13 week DS 'underweight'

[hodgiebreeder]

Hi all! I think I just need a little reassurance about my DS. All a bit of a saga, but in brief..... He is currently 13 weeks and hovering just below the 0.4th centile (having been born at 75th). After gaining no weight at all and still not having regained his birth weight by week 9 (!!) he was diagnosed with tongue tie and had it snipped on Christmas eve. Since then he has put on weight slowly (about 1lb) but still not enough to keep up with the charts. I guess I was hoping for a miracle cure after the tongue tie op, or at least for more progress than we've currently made and I'm under quite a lot of pressure from the medical profession and family to cut my losses and put him on formula or at least up the topups I'm giving him. In all other ways he is wonderful.... Smiling, alert, and meeting developmental milestones. I guess my dilemma is should I just plough on with BF? Are there any long term problems with remaining 'small' and 'failing to thrive'? If I thought it would be the best thin for him I would have no problems with swapping to formula (so please no formula vs bf debates!!) and he certainly does find the bottle easier, but if I did give up bf, he put on weight at the same rate and he was just destined to be small but perfectly formed I would be gutted! Uuuurrgh! Tiring even thinking about it. I've been stressing about feeding him for 13 weeks and I guess I just want it to stop. Any advice anyone? Talk some sense into me please!

Have pm'd you hodgie

I think you could do with a chat to a BF counciler for this, give one of the helplines a ring, they can talk you through all of your feelings on this. See if any more can be done with BF to help his weight and help you come to terms with stopping if that is what is needed.

National Breastfeeding Helpline
0300 100 0212

The Breastfeeding Network Supporterline
0300 100 0210

NCT Breastfeeding Helpline
0300 330 0771

La Leche League Helpline
0845 120 2918

Association of Breastfeeding Mothers
08444 122 949

How big are you & your partner, OP?
Would you have the slightest suggestion of problems if he wasn't formally weighed?

Thanks for your replies. Yes, I have spoken to the NCT helpline numerous times and they gave me lots of tips on how to up my milk supply.... Most of which I was already doing. To be honest the lady I spoke to didn't seem too clued up about tongue tie or how fast he should be expected to gain weight post-op. Maybe I'm just expecting too much of him and 1lb in a month under these circumstances is actually fine .

My DP and I are both distinctly average size-wise, and DP was evidently a small baby/child, so I guess it's not unreasonable to think that maybe he's just meant to be on the small side.

Although in comparison with his NCT friends it is clear he is significantly smaller I'm not sure I'd be unduly worried if it wasn't for the bloody HVs and GPs putting the frighteners up me!! He's certainly keeping up development wise, in fact is even a little ahead (spot the proud first time mum ) and seems happy enough.

I think I'll just try to concentrate on looking at the happy, content baby in front of me and try to ignore the graphs for a bit.

my ds2 was like this although only dropped from 50th to about 5th, i did swap to formula and he put on no more weight each week than he did breast feeding. he is now however putting on loads. i think you need a serious chat with someone in real life and clued up with breast feeding and assess from there. i don't know whether my ds would have put the weight on if I'd continued but my gut reaction is probably.

Yeah does he look healthy, wet nappies etc, with dd1 I had the frighteners put on me by HV and switched to formula at 5 months, but regretted it. Second time didnt bother getting dd2 weighed as much and again smaller perhaps than the other babies but I was more able to focus on the happy content baby!

What a nasty comment bobbledunk

What a nasty comment bobbledunk

Fuck off bobbledunk, there's a dear.

OP, ignore that please. Speak to a breastfeeding counsellor. If he's putting on weight more quickly post-op that sounds like a really good sign. Don't forget formula isn't more calorific than breast milk, sounds like you're doing great and want to do the best for him.

Extremely unnecessary (and uninformed) comment from bobbledunk. Centiles at birth are less important than the one he was on at 2 weeks or so, that's why there's a gap in the charts. Babies are often born bigger or smaller than they end up being in the long run. They can be born big due to being overdue, or even due to hormones/fluids passed on from the mother following birth. If mum is small and dad is big, babies can be born smaller and "catch up" to a higher centile. Centile movement from birth is absolutely normal.

Bobbledunk your comment just made me cry. I hope you're proud of yourself. As if I wasn't feeling guilty and worried enough....
I don't know why I should have to justify myself to you, but just for the record I was begging my HVs and GP for help, not to mention various breastfeeding councillors and none of them spotted the tongue tie (which was 95% I might add). I did the best I possibly could in the only way I knew how with very little practical support as no one could seem to work out what the problem was. I only hope people are more understanding and supportive if you ever come across problems with your little ones.

HodgieBreeder sending you big hugs.
I had a premmie and was harangued about weight gain until I eventually asked HV what should DS be gaining and she said as long as a gain not a loss okay but should be between 3-6oz per week at this stage. Looks as though your little one is in that range to me. Keep up the good work.

Ignore Bobbledunk.

hodgie I'm sorry I don't have any constructive advice for you but I couldn't read and not comment on the vile post from bobbledunk
He/she should be ashamed to make such an ill thought out and offensive comment.

It's very normal for babies to drop centiles and doesn't warrant any comments like that.

I hope you get support to decide what best to do for you and your baby.

Has NCT advice included hiring double electric pump and doing a bit a 'power pumping'?

Short term frequent expressing over a few days (as well as a babymoon of staying skin to skin with lots of direct feeding) should help.

