Has anyone who ebf with poor weight gain...

[thegrandsophy]

...Actually managed to improve their baby's weight without supplementing by just increasing no of feeds per day/breast compression etc. I am talking of babies beyond the immediate newborn phase once bfing established. This advice comes up again and again and I have followed it with 2 of my children to no avail. Baby just seems to take what it wants. Am not very worried that have a slow gainer again (less than 3 oz a week over 1 month, 8-13 weeks) when the lowest limit of normal is 4-5 oz according to bf-friendly websites. Dc is healthy and hasn't yet crossed 2 centiles but would be interested to hear if this advice actually worked for anyone. Should I be reaching for formula supplements? Am I stunting them a bit despite being outside failure to thrive criteria?

i would think that your baby is just supposed to be that size

I had this with DS , the only extra thing I found was he would always seem satisfied after feeding from one side, but some weeks I always offered him second side no matter what, and he would then feed fully again from that side - and those were the weeks he had a decent weight gain

he was also refluxy and never really gained properly until we were advised to start weaning

Not quite what you asked for but some babies are born bigger than genetically they want to be (GD, very good feeding in utero for what ever reason, artificially inflated BW by excess IV fluids) and they catch down to their preferred weight by not gaining as much as they are 'expected' to do.

That's not to say a baby who is not gaining well or appears unwell shouldn't be looked at.

Also, if you have had previous children follow the same pattern (without any kind of pathology/illness) then perhaps it is how your and your OH grow children?

Well I prob phrased it badly but that's what I think too so why offer the advice if thinking you have to increase no of feeds per day etc. I feed frequently and on demand anyway but all the bf-ing websites trot this out. IMO it adds to the stress. It just didn't seem to work and made me feel I should be feeding hourly rather than 2 - 2.5 hourly. Have a niggle of concern as both me and dh are big (91 to 97 centiles on height!)

i think that's for when people have been advised that they do need to increase their baby's weight for whatever reason, and the BF sites are merely pointing out that you can do this with more breastmilk rather than needing to add in formula?

Not on topic at all but I do love your name - it's one of my favourite GH novel

If you are feeding on baby's cues, letting baby end the feed (but offering the other side/first side again just in case), they are alert and meeting milestones and not doing anything like only feeding for X mins/feeding on a strict schedule/etc then I don't think artificially increasing their weight will be a good thing or do anything but make them fatter than they want to be.

I had this with both my DS's. With DS1 I added 1-2 formula feeds per day, with DS2 I just carried on bf on demand. They both gained weight at the same, slow pace according to the red book charts, and are still slight today, despite me being tall and broad. Obviously hcp's are paid to worry on our behalf, but some babies/children are just meant to be small. IIWY, I would go with what you feel is best...easier said than done though, I know!

Thank you for the name compliment - with reference to this thread I too am over 5'9 in my stockinged feet! I do know in my head that dc3 is perfectly healthy - and am far too lazy to give up ebf for formula. was more asking how you get a demand fed/satisfied bf baby to take anymore even if their weight is into failure to thrive levels. Don't believe it can be done but mummynoseynora's post suggests it works. Just not for me!

i think if your baby was actually diagnosed as failure to thrive then that would indicate an underlying issue that did need fixing.

maybe a baby who simply doesn't "demand" and seems satisfied with one side, but like mummynoseynora found would actually take a second breast if it was offered. this is why mums are always advised to offer the second breast even if baby appears to be satisfied I think. if they don't want it they'll refuse, and it they do take it then they need it!

or any number of other things it could be

In addition to what GoodDogs has said - my mum kept my brother's and my baby weight cards and we weighed the same (with in a few ounces) for most of our first year. The differences in our feeding methods couldn't be greater.

DB was ebf for 5m feeding 2 hourly 24 hours a day with next to no solids until 10m (was switched to formula at 5m with solids but he just wouldn't eat until 10m).

I was bf for 8w then my mum was given the wrong meds to stop her PP bleeding. It dried her milk up and I refused bottles of formula so I had two bowls of formula and baby rice/porridge (and apple juice or baby ribena to disguise the milk taste) and bottles of apple juice or baby ribena to drink until I was about 4m when I had 'real food'.

Needless to say my DB is very healthy and I am, well, not . My mum did her best though with no support (HV wasn't interested as I would 'eat' slop) so I don't blame her at all.

