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.

[DamnYouAutocorrect]

Good grief. Tiktok has been on here for years offering amazing free advice about breastfeeding, and has helped hundreds (if not thousands) of women and babies in the process.

What have you done for us lately, Harper?

[tiktok]

Blimey, I seem to have missed something spectacularly nasty from Harper - that was kind of whoever reported (ilovemydog from the sound of it) it to save me from conniptions :) :)

Thanks for the nice comments, all :)

[Maternelle]

Harper I have reported your post.

[HarperSeven]

That's all you have to do to get deleted?! Seriously!! No expletives or anything.

[HarperSeven]

Ticktock, you are full of contradictions. You provide breastfeeding advice on the internet. You argue that formula is an 'intervention': suggesting a woman keeps EBF a child in the bottom centile is somehow not intervention is it? That's a choice too - and you are influencing it. You swagger in, and tell everyone what the latest terminology is for faltering growth and insist that FF is a last resort. I have to reiterate that I find your approach dangerous.

You volunteer with the NCT. You aren't a medical professional, yet you deliver your opinions as though you are one. You have a problem with private consultants as they aren't regulated, ...what regulation are you subject to?

[PenguinArmy]

A child isn't unhealthy just because it's on the bottom centile though

[HarperSeven]

Come on. That's a long bow to draw. WWYD if it were your own child?

[PenguinArmy]

well it was and she was fine (gained less weight a week than OPs)

[HarperSeven]

That's lucky.

[PenguinArmy]

It wasn't luck, it was a judgement based on all the facts and confirmed by several HCPs at various levels including a pediatrician.

To insist that something isn't right based on one fact which can be physiologically normal is rather blinkered. People panic on just the mention of 2nd centile but that's one in every 50 babies.

[PenguinArmy]

[RitaMorgan]

And what is your experience and qualifications Harper?

Why do you have such a chip on your shoulder about this The baby is gaining weight, the OP wants to breastfeed, the medical professionals involved are happy, various posters have made suggestions giving the benefit of their own experience and/or knowledge. Yet you are determined to push formula?

[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?

[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.

[crepesagogo]

Sorry typo! Your plan op.

[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!

[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.

[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.

[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.

[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 :)

[HarperSeven]

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

[RitaMorgan]

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

[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?

[ItsNotUnusual]

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

Odd.

[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.