Obviously baby gets the EBM - the extra calories with less effort should help(as you mentioned bottle feeding is easier - it would probably conserve some of the calories he's using up with the effort of bf ).

Once his weight has caught up a bit more, he should feed more effectively

OP are there any lactation consultants in your area or can you make an appointment to see the infant feeding co-ordinator at your hospital? They are probably your very best bet and real life support is vital. They will assist with increasing and decreasing formula top ups and let you know if there is a real problem. GP's and HV's do of course err on the side of caution (and so they should!) but they are not always as well informed about the norms for a breastfed baby. Are you saying that your DS has put on 1lb since Christmas because that seems to be ok (looking from the outside with limited info). Anyway, main point was find an LC in real life!

Gosh I have rarely read such a horrible post on mumsnet as the one from bobbledunk. Shame shame shame on you.

And you bloody ignoramous, you should know, just for the record, that babies with a tongue tie can struggle to feed even from a bottle - think milk dribbling out of the side of the mouth as fast as you can get it in, etc etc etc.

You did amazingly to keep going in the face of a 95% tie, hodgiebreeder.

It might be worth checking that the tie hasn't reformed: this can happen, particularly - I understand - if the tie was posterior.

The lack of understanding about tongue tie among front-line health professionals is shocking. Well done for getting it recognised and treated, and pretty soon in your DS's life, at that.

And second the comment about seeing a qualified lactation consultant - they are worth every penny and some also work on the NHS for free.

Thanks for jumping to my defence everyone. Much appreciated

Have seen both a lactation consultant and the infant feeding specialist at the hospital who eventually diagnosed the problem. Will give them a call in the morning to see if we are indeed on the right track.

Thanks for the tip about pumping..... I have a medela swing at home but will look into getting hold of a hospital grade one to see if I can make things a little easier.

you can search here for support groups in your area abm.me.uk/breastfeeding-support-groups or the nhs website too. We are lucky in our area that we have a group once a week (used to be twice - grr cuts!) run by LC's so you might have too, and again, also try phoning your local childrens hospital

We're going through a similar thing. DS is now 14 weeks and dropped from 50th (birth) to below 0.4th. He also had a TT and has a lip tie and high palate. We got the TT snipped at 4 weeks but reinvestigated due to poor weight gain; turns out it had grown back. We had it snipped again and did a test weigh... Weighing him before and after a feed to find out exactly what he is taking in (app a rough guide to how much bm, is 20 x weight in kg), and it seems he's still having milk transfer issues so we are seeing an osteopath for cranial.

From what I've read, sometimes just snipping is enough but sometimes you need additional work to help them re-learn how to suck. So far we've had 1 session and I think his milk in take has improved. We're also supplementing with EBM and formula.

There's a really good Tongue tie support group on facebook... Can't link it as I'm on my phone but if you search for: Tongue tie babies support, you should find it.

Good luck x

hodgiebreeder, I'll spare you my saga, but I have been through something similar and I recommend that you stick with bf and supplement with expressed milk if possible. Since he has built up his strength, DS has done really well. It took ages to regain birthweight - one month he only put on 2 ozs:( As you can imagine I was sick with worry, but the last time he was weighed he had put on 4lbs in six weeks! He is now back on the normal percentiles and gaining. I too was under pressure to give him formula, but really I don't see how that would have improved anything. As long as he's getting enough of your milk, that's better than formula. As someone else said, you can pump to keep your supply up and see if he will take the extra. It's a lot of work and faff but it will pay off in the end.

Thanks ring, that sound like really good advice. Do you mind me asking.... Did you hire a hospital grade pump or make do with a standard manual/electric? Also how much were you able to express at any one time? I'm only getting between 1 and 2oz per time. Mind you I suppose that on top of full time feeding isn't too bad . Was just wondering if something more heavy duty would have better results?

No problem. I got the lactaline personal dual pump by Ameda www.mumsnet.com/Reviews/breast-pumps/1102-ameda-lactaline-dual-breast-pump. I paid about ?150 for it (maybe it's cheaper in the UK) but if you can afford it, it's worth it IMO. Pumping both breasts at the same time is more effective (I think it's easier to achieve let down) and with this machine it takes about 10 mins. 1-2 oz per session sounds about right. Remember, you are only topping him up, you don't have to produce enough for a full feed.

I also tried the medela swing pump, which was not half as good as the lactaline. A hospital grade is the best - I used one in the hospital for 2 weeks while DS was in intensive care. It depends really on how long you think you will be pumping for. If just a few weeks maybe hiring one would be cheaper. However, if you will be returning to full-time work and plan to continue bf the lactaline might be a better long-term investment.

Firstly well done on perservering with bf for 13 weeks in difficult circumstances.

I have recently been trying to increase my milk supply as I have 11 week twins and have been mixed feeding due to HV advice as weight gain was low and one of the twins was sub-4lbs at birth. But its getting so that they are having more formula than breast milk so I'm trying to reverse that and want to try to reduce the amount of formula they're getting.

I hired a hospital grade pump, double electric Ameda Elite (£33per month). I have been bf around 3 times a day (sometimes more) and expressing 3 times a day. I also started to take fenugreek supplements last Friday. This morning I expressed 2 hours after bf and managed 8oz, in total I have expressed 20oz today in 3 sessions, (this is double what I used to express) and have been able to reduce the formula feeds accordingly. So I think I have doubled my supply in just 1 week! Might be worth a try?