12

The BF counsellor would probably be able to either check herself or refer to someone who can.

8 in 24 hours is a minimum, I'd aim for more often if there are weight gain issues. Can you spend a few days just in bed, skin to skin, concentrating on feeding as often as possible?

blonderthanred Wed 12-Dec-12 18:28:27

I will try the staying in bed thing, sounds fun! I do really enjoy bf which is also why this is so frustrating. We spend most of our time in contact & I rarely go out so most of the last 6 weeks have been focused on feeding although I've had to fight helpful relatives from 'soothing' him because they want me to nap. He sleeps in a bednest or on my chest. I have a sling but it just makes him sleep so I don't think that would be helpful.

I'm going to try and keep a closer track of his feeding in case I am not giving him as much as I think but I am trying not to give myself additional stress (hence not pushing the expressing so far, but maybe I should have).

blushingmare Wed 12-Dec-12 19:05:00

I'm no expert, but just wanted to say I think you're doing a great thing for your baby by keeping breastfeeding. My dd lost 13% of her birthweight and took 4 weeks to put it back on and I know it makes you start to doubt yourself. I would echo what a pp said about increasing the frequency of feeds. I literally fed her whenever she was awake! Sat on the sofa all day and fed fed fed! Could you cosleep and feed lying down so you can feed as often as possible at night without completely exhausting yourself? Disclaimer: you may create a milk monster as dd (now 6mo) still feeds every 2.5 hours and every 1.5 hours at night

Good luck!

blonderthanred Wed 12-Dec-12 20:06:58

Thank you, that means a lot. I have read up on co-sleeping but really can't get the logistics of it so thought bednest was next best thing. I will work out feeding lying down though and definitely up the feeds. Thank you again.

ChunkyTurkeywiththetrimmings Wed 12-Dec-12 21:55:51

I'll add about the switch/block feeding - although I don't claim to be an expert...

As I understand it, the breast has to be completely emptied to get both supply up and hind milk into baby. Switch feeding is slightly different to the normal offering both sides... you offer one for a few minutes, then the other, then switch back & repeat. This will up milk supply/volume. Block feeding allows the breast to be emptied fully, which allows baby to get the hind milk. You offer the same breast repeatedly within a certain time frame.

The green poos do suggest a slight foremilk/hindmilk imbalance.

DS has had really good weight gain although I can't claim to know why - as DD didn't pile on the pounds easily. However, I don't automatically offer the 2nd breast (I put him back on the same one for a few more minutes) & offer the 2nd if he comes off the first naturally, & if he feeds again within 1.5-2hrs, I put him back on the same breast (within reason - some days this could go on ALL day!!).

More details about increasing weight here

SamSmalaidh Wed 12-Dec-12 22:02:10

That's not entirely true Chunky, as the breast can't be completely emptied, and it isn't necessary to keep the baby on one side, or return to the same side, to get hind milk.

Hindmilk just means the fattier milk that comes from a emptier breast - so if a baby is feeding frequently from both breasts they will get fatty milk.

When a breast is left to get full, the milk is less fatty/more watery - so if one breast is not used for a length of time (as in block feeding) then the milk will be foremilk.

Switch feeding also doesn't mean only feeding for a few minutes off each breast - it means feeding til the baby stops/comes off, then offering the other, then back to the first, and continue doing that until the baby is finished.

StuntNun Wed 12-Dec-12 22:36:27

It's very early days yet Blonder and there is absolutely no need to top up with formula unless you want to. You can tell a healthy baby by looking at them: are they alert, do they look healthy, are they having plenty of wet/dirty nappies. My red book recommends weighing a baby every month, there is nothing to be gained from weighing frequently and looking at 10g weight increases. A belly full of milk and a full bladder could increase your baby's weight by 120g. So don't be unduly influenced by these weights. To put it in perspective my 6yo was put on nutritional supplements due to poor weight gain but only gained 100g in three months. Then in the next three months he gained 2kg! Weight gain is in spurts and leaps, not a steady process.

There are a number of things you can do about your supply. You could ask your HV to weigh baby before and after a feed so you can see how much milk he is getting. Make sure you eat regularly and get rest so your body can make milk. Let feeds go on as long as baby wants to stimulate your supply. Try fenugreek or get medicine from your GP to increase your supply. Use breast massage/compression.

From your description it doesn't sound like your baby's health is currently at risk. You certainly have time to try a few things to improve the situation. You need time to see whether your baby's weight is following the percentile line and remember they don't necessarily stay on the percentile they were born on (my DS1 was born on the 50th but dropped to the 2nd over the first few months and then stayed on the 2nd.) Also it is normal to move two percentiles before they even refer your baby for investigation.

Unfortunately formula is seen as a quick fix but unless there is something wrong with your milk which is exceedingly rare, breastfeeding is still the best for your baby. In my opinion you are doing the right thing by resisting formula. If you try to improve things and it doesn't work then you can introduce formula in a few weeks knowing you have tried everything else.

