Is DD getting too much foremilk?

[VeronicaCake]

I need some reassurance. DD is 16 weeks old. She took 3 weeks to regain her birthweight and has mostly been on the 9th centile for height and weight since. My DH and I were both small babies too so this wasn't surprising.

She was weighed two days ago and her weight has dropped slightly so she is just above the 2nd centile although still on the 9th centile for length. She is still gaining weight and is very smiley, alert, energetic and has great muscle tone (she works out at the baby gym for several hours a day). She produces plenty of wet and dirty nappies, does yellow poos, only spits up occasionally, doesn't seem to have much wind etc.

Breastfeeding her hasn't hurt since she was 4 weeks old. She has started lately to bob on an off for a chat and is sometimes a little fussy during a feed.

The HV looked at my latch as I was feeding DD and said 'ooh she's on all wrong and only sucking your nipple you need to correct that latch'. So she tried manhandling my boob and DD's head which resulted in DD screaming the place down (the stupid cross-cradle hold nearly put paid to my breastfeeding at the get-go - DD does not want anyone to hold her head). And when I eventually told her to stop she warned me darkly that I needed to go away and correct DD's latch because she was probably only getting the foremilk at each feed and that was why she was gaining weight slowly and feeding too frequently. She feeds every 2.5-3 hours, sometimes she goes a bit longer, sometimes a bit less, feeds take about 20 minutes during the day but just 10-15 mins at night.

So I did go away and try and get DD to get a bigger mouthful of breast by taking her off and pushing her on when she did a big wide mouth and she got thoroughly pissed off and fussed through the next three feeds and overnight. The next day I woke up with a blocked milk duct and a cracked nipple.

So I went back to plan A, left DD to get herself on, and she fed unfussily and efficiently. The milk duct seems to be calming down and the crack is healing, but I have been feeling pretty ill and dizzy.

I'm not going mad am I? DD was fine before, and messing around made me ill and her unhappy. Apart from her weight gain slowing down slightly is there anything to indicate she was not feeding well? Her latch does look a bit shallower than the ones I have seen in some pictures, but if it seems to be working shouldn't I just leave well alone?

no, you aren't going mad. she sounds absolutely fine

if you had had advice from a qualified breastfeeding counsellor then you may have had reason to wonder... but from a nosy HV? no way!

your baby sounds absolutely fine, so i would carry on as you are

Your HV doesn't sound helpful

I was told that as my DD was only feeding for 10 mins each time she was "only having a drink" which is why she was petite

Anyway the whole fore milk/hind milk thing is a bit misleading ... It isn't like babies have to feed for a certain amount of time to get the hind milk - the proportions change throughout a feed

Feeding every 2 hours or so sounds ok at this age

If she is gaining weight and there are no other concerns then your DD sounds ok

Being fussy is also usual at this age as they are more distractible

Has she lost weight, or is she just not gaining at the same rate? Because babies can drop centiles without dropping weight (my DD was on the middle line for ages - til about 6 months, and is now settled on the one below)

Your HV's behaviour was grossly inappropriate and if your latch is not painful it is unlikely that she is nipple feeding - it bloody hurts when the latch drops and they're only sucking the nipple.

You may have narrowly avoided (or had the beginnings of) mastitis because of the blocked duct, in which case I recommend feeding as much as poss off the effected boob and taking paracetamol - if your symptoms worsen at all, get your butt to the docs for antibiotics.

If it is working, which you say it is; if DD is happy, weeing lots and pooing as normal then I see no reason to mess about with it. Some babies are just smaller than others - centiles and all that are about averages... someone always has to be below the middle average for there to be an average (if that makes sense?)

FYI the whole foremilk/hindmilk thing is greatly over-explained. Tiktok will probably be along at some point and explain the technicalities of it (because she's awesome like that) but it's generally not something you need to worry about.

Thank you ladies. I've been getting DD to feed as much as possible off the affected side yesterday and today and the duct seems to have cleared and I feel lots better.

I will do my best to ignore ignore ignore (though a little seed of doubt has now been planted - grrr). Thanks jemjabella for mentioning the foremilk/hindmilk thing, I had a look on kellymom and found it quite reassuring. DD definitely gets multiple letdowns during a feed (points when she starts to suck quickly again) so I feel confident she is getting all the fattier milk from the previous letdown first.

It is unfortunate that she has taken a scunner to healthcare professionals and is always grumpy at the clinic. She is delightful the rest of the time!

FWIW I very rarely get my DD weighed, and only then to satisfy my curiosity. There's no need if they are otherwise healthy etc :)