The point of suggesting extra feeds/breast compression is that it is a way of 'supplementing' while continuing to fully bf. The baby who does not want or need this 'supplement' will adjust his intake to compensate, and thus will be unlikely to take more than his body actually requires.

Supplementing with formula may mean the baby does take more than he needs, because you can actually get a ff baby to feed way beyond satiety. The baby may try to compensate by taking much less at the breast. Result can be dwindling breastmilk supply. That's why supplementing with formula is high risk, and giving extra feeds/breast compression isn't.

Many babies do improve weight gain by extra feeds/breast compressions - the ones that don't are presumably feeding according to their needs anyway :)

My dd & ds have both followed the same slow gain pattern & dropped centiles from their birth weights (8lb 5 oz & 9lb 12oz). Hv did lots of eyebrow raising & pushing me to top up with f for dd. I worried & worried, ignored their advice & tried all the techniques you've mentioned to increase gain but they made no difference. With ds I did not go & get him weighed much at all. He seemed heathy & happy so I tried to trust my instincts more. When I compare their growth charts they follow the same curve as each other.

Am now 27wks preg with dc3, fully expect him to follow the same.

DS dropped from 91st centile to below the 9th and took 7 weeks to regain birth weight. As far as I'd been concerned I was feeding on demand etc. and figured he was just skinny, but he also cried a lot, wouldn't be put down etc.
I'd been listening to the rubbish from mws and hvs about foremilk and in an effort to get my poor sleepy baby to take more hindmilk I'd effectively been block-feeding and messed up my supply.
Switch-feeding, breast compression all helped, plus I cut dairy and it all improved. He gradually made it to 6 months ebf on the 50th centile.
But he looked too skinny, he clearly wasn't happy, nasty mucus nappies, never settling etc.
DD who is 3 months now is about 9th centile, but she's got little fat rolls on her skinny self, she's going to be slim when she grows up, whereas DS is solid.
So I'm avoiding taking her to baby clinic too often. They take one look at me and assume she should be massive.

Really, much of the problem lies with the charts - they show average and typical growth patterns, not those of actual individuals. As others have said, many children have a period of catch-down weight gain.

Both DD and DS gained weight incredibly slowly at first, and then suddenly shot upwards just at the point at which they were supposed to slow down. With DD, I allowed myself to be drawn into a lot of panic and pressurised into trying all sorts, and nothing seemed to make a difference. With DS, I held my nerve and just carried on BFing him in the usual manner, and he grew in exactly the same way as DD.

So really, 'poor' weight gain can often be just 'normal' for the child in question.

Well I do think growth charts are fairly well established tools although they obv require interpretation. I would be wary of thinking dc is bright and healthy/producing plenty of wet nappies but not growing as fast as average as I think it is potentially false reassurance. In reality I think a child would have to be really underfed before you could pick it up clinically - hence paeds use of the charts. And the charts are based on bf children so i might be a bit suboptimal at feeding - perhaps slightly less than ideal latch or milk production. I am just musing over whether you actually can increase the intake if a demand bf child by increasing feeds or breast compression. I suspect if they truly are demand fed you can't but it is often recommended.

I think the idea behind increasing feed frequency or breast compressions, is that if you (general you not you TGS) are restricting feeds, even unconsciously, or if baby is happy on a 'diet', or if milk transfer isn't great, then they can be encouraged to to eat more/want to eat more.

If baby is feeding as much as they really do need, milk transfer needs no help and they are growing well then it's just something to do - bfing busy work if you will.

I didn't need to supplement with formula, but I did need to syringe feed expressed hindmilk and had to work very hard on keeping dd awake for more feeds than she wanted. Punishing work, and with my next dc I did supplement with formula too (I am fortunate enough to have a very reliable milk suppply that does not seem to be affected by a bit of juggling).

Mind you, mine was a case of real problems: many years later dd was diagnosed with Ehlers Danlos syndrome and this was almost certainly the reason. Both my children showed the same pattern- but that's because EDS is genetic. So yes, in a sense that's how I grow children- not in a good way.

sorry, I didn't mean to make you feel bad! I should point out that even when I did offer both sides and he took it, his weight gain was never massive - just more than the 1oz he would normally, staid on the low end of the scale, but just about managed to follow a line until we were advised to start a very slow weaning process at 17 weeks which made him shoot up the lines