10 week old not gaining weight.....hv advice strange?

[emonslemons]

i went to the baby clinic for the first time today, and the hv said dd is not gaining enough.dd weighed 2.8kg when born and weighed today 3.9kg she asked how often i was feeding, i explained on demand sometimes every hour during the day. the hv advised me to not feed every hour but every 3-4 hours in order that she wuld get a better feed and gain weight?.....im very confused........any advice?.....

You are right, HV is a loon! Trust your instincts. Are you worried about her weight gain?

Perhaps you could ask the HV why she thinks spacing out the feeds is going to increase dd's weight? If she starts talking about the breasts having time to 'fill up' then you can be assured that she knows nothing about how breastfeeding really works.

Are you offering both breasts (or more) at each feed?

Has dd been checked for tongue tie?

You'll get decent advice from one of the bfing helplines if you are concerned. I worked out that the average weekly gain is about 4 oz (if I've done the maths right), so it's on the lower end of the 'desired average gain'.

Does she seem happy and contented in herself, does she come off the breast and seems satisfied? Is the feeding pain free and comfortable for you?

I had this at 8 weeks, and I found that feeding the baby every two hours on the dot worked to get milk supply better, and feeding from both breasts at each feed. I had milk supply issues and had been feeding what felt like non-stop but baby was badly latched, and essentially never getting a proper feed, even though I thought I was feeding her every hour. See a breastfeeding counsellor please. I think baby not gaining weight very fast, constantly demanding feeds is a sign that they are not completely satisfied. I also made sure I fed at least every three hours at night, and did not substitute any night feeds with formula, if you were thinking of supplementing at all...

Don't space out feeds to four hours whatever you do, whatever other people's babies may or may not be doing.
Because my baby was not latched on properly in the first weeks, I did not get a proper letdown at each feed, hence the drip feeding, baby was getting foremilk at every feed but never getting full supply, supply and demand kicked in, there was less milk available at each feed...you get the picture. You may need to build up your supply as if it was a younger baby and feed more often, but properly. Take time to get very comfortable at each feed, have a drink, some nice music, and don't worry what time it is!!

I had the same advice because my baby was feeding little and often and was only getting the foremilk and not feeding long enough to get the calorie rich hindmilk. By stretching out the feeds my baby fed longer and got more of the good stuff. It worked for me, but follow you instincts

Your HV is talking rubbish and displaying ignorance. Four hourly feeds are a good way to start interfering with your milk supply. Keep feeding on demand, offer both breasts.

Is there a breastfeeding support group you can go to?

It may even be that the scales were faulty - I've heard numerous accounts of HVs scales being out or them writing down the wrong weight, or marking it wrong on the charts.

It's not the 8 weeks one, but on one of the post-birth home visit, a HV weighed my DD on our bed. DH and I were just shocked.

This may help

Kellymom on weight gain

Foremilk and hindmilk explained

The latter is really important to read thoroughly as the fore/hind milk thinking has changed in the past few years.

Kellymom is a great resource for anyone who breastfeeds.

Weighing on a bed???? really?

There is no point in weighing unless it is done accurately :(

OP - spacing out feeds is what mothers do when they are trying to stop breastfeeding.

It is madness to do it to increase a baby's weight.

Do get a second opinion on whether you need to be concerned or not.