ChunkyTurkeywiththetrimmings Wed 12-Dec-12 22:47:39

Sam5 I don't claim to be an expert - as I said - and happy to be corrected, but I have read frequently (on LLL, Kellymom etc) and from conversations with other bfing mums and peer supporters that block feeding is one way to increase hind milk...

Hopefully the info here blonder will help you be confident you are doing best by your baby. Best wishes etc.smile

midori1999 Wed 12-Dec-12 22:48:07

It sounds like you've had a very hard time OP.

I think it is probably worth getting some more support with breast feeding, from a breast feeding counsellor or lactation consultant and also getting your DS checked for tongue tie by someone who really knows what they are talking about. Not sure what area you rare in, but Milk Matters may be able to help with this?

8 feeds in 24 hours is the minimum really, so you are right to try and increase feeds. Switch feeding will help and have you tried breast compressions also? You are right that what you eat won't affect the quality of your milk, so don't worry about that. Just eat to hunger and drink to thirst. Keeping our baby close so you can feed at every little sign he is hungry or at every stirring is good too and skin to skin helps with milk supply/let down. Feeding as frequently as possible and with as many sides as your baby will take will also help with milk supply.

However, you really need some good real life advice from someone who really knows their stuff about breast feeding.

tiktok Wed 12-Dec-12 22:58:08

Blonder this is a concerning situation and its good its being taken seriously. Problem with a talk board is you get info that may not be right and you can easily become deomoralised and confused. This has happened on this thread ie not everything people have said is correct.

Best step next is to get real life help. Try the helplines. If your hv says she is no expert (and her questions about diet indicate she is not) can she refer you to someone who is?

blonderthanred Wed 12-Dec-12 23:16:49

Thank you Chunky, I've spent ages looking through Kellymom and LLL websites and trawling the Internet but I really wanted a sense of whether I was doing the right thing to persist and have faith in bf or whether it was time to give in - and you and the others have reiterated what I felt, so thank you very much.

Stunt it is really good to hear your perspective and read a success story. And also to feel like it's not this urgent situation which is what it feels like but possibly part of a bigger pattern. Just wish I could see a few weeks ahead!

Thank you for the votes of confidence. Have been switch feeding since 5pm with a few breaks for gurgling and smiling (him not me) so hopefully due a couple of hours guilt-free sleep soon.

blonderthanred Wed 12-Dec-12 23:22:54

Thanks to midori and tiktok too, it is so hard to know who to speak to IRL. I exchanged emails with someone from LLL a few weeks ago but there are no meetings in my area. I could go back to the GP maybe? She said she'd see me anytime even without an appt.

I will keep pursuing it anyway but thanks for the input and support.

Ameybee Wed 12-Dec-12 23:34:30

Hi blonder recognise you from the staying awake thread. Sorry you're having a tough time! Just wanted to say that we just found out DS isn't quite gaining as he should, I've started expressing to increase supply and We are trying (only x2 successfully) to top him up with expressed milk, will see what his weight gain is next week but may consider 1 formula feed if the HV suggests it. Has anyone suggested expressing? You could maybe see how much LO is taking then? X

ChunkyTurkeywiththetrimmings Wed 12-Dec-12 23:36:01

What about the NCT or Sure Start centres? I think the NCT also have a helpline & my local childrens centres run breastfeeding support groups... They might be able to refer you to the appropriate person.

maillotjaune Wed 12-Dec-12 23:42:32

Blonder when I was in a very similar situation with DS3 almost exactly 3 years ago I had excellent advice from tiktok and after a few weeks he just started putting on weight. I didn't even change anything!

I was feeding him more like every 1 1/2 hours and every 2 to 3 hours at night with a cluster in the evening.

Hope you find something that works for you.

blonderthanred Thu 13-Dec-12 09:03:09

maillot I hope that happens for us! But have been hoping that every week.

Chunky I'm going to an nct group tomorrow so will see if anyone I can speak to.

Had huge row with DH at 1am as he wants me to sleep. Unfortunately DS is having a fussy night so I am convinced I'm starving him despite mammoth feeding sesh. This way madness lies.

KatAndKit Thu 13-Dec-12 10:36:10

Hi blonder sorry you are having a tough time with the BF. Your HV is totally wrong about the milk quality thing by the way. The problem is likely to be that your DS is not transferring milk effectively from your breast. I would be inclined to strongly suspect a tongue tie. Posterior tongue ties are particularly hard to spot. My DS had a tongue tie although fortunately it did not affect his weigh gain. Breastfeeding was way easier once it was snipped.

If you are finding it hard to access good BF support via the usual channels perhaps phone up La Leche League - the LLL round here have good bf supporters who are very knowledgeable. They also have a BF helpline and hopefully will be able to put you in touch with someone in real life who can give you support in person. Round my way the sure start centre has an excellent bf drop in staffed by a proper lactation consultant but this is not true of all bf drop in groups.

