AIBU to EBF? What would you do?

[pizzawinecake]

Hi all

EBF my baby (he also takes bottles of expressed milk).

I always thought I'd combi feed but baby was 6 weeks premature so I feel like the breastfeeding thing is even more important to him. Apart from
Prematurity he seems completely healthy and no nicu time. So he's 13 weeks old but only really 7 weeks adjusted.

Bf is going well but baby is tiny (he was born at 3lb 13 at 34 weeks)- not only is he tiny for his 'age' as he's premature but he's also tiny for his adjusted age as I had IUGR. He's 13 weeks and 9lbs now.

He's on the 2-9th percentile for his adjusted age but I do find his tiny size a bit of a trigger for feeling guilty I couldn't carry him to term (I had pre eclampsia). He's continuously sticking on this percentile and is growing steadily.

I'm getting a lot of comments from family to add in formula to help him gain weight quicker and I don't know whether I'm being unreasonable by continuing to exclusively breastfeed rather than giving him more calories via formula to help him put on weight quicker. I'm trying to work out if I'm being prideful by putting off formula so I can say 'I EBF for x months'.... rather than putting babys best interests first.

What would you do with a tiny baby?

My 38 weeker has dropped from 90th centile to 25th, he was EBF but I'm combi feeding now and he's up to 50th. He is having breast milk on demand 90% of the time and 2 bottles of formula a day (I have other kids so no time to pump, also pumps don't work for me) and I feel no guilt because it's working!

I have a 34 weeker whose also tiny also perfectly healthy and no nicu time. she was born at 4lbs 11oz (20th percentile) but dropped down to 4lbs (9th percentile) at 2 weeks old as my milk never came in and poor baby was starving. we moved to bottle feeding and she steadily started growing. at 21 months (just turned 20 adjusted) she is still on the 9th percentile and only weighs 20lbs/9kg. Asked doctor about it and he said he was happier with a baby whose following bang on her trajectory than one playing skip rope with percentiles. someone has to be at the bottom and she's just very petite. Doesn't stop her though and she's the ultimate in small size, big personality. She's incredibly stubborn, bright at a button and has more energy than than the energizer bunny. However, people commenting on her size (which is less and less now) does trigger me a bit as i feel guilty i couldn't carry her to term (we don't know why she arrived early - she just decided to come then).

I wish i had been able to breast feed as gives extra protection against SIDS etc which as a premie she is more at risk for but not for gaining weight. as long as baby and mum are both happy and growing to their percentile its no one else's bussiness

My DS was born at full term weighing 8lbs. He was EBF like your baby. He gradually slid down the percentiles for weight and I hoped he'd go back up when he was weaned. But he didn't.

He's now a skinny, fit 6ft 2 er. Some people are just meant to be slim. It looks like your baby is one of these lucky people.

People see him and always say 'ahhh he's tiny'. Which I know is well intentioned but is a bit of a trigger everytime. As if I can't see that he's bloody tiny . Like I haven't been anxious about making sure he's putting on weight for 3 months. Having a tiny baby is hard

My DSis had this with her first baby, who also was IUGR (unexplained) - she found it really triggering and guilt-inducing too. But I promise that if your baby is sticking to their percentile then by the time they’re a toddler no one will notice or care - and that baby my DSis worried about is now a perfectly regular size very healthy teenager, so just stick to doing what you’re doing.

They’re not meant to put on weight quickly. They’re meant to follow their own centiles and not jump too far in either direction (and even if there was an issue with centile jumping, formula is not the answer).

Please ignore ignorant comments. Breastfeeding is natural and Breastmilk is perfectly designed for your baby - it has everything they need.

Similar to you, I have a premature 13 week IUGR baby thanks to pre-eclampsia. People love to point out how small he is (including one obnoxious twat on the way out of the hospital). I combi feed (mainly bottles of expressed milk as DS's latch is quite bad even after hundreds of pounds on lactation consultants) and to be honest introducing one bottle of formula hasn't made any difference to his weight gain, despite what I was hoping.

I was similar to you. Prem babies (DS1 4lb 10 / DS2 3lb 12 / DD1 5lb 13), all had IUGR, both DSs spent time in NICU. I EBF all three and DS 1 and 2 are now both 6ft 5 (at 18 and 20 y/o) and DD, at 11 y/o, is catching up with them. All tall, skinny and very healthy. If you're happy and comfortable and your baby is thriving, keep doing what you're doing. Small babies are lovely 😍

I ended up supplementing my DD with formula as she had bad tongue tie and slipped right down in the percentiles. Combi feeding kept her on the percentile line but didn’t increase her upwards, so if that’s your goal then it might not happen regardless! She only grew when we started weaning.

Do whatever works for you OP, and don’t let anyone talk you into anything.

