Had a horrible, horrible day - need some tiktok and hunkerisms please. (Huuuuge post)

[verylittlecarrot]

I've had a wretched day following receipt of a letter from the paediatrician. Distilled down, it basically reduces dd down to two things; "failing to thrive" and "inadequate calorie intake". It also claims she has some delay in her motor development - ascribed to the failure to thrive - which he hopes would "pick up once her nutrition improves". I am surprised to hear this and don't agree with it.

Other possible causes have been ruled out (thyroid, heart, absorption problems)

The formerly supportive bfc who referred me (at my request) apparently felt a little miffed that I had not followed one particular piece of her advice, namely to express several times a day in addition to feeding on demand. (I attempted this for a while but abandoned it for several reasons, both practical and theoretical, in favour of just putting the baby to the breast at very frequent intervals.) This rejection of her advice has been noted in the letter. I rang the bfc to find out what this was about and challenged her, as she has previously told me I have "gallons of milk" and that supply isn't a problem. She seems less certain about my supply now, apparently.

The letter has a lot more to it and doesn't present me in a great light either. The paed wants to refer us on to a dietician.

There's so much I want to dispute in the letter - the diagnosis, the apparent motor delays, the conclusion that it is my bf to blame, the advice to wean her earlier rather than later (on baby rice!), the assumptions that I take random advice off the internet and lack the necessary intelligence and discretion to research properly info salient to dd's specific circumstances.

But actually, I've had enough. Spent the whole day in tears. I think I've run out of fight.

It's almost worse having gained the knowledge I have, from MN, because in RL you just sound like a non-compliant nutter with odd ideas and bizarre principles. And there isn't a tiktok or hunker in my neck of the woods to back me up, sadly.

So here are my questions

If I were to introduce a high cal formula at this stage, after 6 months of excl bf, perhaps a bottle a day, what effect might it have on my supply? (I already know what it will do to my psyche) Assuming that the hcps are correct, and for some reason I have an inadequate or fragile supply.

Is this likely to damage my long term plans to continue bf until she self weans?

Are there any risks to dd in doing this, vs carrying on bf (and weaning obv)

Is there a formal, diagnostic procedure to confirm that I have low supply? No-one has examined me ever in all of this, it's just a conclusion that has been reached through elimination of other causes.

Taking into account a steady and consistent weight GAIN from day 2 of her wee life, starting at 3 oz a week and now slowing to about 1 oz a week, does this sort of growth pattern seem consistent with low supply? She gained better in the beginning than she does now - might my supply be worse than it was?

If so, is it too late to fix things now?

I still feed every two hours roughly, sometimes more, both sides, and take domperidone (although I stopped for a few days last week as I honestly didn't feel it was making any difference, but have started again in desperation)

Does it make any difference that I still get engorged if she goes 4 hours between feeds at night occasionally? Does this mean anything?

I'm grasping at straws, anything to avoid admitting that my body has provided "inadequate calorie intake", which has caused motor development delays. The very real fear that I might have harmed my baby has been writen down in black and white today. It is sickening to read it.

I'm rambling and incoherent because I'm so upset. But I'm losing my nerve against the pressure. I need to consider formula, if it will help dd catch up some of the weight she needs so badly. I can't forgive myself for causing her problems. I feel like a defective failure. I tried to do everything I was supposed to do and it just hasn't worked.

[captainmummy]

CAlm down! My ds1 was like this - failed to thrive (and this was before they changed the charts upwards, so he would have been well down) and put on about 1oz a week. The HV threatened me with having to take him to the clinic every week, with putting him of formula (to top him up) etc etc. With your first you are soooo much more afraid of everything. ANyway after about 2 months of this they said 'well we can't force-feed him, it is obv. just the way he is. Off you go'. He's now 15 and healthy, intelligent and stronger than me.

[Lulumama]

oh no



after your thread last week about how proud you were to have done exclusive breastfeeding

am absolutely not an expert...

am so sorry you feel like this and feel so despondent and inadeqaute.

don;t know what to say, except hang on in there and wait for the cavalry

[whomovedmychocolate]

Oh how fucking horrible for you - sorry but it sounds like they are just saying 'it's all your fault, you've failed'. Which obviously isn't the case.

Okay your child is six months old, so it's time to start introducing some solids anyway, no problem, how about mashed potato with cream in - lots of calories. It's not only formula that has nutrition in it - food does too.

In your shoes I would (a) not do anything till I'd let the dust settle three days and I'd had a chance to get over the urge to punch these oh so very helpful medics (b) ask for advice from a nutritionist on the best weaning foods for weight gain.