I agree with the advice to feed more often. Try to offer a feed every two hours and see if that helps. I am 8 months in now and only now am I down to 3 hours between feeds in the daytime.

shouldIbecrossaboutthis Thu 13-Dec-12 13:08:25

blonderthanred, I'm not as much use as others on this thread (especially tiktok) but I just wanted to reassure you that even if your baby was gaining weight well (mine was born on 75th and has gone up to 91st and stayed there and is a baby tank!) breastfeeding will still mess with your mind.

I found you just need to have faith in your body. The thing that keeps me going when my baby is being fussy / my boobs seem less full / we haven't had a poo etc is that my baby has plenty of wet nappies and is alert and generally happy. You just have to keep thinking this and reassuring yourself that your body knows what it is doing.

If your baby isn't gain weight as quickly as they would like then it sounds to me like the best solution is to keep feeding and then feed some more. Try not to get bogged down with all the other things like expressing, worrying about which boob to use, just feed feed feed switching boobs when the baby comes off naturally.

Good luck with everything!

Elizadoesdolittle Thu 13-Dec-12 13:24:45

Waves hi blonder.I popped over to this thread after you posted in our post natal group. My DD is 5 weeks tomorrow and still not back to birth weight. I got her weighed 9 days ago and she was 3.4g, today exactly the same, in fact a little bit less. She too had the urine test and came back clear. The hv made a dr appt for her this afternoon. She does have a hacking cough so has been sick more than usual. But like your lo she has wet nappies and although she doesn't pooh everyday when she does it is of good colour and consistency. I am yet to give into formula top ups as I didn't think she needed it but am close to relenting. So although I don't have any advice I just wanted to know you have my sympathies. It's tough but at the end of the day our lo's are happy and appear healthy so we must be doing something right!

tiktok Thu 13-Dec-12 14:20:15

blonder - try the helplines and ask your HV who is the infant feeding specialist in your area (might be at the maternity unit).

Any baby at this age not yet up to birthweight is doing something very unusual....a few babies are just physiologically slow to gain, ie that is just the way they are, but the majority of them are likely to benefit from more feeding, or more effective feeding.

They all need to be checked out - tongue tie, other oral anomaly eg cleft palate, underlying infection, and usually more than once, and by someone who knows what to look for.

First and easiest step is to feed more often, from at least each side each time.

blonderthanred Thu 13-Dec-12 15:31:34

Thanks all. Eliza I am sorry you are going through the same thing.

I was just so shocked yesterday, like I said he looks so much chubbier this week and there's no denying his feet are pushing out the end of his newborn clothes. But having been to a baby group this morning and had several people say 'he's so tiny!' maybe it is more slight than I hoped.

Today I feel calmer and more rational. I am going to concentrate on feeding as much as poss, expressing if I can but focus on bf. Then if no marked increase next week I think I will try supplementing with formula and expressing when I do.

Just spoke to the hv today and she said that my GP is now on leave so can't chase the paed appt. I asked if she had rung them herself but she said in my PCT "paeds don't talk to HVs" - basically as though that was a dead end. I heard myself say calmly, "well what do you propose to do then?" - if I have learnt anything from MN it is to fight my corner! So she is going to see if she can speak to another GP. I asked her about speaking to the breastfeeding specialist at the hospital re. double checking for tt or other issue so she is getting back to me. Why is it such a fight?

KatAndKit Thu 13-Dec-12 16:25:26

I think you might need to bypass this HV - try ringing the hospital yourself to chase the appointment and going either via LLL or a private lactation consultant for the TT. Sounds like your HV is not at all supportive of breastfeeding and just wants you to pack it in and go onto formula.

crikeybadger Thu 13-Dec-12 16:31:45

Hi blonder, sorry everything seems like a battle for you right now.

I just wanted to add a couple of things, hopefully without overwhelming or confusing you...

-being able to poke a tongue out, does not always rule out tongue tie so it's good that you are trying to get hold of the breastfeeding specialist.

-Sometimes a small adjustment in the latch can make a big difference to milk transfer so again, that's another one to consider.

-I'm not sure if this was mentioned before but what you eat and drink has no effect on your milk quality or quantity. You obviously need to eat well for your general wellbeing, but your HV is barking up the wrong tree with that one. (and indicated a clear lack of understanding of bfing).

- Great idea to have a babymoon- just feed at every squeak and do lots of skin to skin. Then as you say, see where you are next week.

One final thought....are you happy that the scales are correct and the weights have been accurately recorded?

Let us know how you get on anyway.