well let me offer some more info. i started off breastfeeding and was told latch perfect etc, but my nipple (almost literally split open from previous very very bad crack with dd1) which made the baby refuse my milk as it was literally filled with leaking blood.
i was in agony so opted for using nipple sheilds as i couldnt see a practical way around getting the slice to heal. the bf councellor advised against the sheilds but didnt know what to do about the nipple.
so she has been feeding with the nipple sheilds since 2 weeks old. she has always been on the tiny side, what i feel is she finally is gaining weight and building a little bit of baby fat which she didnt have before.
up until know shes been very alert and sociable, she coos and smiles all the time and plays with the toy bar on her bouncer since 6 weeks.....which i thought was very good? i knew there was going to be these interfering voices so i avided baby clinic as i felt i knew what was going on with her (and i do).
anyway i finally took her to baby clinic today and it has played on all my insecurities about bf.
im a mess and dnt know what to do im guilt tripping because the hv said if she was hungry she might not cry and let me know and it is possible that even though shes seems healthy and content that in fact she is not.
she poos about 6 times a day, or after each feed, and wees about the same, most recently with her sleeping more in the night ive noticed shes doing even bigger poos that are leaking up her back and down her legs so ive given her a full change of clothes today twice.
ive been feeling so low and confused about what im doing that i offered her a bottle in the last hour even though im feeling its not what i really want, of which she didnt want any at first but then took 1.5 oz after several attempts......i want to feed her only on breast milk but at the same time theres the guilts that im not providing her enough and im worried.....im gona go back to bf clinic.....but im just feeling so unsure of what to do.

thanks for the links worldgonecrazy they are really good analogies.
she seems so content and happy, i really dont know what im to do. sigh.

I have to be honest and say I think your DD sounds fine. I have 4 children and number 2 a dd and number 4 a ds were on the small side and much slower to gain weigh than the other two. As long as she is happy and alert and peeing and pooing I would not worry unduly. The thing is they have these charts and are duty bound to say something if progress does not match the chart. Please don't back down and give your baby formula unless you want to abd get some further advice - to me she sounds absolutely perfect.

well the original clinic i was supposed to attend was the one where the hv works.
but the bf councellor is on holiday for the next 6 weeks so im going to go to the one in the local hospital.
the hv wants me to attend baby clinic for the next 3 weeks so she can weigh dd , she also want to come to my home to observe me feeding, frankly i dont want to but im worried shes gona chase me a bit, she was already grilling me as to why i hadnt been to see her yet!

thanks for the reassurance BSB i think she is perfect, my mum says she is and im from a family of 10 kids so i take what my mum says seriously. im just guilt tripping that i may not be giving her enough milk cos of the sheilds and she refuses my naked nipple now!
so....i was feeling that the top up was the only way out.
but shes not even hungry for it you know, i mean my breast are full of milk and im giving her a top up.....i must be a banana!
i dont wanna do that again.....will the 1.5 oz have an impact for tommorows feed or will everything be ok for me to just continue bf as usual?

No just start all over again and forget it happened. In the scheme of things it is 1.5oz that she wasn't really that interested in anyway - drop in the ocean. I wonder the value of having the HV observe you feeding when her advice is a bit daft - it might serve to erode your confidence even further to be honest. Whereabouts are you, I wonder if a BF counsellor from MN could help you? I just feel a happy baby is not something to be sniffed at!

Oh and make sure she is using the BF baby chart for your dd's weight gain, a friend of mine went though this sort of thing just to discover the HV was using the bottle fed baby weight gain chart!

she is using the bf baby chart, i double checked the WHO website to make sure, she is obviously small being 3.9kg at 10 weeks, she is on the 0.4th centile.
but then her head circumference is on the 9th centile and her length is on the 75th centile. reflecting on the bottle idea makes no sense to me as my breast are full of milk and she tends to cluster feed just before bed, so a bottle doesnt makes sense as she wont take it properly she wanted to take my breast for comfort (which i enjoy as much as she does). yeah you are right about having the hv observing knocking my confidence, but i dont want to come across as an unthoughtful parent whos not bthered about her baby (which she was implying by saying that i should have attended the baby clinic for the babys sake and not avoid it because of my feelings) in some ways she has a point but at the same time i dont want nonsensical advice confusing my hormonal head!
i live in paddington and am planning to go to the bf clinic in st marys. i think that dd may have a tongue tie, as she has a heart shapped tongue like dd1 and cant seem to seal her mouth around a bottle teat or the nipple sheild and so swallows alot of air

A tongue tie would deffo account for slow weight gain- so would be a good idea to get dd's mouth checked and push for the snip as soon as you can.

Once that is sorted (iftt is confirmed) then you may find you can get rid of the nipple shields as the evidence shows that for some women, they can impact on supply in the longer term.

Hope you get some good help at the bf clinic.