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not gaining weight? just give him a bottle of formula

(45 Posts)
fruitful Fri 04-Mar-05 16:09:56

Ds is 3 weeks old, was born 6 weeks early. He weighs about what he did when he was born (4lbs6), hasn't put on any weight for about a week. He's having what I think is a reasonable breastfeed every 3 hours (mostly I have to wake him up). My health visitor says she will visit on Monday, and if he hasn't put on any weight then "we will have to start giving him a bottle of formula each day".

Now, I know she can only advise, and I can say no... I fought against them giving him formula in hospital (he had donated breastmilk down a nasal feeding tube till I could express enough). And I don't want him to have formula now (lots of allergies in the family).

My question is, does it matter that he's not gaining weight yet? He's not losing it either. And although he sleeps most of the time, he has a couple of alert periods each day.

And is there anything else I can do to help?

tiktok Fri 04-Mar-05 16:41:24

Hi, fruitful. What a shame this is all the HV can come up with

I think there is room for some concern about your baby's intake. He is very small, and while he is clearly getting enough milk to tick along, he needs to grow, and that is not happening.

It's good he has alert periods, but he needs to feed a lot more often than this....I guess he is feeding 7-8 times a day, yes? It will help to get three or four extra visits to the breast each day. This might mean keeping skin to skin with you, co-sleeping (make sure you do this safely), and offering the breast every time he gives a sign he might be waking.

Babies of three weeks ideally are not having to be woken for feeds.

How often do you have a pooey nappy? We'd be looking for at least 2 substantial poos each day - that means a proper poo, not just a skidmark.

It's dead easy, really....if there is concern about a baby's intake, then give him more! You should be enabled to give more breastmilk. If it's hard to get him to have several more breastfeeds a day, then you may need to express and give by bottle.

The worry might be that he does not have the energy to feed more often, so merely putting him to the breast is not enough. If this is the case, then he may need supplementing, but the first choice for this would be expressed breastmilk.

Feed him like crazy day and night this weekend, and then see if it makes a difference to his weight on Monday.

paolosgirl Fri 04-Mar-05 16:51:28

I'm sure the Head of Nursing and Midwifery would be VERY interested to know that this is the advice your health visitor is giving out. No wonder the breast feeding rates are low in this country with this kind of 'support'

Tiktok's advice is spot on....and it might be worthwhile contacting your local branch of the NCT or La Leche League for further advice. Good luck - and don't let her force you to bottle feed if you don't want to. It doesn't sound like you're at the stage where you need to be unduly worried - and I'd ask to see the GP or Paediatrician first. Hope all goes well for you

dinosaur Fri 04-Mar-05 16:52:15

Hi fruitful,

My DS3 was very slow to put on weight - he was big at birth (9lbs 6 oz) but took an age to get back to his birth weight - kept losing it instead of gaining it.

However, just as tiktok says, what seemed to turn things around for us was me expressing some milk to "top him up" after feeds. I remember being very sceptical about whether it would do any good, as I only seemed to be able to express a couple of oz after he had fed. However I gave him top-ups after each feed (from a feeding cup) and as I say, after a few days of doing this he did start to gain weight.

I also had to wake him up to feed him - and if he started nodding off whilst on the breast I had to take him off and put him on his playmat, or change his nappy, or take off his sleepsuit or whatever, in order to get him alert enough to feed properly again.

HTH

Good luck, I know how worrying it is, I was insane with worry about DS3 for about a week.

fruitful Fri 04-Mar-05 19:13:11

My midwife has just suggested I spend the weekend in bed with ds, stuffing us both with calories and being waited on by dh - sounds good to me!

I'll try feeding him everytime he looks awake as well as waking him for feeds. Bit worried he might end up doing 5-minute foremilk feeds though.

anchovies Fri 04-Mar-05 19:15:54

My HV said the same as fruitful, she always recommended a day in bed doing nothing but eating for both of us! Definitely worth a try. Always worked to get things back on track after a growth spurt as well.

HunkerMunker Fri 04-Mar-05 19:16:44

Can you feed from one boob for several feeds? That way he'll get more hindmilk - and you could express from the other one for top-ups?

Might be worth checking with tiktok that this is a sensible way forward though...!

