EBF 9 week old dropping centiles..

[TitaniaP]

Hi - sorry in advance for the mammoth post.

My DS will be 9 weeks on weds and has up until now been exclusively bf. He was 7lb 4oz born, and lost 9.5% by day 4. He didn't feed much at all for the first 48 hours (couldn't wake him up/latch him on). He took nearly 4 weeks to gain his birth weight and since then has gained between 4-5 oz a week. He is now hovering between .4 and 2nd centile and was 8lb 10 last Wednesday (at 8 weeks) (was born at 25th and was at 9th at 2 weeks)

I've been seeing the infant feeding specialist (who is excellent) at our local hospital since he was 2 weeks old and she helped me sort out his latch. I feed on demand upwards of 10 times a day and he doesn't ever go more than 4 hours at night.

He does make a clicking sound when feeding but the world and his wife have checked him for TT and posterior TT). I've seen 3-4 different peer supporters at different support groups plus weekly visits to the support group at the hospital. Everyone says his latch and attachment look OK. Also I'm not sore.

His nappies seem OK (plenty of wet and a couple of dirty per day). I've been talking domperidone for two weeks which doesn't seem to have made much difference. I struggle to express (I realise this is no indication) and never get more than about 20ml and sometimes much less ( I have a medela swing and continue pumping after flow stops to no avail). I never really feel full and my breasts don't leak (and never really have done).

I co-sleep, use a sling, feed in the bath, and do plenty of skin to skin, and breast compressions (as I believe they are all supposed to help increase milk production or transfer). My baby is very unsettled - will spend hours at the breast and cries a lot throughout the day. He often pulls off the breast crying too. I think I'm coming to the conclusion that the unsettled behaviour is due to hunger and that I'm going to need to top him up with formula.

I really don't want to do this. I want to ebf my baby boy and it's really upsetting me the thought of giving him formula. So I guess my questions are:

1. Does anyone have any suggestions on how I can increase his weight gain without giving formula, given that everyone thinks his latch is fine and it's not TT - is there anything else it could be?
   

1. Also if I do give him a top up, will this be the beginning of the end of my bf relationship (had planned to continue to a year at least)?
   

The HVs don't seem worried - but surely this slow gain together with the bouts of screaming aren't right?

Sorry for the mammoth post - and thanks in advance if anyone reads for long enough to reply.

[tiktok]

Thank you, debka :)

[debka]

If you come back to this thread tiktok I just wanted to say how grateful I am that you are on MN and give such fantastic advice. Neither of my girls have had a bottle or an ounce of formula and you have helped me to do that.

Thank you.

[crikeybadger]

Yes, I see what you mean about it being personal tiktok. I just wonder if HarperSeven would have been so obnoxious to you if she didn't know that you worked for the NCT. Maybe she has a problem with them?

Whatever the issue is though, there is no excuse for personal attacks.

[buttonmoon78]

Don't sweat the deleted post tiktok it wasn't particularly any worse than any of the others. I think it was just that maternelle had had enough (and the rest of us too).

[tiktok]

Thanks, badger - I'm not upset or hurt or anything, but I certainly do take it personally! I mean, when someone - even a stranger on the internet - says you are being terrifying, and irresponsible, and have an agenda and makes other personal remarks plus goodness knows what else was said in the post that mumsnet deleted, and they do mean it personally, for whatever reason, well....yes....it's personal, innit? :)

[crikeybadger]

I hope you don't take this too personally though tiktok, although it does seem be to be that way.

There is obviously something else going on here, some personal experience that is causing HarperSeven to behave in this way.

Care to elaborate HarperSeven?

[buttonmoon78]

This is getting more and more odd

[RitaMorgan]

Are you a medical professional Harper? Have you examined the OP's baby? Or is this all just irresponsible posturing from you?

Tiktok didn't presume to tell the OP whether to give formula or not, yet for some reason you seem to feel you are in a position to dispense health advice.

