Top up

[TeacupTempest]

Just had little one weighed and she has just dropped off the bottom percentile.

Have been advised to top up with formulas but was wondering if I could express and top up that way as I am worried about formula effecting my supply.

Obviously I shall do so if needed but it feels like a one way step...

Help?!

Have you discussed with HV, tempest? If the HV thinks your baby needs topping up, then I can't think of any reason why expressed breastmilk would be 'worse' than formula.....but talk about it first :)

Have you gone through all the other ways of improving worrying weight?

• switch nursing
• breast compression
• frequent feeding day and night
• skin to skin so you respond quickly to all feeding opportunities

If 'topping up with formula' is the only suggestion your HV made, you might want to seek another opinion.

Hi tiktok

Well we cosleeping so lots of skin to skin
Frequent feeds
I do switch but never quite sure when to

DD has never drained a breast and now I think about it she is quite a slow feeder, often stops, sucks slowly or falls asleep...

Breasts are not meant to be drained :)

You switch when you see your baby's sucking and swallowing has slowed right down. You can google for more info - ditto breast compression.

You can't 'draine a breast' as they are never actualy empty, the more you feed the more you make. You don't actualy store much milk in your breast it's made on demaded.

As ticktok say's there are lot's of things to try with Breastfeeding, switch nursing is offering multiple breasts at each feed. So feed one side switch to the other then back again offering as many sides as she will take.

Ah good! Sometimes She just seems to suckle for short bursts then drifts off.

I think the advice to top up was to try and see if she just needed more milk or if her lack of gain could be more serious. She will be weighed again next week.

So would expressed milk do the job rather than formula?

Yes if it's just about trying to get more milk in. BM is far better then formula and has just as many caleries.

But if it's not a seierious situtation (can really jugge that by your post) then feeding more often, breast compresions and swithch feeding will do that to.

Another thing is do you have a breastfeeding cafe? Getting your latch checked by someone more knolagable to make sure baby is transfering milk well is another good idea.

How old is she by the way?

She is 6 weeks. Have found a local group with a drop in session on Tuesdays so will pop in then.

I guess I don't really understand the top up thing. I seem to have enough milk, she feeds often and only stops when she falls asleep, pretty much attached to me most of the day so I don't see how I will get the op up down her unless I substitute a feed rather than top up...

Not sure I am making sense now sorry, bit stressed about it all I think.

And why op up with formula rather than expressed? Are they worried there is something wrong with my milk?

Getting more confused

Can you call your clinic/HV and ask them, TT?

If they do say something daft about milk quality not being high enough, then you will know how much they know......*

*not much

Not saying this is the case but some not so well trained HV will suggest formula topup's before even suggesting extra BF or expressing.

Could you speck to another HV maybe they have some who's a bit more trained then your regular one.

It's a very small clinic...think just one HV. I did see doctor and he was in agreement with HV, but I was so upset I didn't ask about expressing.

I have a pump on order for next day delivery so may just try and top up with expressed milk for a few days to see if there is any progress.

Is there anything that could mean my milk isn't up tp scratch?

Extra BF is tricky simply because she feeds so often already. Perhaps I could take her off the breast more often if she falls asleep or slows sucking in order to wake her up hoping she will resume feeding?

Try breast compression, TT, and switch nursing.

Thanks tiktok

One more question if anyone has a moment...could our latch position be wrong even though I have never had any pain or soreness and I can see Dd's jaw working and swallowing?

There is a possiblity she isn't feeding as efficently as she could be which is why I suggested you getting the latch checked.

The main thing though is she having lots of wet nappy's? As this is the biggest indicator of intake. Has she beeing pooing regular, although by six weeks this maybe slowing down.

Yep lots of wet nappies and plenty of dirty ones so I presume something is getting through!

You said she's droped off the bottom but what has her weight gain been? Was she small to start with?

If baby is happy healthy and gaining even if slowly this can be absolutly fine. Although if they drop more then two centiles they should be look at more closely to make sure nothing else is causing the low weight gain.

She was 6lb 3 at birth. Dropped to 5lb 10 and now at 6 weeks is 6lbs 8.

She always measured small t scans too.

She seems happy and alert and showing more signs of focusing and engaging. Dr could not find anything wrong with her at the check up today.

So her weight gain is slow and doc checked her and she is fine appart from that.

There really is lots you can do with BF before you need to resort to formula if at all. If weight is still an issue at next weight in ask if they have a feeding coordinator that you could see as you would prefer to carry on BF.

Don't worry about your milk, it would be highly unlikly for there to be any problem there at all.