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.

[HarperSeven]

Rita - if ticktok runs a BF consulting business then she should declare that - it would mean she has a conflict of interests.

[RitaMorgan]

In what way Harper? Why does it matter if her work is paid or unpaid?

[larrygrylls]

Harper,

What conflict of interest? I do not agree with everything Tiktok says but she certainly helped my wife with good advice when we had our first baby. She seems to go out of her way to give sound advice freely for those trying to breast feed. How can that be a bad thing?!

Spag,

Titania came on here with a specific problem, so let's try to be helpful to her. Her baby is 0.4th centile for height and between 0.4th and 2nd centile for weight. That seems to be a normal small baby and there is absolutely zero evidence of FTT. She is also getting a lot of appropriate help and her baby is being well monitored. The only real problem to me seems pain on the breast and during the day. So, in order, she needs to address possible silent reflux with antacids and then maybe consider lactose intolerance, though normal wees and poos and no rash suggest otherwise. Beyond that point, it becomes a personal decision whether to supplement or not. Personally I see no need for it based on what we have been told but having had a very skinny baby who put on weight very erratically, I sympathise with those who want to avoid the stress of every single weigh in by supplementing a bit.

[RitaMorgan]

Cow's milk protein intolerance rather than lactose intolerance.

[HarperSeven]

Rita - If anyone in the business of selling breastfeeding advice comes on to the forum promoting breastfeeding as the answer to someone's problems, then that is generating business for their industry and conceivably for them personally.

MN gets a huge amount of traffic: women read this nonspecific advice advising them to persist with EBF and possibly see someone who can help them with techniques to improve supply or transference and to only use formula as a last resort, and they do often end up calling private lactation consultants as a result.

If that happens, the reader should be informed if the poster has such a vested interest, they're not just a concerned onlooker.

[Spagbolagain]

Yes larrygrylls I totally agree, I think you think I am disagreeing and I'm not :)

Mum of very healthy small boy here, went through all the same concerns re weight and stress, decided not to supplement myself but can understand some people choose to and why!

It can be a really stressful time, and people making horrid comments doesn't help especially if their facts aren't right. I think Tatiana sounds like she is doing all the right stuff (in my non-expert opinion), I would be doing the same. Doesn't sound like her baby is not thriving to me, I never said it did! It was Harper who asked me if I had ever heard of it, and I have, but it's not the same thing as being consitutionally small, which my Ds is. But if it is used as a diagnosis, that is a medical thing, not an emotional one, and absolutely not one that should be blamed on a mother who is probably already worrying like mad. I just don't understand why people are so horrible and judgy on a support thread.

[RitaMorgan]

Ah yes, the evil breastfeeding industry desperate to destroy formula companies and risk the health and lives of babies in order to make a quick buck...

Formula is a last resort for those who want to ebf their babies - and if someone asks for advice on breastfeeding, they will get advice on breastfeeding. Whether or not someone is paid for their work in supporting mothers is irrelevant.

[TitaniaP]

When I posted my question I had no desire to spark a bf v. ff debate. I asked for help in continuing to bf whilst keeping my son healthy and happy. I made it clear that ff was for me a last resort (my choice)

If I had come on saying I wanted to give up bf and start ff and asking for advice on how to do it I wouldn't expect people to tell me that I was being irresponsible and putting my own needs before my sons. The same is true of wanting to bf.

Harper although some of what you've said has been useful in so far as it's made me question why breastfeeding is so important to me.

However continually labelling my son as a failure is not helpful and down right upsetting. As I've said none of the multiple HVs, the IFS or the GP are concerned currently (but we continue to monitor closely). Why are you more qualified to comment than they are?

[Spagbolagain]

Nobody is more qualified Titania, and whatever you do or decide, it will be just fine. My small but delightful DS agrees.
Hoping that all continues for you on the bf front and things settle down. Sounds like you are getting good support in RL and that is so important. Hope it all works out well :)

[buttonmoon78]

Titania I'm impressed you've stayed so calm through this nasty (only in parts) thread.

Everything will be fine. As you know well - that's not me being glib or smug, I have no reason to be! Go with your gut. Regardless of whether he's tracking a centile or not, if you get to next week and decide to supplement with formula then it might put your mind at rest with a bottle a day. And as others havbe said - it needn't be the end of the road for bf.