[PenguinArmy]

I am sorry you are having to deal with this as well tiktok

[tiktok]

Penguin - thanks.

The situation we were discussing was one where the baby's weight and health were not considered to be a cause for concern by the HCPs - they, as I indicated, could be wrong. But if they were right in that all was really well, then of course formula would be a last resort, because why would you intro formula to a healthy (though small, though growing) baby whose mother strongly did not want to use it and wanted to continue ebf?

I urged the OP to question her HCPs, explore options with them, and to take all the info into account. Nowt wrong with that!

I have to stop posting now as my laptop is running out of battery, but I am a bit sad a potentially useful thread was hi-jacked by someone with something deeply personal against me :(

[PenguinArmy]

It can you seem to be insisting elsewhere it does, glad we've cleared up that part then.

The baby has been a gaining an average amount of weight. Also FF can exacerbate some problems e.g reflux.

besides 1 in every 250 babies isn't terribly uncommon. That's a lot of babies in the UK if you add them all up. Besides the OPs baby is between 0.4th and 2nd which is a rather large scope.

You've made your point, people have countered. this isn't going anywhere apart from you seemingly have a grudge against tiktok

again apologies to OP for hijacking of thread

[tiktok]

I did not say that, though.

I said "The OP's baby has to do a lot of catch up from a difficult start and this has to be taken into account. Weight gain seems within normal limits now, and if all else is well, then it may well be a case of just waiting, feeding often, and ensuring that no opportunity to get milk into the baby is missed....I think 10 times a day is actually not very often for a baby in this situation, and it doesnt sound as if switch nursing has been tried, either. So there may well be further options to try, and maybe you can discuss these, Titania, with the real life support you have?

A baby who's unsettled may well be going short of calories, and more breastfeeding is usually the answer to that, but if not then judicious use of formula top ups is sometimes an option - but it should be last on the list, with a baby whose health and growth is not really an urgent issue.

I don't always find it reassuring when HVs say nothing is amiss, by the way. I come across plenty of situations when they simply don't really know what to do, and they overlook sometimes quite serious difficulties in the hope they will resolve themselves. I don't know if this is the case here, obv.

OP, maybe now is the time to consult again with whoever you trust most?"

There is nothing there at all that gives advice, tells her not to give formula, and indeed I am careful to say we don't know what is going on fully.....and that the OP could usefully seek more info.

The HCPs had told this OP all was well....and I even suggested this reassurance could be questioned.

I stand by what I said.

[HarperSeven]

Rita - do you know how many babies are at the .4 centile mark? 4 in 1,000. It's not just uncommon. It can indicate real health problems.

So for a BF volunteer with the NCT to come on here and say to the mother of that child that formula should only be judiciously used as a last resort - is horrifying.

[ItsNotUnusual]

HarperSeven - you really do appear to be targetting tiktok with some bizarro agenda.

Odd.

[tiktok]

NCT regulates all its practitioners - I have to demonstrate regular inservice training and updating, supervision, frequent practice etc etc.

It's self-regulation in that the organisation does it - like the Law Society, The GMC, the General Nursing Council and similar bodies. I can be kicked out or retrained if needed.

How have I been 'irresponsible'???

What is your beef with me?

[RitaMorgan]

They only person who has behaved irresponsibly here is you Harper.

[HarperSeven]

tiktok - who are you regulated by? I think your behaviour is irresponsible.

[faverolles]

Harper, in my experience (52 months bfing and counting) Tiktok and her fellow bfc's know infinitely more than most HCP's.
And for what it's worth, 4 babies in my close family have been tiny, but are all healthy, they are just small. There is far more to a diagnosis of FTT (or FG) than just a look at the centile charts.

Tiktok - without you and the other bfc's on these boards, I probably wouldn't still be feeding my baby now, so a huge Thankyou from me too :)

[Squigglywiggly]

We had similar problems, my dd just didn't want to gain weight despite feeding all the time. Latch was checked, was expressing etc.