WLmum Thu 13-Dec-12 16:53:45

Hi, what a stressful time for you. Dd1 did not gain weight as expected even though I fed her almost constantly. Sounds as though it's a bit different to your ds though as she cried loads and hardly slept. Despite being assured at bf clinics that she was feeding ok, clearly she wasn't as when I switched her to ff she piled on the weight. I too had little success with expressing but I do think that was largely because my supply was low, and I had a crap expresser. When I got a better one, and had a bit more rest after dd had had some bottles, I started to be able to express much more until I could get 8 oz in a sitting. In hindsight I wish I had tried mixed feeding earlier and replaced bfs with expressing to get my supply up - fenugreek is also great for boosting supply but it does make you smell like maple syrup!, and then moved back to ebf when I was confident about supply. I think dds problem was that she had a very weak suck so only got a tiny bit if milk at each feed but stayed on trying for more/comforting.

Good luck with whatever path forward you choose.

ChunkyTurkeywiththetrimmings Thu 13-Dec-12 17:56:10

Really hope you get some (pro-bfing if that's what you want to do) support to get him gaining weight at the correct rate. It is very difficult to keep perspective when it is a) your boobs/milk/body that is perhaps perceived to be "failing" and b) your baby & all you want is that they are healthy & happy. Best of luck.

blonderthanred Thu 13-Dec-12 18:22:08

Thanks again to those who've taken the time to post.

Spoken to HV (again), locum GP and (hallelujah) breastfeeding specialist who has arranged appt on Monday to check again re. tongue tie or other issues. So a weekend of intensive bf and then we shall see.

Does the fenugreek really work? I wasn't sure if it was worth getting some.

SpanielFace Thu 13-Dec-12 18:29:22

This sounds so similar to my DS. He lost 11% of his birthweight, and had still not returned to it at 4 weeks. He was also incredibly fussy, constantly hungry and unsettled. He turned out to have a tongue tie which had been missed, it was only when we saw the breastfeeding specialist that it was picked up. If your baby has a heart shaped tongue I would say its highly probable that is the problem. DS had his snipped at 5 weeks old and it's been smooth sailing ever since, although he's still on the 0.4 centile line! I really hope that you get the help you need, I was so stresses and worried about DS so I feel for you.

StuntNun Thu 13-Dec-12 18:29:24

I wonder what the effect of the GD is Blonder? If he was 8lb at 38 weeks then he must have been getting a lot of extra glucose in utero. It is possible that some of what you are experiencing is an adjustment to feeding on his own after being oversupplied. Hopefully the next few days will make all the difference. Honestly it's amazing humans survived for hundreds of thousands of years without scales or formula milk. The way the midwives tell it we would have died out as a species without formula milk.

blonderthanred Thu 13-Dec-12 18:46:23

Stunt I suggested that to the mws but they dismissed it. He was measuring 3 weeks ahead on ultrasound. Also the person from LLL said CS babies lose more weight in the first 24 hrs because they don't have fluids squeezed out during birth. If he had weighed 7lbs8 at birth he would have regained bw at 3 weeks and we'd only be weighed monthly - I wonder how it would have worked out then. He'd still be a slow gainer but perhaps without this panicked response.

Spaniel Sorry you had to go through it too. I kind of hope it is that for us as it would make sense of what is happening and is a relatively easy fix. HV insisted TT impossible if he is latching but it sounds like that's not always the case.

SpanielFace Thu 13-Dec-12 19:06:31

I was told that it couldn't be a tongue tie as DS was latching & I had no pain. It's rubbish. Have a look at http://milkmatters.org.uk/2011/04/15/hidden-cause-of-feeding-problems-however-you-feed-your-baby/

Obviously there are lots of other possible explanations, but tongue tie is underdiagnosed - apparently it affects 10% of babies!

Has anyone suggested breast compressions to help with milk transfer? That did make a difference to us before the tongue tie was snipped.

KatAndKit Thu 13-Dec-12 19:26:16

My DS had a tongue tie and still has a lip tie. He latched on, he was able to take in milk enough to gain weight ok and I wasn't really in any pain. He did keep bobbing on and off and took ages to feed and his latch was quite shallow but nevertheless it proves that even if the baby is latching a tongue tie is quite definitely possible.

At the BF group I go to there was a woman with a teeny little girl who was taking ages to regain weight and guess what, it was TT.

ChunkyTurkeywiththetrimmings Thu 13-Dec-12 19:37:09

blonder my DS was tt and has been growing like a weed. He latched on ok although shallow, so it was uncomfortable but didn't cause me severe pain or trauma. He had a severe (90%) tie with little to no lateral mobility. Essentially, it doesn't follow that because he can latch, he's not tt. It could be why he isn't efficiently feeding...

According to the Lactation consultant at Kings, 1 in 7 babies are TT & 2:1 ratio of boys to girls affected.

mamaonion Thu 13-Dec-12 19:40:49

Hi op it sounds like you're doing a great job and I would echo advice to talk to bf expert in rl who can help you deflect negative inaccurate info about bf with good, evidence based factual info about bf. So many hv and GPs are poorly informed and this can so easily undermine your confidence.