[tiktok]

I am a volunteer breastfeeding counsellor with NCT. I make no money whatsoever from this - in fact I am prob frequently out of pocket, if I did the sums. Part of my volunteering is to offer support and information on mumsnet. I have never hidden my affiliation with NCT here.

Even if I had a private bf consultancy (ha!), how would posting on mumsnet help it? I have never shared personal information here beyond the barest bones, and there is no info on my profile.

To clarify, I stand by the principle that people should hestitate before 'recommending formula' to someone on a talkboard - if somene asks about formula then of course, share info, but not 'recommend' it. Formula is an intervention, and 'recommendations' for its use should come from people involved in the real life health care of the poster and her baby - that way, the full story can be assessed, in person, and the chances are greater that a safe, and appropriate choice can be made.

Hope this clears things up for you, Harper. I don't deserve your sneering, unpleasant implications or your false accusations, either.

[tiktok]

To clarify, I did not advise anyone to continue ebf, I did not advise anything, in fact.

[tiktok]

Sorry about this - me again :)

I don;t think I have ever suggested someone sees a private lactation person - ever. I ask them, as I did here, if there was someone they have already seen who was helpful or to find out if there is someone in their area who is qualified to help.

I am assuming this would be someone within the healthcare service or trained by one of the vol. orgs. And that there would be no charge for the mother.

There are very, very few private practitioners in breastfeeding support, and some of them are ok, some are excellent, and some are really, really poor, and because they are unregulated, even if they have an IBCLC, I think it would be a bad idea to suggest someone saw one.

So Harper......stick that in your pipe and smoke it, why doncha? :)

[Gincognito]

Tiktok, from one stranger on the Internet to another, thank you. You played a huge part in protecting my son and my breastfeeding relationship. Your work is invaluable.

Ooh and Larry don't tell your wife but I have a little crush on you, too. :o

[TitaniaP]

Can I just say that I appreciate too the advice that Tiktok gives. As mentioned before I don't post much - but have lurked on here for a few months and frequently see her comments and she talks a lot of sense.

I am very sorry that I've started a post that's caused so much controversy when all I was doing was asking for support. I'm getting my DS weighed tomorrow (although I don't expect to see the fruits of my all day feeding frenzy yet). I will post the results but on a new thread as I feel this one has been derailed somewhat..

[buttonmoon78]

Sad but true T - just what I was afraid of further up! I'll be looking out for your other thread

And at the risk of this turning into a total love-in, tiktok kept me going a couple of times too, just by saying 'what about this...?'

[PenguinArmy]

Hi OP just popped on, sorry your thread went like this.

DD was a slow gainer, 2-3oz a week for the first 6 months but no HCP ever had concerns despite being 50th height and averaging 2nd centile.

Hope you master the lying down and reflux issues subside or settle. Please come back (or maybe start another thread) if you have more questions require more hand holding :)

[PenguinArmy]

crossed posts

[BornSicky]

Hi OP,

I had a slow weight-gainer and it is worrying. Sounds like you're doing all the right things and the plan moving ahead sounds good too, and just wanted to add my support for Tiktok's advice as well.

I found my supply varied at different times of day and expressing was always a bit of a struggle.

I have rented an electric pump from my local children's centre which was cheap and very helpful. It might be worth looking into if you want to try different pumps without spending lots of money.

best of luck.

[JetLi]

Tiktok helped me in my dark days - love ya tiktok

[BornSicky]

(not my thread at all, but...)

harper that's just plain spiteful and nasty, and totally unwarranted.

[ilovemydogandMrObama]

harper I've reported your post as it's personal and nasty.

[JollyBear]

OP sounds like you are doing all the right things. Good luck and I hope your DS continues to gain weight.

I just wanted to say in support of tiktok that when I had my first DD was told by two consultants I could not breastfeed on my medication. DD1 was a poor feeder and when I came to ask advice on MN, Tiktok mentioned that the medication may not be a hindrance to bf. At the time I continued with FF - scared to challenge the drs. However when pregnant with DD2 I did more research, and to cut a very long story short DD2 is exculsively BF. I want to thank tiktok for planting that seed of doubt about what the consultants told me. I only wish I'd have had the confidence to do the same for DD1, not because I think formula is the devil's work but BF is much easier!

[PoppyDoolally]

Right, harper- what mean spirited attitude you are displaying here. Please stop and think about what a terrible chip on your shoulder you seem to have and why.

Tiktok a million times thankyou from a serial lurker.