Top up or not?

[magpieC]

DS is 15 weeks, EBF, and now tracking 0.4th centile. He was jaundiced (needed phototherapy), lost 11% of his birth weight and took 5 weeks to regain it. We stayed under the midwife's care for this and she was very supportive and was happy that as long as he was gaining (albeit slowly) it was fine. For a few weeks after that he was between 2nd and 0.4th before dropping onto 0.4th.

We then discovered he had posterior tongue tie which was snipped at 10 weeks. Feeding has become much easier although doesn't seem to have made much difference to weight gain (in that he's still following the same line). He seems quite happy and is developing nicely :-) At the moment he's sleeping for 6-9 hours between feeds overnight and then feeds every 1-3 hours outside of that (tends to get more frequent as the day progresses).

The question is whether or not we should do formula top ups?

DP (who was FF himself) wants to - and has wanted to for a while. He feels it's better for DS to be further up the graph. I've been resisting - DS is following a line, I like BF, it's no hassle etc. Tbh I've always expected to BF and never thought we'd have problems so FF is complete anathema. I asked the HV 4 weeks ago whether we should top up and she said it was up to us - if we wanted to she'd support us but if we didn't then she didn't feel it was necessary and she'd just keep an eye on the weight gain.

We're seeing her again tomorrow and so I think we'll have the discussion about top ups again (depending on what his weight is this week). Part of me says that it's no big deal to top up - we've got this far EBF and will still do as much as possible, but then I also think that as long as he's gaining along the line he's doing ok.

So, what do you think - and if we go down the top up route what's the best way to do it to avoid affecting my supply as I still want to BF as much as possible?

I can't see any reason there except your DH wants him to weigh a bit more?

Sounds like you have a lovely sane HV. IME they are often too keen to encourage top ups. So DS is feeding well, growing steadily, and seems well?

Up to you of course, but the phrase if it ain't broke don't fix it springs to mind

Feeding pattern sounds very healthy and normal too.

Yes, it sounds like things are going very well and I'm not sure why your DP wants your DS to be further up the graph You sound as though you are not keen on the idea.

Does your DP understand how the graphs work? There's no ideal weight, 50th centile is just the mean weight. Is he worried that a low centile means that your DS is not healthy?

I would get as much information as you can about mixed feeding before you decide, perhaps you could talk to a BF counsellor about it so that you can get the pros and cons. If your DP wants to feed your DS, how would you feel about expressing for a feed?

Thanks for your responses. Yes I think DP would just feel more comfortable if he weighed more. He knows that someone's got to be at the bottom just not sure he wants to be us and yes possibly thinks it would be healthier.

I think there is an element of also wanting to help with feeds but I don't get much out with expressing (after a feed) - an ounce if I'm lucky; barely covering the bottom of the bottle if I'm not. I do express sometimes and put it in the freezer and have left the two of them for a few hours one afternoon and DP did give him some with a bottle. I think it's also the reassurance of knowing exactly how much milk DS is getting (oh for a gauge on the side of each boob ...)

I agree with reply #1 and think your lo sounds absolutely fine. And oh to have had a normal hv like you do!! Enjoy your bfing I too am a firm believer in if it aint broke don't fix it

I agree with the posts above - if you're happy with your lo's weight and the HV, too, no real reason to change anything. Someone has to be on the low graph! However, I do sympathise with your other half wanting to help with the feeds, too. Maybe you could compromise and do one formula feed a day that would be his, and his alone, responsibility? You could give him the one at the time you least like, e.g. the really early morning or really late night one...

But it might be worth mentioning to him that topping up might not make any difference to the weight gain whatsoever - we have been topping up DS with formula pretty much since day 1 (issues with low milk supply after ECS, missed tongue tie etc), and in spite of that, at one point he still dropped from the 25th to the 9th centile, which he is now following beautifully. He is happy, smiley and perfectly healthy, just a long and thin baby (so unlike his parents, sigh...).