In hospital urgent advice needed!

[RachaelLaurenDaisyStone]

Hi, my baby is 10 weeks old breastfed only and we've been admitted to hospital for a few days observation as she has had a very slight weight loss since her immunisations 2 weeks ago (lots of dioreah) born 7lbs 6oz. Was gaining along her percentile and only lost 7%of birth weight. Went from 8lbs 15oz to 8lbs 10oz and has gone back up to 8lbs 12oz but they still have admitted us even though I protested. So anyway the advice I need desperately is that I feel I am being bullied into giving her formula, and they are forcing me to wake her up in the night for a feed. She feeds well in the day every 2-4 hours on both breasts and I have a very good supply I express every morning and get 6 oz in about 10-12 mins. But she has slept through the night since 4 days old. This has never effected her negatively before. I really feel the jabs are the reason she's lost the weight and is slow gaining. Can I refuse to wake her up in the night to the doctors? I'm now giving her a 150mls as well with both breasts at every feed I see think that will be helping her gain without waking her up and without giving her formula. Please can anyone give me advice on what my rights as a parent are?! It's not like she's underweight she's still in the 50th percentile!

You need proper advice asap. The Natuonal Breasrfeeding Helpline is NHS funded, and staffed by women who know their stuff. You could call, or get your doctor to call - most doctors have limited if any knowledge of the mechanics of breastfeeding. Yours clearly doesn't know that breastfeeding less frequently will reduce supply, due to a hormone called Feedback Inhibitor of Lactation (FIL). They are right about it being important at night, due to higher prolactin levels.

however, slow weight gain and sleepiness can indicate a baby who is feeding inefficiently, so it's important that you have someone knowledgeable observe a feed, before anything else.

You could also call in help from an IBCLC, who are highly qualified BF experts - find one on www.lcgb.org.

I can't emphasis enough how important it is that you can discuss things in depth with someone who knows - Mumsnetters are great for support, but you have no idea what our qualifications are, and we only have bits of information.

It sounds like you're having a really rough time, being proactive in getting qualified support at this stage will help you mentally as well as physically.

Apologies if that sounded unsympathetic- it sounds like a very stressful situation. Looking after yourself is really important when you have a baby, especially if you are breastfeeding.

You sound really quite unwell yourself OP. Do you have mental health team involvement? If so do they know you're in hospital?

It doesn't sound like you're eating enough to sustain breastfeeding. I know formula sounds scary but it's not as bad as it seems- it wouldn't be sold if it was risky to your child in any way. You can still breastfeed as well and when things improve you may be able to exclusively breastfeed again. When my daughter was born she lost weight, i now realise it was due to feeding being painful I wasn't letting her have enough. We had a few weeks of formula top ups and expressing and it all sorted and she has just weaned off the breast aged 2.

OP, I'm not sure if any of us are properly qualified to give you advice. Your circumstances are beyond a bit of casual advice over the Internet.

You need proper medical advice from healthcare professionals.

This is her ATM just before a feed, the nursery nurse has my redbook but I'll add a picture after xx

Ok thanks guys I'll def give those guys a call. I just feel so blind sided that this wasn't flagged up at all before and even now one doctor says he didn't know why we'd been admitted. The dietician said there's nothing wrong but the one who admitted us obvs think there is a problem. I'll do whatever's best fir my baby but right now i don't knkw who's advise is best!!!! X

She really hasn't been putting weight on well, and going from the 50th centile to the 2nd centile is a big drop. I would be very concerned about this, and I can understand why the doctors would want to admit her for monitoring.

It sounds like you are hardly eating, and that may well be impacting on your ability to feed your baby. Formula is safe and appropriate for babies. The list of ingredients is tightly controlled for that very reason. Nearly all babies in the UK have formula at some point, it really isn't something to worry about if it's necessary to give some. You could think of it as medicine that she needs to help her, if that makes sense.

That's a good way of thinking of it speaknowords about it being medicine. I've just been always told how bad formula is. If they're going to suddenly say she needs it I want to know why and what it means x

I know you are worried about formula but low weight can also be very dangerous for infants too.
I ended up giving formula when my youngest lost weight, because my milk didn't come in probably due to stress. I was devastated for similar reasons to you but once I had stopped breast feeding I realised that my desperation was clouding my judgement. My baby and I were both much happier.
I would ask the hospital how you can make a complaint, ask them who is most senior that you can speak to now. That you don't feel basic things are being done (wrist ID band) and that you are confused by their advice.