Just a thought, when I saw a paed we sons allergies at 6 months he looked at my red book and dismissed my concerns about not tracking the bands in the book. He said 'drs are more concerned with an infants weight gain from 6 weeks onwards as it can be very misleading to track from birth, from 6 weeks we get a more accurate representation of babies growth, birth weight is more influenced by efficiency of placenta..,' (paraphrasing here).
He is highly respected allergy specialist at guys in London.

Could your gd gave lead to baby being bigger than maybe he would otherwise have been and maybe he's evening out to his natural weight? Maybe someone more knowledgable on here can advise on this.
I was just so surprised to hear him say this as hv in my clinic are very obsessed with the growth charts and always track from birth.

StuntNun Thu 13-Dec-12 19:52:50

I was told the same Mamaonion when my DS1 had problems, that the nutrition he got in the womb was very different to how he fed when he was in charge of feeding. With DS3 it is the opposite way round as I had a placental abruption he was very small at birth but since then has been gaining half a pound a week so he's making up for lost time now he's out.

Shelby2010 Thu 13-Dec-12 20:02:10

Just wanted to empathise with you, my dd stopped gaining weight at around 2 months. I spent a month going to bf clinic, expressing, switch feeding etc etc but still very little weight gain. In the end I reluctantly started topping up with 1 feed of formula, she started gaining weight almost immediately. And despite the predictions we then continued to combination feed until she was over a year old.

I do feel a bit guilty that I hadn't given her formula sooner, but I thought it would mean the end of bf. So be reassured that if you decide to then you can quite easily do both! Afterwards I wondered what I'd been so worried about, it really isn't the end of the world!

blonderthanred Thu 13-Dec-12 21:34:58

Thank you, those are really interesting thoughts re the GD and people's experiences of TT. I really am grateful. And slightly overwhelmed.

Strange that he sleeps quite well (but is also v alert at other times). You would think if he was not getting enough milk he would be either restless or overly sleepy. He does get quite grumpy/screamy at times but that's usually if he needs a burp/poo or at the end of a cluster. Oh well. Going to try and get some sleep now till the next feed.

StuntNun Thu 13-Dec-12 22:21:44

I'm the same as Shelby, with DS1 I topped up with formula from 4 months (due to supply issues caused by using nipple shields) but continued mixed feeding until 8 months when DS1 self-weaned.

Elizadoesdolittle Thu 13-Dec-12 22:24:36

Well as predicted the dr didn't find anything wrong with my DD so has referred us to the peads. Think I'm in for a long wait for an appointment though.

blonder you are doing a great job. If you don't mind I will follow this thread with interest. Although I'm sorry to see others are having the same issues its nice to know I'm not alone iyswim. i thought it was all going so well and that DD had taken to bf very easily.

I too don't understand as DD seems happy. Is very alert and doesn't cry often or seem in pain so I don't think she is going hungry. Think I will get myself to the bf clinic to see if I can get any answers there. I do think I could feed her more often but as she wasn't asking for it I wasn't feeding her as I thought I was just bf on demand but she obviously needs more than she thinks she does.

Good luck blonder I hope you get your answers soon.

blonderthanred Fri 14-Dec-12 03:45:01

It's good to know that people have topped up without giving up bf, as I worry one will lead to another.

I said to the hv if I did top up and ds put on weight I still wanted him checked out and I wanted support with bf to make sure I could continue to mix feed or aim to return to ebf. She seemed completely flummoxed by this - I get the feeling I'd definitely have to fight for this.

Eliza I'm sorry about your dd, I haven't posted much on the nov thread lately as I didn't want to sidetrack it & so many people are having their own bf/ff issues but we can always update each other on this thread. I know the paeds are busy people but seems funny it's such a concern yet appt takes weeks to come through. I guess if they really thought we were in danger it would all happen more quickly so that's something. I'm going to try a few different bf groups to see if I can get to the bottom of this. Ultimately from what I understand, bf should be enough for most babies & we are working hard - so we should be able to make it work!

tiktok Fri 14-Dec-12 08:59:41

Eliza, interesting point about your baby not seeming to ask for more feeds....this can happen, that the baby for whatever reason does not 'insist' much and takes sufficient milk to tick along ok, but not really to grow as he/she might. All this with the caveat that some babies are physiological slow growers in infancy (and some are fast!) and they are just fulfilling this 'destiny' .

Some babies are laid back and have the sort of relaxed personality which does not lend itself to much asking/insisting/demanding. I have seen this happen in busy households, typically with a third or subsequent baby, where there is often something interesting to see, watch, or react to; the baby gets a lot of socialising and emotional connection from being with siblings. I've wondered if this sort of baby gets to be able to 'manage' on less frequent feeding.

