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Infant feeding

Massive percentile drop

32 replies

WeShouldOpenABar · 30/01/2018 15:13

DS had his six week check today and has dropped from the 75th to the 25th percentile, I'm assuming this is as bad as it sounds.
Doctor just said to supplement with a bottle for every feed but I'm really not sure what that means. He fed off me for 20 minutes when we got home and possed at the end while still on the boob and took himself off, I would usually consider that him being done but he took 4 oz of aptimel after that so I'm obviously wrong.
I'm mortified I've left him hungry , I've been crying since the doctors hours ago.
How long should I offer the boob for, how many oz of milk after? How do I know I'm not starving the poor thing.

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dementedpixie · 30/01/2018 17:21

Could you have swapped him to the other boob to see if he took more from that one?

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dementedpixie · 30/01/2018 17:23

If you want to continue breastfeeding then giving 4oz after each feed will reduce your milk supply. Could you feed more often and offer each side more than once?

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Hedgehog80 · 30/01/2018 17:25

Both my girls were on the 98th centile when born and dropped to 75th by six weeks
All three boys born on 75 th. First two dropped to 25th and number 3 is inkybtwo weeks old so notbsure what he will do. All were/are breastfed

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LadyRenoir · 30/01/2018 17:26

I think the problem is you won't know how much milk he has been having. Babies can be on a boob for an hour and have not much milk at all.
But then as the person above me said, topping up too much formula will decrease your milk supply. Has the doctor recommended something? I think that would be for the best if you maybe ring and ask them.

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Midnightpony · 30/01/2018 17:28

Contact a lactation consultant for help. Or your local la leche League

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Hedgehog80 · 30/01/2018 17:29

You can also get supplementer systems of you really need to which may be better than a top up ?

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tmc14 · 30/01/2018 17:31

I would very much recommend better IRL support... do you have info on local breastfeeding/la Leche groups/Lactation consultant/breastfeeding helpline? It doesn’t sound like your Dr was very helpful and it is very likely with good & knowledgable support you won’t need the top ups. Good luck xx

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tiktok · 30/01/2018 17:31

This does indicate a need for some help to ensure feeding is going well - but the doctor's advice is not compatible with preserving breastfeeding. Is there someone you can see who is knowledgable and helpful about BF? Your Hv? Breastfeeding support group? Call any of the BF helplines, too. It may be you need to feed more frequently, and to use more than one or two breasts each feed. Switch feeding - feeding one on side then the other then back again - will increase his intake. Def get a second opinion on whether you need formula or this huge amount of formula.

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TheVanguardSix · 30/01/2018 17:38

30 minutes each breast, every 2-3 hours (depending on the 'demand') should do it. However, book in with a lactation consultant! Your HV can arrange this very easily. I can't recommend this enough. I had no idea my milk supply could be so rapidly improved and without too much effort.

Is your little one a big sleeper and perhaps not feeding enough on account of napping?

Eat porridge oats to milk supply. It works!

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tiktok · 30/01/2018 17:38

If he has four ounce top ups of formula at each feed, then there simply is not 'room' for breastmilk - he weighs about 10 pounds now, and if fully formula fed would have about 25 ounces in 24 hours. If he's feeding eight times or more (which would be expected), and doc says four ounce each time, then......well, do the maths :)

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TheVanguardSix · 30/01/2018 17:39

*ear porridge oats to help INCREASE milk supply.

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Lweji · 30/01/2018 17:42

Part of the problem may be that weight at birth doesn't correlate with post-birth weight.
Your baby may well be a natural 25% that was born heavier.

I'd check with the doctor, but if he's having dirty and wet nappies, and seems happy and active, I don't think it's a problem.

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reallyanotherone · 30/01/2018 17:47

Did the dr say anything else? Did he look dehydrated? anything clinical or is it just the weight? Seeing/pooing/behaviour all fine? Is he actually losing weight or just putting it on more slowly than average?

Generally speaking, dr.s, even m/w and gp have very little bf experience. They have no time or knowledge to actually help. The extent of most bf advice is "top up with formula" which usually sets up a slide into total ff.

What do your instincts say? Do you think he's starving? Do you think there's something wrong?

Babies will nearly always take formula after a breastfeed. It's a bit like us having a full roast dinner- you think you't not hungry then someone offers you a wafer thin mint- you squeeze it in because it tastes nice.

FWIw mine slipped from 50th to 0.4th in about the same time. I had a very good hv who never even mentioned formula- gave me lots of tips and tricks about increasing bf instead.

I was referred to the GP who also said top-ups may be a quick fix with the numbers on the scale, but if there is anything actually wrong, that weight gain may mask it and delay investigation/treatment. So we were referred straight to paeds for bloods and examination. First question was "are you worried, or is it the hv/gp?". I wasn't worried over much because she was so well and happy in herself. Bloods were fine, measurements were fine, paed happy, carry on bf.