Enjoy your babymoon - I hope your DH brings you nice things

tiktok Fri 04-Mar-05 19:44:22

HM - not a sensible idea, sorry! This (one sided feeding) tends to reduce supply, as is suggested to mothers who are troubled by over supply, and never to mothers whose babies' weight is giving concern. This baby needs volume - and it's best achieved by using both breasts as much as possible

Fruitful - don't worry about 5-minute foremilk feeds. The more often he feeds the better.

Newyearmum Fri 04-Mar-05 20:06:24

Ok I'm getting on my soapbox here!

When the HV comes out with a comment like that, what you hear is, "stop pussyfooting around with all that breastfeeding nonsense. It's time to give him some of the hard stuff". And that is so outrageous, unhelpful, and ill informed. (Where is the thought process? This mother is bf and wishes to continue to bf, therefore a different solution is needed. I mean, its not rocket science is it?)

In terms of that solution (or potential solution) I totally agree with Tiktok about the need to feed more frequently. My DD was never able to wait 3 hours between feeds until she was at least 8-10 weeks old (and she was full term and weighed 6lb 4oz at birth). I was feeding her every 30 minutes or so in her first week of life because of her jaundice (at night it was every 2 hours) and because they kept saying exactly the same thing to me about formula and how I had to breastfeed 'aggressively' if I wanted to avoid it. While 'aggressively' probably isn't a very good word to describe any kind of bf, it kind of guided me through what I needed to do (ie. not feeling guilty about waking dd up in order to feed her).

Before you decide to give him formula, call the NCT breastfeeding line on 0870 444 8708. They were a godsend to me. And I agree with Paolosgirl too - don't do anything you're not comfortable with until you've spoken to a paediatrician.

Your HV just doesn't sound up to giving that kind of so-called advice.

So back to bed, boobs out, good book for when the baba's asleep and get your dh running around

tortoiseshell Fri 04-Mar-05 20:40:55

fruitful, congratulations on the birth of ds! Have you tried 'switch' feeding - it may not be appropriate in your case, but worked for me (though my babies were over twice the size of yours!). If he nods off at the breast, switch him to the other side, and keep switching - 2 or 3 goes on each side per feed - the theory is the more ready foremilk keeps him awake, and so he's able to take more. The weekend in bed is very like Sheila Kitzinger's scheme for increasing supply.

HunkerMunker Fri 04-Mar-05 21:17:55

Don't listen to me Fruitful Listen to Tiktok - she's super-wise

Debi99 Sat 05-Mar-05 13:53:13

Hi I have a 15 week old and he only reached his birth weight ay 9 weeks, I persivered with the breast and over the last 5 weeks he has been gaining 8 oz a week +.
I fed fed fed with lots of rest and high callorie food (healthy though cheese and chicken lots of fruit and veg)one thought is to express some fore milk of then let him take the hind milk. keep the milk just in case you need it it, but the more you feed the more you make, the more rest the richer the milk. I refused to give in and give fornula, I bought the Haberman bottle after seeing it on the baby wisper as it is supposed to stop him getting lazy, keep at it if it is what you want. it will come right with some effet I found La Leche League fantastic I would of given up if it were not for them.
good luck

webmum Sat 05-Mar-05 14:07:05

I had the same advice from hv when dd2 (14-16 weeks) put on only 1 1/2 oz per week two weeks running and she dropped off two centile lines. The next week she had put on 7oz but was still told it would eb wise to think about weaning (baby now 16 weeks) or to add a bottle of formula a day. I said I'd waitanother week as dd2 has been unwell on and off for the past 6-8 weeks and she I think its normal that she did not gain as much.

She's feeding like crazy now, and resumed all her nighttime feeds , which is a bit of a drag for me, but I don't want to put her on solids or formula just yet.

I was actually quite shocked at this kind of advice, aren't we supposed to wait till 6 months before weaning? I hear lots of mums at the baby clinic have started way before, it seems that the HV has not picked up on WHO advice...

Fruitful I hope it gets better for you!! A big hug

fruitful Sat 05-Mar-05 20:24:43

Well, he fed really well last night, 4 or 5 good long gulping-it-down feeds. But today has been exhausting. Feels like he's been on the boob all day, but not really feeding that much - two sucks and asleep, and crying for it again not long later. At least he is crying for it, I suppose. Feels like there isn't much milk there though . Ds is currently yelling in dh's arms, and I only finished attempting to feed him 20 minutes ago and I don't want to try again.