We know that in societies with no strictures or ideas on how often babies 'should' be fed, and where babies are with their mothers more or less all the time (99.9 per cent of human existence has been like this - we certainly evolved that way), babies feed literally dozens of times in 24 hours - many, many more times than the 8 x or three hourly that the OP has learnt/been told is normal. 8 x in 24 hours may suit some babies just fine, but some would benefit from being enabled to feed very often from the beginning.

I hope you get good help soon.

Elizadoesdolittle Fri 14-Dec-12 09:27:15

tiktok you make a very interesting point about some babies just taking enough to coast along. She is a very calm baby and I have a nearly 3 year old DD who is very loud and active so DD2 does quite often get left a bit longer than DD1 would have been as a baby. But as she seemed content to watch the world go by I let her.

But that will change. I will feed her more regularly even if she doesn't appear to want it.

Thanks for your insights everyone. They've been interesting and most helpful.

WLmum Fri 14-Dec-12 09:36:51

Yep, fenugreek really does work! It gave me a real boost after just a couple of days and helped with my confidence. You could always use the boost in supply to try a bit more expressing. It's nice to hear success stories of mixed feeding - I think i waited too long for fear that it would mean an end to bf. Sadly for me it did, but I do think if I had temporarily mixed earlier it would have given me a better chance.

Elizadoesdolittle Fri 14-Dec-12 09:37:21

blonder I'm very sorry that you have a very unhelpful hv. That's one way our situations differ. Mine is very supportive and has said there seems no reason at this stage to top up with formula as I'm doing a great job. Having her on my side has made a great deal of difference as every other person I've seen has just said ff top up. She's given me the confidence to carry on ebf. She was my hv for DD1 so think that's helped. And just to add DD1 was ebf till 3 months. After that I went onto mix feed as I couldn't get on with pumping with her. It worked well so can be done. I intend to do that at some point in the future with DD2 but not ready yet. I'd like to make it to 6 months if I can but just taking it a day at a time at the mo. this thread has given me the confidence to carry on and up the feeding and pumping so thank you for setting it up.

blonderthanred Fri 14-Dec-12 10:11:41

Well I just had a call from the bf consultant and she has spoken to the paeds who are going to see us at 11am! So I am really glad I pushed rather than just accepted the crappy 'paeds won't talk to HVs' line.

Just to say in terms of feeding, I've fed totally on demand which for my son has been fairly sporadic but involved lots of cluster feeding as well as focused shorter feeds. I've carried on as long as he wanted & not had a problem with comfort sucking if he wants that too. It's just that at the weigh ins, the question we've been asked is if he is feeding 8/24 which I thought it worked out at an average of (not that it's been regular intervals or even exactly the same each day). So it's not that I've been aiming for this figure, it just seemed to work out as that on average. Sorry if that sounds defensive but I just wanted to add that!

tiktok Fri 14-Dec-12 10:21:56

blonder hope you get good help today.

I know that this '8 feeds in 24 hours' is often used as an official benchmark.

It shouldn't be!

catwoman101 Fri 14-Dec-12 10:27:16

Mono one is judging you blonder, some babies do feed 8 in 24. It's just that lots also feed 20 in 24, like mine!

Good luck today, let us know what pads say. Don't be upset if they do advise ff, you have given the good stuff exclusively for 6 weeks, and that is the optimum for all the yummy antibodies etc, and better formula than unhealthily low weight. (although obviously hoping for you that they say carry on with bf ing )

Elizadoesdolittle Fri 14-Dec-12 10:39:58

Good luck blonder. Hope you get some way in getting the answers you are looking for. Fingers crossed!

blonderthanred Fri 14-Dec-12 15:28:01

Well there were no quick fix answers unfortunately. They don't think there is any tongue tie and no other problems with his health thank goodness. He had to sit on a little pot to get a urine sample so it looked like we were starting potty training very early.

Interestingly he is 50g heavier so either he has gained that in 2 days or there is a variation in scales. So according to them he is just 10g below birthweight now.

Their conclusion was that either he has yet to find his centile (he may end up staying on a low one or else move back up over time) or he is not getting enough calories from the milk he is taking. Either way they think it is too early to decide so they want me to continue ebf (hurrah) and take him to be weighed in 2 weeks. If he has slipped further then they may advise supplementing with formula but until then I should just carry on as we are. They did say to eat and drink plenty though...

tiktok Fri 14-Dec-12 15:57:30

That all sounds fine (though their repetition of the eating and drinking plenty indicates a lack of knowledge smile ) and sensible. It's very possible for babies to gain 50g in 2 days.

A re-weigh in 2 weeks sounds ok.

ChunkyTurkeywiththetrimmings Fri 14-Dec-12 16:05:50

No quick fixes, but at least no obvious issues. Two weeks of duvet days & eating choc then??!! grin

Glad you can keep on with bfing, as that's what you want to do, so fingers crossed he goes up by the required amount by the next weigh-in.