In end, was advised to top up every other feed with formula. By week 1 we were down to 1 top up plus other if particularly hungry and after 4 weeks we dropped all top ups. Note I always breast fed first. I don't know if she just needed to build up strength or just took a bit longer to learn.

But she is a very happy 8 month old now who I am still bf.

Keep us posted.

[larrygrylls]

Harper,

You are spectacularly ignorant. This is based on your assertion that someone on the 1st centile needs formula. It really is a case of "baby bmi" rather than weight alone. Height and head circumference are important factors. Even if a baby is genuinely skinny, supplementing with formula is rarely the right thing to do before you have ruled out other treatable factors (assuming the mother wants to BF exclusively).

The NCT bf counsellor course is not trivial (my wife is considering it). I think it takes several years of both theoretical and practical training.

I do think that, where there is a genuine cause for concern regarding weight gain, it is important to see an appropriate paediatrician (one who has experience with neonates and feeding) to exclude other causes and, if necessary, to prescribe drugs. Most GPs are very inexperienced in this area and provide very poor advice and, even when they are good, they are not allowed to prescribe a lot of the relevant drugs.

[tiktok]

This is getting bizarre. Harper - I said formula was an 'intervetion' and you take exception to this. Of course it is an 'intervention' - it 'intervenes' just as taking paracetamol for a headache 'intervenes' . It's something that the OP wanted to avoid unless she had a good reason to use it, and I respected that. The word 'intervention' does not mean 'very bad thing' - it is something to be used when necessary and unlike you, I did not decide when a baby I did not see, belonging to a mother I did not now, on a talkboard actually needed it. I supported her remaining in touch with her HCPs and exploring with them what her options might be, and supplementing with formula would of course be one of them.

I am regulated, even as a volunteer and I work within boundaries - I don't given medical advice and I don't assume or share knowledge I don't have. I know what I don't know and I certainly don't think a baby on the lowest centiles definitely needs formula, that he is 'failing to thrive' and that his mother needs to be told to (in effect) get her act together.....all of which you managed to do.

Breathtaking, it really is.

[TitaniaP]

Crepes - exactly why I don't post much. I thought I was posting in breast and bottle feeding. I should have gone straight in for AIBU!

[crepesagogo]

Sorry typo! Your plan op.

[crepesagogo]

Harper you aren't reading properly. Tictok doesn't provide 'advice' she shares information that a poster can then use in consultation with her midwife or other health professional. The op did indeed consult with her IFC, who will almost certainly also be a midwife. The poster found the info useful and her plan came from her consultation with a health professional. Ticktok cautioned about anyone drawing too many conclusions without knowing more. Afaik the nct bfcs are internal updated and regulated.

The centile charts should have babies distributed from the bottom to the top, am not sure why you are more qualified than the hps and the mother to judge whether this baby is on its correct curve. Actually this baby had a slow start but if its gain is 4-5oz a week then that is within the normal range for a baby of this age and this is why the baby is now tracking a line. In this context your approach is hard to fathom.

The language used is correct, it correlates to that which hps use, nothing swaggering about accuracy. If a poster has over reached themselves then that poster would surely be you?

I care because tickok helps mothers and babies she clearly doesn't encourage mothers to ebf at all costs. This section of the site provides real support and posters with understanding of the mechanics and pressures of bf can really contribute.

Anyway op...why was it you don't post much, summat about bunfights :)

Good luck with our plan.

[PoppyDoolally]

I think the problem with harper and others similar is that they see a battle, with it's battle lines and propaganda. Whereas it is simply a case if an OP requesting help; a kind and knowledgable person providing it in a responsible and balanced way; and OP happy to receive said advice.

Sadly, many people take exception. Does harper also disagree with the notions of charitable giving, of blood or Breastmilk donation, or of other such worthwhile causes?