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Infant feeding

dropping centiles ngiht waking pressure to swap frmo bfeeding to formula

24 replies

hettie · 25/06/2007 19:43

Sorry in advance for the long post but I really need some help and I thought all the info might help people give advice.
DS was premmie and small and then had to have bowel surgery. He?s now 18 weeks and exclusively BF. He?s dropped from mid way between 2nd and 9th centile to 0.4th. There has been some concern over this- health visitor and his consultant at outpatients appointment. I have been given several bits of advice from thinking about my own diet () to thinking about topping up with formula and also early weaning. No one has actually pushed it too much as at the moment they are still saying ?well we aren?t really worried yet? He has also had a couple of illnesses.
Anyway, 2 weeks ago he went from sleeping from 7pm ish to 5.30 6.30 am ish to waking 2 then 3 then 4 times a night and being really unsettled and hard to get back to sleep. He also stopped sucking his thumb (which he used to get himself back to sleep). And after 3 days we went to docs (who then passed us back to hospital) and turns out he had thrush in his mouth and a urinary tract infection. Both have been treated and he has finished his course of antibiotics and thrush treatment 2 days ago. He seemed a bit more settled only waking once at 2.30 am for the last 2 days of treatment. But last night he was awake at 10.30 and didn?t get back down until 12.30, then 3,30 and 4,30 and then 6.00 am (up for day after his feed). I fed him each time but it didn?t seem to be satisfying him and he was very unsettled. I should mention that he has always been relatively easy to settle back to sleep. He still isn?t sucking his thumb it?s like he?s forgotten! Anyway I am considering giving him a formula feed at 10.30 (if he waked up again). I really really don?t want to give up breastfeeding but this constant waking is taking its toll. Plus I don?t want him to be going hungry because I don?t seem to have the milk for him. In addition to this I know if his weight is still and issue at his next weigh in then I will be referred to a dietician. My questions are this

  1. I thought bfeeding worked on supply on demand why might I not be being able to provide him enough?
  2. What?s people?s experience of being able to continue bfeeding whilst introducing some formula?
  3. Anyone any clue as to an alternative theory to the night waking if it?s not hunger?
    Cheers in advance, but I am getting quite stressed about all of this and really need some words of wisdom
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CorrieDale · 25/06/2007 19:48

4 months is a bit of a growth/developmental spurt time. Which tends to involve lots of night-waking, unfortunately. It's bloody hard work, I know. Why not give it a couple more weeks before making a decision. I think in your cirucmstances I'd want to know that he was definitely over the thrush and UTI before making a decision.

I think that it's pretty well accepted that formula top-ups can (and usually do) adversely affect supply. Some people can do it without noticing the difference, some can't. Trouble is, you don't konw which you are until you've done it.

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cathcart · 25/06/2007 19:57

I have just had a very similar problem!
I was getting myself quite worked up about this and so I went to the clinic today...

In brief...dd is 20wks, is teething and has had a cold so very unsettled at night. Was taking the odd bottle of ebm which resulted in fussing at the breast and not filling up properly, so I was considering formula for her last feed.

Checked her weight today and she has dropped a little, but my hv said at this age her weight gain will start to slow down anyway. I asked about the formula and she said 'please don't do it! you are doing a great job - breast milk is all she needs, it is designed especially for her, not for a calf! '

Well that was what I wanted and needed to hear! I have decided to stop giving her the ebm unless absolutely essential as she has taken to the fast, easy flow of the teat and may decide she wants that instead.

Night waking could be from teething? or beginnings of a growth spurt? Or just a habit that he's got into after he was ill?

There is a whole thread on sleep problems at this age 'sleep is for the weak, we got too big' ( or something like that!)

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cathcart · 25/06/2007 20:00

Give it time hettie - at this age they are changing so fast, their patterns are bound to be all over the place rom time to time...

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MarsLady · 25/06/2007 20:02

hettie.... I say this a lot to people but honestly it works.

You need to babymoon. Spend a lot of time doing skin to skin with your DS. Feed him often. To get more milk you have to feed more. Don't worry it will all start to settle back, but really for now you need to feed and feed and feed some more. You DO have enough milk. Topping up with formula will simply make your own milk supply diminish! So.... if you want to continue bfeeding.... feed more.

You don't need to stress angel. Just rest when he rests. Go to bed with him in the day, be naked (top half or all your choice) and let him be amongst your breasts. Feeding will make you sleepy and so if you are both on the bed together you'll nod off, he'll nod off and all will be well. We cope with the nights by being sensible in the day.

Also, now that the infection etc has been sorted he'll probably start to come back to himself.

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elesbelles · 25/06/2007 20:06

hi hettie. i had the same problem at around the 18 week stage. i would try to persevere with it. they do, as corrie said, have a spurt at this time and it might just take a while for your milk flow to catch up. i think that, as he has been ill your milk is best for him at the mo anyway. i remember the days and night blurred into one another i was so tired!! i wish you the best of luck xx

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cathcart · 25/06/2007 20:08

oh thats lovely marslady! I'm going to do that tomorrow afternoon!
(if you see me on mn -shout at me please!)

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MarsLady · 25/06/2007 20:09

I will honey. I will

Let us know how it goes Hettie!