KatAndKit Fri 14-Dec-12 19:09:28

Glad you have been given the green light to carry on bf. Feed feed feed and hopefully in two weeks time everything will be getting better.

catwoman101 Sat 15-Dec-12 09:46:25

So pleased your dc is healthy and they want you to continue bf ing for now.

You do need to drink and eat lots for bf ing, but it is not for the quality of the breast milk, but the health of the mum. If she is low on fluids or calories the breast ilk keeps coming but mum gets dehydrated and low on energy, and Boone needs that with a new baby.

Bryzoan Sat 15-Dec-12 10:18:31

Hi blonder and Eliza,
Just wanted to say I had similar issues with dd. Working with paeds and a lactation consultant the way we got round it was to keep bf, but also express at each feed and give a top up. That way the paeds were happy she was getting a measurable amount, and weight went up (and if it hadn't we would at least have ruled out not getting enough as the issue). There is still the nipple confusion risk, and it is bloody hard work bf, bottle feeding, expressing, washing and sterilising every 3 hrs (used to take me an hour and a half all in) but keeps your supply, gives them ebm, and you have a really good chance of fully bf later. It took us 3 months to establish bf fully (though dd was prem and had other issues) but I felt it was so worth it - and we kept going very happily till 16 months.

If you do go the expressing route on that scale, hiring a hospital grade machine is a must. I would never have got the volume otherwise. Medala hire them - can't remember costs but around 25 - 45 pounds per month.

I got loads of advice on feeding with dd and the best advice was that as long as the baby is fed well, and you keep your supply going, and keep giving the baby opportunities to bf you will get there in the end. Just try not to loose your marbles competent meanwhile though!

Really good luck, whatever you decide

hillyhilly Sat 15-Dec-12 11:43:46

So glad they've given you two weeks before next weight in, so you don't feel so under pressure. Different sets of scales can make a difference when we're talking 10g as can whether they've just we'd or pooed.
Stick with it, I'm sure you'll be fine

horseylady Sat 15-Dec-12 21:25:09

Great news blonder!!

So annoying it takes so long to see specialists though!

Good luck!

Elizadoesdolittle Wed 19-Dec-12 10:58:38

I have my appoint with the peads tomorrow morning. I'm hoping they will be as encouraging with me as they were with you blonder. Hope you're getting on ok.

bryzoan thanks for the encouragement and for sharing your story.

blonderthanred Wed 19-Dec-12 18:54:31

Oh good luck Eliza! Really hope you get some answers and support.

I have an update - went to bf group at hospital today & saw bf nurse who helped sort appt last week. She got a colleague to look and they think L might have a posterior tongue tie after all! So we are being referred to another hospital to investigate further. She said just because he latches on doesn't mean he can't have a TT and especially as he slips off it could indicate one, along with the heart shape and the fact that his tongue doesn't reach the roof of his mouth. So the saga continues.

Elizadoesdolittle Fri 21-Dec-12 09:08:10

Well I have no real answers. She may have mild broncilities (sp) which they can't do anything for. This is what's causing her to bring back up most of her milk. Advice was to feed feed feed and top up, which I have been doing, she's just been bringing most if it back up. She is very hit and miss with taking a bottle so it's hard to top her up and I'm not finding enough time to express the amounts i need. Am glad it's the Xmas break coming up. I'm going to just sit and feed all day and everyone else to fetch me food and drink smile

Got to go back on 2nd jan. hopefully her cough will clear up which will help a great deal.

blonder glad you are getting some help and advice re the breast feeding. I don't think this forms part of the issue for us but I think I'll go to my local breast feeding clinic once the Xmas break is over to get it checked out.

blonderthanred Fri 21-Dec-12 09:17:06

Sorry no concrete answers Eliza. Must be so frustrating that the milk is coming back up when you are working so hard to get it in.

Hope you have a restful Christmas break feeding and being fed. I keep telling L I am trying fatten him up like a Christmas turkey!

blonderthanred Fri 11-Jan-13 11:40:50

An update:

Well the end of our ebf journey has come despite finally having his posterior tongue tie snipped on Wednesday. He has only put on 45g in 9 days and has dipped below the 0.4 centile. He is 11 weeks today and just 8lbs9.

GP & HV obviously very concerned and want me to offer a 3oz formula top up after every bf to try and get his weight up. As I'm up to expressing 5oz a day I asked if a couple of the top ups could be ebm but they said no. Which was odd I thought. Not as odd as the GP saying I shouldn't express at all as 'the baby would miss out on the colostrum'. Wtf?! I assume he means hind milk.

Anyway I agree that he needs some extra calories and I'm going to give the formula but also express to keep my supply up and hopefully return to ebf or ebmf in the future. I really hope I'm doing the right thing. Any comments or input very welcome.

tiktok Fri 11-Jan-13 12:12:08

blonder, thanks for the update. I think there is justified concern about your baby's weight, and top ups don't have to be permanent.