Google "catching down". Some babies seem to take a few weeks to find their line. Mine stayed happily on 0.4 and is still thereabouts 10 years later.

Kellymom is your friend. Lots of very sensible advice :) Try and get a rl consultation with la leche or a bf specialist- this is what your GP should have done rather than take the easy way of top up with formula. At the very least they should have tried to help with the bf- and if they were genuinely worried about the weight you should have a paed referral.

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Annwithnoe · 30/01/2018 17:51

When my DS dropped weight I was advised to spend as much time as possible skin to skin with him, so we spent a lot of time in bed, and I put him in a sling but actually against my skin when we were up and about. I did a lot of sniffing and kissing too as that’s an important part of how our bodies recognize what babies need. I fed on demand, as often and as long as he kept sucking, for that week.
Real life advice from a qualified lactation consultant will make all the difference if you can access it.

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WeShouldOpenABar · 30/01/2018 18:16

Thanks all, I felt a bit overwhelmed after the doctor and like I'd let him down. She really gave me no useful info or advice just said he's not gaining enough weight top him up at each feed.
I rang the public health nurse and she said if I don't feel there's an issue to leave him as is and come in to her on Thursday and we'd make a proper plan if we need one.
She also said we in Ireland use the UK percentiles for birth weight and then move onto the WHO stats after that so they're not always comparable. Also said she'd check a small tongue tie a midwife mentioned to me as they don't always affect feeding until later on so it could be playing a role.

Just wish the doctor had given me some reassurance or info. I am very tired as any new mother would be and managed to get myself hysterical about starving him, if my dh hadn't come home and made me call the nurse I'd have spiraled further.

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WeShouldOpenABar · 30/01/2018 18:19

Also I already feed off both boobs for most feeds and he asks for it every three hours like clockwork so it was a shock to me that anything was wrong. I've sent dh to the health food shop for some supplements in case she recommends them

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tiktok · 30/01/2018 18:37

The uk charts and Who charts are totally comparable - designed to be that way. I wonder if she means there is no birthweight on the Who charts so the centile for birthweight is filled in on the uk charts....they are not different apart from that though.

You might be helped by checking out the latest info on growth - it's the NICE guidelines on faltering growth. A drop from 75th to 25th definitely comes within the threshold for further checking out. Yes, it might be your baby finding his 'own' pattern, but you can't assume it. Nappies and not being dehydrated are not really signs - visible dehydration at six weeks would be quite serious, so just not reaching that stage doesn't mean all is well.

The sensible thing at this stage is to work very hard at BF more often :) Three hourly is not really enough to make up for lost time, as it were - like ppl say, skin to skin, feed a lot, going from breast to breast and stay in touch with the nurse for further checking. Weighing him again is essential.

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WeShouldOpenABar · 30/01/2018 18:43

Do I need to "make up for lost time" is the goal to get back to the 75th as soon as possible?then what?
When I say every three hours I mean that's his standard gap. He clusters and can be on a lot more sometimes. I always fed on demand as the midwives said that he would regulate his own requirements that way.

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tiktok · 30/01/2018 19:27

I don't know what the goal would be. There may not be a goal. He may be fine :)

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FruitCider · 30/01/2018 19:42

How was your birth? Did you end up induced, or on a drip for other reasons? That can artificially make your babies weight higher at birth than it should have been.

Topping up with 4oz formula after every feed is a bad idea. You would be better off getting baby checked for tongue tie and expressing for 5 minutes after every feed to increase supply x

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WeShouldOpenABar · 30/01/2018 19:48

He was 6 days over but spontaneous labour. 4 oz was just what he took n himself as I had no guide as to what I should aim for, this is the first time I've had to consider ounces

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BrawneLamia · 30/01/2018 19:56

If

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BrawneLamia · 30/01/2018 19:59

If you have no older children to look after, I would spend a few days at home, snuggling up having skin to skin. You will probably find that he feeds loads if the milk supply is right there in his face.
Does he sleep for long stretches at night? You might want to wake him for feeds, or co sleep for a bit to encourage regular night feeds.

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DryHeave · 30/01/2018 20:06

Is he often sick after a feed? Does it seem to be quite a lot? Just thinking if it’s going down regularly (but then coming back up) the net amount in tummy would be much less,

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ForFuckSakeSusan · 30/01/2018 20:07

Some really shitty advice from your GP, you do not need to top up with formula if your LO is otherwise well, i.e plenty of wet nappies, fontanelle not sunken or bulging, alert, good skin tone, happy, reaching milestones etc. What you do need to do is make a plan with your public health nurse or possibly attend a breastfeeding support group for a bit or real life support.

You do not need to go back up to the 75th centile; children usually track between one centile, so say between 50th and 75th, sometimes they may be 50th, sometimes closer to 75th. Your LO may well now just stay on the 25th and that would be perfectly fine. Please try not to worry about this too much OP, easier said that done Flowers

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