Is this not really bad advice?!

[Bodenbabe]

My little niece is only 2 days old and she has lost a pound from not feeding and the breastfeeding-expert midwife told SIL to give the baby formula because she's not getting enough milk and she has lost a pound. All babies lose weight in the first week or so though - is a pound really that bad? Midwife told them to wait a few hours or so between feeds (for a 2 day old baby?!) and apparently as soon as baby is latched on she pulls away and screams. I know SIL wants to try to breastfeed so telling them to give her formula at only 2 days old seems really wrong, doesn't it? Fine if you want to FF, of course, but if you want to BF should you really be doing this? Anything I can suggest to them to help?

She's lost 1 lb in a day?

Is thAt even possible?

Her milk may not have even come in at 2 days

Baby should not wait hours between feeds either

Lots of skin to skin, offering the breast at every squeak and topping up with ebm?

But at 2 days milk may not be in but should be on the way ....

Actually Ive just realised she's 3 days old (I can't count :) )so it's 1 pound in 3 days. But isn't the 10% guideline for FF babies anyway or have I imagined that? I don't think it was traumatic, no. I do feel bad for them, I remember how hard it was!!

Bodenbabe - what you say does sound a bit odd.

I would be very surprised if a baby has lost a whole pound on day 2. I would be suspecting weighing error. I would also wonder why a baby is being weighed on day 2 - very unusual.

There may be a reason why the baby is being given formula. Usually, if a baby needs more milk at this stage (perhaps because of low blood sugar - properly diagnosed) then the mother would be encouraged to express colostrum if the baby is not yet feeding often and vigorously.

There is never a good reason to wait a few hours between feeds - really, never. So something is strange there.

Mum and baby need to be skin to skin 24/7 with gentle encouragement and offering the breast with no pushing - and someone experienced and knowledgable needs to be brought into the situation to observe what's going on.

The 10 per cent guideline is for all babies.

I would be concerned, yes, if a baby had lost more than this amount at 3 days. But it is not necessarily a reason to do anything except improve the breastfeeding alongside expressing colostrum/milk, so the baby gets more milk inside.

If the situation needs more than this, then in extreme cases formula might be needed...but again, never spacing out feeds.

well if she is not taking in any milk, then i agree treat the formula as medecine

nothing against you but i do get hacked off when people treat ff as the devil. i dripped some on my nipples on day 3 as no milk yet. now i am only bf and will do for 7 months ebf

but that ff on day 3 gave me some sleep!!

dont assume that its bad advice

porcamiseria - who is treating formula as 'the devil'?

The OP describes a mother who wants to breastfeed. Formula - while possibly necessary, as all the posts here acknowledge - may undermine this choice. No one is assuming the advice to give formula is 'bad', but it is at least questionable in the situation as described.

I get hacked off with posts that talk about other people thinking formula is 'poison' or 'the devil' or 'evil' when doubts about the use of formula are expressed.

I got given the advice to space feeds when my DD still hadn't regained her birthweight at 2 weeks. Luckily by two weeks in I knew enough to know that that sounded like bollocks and spoke to a bf-ing counsellor for some reassurance.

The weight situation is hopefuly benign, loads of perfectly healthy babies lose a fair bit of weight to start with and take a while to regain it (like my DD). But obviously it does need keeping an eye on. Problem is your sister is being advised by someone who does not sound very informed about breast-feeding. A bf-ing counsellor would probably be more helpful. If you don't know of a local one then the NCT breastfeeding helpline is staffed by qualified counsellors and open 8am - 10pm every day 0300 330 0771.

In the meantime things that worked for me and DD included me trying to relax (not easy), loads of skin-to-skin and offering the breast as often as poss. Is your SIL still in hospital? If so privacy may help. The staff when I was in kept wanting to observe DD's latch but I found feeding with an audience really hard and coped better when by myself. I noticed that when I got help from a counsellor after getting home she tried hard to help me relax first and got me a drink and chatted before asking if DD was ready to feed which made a big difference.

As TikTok says improving the feeding situation is probably all that is needed, but if your SIL does give her DD some formula this doesn't mean bf-ing is doomed or will inevitably be harder. Your niece is really young so they still have lots of time to make this work.

