Infatrini or not - Am I making the right choice?

[asphyxia]

I started posting about DDs weight 5 weeks ago when I stopped giving her formula top ups and she lost about 100g in weight.

In the past 5 weeks, she has either lost or gained 20g or has had no weight change. We went to see a consultant at the hospital on thursday who kept saying to me "we can't keep ignoring this". I'm not ignoring the issue. I've had many great suggestions on here and in person at bf support group and I've tried to do as much of it as possible. Last week I've re-introduced a 60ml ff at bedtime and done lots of compressions, switch nursing, expressing and generally fed her as much as possible. She started to poop every day instead of every other day which I thought was a great sign but still no weight gain! She has had a cold for the past week so could that have totally ruined our efforts?

Anyway, the consultant suggested we introduce solids at 17 weeks but I said no to that because I thought she would just end up spitting most of it out. So we ended up agreeing on high calorie formula top ups. The dietician would like her to have an extra 200ml each day of either breastmilk fortified with regular formula or Infatrini. This would be 100ml at about 10am and again at 10pm. Now that I've had time to think about it, this seems like alot. I have until 6th dec for our follow up appointment in which time they will be doing more tests to make sure she is digesting properly. All opinions and advice welcome.

asphyxia - I think your consultant is talking sense. Babies need breastmilk, for sure, but they do also need to grow and the baby who does not grow, despite massive efforts to breastfeed with nothing else, does need supplementing, IMO, which you are doing...but it may not be enough, as your consultant suspects.

What does the dietitian mean about breastmilk 'fortified' with regular formula or Infatrini? Usually, fortifier is added to expressed breastmilk and while it is formula, it's not the usual sort. I don't think Infatrini is added to breastmilk, is it?

100 mls at a time of supplement is not a huge amount - it's less than most fully ff babies would have as a feed, once beyond the newborn stage.

Is there any chance of you getting donated breastmilk?

Have you come across Aitch on mumsnet? She had babies who ended up needing formula supplements despite her huge efforts to bf.

Hi tiktok and thanks for the reply.

The dietician meant to either give her 100ml Infatrini or 100ml ebm with 1 scoop of regular formula mixed in. I did make sure I was clear about this because I had read up on it and assumed we would be given Nutriprem or something similar. I don't think I could take donated bm - would feel like we're taking away from more needful cases.

I haven't come across Aitch I don't think but I'm always keen to hear similar stories. Could you point me towards one of her threads?

Am off to call the hospital for giving us out of date Infatrini. DD spend all day yesterday with an upset stomach because of that. (bad mother didn't check bbd before giving baby some)

Adding powdered formula to ebm would not be safe, asphyxia - the dietitian should know this. Powdered formula has to be mixed with water at no less than 70 deg c. Human milk fortifier is the product intended for this - maybe this is what the dietitian meant?

You can search Aitch in the archives - she's very prolific :)

I thought that didn't sound right! She definatley meant for me to add regular buy-it-at-boots formula. So when we go back on monday for some tests I shall ask to speak to a different dietician and mention the out of date Infatrini and the poor advice on fortified breastmilk. Hopefully they can give me something proper to add to my ebm.

"Am off to call the hospital for giving us out of date Infatrini. DD spend all day yesterday with an upset stomach because of that. "

that's awful (and no doubt didn't help with the weight gain thing) - your poor DD

Thankfully she is much better today. I feel really guilty for not checking the bottle myself. Should know better than to trust the hospital.

I don't think I would have thought to! Just busy figuring out what to do with it.

Glad she is better now :)

Just to add, asphyxia - adding formula powder to ebm would not give the correct fluid balance to the formula and could potentially overload the baby's kidneys.

This would be a serious error in a baby whose growth is giving cause for concern.

What was she thinking??

Well I spoke to the same dietician today. Again, she was confident to advise me to put one scoop of shop bought formula into 100ml of breast milk and that "hospitals have been doing it that way for ages". She also said nutriprem is not sterile either but I'm not sure about this. I told her I would not be taking her advice and will just give DD my ebm as is. She also seemed quite annoyed that she then had to go check the dates on all the nutriprem in the store room

check the dates on infatrini [brainworms]

Good for you for being assertive, asphyxia.

Mixing powdered formula directly into breastmilk cannot possibly be safe - whatever hospitals have been doing for ages.

If it's considered your baby needs supplementing with formula, then there are safe ways of doing it, and unsafe ways of doing it.

The dietician called me back earlier to say a colleague advised to mix 1 scoop of formula with 20ml 70 degree water then mix in with the breastmilk. I won't be doing this either. DD will just have ebm instead of 100ml infatrini every other day.

Hi asphyxia,

I just wanted to share my positive top-up/bf story with you. Both of my dds have needed supplementing despite my huge efforts to EBF. DD2 is now 8.5 months and since weaning her at 6 months, bf has become so much more enjoyable and rewarding- it was a tough road to get to here, but really worth it.

She didn't gain any weight for a long time, and didn't regain her birthweight until about 11 weeks. I had great support and tried everything I could to increase her bm intake, it just wasn't enough. (I tried co-sleeping, babymooning, breast compressions, switch nursing, fenugreek, more milk plus, domperidone, hospital-grade pump expressing, you-name-it-I-tried-it!)

In the end, I decided to use a supplementer to breastfeed DD the formula that she needed to grow and put weight on, and that worked really well for us. Now that she eats meals(and boy, can she eat!), we just bf when she wants(4-5 times a day), and she's offered formula a couple times a day in a bottle, but she definitely prefers to bf.

It was hard going before she was weaned, but having eventually ff DD1, and seeing how much DD2 enjoyed breastfeeding helped me to carry on.

I hope your dd starts to gain weight soon with the additional calories you're offering her. It's a really tough situation to be in, but you sound like you're doing so well!

Thanks for sharing your experiences ilovegreenbeans. I was hoping things would get better after weaning. The consultant suggested we introduce solids at 17 weeks to improve her weight gain but I chose to try the high cal formula instead. I really want to do blw and because I feel like a great bf experience hasn't happened I want a great weaning experience.

I am worried about what the bf support leader is going to say about the top ups but I've missed DDs first 16weeks of life because I've spent the whole time worrying about her weight. Now I'm taking the decision to enjoy our time together, especially the feeds and stop feeling like a bf fraud and failure.

asphyxia - interesting that the dietitian had to change her recommendations; my bet is she didn't know about the need to mix with 70 deg C water. A bit shocking.

You are making a decision based on good information, and after a long struggle to exclusively bf....for some women and babies this does end in some formula supplements, and any comments from the support leader are totally outof order. It's awful you are worried about this :( :(

I'm sorry too that you are worried about telling the supporter what you've decided on. Mine was excellent and realistic and saw that we needed to give DD2 extra calories. I saw it like medicine- given once or twice a day, a certain amount, for a certain reason. Nothing more to it!

Enjoy weaning- and I hope you start to enjoy breastfeeding soon too. I have and I never thought that I'd say that!