I agree you need to monitor your baby's weight but a slow weight gain is not necessarily a bad thing and I'm surprised they can diagnose so early TBH.

You are not defective. You are not getting the help you need nor decent advice it seems. Hang in there, you are will solve this and THERE IS NOTHING WRONG WITH YOUR MILK!

[captainmummy]

Oh and I tried expressing - but he could smell it! And then wanted it, so vicious circle. In the end I did top-up with formula, at which point I also started weaning (he was 5 months, we did it earlier in those days lol) and found out that he just doesn't like milk. Still doesn't, unless it's got milkshake mix in it!

[verylittlecarrot]

Thanks girls

Captainmummy, I'm rather a longterm ranter, I'm afraid - dd is 6 months old so I've been going through this for a while and boring the other mnetters too. Today just sort of made the accusations official, IYSWIM.

Thanks for the reassurance.

[lljkk]

I haven't read your previous threads so ignore this if it seems inappropriate, but...

"Is there a formal, diagnostic procedure to confirm that I have low supply?"

Are 'they' saying you have low-fat milk (?) or too little milk?

Simple way to see how much milk is going in, weigh baby before and after feeds on high precision scales! Getting the right scales is the hardest part (need same sort that HVs use). Keep records and present to pediatrician. Might still argue about the fat levels, but if you can express 4-6 samples at different times of day, a laboratory could test them for fat %.

[verylittlecarrot]

Have started weaning - an erratic combination of BLW and "let mummy help with that darling"

Would willingly stuff cheese, olive oil and cream laden foods down her gullet, if she could just lose the tongue thrust reflex which pushes them back out again...

[Lazycow]

sorry I am not a paediatrician but can you really diagnose most developmental delays at 6 months old? How exactly is she delayed?

I am really sorry you are in this postion. I really don't know the full answer to all this but I can say that after fully breastfeeding for 6 months your supply is as established as it will get so 1 bottle of formula a day should not affect your supply at all.

[FairyMum]

I also had babies who "failed to thrive" and HV was all over me as a rash. GP also worried. But my children are naturally very very slim as am I so it was just the way they were. They are great eaters today but still very slim. I thought it was more calories in breastmilk anyway and certainly more nutrition? I would call LLL. They have experience of a lot babies "failing to thrive". They were a great help to me!

[Lulumama]

if she has a tongue thrust reflex still, then she might not be quite ready for weaning... she is still gaining a little weight isn;t she?

at 6 months not all babies can sit, roll over, crawl etc... i had two late crawlers and walkers.. nowt wrong with them now, but DS referred to paed for investigations .. they can scare the bejesus out of you !

[verylittlecarrot]

She's been weightbearing since 8 weeks, babbling for ever, great head control since 3 months, sits with support, can raise herself on forearms when prone.

She has rolled over occasionally, but a baby that detests being on her tummy doesn't get put down on it much. She's a velcro baby so doesn't get much opportunity to lie down and roll over anyway. He seems to have taken this to mean she's incapable of rolling over.

He said she has minimal head lag still on being pulled to sit. ??

And claimed she is "not making any attempt to sit even when given some support". What? Is she supposed to pull up a chair or something?

[verylittlecarrot]

She's gaining roughly 1 oz a week, perhaps two at most.

[policywonk]

No advice I'm afraid but sorry to hear you've been through the mill vlc. It's a shame (to put it mildly) that some health professionals are so insensitive. I'm sure you'll get some great advice on here.

[NineUnlikelyTales]

You are entitled to ask for a second opinion and to ask that the next paed is a consultant with knowledge and experience of BF babies. Contact the LLL, they will help you.

[Lulumama]

at your pull up a chair comment

sounds like she is doing fine, in my non expert opinion

surely not all babies develop at the same rate, hence there is an average,and some are above, some are below

DS did not walk until he was 17 months.. got a lot of earache about that from my old HV. DD did not walk until 16 months.. new HV said, why should she walk when her brother fetches her whatever she wants??

do you have a follow up appointment?

[mylovelymonster]

verylittlecarrot - my DD was the same in that she very quickly plateaued in weight gain and the HVs were making me feel awful, so I stopped going because she was happy, energetic, slept well, plenty of dirty nappies etc. She didn't sit unaided until she had her first cold at 10 months which slowed her down - the HV at her 8/9 month check was very upset that she couldn't do that . How can this paed judge your LO is behind in motor skills? don't all babies do things in a broad time frame?

So sorry you've been made to feel crap - you don't deserve it. Apart from all this criticism from the 'professionals' who obviously know best, are you happy with how she's doing apart from the weight?
If necessary can you get a second opinion? From a real Paed expert?