You are doing brilliantly so keep it up as long as you want to. While the HVs are very pro breastfeeding, they're also very pro babies gaining weight and meeting milestones, so if they are happy it's a good barometer. Maybe your baby was going to be a skinny, small kid anyway. My kids were both born chunky, ebf, and have settled into being slightly on the small side, skinny kids over time.
I was lucky in that my mum bf us all and so I never got the pressure that lots of first time bfers in their family get. Family members either mean well or maybe subconsciously feel implicitly criticised by a different approach and so they suggest bottle feeding to give you a break, fatten up the baby, get more sleep, let dad do stuff etc. etc. It's amazing how a different parenting choice can trigger family members who took a different road. So you may just have to be aware of that dynamic and have a nice simple phrase that you repeat 'no, we're happy as we are thanks' and maybe find another place to complain about things where the bottle won't be immediately the answer. Good luck!

Dd was full term and a mid range weight. I had trouble getting enough milk to start with so eventually took fenugreek. Combi fed for about 6 weeks before getting to ebf.

Dd’s weight fell down quite quickly to 10% but then she stayed there for months. The child health nurse was concerned but once I saw her tracking well, I just carried on. Her weight moved towards the middle range after weaning.

I think this is super true. My mum and grandma didn't bf for long (they were of the view that they had chores and other kids to look after and didn't have time) so think I'm basically being a bit extra and millennial by still bf and not being able to leave the baby for long. They are the type that say 'we just put you in the cot and you just slept, none of this skin to skin all day nonsense'

You are us around 17 years ago. Our DC was a similar weight and gestation at birth - but earlier and a bit smaller and I also had preeclampsia. We mix fed from the start, they didn’t even suggest expressing initially. I asked to have guidance on how to and when it didn’t come I got proactive and called my Doula.

Your DC is going along well compared to mine re weight gain. Although ours didn’t lose weight, the gain was super slow and he was off the charts. At 5 he was in age 2 clothes, in Yr 8 the piano teacher commented on how tiny his hands were, at 17 he’s 6ft tall. You will get there and look back telling people the stats until your DC tells you to give it a rest 😂

Regarding mixed feeding - I was lucky enough to be able to BF and EBF our DC as well as him having some formula feeds. This is where I think your DC growing faster than mine did is a consideration. You have been successful. I think formula could take some pressure off and that’s fine if you want to.

Sounds like you are doing amazing. Breastfeeding has loads of benefits for you and your baby and formula carries health risks. Breastfeeding is absolutely in his best interests. As breastfeeding is what you want to do ignore everyone else.

And I bet they did it different to their mums too!

Just to add to the reassuring comments - my baby was born at 38 weeks as I also had IUGR and was 5lbs. I breast fed for 6 months and then switched to formula as I was going back to work. DD crawled along the bottom centile until she was at least a year old, had the appetite of a flea and caused her dad and I much anxiety. She is now early 20s, eats well, loves trying different food ( usually in expensive restaurants 🙄) is very busy/active and is a great looking healthy young person.

Relax and enjoy your baby and keep doing what you're doing - it will all be fine.

My youngest was born at 28 weeks, 2.11lb. I breastfed him and while he was in the NNU he was tube fed my milk plus they enhanced it with formula. He came home at 9 weeks ( so not even officially born) and I continued to bf him until he was 2, obviously weaned him when he was ready.

Do what’s right for both of you. He’s 27 now and 6”2 !

Stay as you are and remind your family that health practitioners are happy. I would also say its a range there is always babies at the top and babies at the bottom! It doesn't mean they are unhealthy your baby is tracking and gaining weight. Your doing brilliantly don't let doubts creep in about that!

As a PP has said, giving him formula and seeing if this helps him put on weight may actually indicate that he is being over fed then which isn't good for him. Your breast milk is perfectly balanced for what he needs - if he wants / needs more your body will produce it for him. Every time he feeds he is sending signals back into your body to start "preparing" the next feed with the appropriate amount of fat / water he needs.

Breast milk also triggers an enzyme in his gut that tells him when he is full up - formula doesn't do the same thing and this doesn't develop until much later in formula fed babies. So as long as he is sticking to his line, is satisfied after feeds, is having enough wet and dirty nappies, and you're happy to be feeding then there is no need to switch or top up with formula.

NHS advice states to wait until 6 weeks to start expressing so your supply has established so as he's 7 weeks you could try this now. Not easy fitting it in I know, I used to do it between the first morning feed and the mid morning one, as my baby didn't always drain my breasts after the morning feed, but if they've fed all night this might not be the case! When they get a bit older, last thing at night was a good time as well when they start going to sleep earlier in the evening.

Good luck x

I'm pro breastfeeding. You have no need to supplement with formula. Your body is producing all he needs.

There's nothing stopping you pumping so you can give a bottle to baby and go to the gym.

You're doing great, OP, and giving him the best possible start.

I had to top up formula with both babies in the early weeks very occasionally due to various issues but they really struggled with digesting it after mostly breast milk, and quite often just yakked it back up again anyways.

Your baby is growing as he should be, and that's all because of you! So keep going 

With the gym aspect, I would nurse my son before heading out to the gym and work out for 90 minutes and nurse him when I returned if he was awake. My gym was a 10 minute walk into town though.