Disheartened by baby's weight loss

[ArialAnna]

Backstory to avoid drip feeding:

My original intention was to exclusively breastfeed DS but he has been combination fed from day 3. He was born by emergency c-section following a long labour. The induction drip caused us both to have low sodium which left both of us excessively tired for the first few days. This combined with tongue tie meant the feeding got off to a poor start. As he hadn't pooed in the first couple of days, the hospital told us to start topping up with formula after every breastfeed, which we did. He had a tongue tie op in hospital when he was three days only (I assume for the forward tongue tie). He was gaining weight okay but only when we continued supplementing with formula, otherwise he would stop gaining weight. Other than the weight he always seemed fine - he's always been a happy little baby who's pretty alert and seems to be developing with how the baby books suggest he should.

I still felt something wasn't quite right with his latch as he never stuck his tongue forward and the GP said we had a weak suck reflex, so I took him to a private lactation consultant. She said he had a set back jaw, retracted tongue and posterior tongue tie. The did some osteopathy to bring his jaw forward and corrected the tongue tie with a second operation the following week (in week 6 of his life). After this his suck improved a lot. Gradually he started drinking less and less formula, and bottles were continually going untouched, so I thought 'Yey, finally my supply is catching up' and now we only offer him one bottle a day (in the evening) which he barely touches most nights.

But just got him weighed again today (week 13) and he's lost a little weight since he was last weighed three weeks ago. HV said we should go back to supplementing with formula after every feed, which of course I will, though I'm worried about whether he'll take it. I just feel so disheartened by it as I really thought we were making good progress and now it just feels like we are back to square one! Also I don't understand why he wasn't drinking much of the evening bottle we offered, as surely he would it he were hungry? But obviously not! Part of me feels like it would just be easier to switch to formula full time as at least I'd know exactly how much he was drinking, but I don't really want to do that. I'm dreading starting solids as I've heard that babies loss weight initially on that too.

Has anyone got any words of comfort / advice? Particularly if you were in a similar situation.

Rather than supplement, could you not just offer extra breastfeeds?

Guess I could try that but a bit unsure as it would go directly against the advice of the HV today, as she thought I might be feeding him too often (so only drinking a bit at a time and not getting enough of the more calorie rich hindmilk)

It's a bloody minefield!

Hv sounds like she doesn't know much about breastfeeding tbh. Increasing formula will decrease your breastmilk so depends what you want to do. Kellymom website has loads of info on breastfeeding

kellymom.com/bf/got-milk/basics/foremilk-hindmilk/

kellymom.com/health/growth/weight-gain_increase/

This surely depends on whether the weight loss is due to your lack of milk or his inability to suckle effectively. If the former, then demented is spot on and you need to think about how to increase breastmilk by feeding more.

If the latter, then the HV is right and cutting out the most efficient way of feeding this particular baby will only make him more tired and less able to feed effectively.

My dd was in the latter category. I produced enough milk to fill the freezer with expressed milk, it just flowed out of me, but dd got less and less able to access it.

Breastfed babies do weigh less than formula fed too, this may account for a slight reduction in weight. But it is important to keep an eye on weight gain.

Do read the links given from kellymom. Think about how often you are switching sides, it might be that staying with one breast a little more might work better for the hindmilk. I had one lazy feeder, who would have tried to get away with foremilk all the time if he could, it took me offering the same breast more often and encouraging the extra effort it took to get the hind milk and less of the ultrasweet foremilk.

The biggest most important factor is looking out for wet nappies. I would think twice about supplementing with formula, if your baby is suckling well and having wet nappies. I would offer more skin to skin time, and more feeds for a bit, to increase breastfeeding instead.

I hope it works out for you.

First massive well done for your Breast feeding journey so far.

I've had similar and managed 22 months of exclusively bfeeding.

When you say losing weight do you actually mean a slow weight gain? What percentile is he on? Also what weight was he before and what was he 3 weeks later at the weigh in.

You can go against HV advice when it comes to feeding- indid and my other friends did too that we're passionate about feeding. It can take a while to get the supply fully established.

My son was born 70th percentile and at 2.5years old dropped and dropped but has sat on 25th percentile for over a year. Busy, happy boy.

My husband has asthma so amongst other reasons I decided to breastfeed for a year (ended up being 22 months) and he's had various chest issues (most likely genetic) but my respiratory specialist paeditrician has said to me that the breastfeeding will have really helped and it could be far worse.

