Underweight BF baby

[becausewecan]

My dd is 15 weeks old and weighs 8lb 6. She was born weighing 6lb 11 and quickly regained her birthweight in the first week. Since then she has gained weight very slowly. It's taken a month to gain 4 oz.
I am exclusively BF but am now being advised to top her up with formula by all and sundry. Should I take their advice?
I've really enjoyed BF and thought is was the one thing I was managing well. I got through the constant feeding in the early weeks and gradually dd had established her own feeding pattern roughly every 2.5 to 3 hours. I've tried feeding her more but she's not interested. Surely if she was hungry she would feed more? I can't see how a top up would help unless my milk isn't good enough?
She has plenty of wet nappies, dirty ones every 3-4 days. She is bright and alert and apparently has good muscle tone. She does cry a lot but I always offer the breast but it seems to be wind related. She'll just suddenly start screaming until she passes wind and can get quite hysterical. The doctor advised she has colic.
All my confidence has been undermined. Convinced she was starving last night, although she was refusing the breast, I ended up in tears trying to make up a bottle while dd screamed. Turned out she was just tired :(
She is a long baby and I wasn't worried until people started commenting.
Any advice please?

:(

It is so difficult to cope with situations like this. It's not at all uncommon for mothers to be advised to give formula, and of course in some situations it's needed. But it's also not at all uncommon for formula to be advised when there are other options, and it doesn't seem clear in your post that all of these have been considered.

If all that is 'wrong' is lack of calories then you could ask whoever-is-telling-you to top up about these options:

• feeding at least two, and possibly three or four breasts each time - 'switch nursing'. This increases the volume of milk made and going into the baby
• breast compression (google it) which enables the baby to take more milk from each breast
• feeding more often, especially at night (though I see you have tried feeding her more often - offering in response to every minor feeding cue could help. You will need to keep her close, possibly in a sling, to be aware of these
• supplementing with your own expressed breastmilk

A call to any of the bf lines will help you, too.

Thanks tiktok I'll try the breast compression.
I was told by the HV to block feed from one side but I'll try switching during the feed.
I am trying to feed more often but so far she'll just fuss or fall asleep. She still feeds 2 to 3 times at night anyway and we cosleep so I can easily respond.
I've given myself 2 weeks to try and increase her weight and will then decide about the top ups

Appreciate the advice :)

Aaargh! Block feeding is for babies who are suffering from their mother's own over supply. It is useful because it reduces the amount of milk made - the HV sounds v. confused.

Good luck with the change of regime :)

A lot of us have had success with switch feeding. At one stage I was on 10 sides to get LO to feed for a good period of time. Even at 8 months we normally do 4 sides.

I've tried it this evening and managed to get her to feed for longer periods a little more often.
Spoke to my mum too and she said I was a skinny baby and I was formula fed. She was always getting visits from health professionals convinced she wasn't feeding me enough...maybe its genetic!

I think 4-6 months was when DD was her skinniest. She dipped below the 2nd percentile at that point. She was another with good muscle tone (rolling at 11weeks, crawling 6months on the dot etc.). If you're happy with everything else then I'd try and relax and make sure she has access to food whenever. But see some more BF educated people in real life for reassurance, especially with the wind thing. DD was feeding every 2 hrs all the day round up to 6 months.

Also at this age they get a bit too interested in what's going on around them and get hard to feed during the day.

I think you should feed her very often - at least every two hours and see if there is a change. Sometimes babies get too tired to demand lots of feeds. And check how she is latching on. I had a thin baby, and he ws bright alert smiley kicking wet nappies etc and I misintepreted his behaviour not realising he was hungry. Because he was feeding often it didn't occur to me that perhaps he wasn't getting enough milk. And that was because he wasn't properly latched on, but sucking as if I was a straw, rather than properly milking the breast.

Often your baby is so familiar to you, and so lovable that you can't tell they are a) thinner than they could be in an ideal world b) a bit tense and unsatisfied due to not quite being full. My baby wasn't sleeping very well either until he became satisfied.

Don't give up breastfeeding (I didn't) but don't assume everything is fine. In my case it wasn't, and I felt so so bad about it. My baby became much much fatter when I latched him on properly and fed him very very often from 10 weeks. By 16 weeks he was back feeding at more leisurely intervals. (I also topped up from 10 weeks, but that may not have been necessary)

I could also feel that I had more milk once the latch had improved and I had worked at increasing the supply by feeding often (2 hourly). I could feel milk letting down, and the baby gulping it down in great quantities, whereas before, that had not been so obvious (bar the first two weeks) Often that is quite a good indicator of the fact that you are making enough milk and that things are going well. Switch nursing worked for me too.

Thanks for all the advice. I go to a breastfeeding support group so I'll get the latch checked next time I go. No one there has been worried but I'll ask again.
I'm also feeding in total silence as even with the radio she is always looking round for the voice! Hopefully I can post good news in a few weeks.

After following all the advice given baby has put on 5oz in 3 weeks which is marginally better than before. This was with a cold and teething so I have now got some confidence back. Thanks for all the support :)

Thanks for reporting back, OP!

I'm pleased to hear things are getting better! I agree with first poster - you don't need to use formula and it can decrease your milk supply. However there is nothing wrong with combined feeding if this seems right for you and your baby, and many people make it work for them. So, you can either just BF more frequently - even if this means waking your baby up in the night to feed, or top up with formula. Either can work but it's your decision. It is better for baby that Mum is happy with whatever method she chooses, so do whatever you feel works for you and your baby. If you did choose to top up with formula but then wished to return to BF-ing only, you can always do so - your body will produce the right amount of milk, and you can always express to quickly increase your supply if needed, so neither method is a path of no-return. Even though it may not always feel like it, you'll know what's best for your baby. The weigh-ins are only a guide, not law, and all babies grow and develop at different rates. Does your baby seem otherwise well? Does she produce at least 5 wet and/or dirty nappies a day? It sounds like you're doing a great job!