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hettie · 25/06/2007 21:12

hi marslady, oh I really do hope you're right...
I struggled so hard to bfeed (he was on a drip for first week so I had to pump to start supply- yuk!) and would really miss it. Will try a few more chilled out days...
Hope to see a change soon...

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cathcart · 25/06/2007 21:18

good luck hettioe - 'babymooning' sounds lovely doesn't it? No-one can accuse of of being lazy as its for the good or our lo's!

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Chirpygirl · 25/06/2007 21:21

Can only be quick as DH needs pc, but were you treated for thrush? I only ask as you might not have symptoms but may have passed it back to him as I know DD had to be treated when I was the only one with symptoms.

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hettie · 25/06/2007 21:31

eah- was treated so soping we are both in clear......
the later wakings don't seem to be food realted (i don't think) as he eats very half heartedly.
What would be great is if he relearnt to suck his thumb!

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divastrop · 25/06/2007 21:35

i just wanted to add,although i know nothing of bf,that my fully ff dd3(15weeks) has just had a bout of thrush following antibiotics for an ear infection,and has been a nightmare to feed,she wouldnt take a bottle atall over the weekend and even though the thrush has now cleared she is still crying whenever i try to feed her.

also,i remember my older children started waking alot in the night around 4 months,even though they were ff.of course,the advice then was that they were probably ready to start solids,so that what i did,but looking back it was probably just a growth spurt,or the start of teething(also had trouble feeding them when they were teething!).

anyway,the point im trying to make is giving formula might not make any difference anyway IME,so go with your gut instinct

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iamasurvivor · 26/06/2007 03:48

hi hettie, for an 18 week old baby to be sleeping from 7pm to 5.30am seems a very long time, especially when breast fed. he may well be going through growth spurt but then again he may be catching up from when he wasnt feeding very well. have you tried cluster and dream feeding??

cluster feed - feed at 4pm then again at 6pm. but baby down to sleep, then dream feed (feed them whilst they are still asleep) just before you go to bed. the idea behind this is that baby stockpiles calories and this helps them to sleep and be more settled during the night.

also like the idea of 'babymooning', i used to have duvet day one day a week where i just stayed in bed with dd, fed on demand and slept when she slept. good luck and i hope some of this helps

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hettie · 26/06/2007 15:47

have tried feeeding more frequently in evening, made no diff....
pattern last night was 7.00ish, 10.30 pm, 2.45 ish , 4.00 ish then 7.30 am, so 3 feeds in night (in addition to 5 in day)
will see if its growth spurt, but..... really at a loss

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MarsLady · 26/06/2007 22:30

Honey it can take a couple of days for things to make a difference. Give it a week and see what happens. It will get better.

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DebsCee · 26/06/2007 23:55

Had a similar experience recently with DS2, exclusively BF, was either sleeping through or waking once in the night, then from 18 to 22 weeks he was waking lots at night and was very unsettled but always hungry. I was shattered and thought it would never end!

I just went with the flow and fed him when he woke and after about 4 weeks he just stopped waking to feed and now he is back to waking once at night for a BF or not at all.

My advice is to ride it out for a few weeks if you can, you may find he sorts himself out.

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kiskidee · 27/06/2007 00:03

to help you cope with night feeds and to provide as much calories as you can, have you thought of cosleeping? i found it a godsend when i went back to work and dd would fed at night.

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hettie · 27/06/2007 15:43

well the outpatients at the childrens hospital went well, he is still on 0.4th but the consultant seemed happy enough....
he was more settled last night although still woke at 10.00 and 2.30 then 5.30....
Had health visitor around this pm who talked about early weaning, but I said i wanted to give him a few weeks..... We'll see
I have noticed he gets a bit disctracted during day feeds (finding the world all too exciting at the moment) so am taking my mums advice to feed him somewhere quiet..... Seemed to help him take a bigger feed earlier. fingers crossed!

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MarsLady · 27/06/2007 15:44

That's fantastic news Hettie! Well done you. Looking forward to the updates in the coming weeks.

Have you tried babymooning?

I love babymooning!

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hettie · 27/06/2007 15:51

yeah we had a day in bed yesterday- it was very nice obviously at outpatients today so not poss
am feeling quite positive though

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Habbibu · 27/06/2007 16:04

Just wanted to add then when my daughter was very distractible (and still is) when feeding, I found that gentle rhythmic patting would often settle her and keep her going.

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Highlander · 27/06/2007 16:26

given his prematurity and gut problems, early introduction of solids is the last thing you should be doing.

Word of warning - friend of SIL's had a preemie and was pushed into early weaning (5mo). He had a history of reflux and was not coping at all with solids being forced down him. Now 2, he has a serious food phobia, thanks to the HV saying to mum that he wasn't eating enough and that she had to sit with him at the table until he had eaten the prescribed amount of food.

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MarsLady · 27/06/2007 22:28

Well done hettie. So tomorrow... more of the same? Babymooning that is!

Highlander.... doesn't it make you ?

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Tommy · 27/06/2007 22:35

DS3 is a similar age and has been doing similar things at night. However, I have no idea if he is losing weight (I assume not - he's a bit of a lump!) as poor thing, being the thrid child never gets taken to the HV.

Anyway, what I'm trying to say is that growth spurts and lots of feeding are very usual. I think you were lucky him sleeping from 7pm til 5.30. Please just keep feeding him and spend lots of days in bed -

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