You could get a seocnd opinion about the ebm - your doctor is quite wrong about the baby not getting the 'colostrum' (WTF???! indeed) or hindmilk. 5 oz of ebm is the same, calorifically, as 5 oz of formula but you prob need a bf specuaist to confirm this to you, and write it down for the doc....I think you said you'd seen one?

blonderthanred Fri 11-Jan-13 13:35:55

Thanks Tiktok. The TT specialist we saw on Wed is an IBCLC and said I could call her any time. I've also been seeing the breastfeeding counsellor at the hospital where I had DS. So I will ask them. I am happy to do all three bf ebm and ff and see how it goes.

When we saw the paeds before Christmas I asked about TT and they said it was a red herring. But the IBCLC said his tongue function scored 4/14. So I can't help wishing we had had that looked at earlier and perhaps he would have put on weight.

It certainly feels like his latch is twice as strong now. So I am hopeful that he will start putting on weight from bf as well as the top ups. I just need to make sure I increase my supply at the same time. I've hired a hospital grade breast pump so expressing is as efficient as poss.

mawbroon Fri 11-Jan-13 23:35:24

It is very possible that the tie has not been released fully.

Come and join the tongue tie babies support group on facebook.

Just snipping the tongue tie is not enough. It needs to be combined with some sort of bodywork such as craniosacral therapy. The pull of the tie can cause tension in the head, jaw and neck and needs to be released for maximum benifit. Some babies also need suck training to teach them how to use their "new" tongue and mothers also benefit from learning deeper latching techniques. This is something a lactation consultant could help with, but it needs to be one who has taken a specialist interest in ties and understands them well.

Even if you decide to stop breastfeeding, please do not ignore the tie. DS1 went undiagnosed until age 6 and has suffered a long list of problems directly related to his ties, they can affect the whole body.

MsElisaDay Sun 13-Jan-13 18:10:34

Just to say that it's perfectly possible to return to ebf after topping up with formula- I did, after a month or so of giving DS two or three Aptamil feeds a day.
We were forced to top up after DS refused to feed and was still significantly below his birthweight at 4 weeks. The midwife sent us back to hospital, where they insisted he was given formula straight away. He wolfed it down as I cried- I felt i'd failed him.
After returning home I began a cycle of attempting to bf, then bottlefeeding and then pumping, every 3 hours. Over the next few weeks my supply went up and I could cut out the formula, feeding him only ebf.

Now, six weeks later, and out of the blue, we're finally breastfeeding. I'm only pumping to create a freezer stash, and he seems satisfied and happy- as am I!
Of course if you choose to ff then fine, but it doesn't have to mean the end of bfing if you don't want it to.

crikeybadger Sun 13-Jan-13 18:31:07

Glad you've finally sorted out the reason for your LO's slow weight gain- it just shows how hard to diagnose these ties are, unless someone is really specialised in spotting them. Must make you feel a bit upset though that it has taken this long to get it snipped. sad.

Personally, it would seem madness not to give DS your breast milk, if you have the same quantity as formula available. Formula is likely to take longer to digest for a start, so may increase the gaps between feeds, which is obviously not what you need. Obviously though, you should go with what you feel is best.

I'm pretty sure that kellymom has a list of the calorific value of breast and formula milk. I'll check in a mo'. smile

crikeybadger Sun 13-Jan-13 18:33:20

Here you are.

Actually, there's more calories in breast milk than formula.

blonderthanred Sun 13-Jan-13 18:57:29

Thanks Crikey. It certainly is harder to fit in as many feeds as I was - a full cycle (left & right breasts + bottle + winding etc) is now taking about 2 hrs!

However I feel sure DS is taking more milk in from bf as the difference in feeling is noticeable. So I am focusing on the quality of feeds.

I thought that was true about the calorie content. I'm currently able to express enough for 2 top ups and I'm not topping up night time feeds at all (still need to sleep!) so formula top ups are 3-4 times a day. I am hoping that with a couple of weeks of supplementing and working on my supply & DS's latch, I'll be able to start dropping the formula top ups.

By then hopefully his weight will have increased to a healthy level and he will be naturally taking in whatever amount he needs to find his own growth pattern. That's the ideal scenario anyway.

crikeybadger Sun 13-Jan-13 19:51:10

That sounds like a good plan blonder. Hope it all goes well for you both.

city1984 Tue 15-Jan-13 23:20:01

AI a also wanted to add that it is possible to return to ebf. My ds lost 18 % of his weight on day 5. We were back in hospital where he was tube fed for a couple of day. Was than bf for a week with full formula top up which he took. By week 3 he was up to birth weight and we dropped formula. At 4 months he is now between 25th and 50th centile (born on 75th) and everyone is happy. Good luck op.

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