DD put on weight slowly when weaning too, and only had a spurt at 11 months, between bugs, and quickly went from 9th to 50th centile. Both DH and I are slim build so we're not too concerned she's not a heffer.
Huge hug to you and a large brandy for your nerves. Really angry you're not getting better support

[NorthernLurker]

how awful for you! No specfic advice or skills to offer but just wanted to say I am sure you are doing a grand job! Oh and my dd1 - mad no effort to sit unsupported till 8 mths plus. She was and is fine - just like being on her tummy better. Hoping tomorrow will be better for you

[tiktok]

vlc....I share your scepticism at the letter and the diagnosis.

One aspect of this, and I think it is an error many HPs share, is to mix up 'production of milk (ie supply) with intake of milk. It doesn't matter how many gallons of milk a mother makes, if they don't get into the baby!! So, the first thing to be done when there is a ? over a baby's growth, is to get more milk into the baby. This, you have done. It is, therefore, overwhelmingly likely your baby is small because she is made that way and she does not take in huge amounts of the no doubt gallons you are able to make, potentially, because of the same reason. I am not a doctor blah blah blah.....and I would not know how to assess minor motor delay if it bit me on the bumb, but I do know that assessments like these on babies as young as this are hard* to be accurate with.

Test weighing - as lijkk suggests - is a very dodgy thing, and I would say a discredited way of assessing growth and intake....not accurate, and somewhat pointless. Babies take in massively varying amounts of milk at any one time, on any one day, and in any one week or month. There is a study showing this - I posted it a couple of weeks ago. Later I'll find it again.

Mothers' level of fat in their milk is pretty much the same, across populations and diets. There is a variation in fat in indvidual feeds, but overall, it evens out.

I suggest going for a second opinion - is that possible?

[cmotdibbler]

Would you like another hanky ? And a big mug of hot chocolate with cream ?

There hasn't been any doubt about her development before has there ? And the variability in what they do is so huge, that if she is pushing up and sitting (at 6 months DS could sit if put like that, but tended to slump over to one side, that sounds pretty good to me.

I'm sure someone who knows far more than me will be along in a minute with some practical advice.

Sorry lljk - test weighing doesn't work, there is a research paper on the subject.

[AhhChewww]

Verylittlecarrot it's awful what are you going through at the moment.

I'm not an expert child development but I have 8 months old dd and spent every day with my friend's 7 months old dd.

My dd is exlusively bf and she still doesn't sit unsupported, she started to roll over at 5 months and only now begun to crawl.

My friend's dd who is ff since she was 2 months also doesn't sit without support and still doesn't really roll over beacuse she doesn't like to spend time on her tummy.

So there... Babies do develop differently and being bf or ff doesn't clearly make any difference to their development.

[verylittlecarrot]

Thanks all fot the lovely responses. I kindly accept the hankies hot chocolate AND brandy, if you don't mind..

tiktok - I tried to say that to the bfc. She wanted me to pump to "tell your body to produce more than the baby asks for, then top her up". I can't see the logic in this...her appetite is X, how does it help her if I make X+Y? Surely she'll still only take X? What I need is an appetite stimulant for her, not oversupply with blocked ducts.

I think I just want OUT. I'm so nervous now of any contact with any hcp, it just seems to be an opportunity for trouble to be caused. There is supposed to be a follow up appointment on the 29th Feb. (and then a referral to a dietician, which I don't think I want) I'm in two minds whether to go at all.

The letter (which I had to demand a copy of, as I wasn't included in the distribution) was written after an appt on the 9th Jan, prior to getting test results. Most of the test results are now back and are clear. The paed spoke to me on the phone two days ago to tell me this. He also told me that malnutrition shows up certain markers in the blood tests and there was no evidence of this for her.

He admits that she isn't particularly wasted, although she is thin, and her buttocks have "reasonable fat pads". Poor babycarrot, she'll hate to hear that when she's 16.

Do you know - I have stupidly never thought to call LLL. I'm going to tomorrow.

Tiktok, what do you think about the high cal formula? Would it be a good idea in our situation?

[BITCAT]

What a complete bunch of bastards ohhh excuse my french..how dare they make you feel like this...i feel for you but all i can say is chin up..don't let um grind you down..my ds2 really slow to develop wouldn't take anything with lumps until 12mths and speech, walking everything much slower but he got there in the end. I want to give you big hug!!!

[halogen]

What are the motor delays? Are they really significant? I would do some research on this myself if I were you. My daughter didn't roll over unaided until she was about ten months old and yet she could walk at that age. Sometimes babies just do things a different way or in a different order for no discernible reason.