So bloody sick of it - despite feeding constantly, DS is not really gaining

[Hopefully]

Having avoided HVs since DS2 was born, I finally gave in and took him for his 3 month check today. And, yup, he's slipped way down the charts, from the 50th at birth to below the 0.4th today (12 weeks + 2 days). Have posted about feeding frustrations here (in a nutshell, he feeds lots, doesn't feel like we've left newborn feeding pattern behind)

HV was very nice and non-alarmist, but referred me to GP, who I saw this afternoon. GP was reasonably concerned, especially as DS2 is pretty long and his head measures on the 75th percentile.

GP's initial suggestion was to express every feed and give it by bottle. At my face he agreed that perhaps I could try expressing and topping up.

I'm feeling so bloody down about this, as I was so relieved that our BFing relationship was going well - had a hell of a time with DS1 )colic, undiagnosed tongue tie, slipping down the centiles etc etc), and now my confidence is completely shot.

I just don't know what more I can do. DS2 is already feeding at least every 90 minutes round the clock (more like hourly or more during the day, very occasional 3 hour gap at night, but only about one night in 5), I am just about keeping on top of everything with very busy DS1 (2.9) to look after as well, and I just don't have the time or resources available to sit and pump for hours every day.

DS2 doesn't nap terribly well, so he has kind of got into the habit of feeding to sleep and dozing on and off in my arms, but I didn't think it was so 'bad' that he wasn't taking proper feeds, iykwim.

DP has already started mentioning formula more and more frequently, and I know he would quit happily give it as DS1 had a bottle a day from 10 weeks and 'he's fine' (DP's words). I am prepared to give formula if I really have to, but I would prefer to solve this with a BFing solution if I possibly can - seems a shame to ruin a good thing.

However, I just don't know what to do to solve it without formula! I feel like all my attempts to be more baby led this time (was a bit more routiney with DS1) have completely failed and I may as well not have bothered.

Help! Wisdom appreciated!

[orchidee]

Bollox that's really disappointing, you've a lot on just now. I'm sure someone with experience will be along soon. (Trying to think of something helpful...)

Okay, just to recap, DS is feeding almost all day but not putting on weight. And you're confident the latch is okay, but is it maybe worth getting it checked? Or just to speak to a lactation expert (as opposed to HV / GP / any other HCP for whom BF isn't their core interest.)

I've no experience with expressing but it sounds like you'd struggle to fit it in along with your feeding pattern. I believe some hospitals etc will let you hire their industrial-grade pumps. I think the last thing you need is to faff about with something that's not going to collect much milk or take ages to do so.

If you do begin to top up with formula, it's not the end of the world. But with the effort you're putting into BF I can understand that'd be disappointing. So the priority would be to get DS's weight stable while maintaining your milk supply.

Can I (in a non-patronising way) say: look after yourself too and keep posting.

[MockingbirdsNotForSale]

Hiya Hopefully. That sounds pants. However, is your DS content and does he look satisfied after a feed (despite wanting to feed again 90 mins later)? If he is then I personally would really try not to worry, especially as he is growing length and headwise. Instead of expressing (I am rubbish at it and definitely produce less than DD takes) perhaps you could ask to borrow some baby scales and weigh him before and after a feed to see how many oz he's getting?

[linklonk]

Hi there,
I saw your post and really feel for you. I applaud your commitment to breastfeeding, and I sincerely hope you can get the support you need. Have you considered getting in touch with La Leche league? They are usually wonderfully switched on. I'm not sure what they would say about the breast pump, but I've always found people hate them.
Are you really worried about baby's health?
Some babies just don't stay on the same growth line, and remember those centile charts do not apply to breastfed babies. More worrying are signs that baby doesn't have enough fluids or energy, lethagic looking eyes etc. Honestly, I think it wouldn't hurt for you to focus on looking after yourself whenever possible. If you can, sit or even lie down. If you have a toddler, find something easy to do with him while you feed and snack, such as watch a film together(or even two). Keep a stash of paper, crayons and stickers handy for him for when you want a quiet moment, or remove jaggy things form your sewing box and let him have a good rummage, these quiet times can give you a well needed rest.
Certainly my babies fed for very long stretches, I decided this was valid work and used my free hands to hold an enjoyable book or chat on the phone, and at this early stage I always had heaps of food around.
Later on when I had children and a baby I found the ring slings gave me freedom to feed and move around doing things, but if I could grab a nap I did.
I really really wish you well. Try not to be disheartened, you are doing a fantastic thing, and you were feeling good until now...

[linklonk]

btw, you have not failed at all. You have a lucky baby who has recieved your milk exclusively for three months! Remind yourself that you've done brilliantly, anything else you manage will feel like the cherry on the top of the icing on the cake. In my experience it gets easier, so easy it feels like cheating.

[japhrimel]

You've done great. But you should not have to stop if you don't want to.