Dd is in bed, thank God, but she was sick 3 times this afternoon. And I'm sore, and thinking longingly of sleep and formula that dh can give him...

pupuce Sat 05-Mar-05 20:35:34

fruitful... I don't know how keen you are to breastfeed.... but if you are very keen.... hang in there... it will get easier!!! Are you still doing skin to skin? that would stimulate his senses and interest!!!

fruitful Sat 05-Mar-05 20:41:47

Very keen! Don't want all the hassle of bottlefeeding, and bfing is so lovely when it starts working. And there's the allergy thing.

Will go and take my clothes off!

pupuce Sat 05-Mar-05 20:47:24

fruitful.... I know it sounds difficult but if you really feed often and encourage your baby.... it will work out and once you get passed the current difficulty it will become easier.
You could express if need be..... come back and we will support you.

Amanda3266 Sat 05-Mar-05 20:53:05

Hi fruitful,

I haven't read the rest of the replies yet - only your post but as a HV myself I can say DO NOT GIVE IN. These charts being used to check weight are notorious for causing anxiety and not even based upon a true sample of breast fed babies.
It would be worth giving everything to breastfeeding right now - rest lots, eat a good diet and have lots of skin to skin contact with your DS. Ideally if you have support then don't do anything other than feed - this will really increase your milk supply if this is an issue. Look for plenty of wet nappies which will give an indication that plenty of fluid is going in and some dirty nappies too (can vary in how often BF babies go).
Hope that helps - it's a shame your HV couldn't come up with more support for you than the "we'll have to give him a bottle".

Hope that helps a bit - I'm sure others will have given good advice too.

Mandy

highlander Sat 05-Mar-05 21:22:14

to be fair, if the HV isn't properly trained in BF, then of course she's not going to give the appropriate advice. That's not her fault, it's the government/PCT not making funding available for midwives, HVs and GPs to go on BF courses.

Fruitful, if you have the energy, write to your PCT and complain, as well as passing on your new-found info to the HV.

PS I remember DS going through a non-stop feeding phase at that age and worrying my head off if I had enough milk; my boobs were so floppy at night. I was soooooo tempted to give him a bottle of formula. As tik-tok says, as long as they feed often, your body makes enough for the blighters

milward Sat 05-Mar-05 21:44:27

Good luck fruitful. Loads of good support here. Keep bf as much as poss. It is alot of time at first. bf in bed is great - when I did this I had a tv& radio in the room as well so I could have something on at the same time. Is he growing in length & head circumference? - these are good indicators of growth as well. Also thinking of stomach size - you always hear that the size of a stomach of a full term baby is that of a walnut!! - I don't know here (someone correct me please) but perhaps the tum is small & needs to be filled more often with bf until it's grown some more?? Best wishes xxx

moondog Sat 05-Mar-05 21:51:42

Just another post to offer my support and thoughts.
You lie down and relaaaaaaax girl!!!!!
XXXXX

pupuce Sun 06-Mar-05 19:57:46

How are things fruitful?

fruitful Sun 06-Mar-05 21:41:55

He's been feeding better today, and I feel more as though he is getting milk and less like a human dummy. He has started spitting up quite a lot though - do you think he could be taking more than he can handle? He's not due to be born for another 3 weeks so I guess his stomach is the size of a peanut!

I haven't managed to do much lying around relaxing because dd isn't well and only wants her mummy. And dh has to go to work tomorrow, aagh. He gets to do all the nappies and burping and settling tonight though, I'm just providing the milk!

snafu Sun 06-Mar-05 21:48:37

Fruitful - just wanted to add my support. Glad to hear your ds is feeding better.

I've just heard that a friend whose dd is 2 months old and not gaining has been 'taken off' breastfeeding altogether and put onto exclusive formula-feeding on the advice (of course) of her HV. She is devastated as she really wanted to bf and was finding it easy - the baby just wasn't gaining very well. I am going to try and direct her to MN for some more helpful advice!

Newyearmum Sun 06-Mar-05 23:09:08

Fruitful
Great news about your ds feeding better. I wouldn't worry about the spitting up too much - could he have a little cold? That always does it for dd.
Good for you for keeping it all together and persisting

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