I already asked for their discharge policy, complaint policy and requested s copy of her notes. As they' lost them' nit realizing they'd actually left them in the room. And I could see that littéraley in the same page conflicting requests. At the top of the page it says I've been told to feed every 4 hours and top up 70mls about half way down 3hoyrs and 50 mls and then the next entry a different consultant had said feed every 3 and don't limit the top up!!!

Who has been telling you that formula is bad?
It isn't bad its just not quite as complex as breast milk.
If your dd is struggling to gain weight, then giving her a top up of formula can only be a good thing.

They are also limiting the time she is on for. I have to have her off the boobs within 30 mins and the bottle done in 10. So 15 mins a side. I can still see milk going into her mouth. Even had a little squirt when I took her off at the last feed. I also think she's getting a blister on her lip. I asked the nursery nurse and she said she's not allowed to say anything medical. There's no BF councilors on the weekend, there's no doctor on the ward as it's the weekend so he's been called to another ward, the nurses are apparently all busy. I wandered around a bit and found one and she said she doesn't work on that ward and said to ask a 'tom' haven't got a fucking clue who Tom is.

And NCT kept on an on about it, every midwife appointment, got added to a breast feeding support group on Facebook, breast is best leaflet and the health visitor. All told me how bad formula was. X

I agree that you are certainly not getting enough calories to breastfeed properly. It's true milk gets first dibs on calories and you come second but that's only if you eat enough calories to begin with. If you don't your body will be using everything it has just to keep you going.

Breastfeeding burns something like 500calories a day. Salad and water just doesn't cut it.

Regardless of any other problems such as her thyroid you need to consume a lot more calories than you are in order to breastfeed successfully. There's just no getting round that.

Formula isn't bad in any way, shape or form. You are absolutely misinterpreting what your HV/MW/leaflets have said. Breast IS best but that's not the same as saying formula is bad.

She's beautiful op but she does need to put some weight on. You aren't eating enough from what you've described below. Did anybody tell you you need more calories when feeding?

When the doctor comes round tomorrow you need to talk to them about some help for you and your disordered eating. If they don't seem to understand then you need to try somewhere else. Your old eating disorders team could be a start.

Formula isn't bad. It was needed by both my sons when they were born and helped them recover from being unwell. Breastfeeding, if going well with no problems, is just the normal way of feeding a baby. In that situation formula isn't needed as it isn't any better for the baby, and has some small additional risks. BUT, sometimes babies need formula, sometimes it's necessary. Again, think of it as medicine. It contains all the calories and nutrition a baby needs to grow. Yes, breastmilk contains other things as well, but if breastfeeding isn't working for some reason, then formula provides what your baby needs.

Weekends in hospital can be a bit rubbish as it can seem like no one is around. Tomorrow morning you should have doctors rounds - I would insist on discussing what's going on with the doctor then if you can. Explain that you're confused, that your baby doesn't have ID bracelets etc etc. Ask why 4 hour feeds and why limited time on the breast. Ask them why you shouldn't feed more often.

Formula does have risks associated, it's true, BUT, not as much many risks as under nourishment. That's why its important to find out why the weight gain is slow, it may or may not be a feeding issue.
Only once you have that information can you make a decision. Please call the helpline.
Try to think of the hospital food as medicine - you need to take in a maintenance load of calories to keep you and your baby well.
And

I promise you, formula isnt bad. I promise you. I breast fed my 4 year old for 5 weeks and couldnt do anymore, then we went to formula. He has had 1 sickness bug in his whole life and in his class, I coudlnt tell you which child was breastfed or formula fed. Honestly. I now have a 10 week old. He was breastfed till 5 weeks and had a slow weight gain. He was hungry all the time so we combi feed with formula. He is a huge chuck of lovelyness and I promise you as soon as he was more satisfied on the top ups everything got better. It really isnt bad, being underweight is bad. Maybe other posters who combi fed or fomula fed can share their stories and give you reassurance? Becasue we are not a leaflet or nct class. We are mothers who have done it first hand.
On a side note, I have an eating disorder to. I understand, i find slimming world great as its a control I have over what I put in my body and i loose weight, but its managable and healthy which I need to be a good mother. Good luck to you.