My experience with DD was that, although our latch looked fine, it wasn't deep enough for her to be getting fatty enough milk out. She had a lot of signs of foremilk imbalance - green poos, etc - and was feeding all the time. Once we started improving latch and positioning for what worked for her (firm cradle hold) she started improving. At 6 months she's gone from being on the boob at least once an hour for anywhere from 45 minutes to 6 hours at a time, to having 5 minute feeds and is still climbing the centile charts.

The issue with not having regular weight check-ups is that you don't identify any potential issues early on so more time goes by before you make a change.

[Hopefully]

Thanks for the lovely comments.

Am going to go to BFing cafe tomorrow - apparently the BFC there is very switched on and also useful as a defence against pro-formula doctors!

japhrimel DS has no signs of too much foremilk (well, no green poos...), but I'll mention it to BFC tomorrow.

linklonk I have been feeding in the sling a bit, but i find it a bit uncomfortable, and DS always falls asleep really quickly due to the combination of semi-darkness, rocking and feeding!

Orchidee will mention hospital pump to bfc and see if she can advise. I do have an electric one, but only a single.

Have just told DP in no uncertain terms that I do not wish to hear the suggestion of formula unless it is coming from me. It's hard as he's paranoid about me getting to the same state of exhaustion I did with DS1, but TBH I am nowhere near that, and also am prepared to take a bit of tiredness in exchange for EBF a bit longer!

Will also take advice to look after myself to heart. Not quite sure when I'll find the time though!

[crikeybadger]

Sounds hard going Hopefully

It could be that the latch does need some adjustment like japhrimel says -might be worth a visit to see someone to get it checked.

I only skim read your other thread sorry, but you mentioned that your first child had a tongue tie. I'm assuming you've had DS2 checked by someone who really knows what they're looking for as they do get missed a lot. (sorry if I'm teaching a granny and all that!)

The charts are for breastfed babies and have been for a while now. How do you feel about his health and development generally aside from the frequent feedings?

[crikeybadger]

Sorry, too slow to post as usual

Good that you are going to see the bfc- hope you get some help.

[Hopefully]

Crikey no I haven't actually had DS2 checked (apart from by GP, but they never spotted DS1's) - latch is pain-free though, and DS2 can poke his tongue waaay out, so I assume all ok there.

Apart from weight, he really seems like a v normal baby - very alert, good skin tone, smiles and gurgles at appropriate times (you know... like 3am ). Plenty of wet nappies - not really really wet, but needing a change every 4 hours (washable nappies). Not so many dirty - only about one every 36-72 hours.

[Hopefully]

Grr, am pumping now and getting cross - can't see how I'm ever going to stay ahead of his top ups with EBM. He downed 1.5oz earlier and would have had more, but I'm only getting about 1/2-1oz per pumping session (have never been a good pumper - I'm getting about twice what I used to get when pumping for DS1!)

[crikeybadger]

This might be worth a look at. I only mentioned tt as I know they are often hereditary.

[crikeybadger]

Yikes, now I'm cross posting with Rita on your other thread

One more thing, have you considered trying switch nursing?

[zlaya]

Hopefully, switch to the bottle, your milk is probably not calorific enough four dd, sorry that is all I can offer in terms help. Rather then having slip down even more, don't feel bad

[zlaya]

Hopefully, I have just reread the OP, you are feeding every 90 min, it also sound as if you are drying up, had the same problem when Ds2 was six months old, I don't know how I have survived, Ds2 went from feeding from every 3 to 4 hours to waking up every hour and then every 40 min, i was drying up, I feel for you

[TheRealMBJ]

Zlaya, it is highly unlikely (nay impossible) that the OP's milk isn't calorific enough. It is definitely possible that there may be supply and/or milk transfer problems here but these can definitely be overcome with good support and information.

I agree with crikey about seeing a BFC, rechecking the latch and checking for TT. Breast compressions and switch feeding are also worth a go. Topping up with a bottle may be counterproductive, in that it will mean less stimulation at the breast (and you are just coming up to the 3 month growth spurt)

Don't feel pressured into changing to ff if you don't want to, and do see someone truly knowledgable in bf.

[zlaya]

And how do you know that THEREALMBJ?, you have never heard of it? Dah, baby is not gaining wight, not staying in even in fact is loosing it, does that happen from good, fatty milk or thin watery one?

[TheRealMBJ]

zlaya I know you are trying to help, but you are spreading misinformation here.

This baby is not losing weight, he is dropping down the centiles. There is a difference. he also seems developmentally normal from what the Hopefully has said so there is no need to panic and rush to formula at this stage

OP, your DS may not be accessing enough of the high-fat (hind) milk if his latch is not adequate. The way in which a breast releases milk means that the low-fat, watery milk is released first, quenching the baby's thirst. Further suckling then releases the sticky fat globules from the sides of the ducts resulting in milk that gradually increases in fat and calorie content. The baby may have trouble accessing this high-fat milk if latch is not deep enough. Breast compressions can certainly help here as a temporary measure.