Thanks tiktok, that's very useful. There are no blood sugars issues.

porcamiseria, I've nothing against FF at all! I did it myself with 2 DCs. I clearly said "fine if you want to FF" - I was only querying it from the point of view of a parent who wants to BF.

Veronica, thanks too for the number - I will pass that on. I know I went wrong with my DCs by not contacting a counsellor. SIL is home now, btw.

" porcamiseria - who is treating formula as 'the devil'? "

Thanks Tiktok :)

My little niece weighed 6lbs 6oz at birth and on day 5 had lost 16%, despite appearing to feed three hourly (although SIL was worrid about latch) - and did not look ill - was alert, wet nappies etc. On arrival at paedatric A&E they gave her some formula. Blood tests were done and she was severely dehyrated and put on a saline drip and was tube fed. SIL immediately started expressing etc.

When she was released from hospital (4 days later) they were told to feed her at least three hourly day and night and offer 1oz expressed milk in a bottle after each feed.

6 weeks on she is being EBF. But both my brother and SIL wish they'd given some formula on days 3-5 as milk was slow in arriving and DN was a small baby. Perhaps she might not have needed hospitalisation otherwise?

MumNWLondon - but three hourly feeds are nowhere near enough for many new babies, seriously. And add to that, merely 'appearing' to feed, and you have a recipe for a baby simply not getting sufficient milk, and needing treatment for dehydration.

It's great she has overcome that difficult earl start - but the error was not the lack of formula on day 3-5, but the lack of proper support to keep the baby close and in contact with the mother, and a lack of expert observation to spot ineffective milk transfer.

Presence of wet nappies are not necessarily a sign all is well. Nor do dehydrated babies look ill.

:( Your SIL was badly let down.

a pound is alot of weight to lose, and the fact you questioned it made my hackles rise thats all

all i am saying is that some people have used ff in the very early days when struggling to bf then gone on to ebf sucessfully

tiktok - the problem I think was that the baby didn't demand to be feed at all, although it those first few days SIL did try and feed as often as possible (more than 3 hourly) and she was def holding her etc a lot, but the baby wasn't able to transfer milk effectively and this wasn't spotted.

The problem was compounded (it was a first baby) because the midwife visited on day 3 (ie first day home) when it all appeared to be ok (but midwife did NOT observe a feed) and then not again until day 6 when she'd already lost too much weight.

So yes, she was badly let down. In hospital it was discovered that the baby couldn't open her mouth wide enough to get a good latch and he tongue was quite far back in her mouth. On release from hospital the baby was feeding with nipple shields but still couldn't latch without.

The 3 hourly advice was on release from hospital, however she was weighed every 2 days after that and weight gain has been good, despite slow start at 6 weeks is EBF and has caught back up to 25% centile. And she is now demanding her food! SIL has pretty much been able to ditch the nipple shields too.

????

I questioned it because it was indeed a lot in just two days - would be very unusual, and could be a weighing error. And in my later post, after I learnt it was a 3-day weight, I expressed concern at the amount, which indicates poor milk transfer.

Why would your hackles rise at that?

I was almost pushed into dropping bf as my ds had lost a mere 12oz 24 hrs after birth. Turns out he'd not been weighed correctly...

I gave all of mine a ff about day 2 TBH. I offered breast all the time but just at the point where I thought I might go insane with no sleep and sore boobs I gave them a ff which meant they had a good sleep, as did I and then about 12 hours later my milk came in and everyone was happy.

eh tiktok? my hackles raised a bit at the OP, not at you!

Oh, I see!

Am baffled as to you raised your hackles at me either. Yes, a pound is a lot to lose - that's why I questioned that the midwife was getting them to wait 2 or 3 hours between feeds.

When dd was struggling to suckle as a newborn, the hospital did everything to work around my desire to breastfeed; they even helped me to feed her donated breastmilk through a cup, so that she wouldn't get used to the bottle or the taste of formula.

In retrospect, I know that dd's problems were part of a bigger pattern which could not be solved so easily, but I am grateful to the hospital because they worked with what we knew then and did everything to support me in my breastfeeding. There should be more like them!

And fwiw we absolutely found that what tiktok said was true: dd went on producing wet nappies even when she was seriously losing weight (at a later stage) and she looked alert for a very long time and appeared to be feeding.