I would drop Formula personally and keep boobing. You can express off some of the more watery milk and then feed after so that baby has some more more fat rich milk.

Lactation consultants and paediatricians would only be who I listen to and not GPS or HV so much when it comes to breastfeeding. It is just so very specialist.

A lactation consultant has to to have something like 3000 hours of active breastfeeding work before they can even sit exams and would blow a GPs breastfeeding (certainly a HVs knowledge) out of the water. - they are very valuable in many other ways I might add.

Could you send in a photo of your babys weight chart from the red book?
Also there is an amazing Facebook group called UKBAPS that saved my journey alongside a lac cons as I didn't have his tongue tie cut until 17 weeks. HV missed this completely (not their fault, just don't have the training of knowledge.)

I don't believe Formula is the answer. My breastfeeding journey is the thing I feel proudest of in my life almost. It was the hardest thing ever (blood, sweat and tears) but I think we might be beating asthma and I'm certain it's down to bfeeding and having a dog and cat and not using bleach!)

my middle child didn't pile weight on (was tongue tied etc) was born at 9lb8 and was only 13lb at 14 weeks (however was rolling over and alert etc. at all times) having almost driven myself mad with talks of supplementing (she refused bottles and cups) I kept going, she's now a tall slim child.
My other children had been half a pound either way (birthweight) and were a stone at 6 weeks exclusively on breast. google catch down it might be that? lots of HV have no idea about breastfeeding and breastfed babies.

Thanks guys for all your support and advice.

Cory, I'm not sure whether low supply or inability to suckle that's causing the problen. I suspect it's more the former (low supply) as with all the problems my supply has probably never been properly established. But then I'm not sure LO is 100% efficient at getting everything as his latch is still a little odd (it's impossible to make him open his mouth very wide) and I do end up doing breast compressions and manually hand pumping into him!

Mainlywingingit I've attached his chart - be good to hear your thoughts. He was born on 50% but was slow to get back to birth weight and since then has hovered around 25% but is now at just under 9% going from 3.35kg three weeks ago to 3.31kg now.

How often is he feeding? Could you try expressing and offering that as an extra rather than formula? Expressing could also help with increasing supply.

Have you tried doing the exaggerated latch (also called the flipple), to try and get a deeper latch? There are videos on YouTube about it.

When does the HV want you do have another weight check?

I would go against the advice that says it'll all be fine, don't worry. My son had a weak suck due to problems that weren't recognised until he was an older baby and he got very seriously ill because of dehydration. It wasn't obvious to me, despite him being an experienced mother, that he was dangerously ill. Breastfeeding is great and fantastic, but sometimes it needs to be supplemented with formula even for a short period to keep a baby safe. Formula is not going to harm your baby but weight loss and malnourishment really can. Be careful and don't listen too much to those who are pro breastfeeding at all cost. Of course breastfeeding is ideal but there are situations where sometimes a baby needs help to get the nutrients they need to grow and develop properly and for various reasons this may not always be possible through only breastfeeding.

Sorry, that was terribly written and full of mistakes, but you get the idea!!!

Thanks for showing your charts.
As your baby has had an actual weight loss from 3.35 to 3.31 (I think, it said) as supposed to a slow weight gain, I think you have to be a bit more cautious.

Sometimes tongue ties grow back - I would book in lactation consultant again asap as a last attempt and in the mean time up the feeds to ensure hydration.

She will advise you best as the professional. Try not to worry, most likely the tongue tie and possible suck issue compounding it.

Keep us posted, I know it's so hard, you are not alone Xx

I have been upping bfs and supplementing each with formula for the last few days as I don't want to risk him getting dehydrated or undernourished. I'd love to be able to exclusively bf but given that I've never been able to do this and he's over three months now, I might have to accept that that ship has already sailed.

I don't think his tongue tie has grown back given how he moves it around now. Even if it had I really don't want to put him or me through another operation - it just doesn't seem worth it to me.

Next weigh in is Wednesday - he's been drinking around 300 mls of formula per day on top of breastfeeding so hopefully he'll have gained some weight by then, fingers crossed!!

How did the weigh-in go ArialAnna?

He'd gained a bit - up to 5.59kg now, but he's still under 25% line so have to go back for another weigh in next week. He's been pooing more regularly over the last few days tho so I'm hoping that's a sign he's getting more and his metabolism is speeding up.

Sounds positive that he is pooing more, you must be relieved to know that he hasn't lost again. As long as he stays around the 25% or more that would be good.