You've not mentioned your DH much apart from to say about his commute. Is he taking care of you at this difficult time. Can he bring you in snacks and look after baby while you nap? Sounds like you need some real life support.

On Monday please insist on seeing a Lactation consultant/ infant feeding coordinator to assess your breastfeeding. They may be attached to the postnatal ward. Someone experienced needs to assess your breastfeeding to ascertain what the difficulty is, then they can advise on treatment.

In the meantime please at least make sure you are drinking enough. I notice my baby getting frustrated when I'm dehydrated as it affects my supply. You use a lot of liquid breastfeeding. Your wee should be a pale yellow colour. If you are staying in longer, ask your partner to bring in a bag of snacks that you prefer.

I don't understand why they want you to limit breastfeeds. It doesn't make sense. However I think somebody experienced needs to assess you feeding in person. I'd make this your priority tomorrow.

OP, please be aware that you have potentially outed yourself by posting pictures of your DD.

Perhaps ask MN to delete your post as it is identifying.

Easy way

Feed every 3 hours. Give breast first. Top up with 80mls breast milk or formula ( it's not gonna harm her, however malnutrition and weight loss will). If she won't wake, let her sleep longer but she should make the volume up. So basically, if sleeps 4 hours needs 105mls etc.

This calculated feed is on 150mls/kg/day (based on 4.2kg)

This is how much volume a baby needs to gain adequate weight (as per infant dietitian)

If you do this for 48-72 hours and no gain they need to investigate further. If she does gain weight then it's likely a supply/ feeding issue

Your DDs slow weight gain does sound pretty concerning. My DD is almost 9 weeks and weighs around 9 lb 8, and this was off a birth weight of 5 lb 11 (she was premature). I'm surprised your health visitor hasn't been concerned about dropped centiles sooner. The jabs are irrelevant here as her weight gain was clearly slow before that.

My DD had to have formula (almost exclusively, and via NG tube) for her first 4 days before my milk came in as she was too small and sleepy to feed. I was very concerned I wouldn't be able to establish breastfeeding but in fact we got on to exclusive breastfeeding very quickly, so a bit of formula needn't jeopardise BFing with the right support. I had the same experience as you with different people constantly changing the feed plan... 3 hourly? 4 hourly? Top ups? No top ups? I know this can be very confusing. It's certainly far from ideal but I would focus your energies on getting your DDs feeding sorted rather than worrying about complaints and discharge. Could you go with whatever formula top ups are suggested this evening/tonight and then tomorrow ask if the hospital has an infant feeding specialist, insist you see them of so, and then be very firm that you want a clear plan? This was what I did when I was being given conflicting suggestions from different doctors/midwives.

Hi Rachael I have two ds who are now aged 13 and 10. I bf my first for 3 weeks then I found it so hard for various reasons so I gave up. I am sure my guilt about this contributed to my PND. So it wasn't an easy decision for me. My second I bottle fed from the start due to him being on scbu, and me throwing up constantly for a day afterwards. When ds2 was on scbu we were on a programme of feeding every three hours, and they were a bit concerned because he brought up milk from every feed. He continued to bring up milk until he was upright and walking aged 14 months.

I didn't breast feed for very long at all with my first, but he had that first milk, that is supposed to help with immunity. Well he is my one with eczema and asthma and allergic reactions. My ds2 who was formula fed doesn't have any of these issues at all, so even though breast milk is fantastic, it doesn't always go that it can prevent these things from occurring.

Take care of yourself and your gorgeous daughter. Sometimes to be a mum you have to sacrifice what you hold dear for the sake of yourself and your child.

your dd is beautiful, but if i'm honest her weight is a bit shocking, and if this were one of my dds, I'd have been formula feeding them by now. I'm surprised your HV told you it was fine to bf, if you thought you'd have recurring eating problems (as you have), formula is good and far, far better than a baby that's not gaining weight properly. I'd be waking her up, at least 2x per night until she hits an average weight.