[Hopefully]

As MBJ says, DS is not losing weight, he is just gaining v slowly. I have no more reason than I did at birth to assume I have no milk/am drying up - I have never leaked/got engorged etc, so no change on that score, and I can hear DS swallowing when he feeds.

I did breast compressions a while back (when he was falling asleep feeding a lot), but I'll start doing them again as a temporary measure.

Crikey thanks for the tt link - looks like it's worth getting him checked as it doesn't always mean painful feeding. hope BFC today can have a look.

[tortoisefairy]

My ds3 lost weight steadily and was ever so unsettled. Cried constantly, went down the route of milk allergy and got nowhere. In a nutshell we had a nightmare time with no one able to diagnose him. In desperation tried an oesteopath. Within 2 days he was a different child. They think that because he had a short cord when born that something happened to his guts/ digestive system at birth when he was tugged out. I really feel your pain and cannot recommend an oesteopath enough.

Also did a similar thing happen with DS1? Mine have always been small and gone down the charts. I figure after 3 DS that that is the way I make them! I understand that you can't help but worry though.

Also I assume your diet is good? eg enough healthy and fatty foods?

[MamaChoo]

Well done on persevering, Hopefully, bf can be tough but my experience is lots of support helps, so good luck with the bf cafe.

Sometimes when no-longer-newborn babies are fed often, they CAN (i am not saying this is the case here, because you know your baby and I dont, so I am just adding this to the other observations) get into a cycle of eating a small amount, falling asleep for a short time, and then waking up and not being rested enough to eat a really good feed. Consequently they arent full enough to get a really good rest, and on waking are too tired to feed really thoroughly...you get the picture. Anyhow, just a thought.

[Hopefully]

Yup, DS1 slipped down the charts from birth until about 7 months, when he was well established on solids. I'd always assumed it was because of the tongue tie, but feasibly there were other issues too. It makes me because no-one ever investigated his slow weight gain because he was on the top percentile line at birth, so tt was never diagnosed until much later, despite agonising feeding/poor weight gain/no pooing.

[missnevermind]

All my babies have been big / heavy / long at birth.
After being born all three of them have gone from over the 75th centile to below 0.9 one of them 0.4 over the course of their first 6 months to a year.

It has been decided that as I am short and fat ( medical term ) and DH is tall and skinny, 6 foot, 8 and a half to 9 stone
They have been over nourished in the womb and the dropping down the centiles is 'catch down' and them returning to their natural weight without it being over inflated by me.

[ladylush]

I feel for you. dd went down the centiles and it was very worrying for me. When she was 6 months of age I went to a breastfeeding clinic and posterior tongue tie was diagnosed. She had it released and things improved but she stayed on a low centile and now at 2 years of age she has nutritional replacement drinks to try and increase her calorie intake. However, dd was premature. Hopefully your baby will find his line and stay there. You've done well to bf. I can't advise re changing to formula. I had in my mind that I wanted to do it for 6 months. So when dd started dropping centiles, I wasn't too worried because I thought I'd have more control by giving her formula (better able to monitor her calorie intake). However, dd had other ideas and refused to take a bottle (wouldn't take ebm either) so I had no choice but to continue.

[MissingMySleep]

those charts are based on formula fed babies, not BF babies so if baby looks happy and well you are the best judge

however there's no harm in a formula top up, I had to do it cos my DC1 fed so much it was the only way I got a bit of sleep. My mum did it with all 5 of us cos we were all hungry babies.

DC2 did not feed well at all. Looking back I think it may have been a lot to do with me not looking after myself. She slipped through the centiles (born 98% by 5months she was about 4%) I cracked and put her on food early. She looked so ill and I had tried EVERYTHING. Obv not ok for your 3m baby. But it felt like the right thing to do, she put on a lb a week and went from looking poorly to looking great.

You're the mum, your gut feel will be right as to whether baby is thriving or not.

[tiktok]

The older charts where feeding was not differetiated were ditched a couple of years ago - charts in use now are from data based on bf babies.

I agree - this is a situation that needs fixing, as long as weight was taken accurately and recorded accurately (mistakes have been known!). Hope you get some good help today, OP.

zlaya - it's not helpful to tell a mother who comes here wanting to breastfeed to stop! You cannot tell if the OP's milk is creamy or watery, and the research shows that there is absolutely not a type of mother who produces one, and another type who produces the other sort. Fat in milk does not reflect the mother's diet or well-being or anything - the most likely reason for an otherwise healthy baby's weight concerns is that the baby is not getting enough milk, and milk calories between mothers simply don't differ significantly. How unpleasant to diagnose 'drying up' from a brief post on a talkboard :( :(