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Infant feeding

Get advice and support with infant feeding from other users here.

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Original poster

Week-old baby "must put on 50g a day" or FF - according to HV

23 replies

threefeethighandrising · 27/02/2012 20:26

A good friend of mine is has just become a mum this week.

She's not on mumsnet (yet!) but I'm going to send her a link to this thread.

Her HV is concerned about her baby's weight, as it's dropped since birth. She's said that he must put on 50g a day - the implication that if not they'll need to look at FF, and she's coming back to check.

Apparently he's been sleeping too much during the day then not feeding enough when he is awake.

My friend is very keen to BF, and is now waking her baby in the day when she can, and trying to feed as much as possible.

I just wanted to ask has anyone got any advice for this situation?

Shouldn't the midwife be supporting her choice to BF as much as possible, and talking about ways to up her milk supply / make sure her baby gets more access to her milk rather than using FF as a stick?

TIA

OP posts:

LineRunner · 27/02/2012 20:29

I thought all bf babies dropped a bit and then started to put it on? Mine did.

Original poster

threefeethighandrising · 27/02/2012 20:29

Sorry I can't count! It was last week so their baby is a week and a half old, important to get this stuff right

OP posts:

Original poster

threefeethighandrising · 27/02/2012 20:31

"I thought all bf babies dropped a bit and then started to put it on?"

That's what I thought too.

But even when the weight loss is enough to be concerning, shouldn't the HV be encouraging things that increase a new mum's milk supply - or otherwise support BF, rather than basically saying "if you don't meet this target then it'll have to be FF for you"

OP posts:

RitaMorgan · 27/02/2012 20:32

Yes, the midwife should, but practically they don't tend to know anything about bf so go for formula as the "safe" option.

How much weight did the baby lose?

Can you get your friend to call one of the breastfeeding helplines? In the meantime wake the baby at least every 2 hours to feed, offer both sides each feed (and swap back and forth several times if the baby will take it) and try to keep the baby as close as possible, lots of skin to skin, to respond to any feeding cues.

camtt · 27/02/2012 20:32

obviously your friend has to be satisfied that her baby is healthy, but she isn't obliged to do what the HV says, and she shouldn't be emotionally manipulated into doing so. Babies don't all gain weight at the same rate, most do lose weight post-birth. I suggest your friend tries to find a breast feeding clinic/cafe to get an alternative source of advice if she isn't sure she is happy with the HV's recommendation.

Original poster

threefeethighandrising · 27/02/2012 20:38

Good idea about the helplines, I'll pass the LL number on to her.

Does anyone else have any advice which might help her about how to make sure your baby is getting enough milk in the early days?

Or advice on dealing with HVs giving duff advice (and this is duff advice - isn't it?)

OP posts:

Original poster

threefeethighandrising · 27/02/2012 20:38

Or LLL even :)

OP posts:

RitaMorgan · 27/02/2012 20:42

50g seems like a random target, but - none of us have seen the baby and don't know how severe or worrying the weight loss is. It might be really important that the baby gains weight quickly - your friend could always ask for a second opinion from a paed though.

crikeybadger · 27/02/2012 20:47

Babies do lose some weight when they are first born, but it is usual for them to start gaining by this point. Is he gaining any weight yet?

If he's not gaining weight, then the HV needs to come up with ways to support your friend and give suggestions as to how she can increase milk intake (RitaM has offered some above).

Once back to birth weight, it is recommended that babies are not weighed more than once every four weeks. This prevents the anxiety and stress over small weight fluctuations. Giving a daily 'target' can't be helpful and in fact according to kellymom, the average weekly gain should be in the region of 170g so 50g seems excessive in itself.

Can you clarify if he's still losing or gaining though - that would be helpful for those looking to give suggestions/advice.

YuleingFanjo · 27/02/2012 20:49

your friend is doing the right thing to wake th e baby. She should aim to be feeding the baby every 2-3 hours during the day. I made aa chart and wrote down every feed to make sure my son was being fed at least 10 times a day. Is the baby getting the hind milk?

WhatLarks · 27/02/2012 21:03

I don't have any formal advice to give, but can tell you that my EBF baby lost weight and didn't put it back for about 2 weeks. My midwife also told me to give him formula, but I didn't (mainly because he wouldn't take a bottle). The next week he went from the 75th to the 91st centile, and has followed that line ever since. Hope it's the same for your friend!

tiktok · 27/02/2012 21:10

You can't be sure it's duff advice....we don't know how much this baby has lost and if there are any other problems. Sometimes babies need to gain a bunch of weight quickly if they have hit a a real problem - but 50g a day sounds an unrealistic amount.

Frequent feeding, both breasts at least at every session, switch nursing, skin to skin cuddling day and night is important. Frequent soft yellow poo is a good sign at this stage, and by now the baby should be at least close to birthweight with weight going up.

Original poster

threefeethighandrising · 27/02/2012 21:11

Thanks for the replies everyone.

He's gaining weight.

Sorry I don't know the figures.

OP posts:

Ciske · 29/02/2012 08:37

According to my midwife, a newborn baby will drop 10% of its birth weight in the first week. This is due to losing the first poo (which is very heavy), and its birth fluid, rather than losing actual fat. So it's nothing to worry about.

DS (6 days old) is a tiny little man, but to understand if he gets enough food the midwifes don't check his weight, but whether he has plenty of wet/dirty nappies, and whether he's alert through the day.

If feeding is an issue, they shouldn't be waving formula over your friend's head as some kind of threat, but support her all the way in getting regular and sufficient feeds going. My midwifes have been brilliant and offered to send around the BF consultant daily if needed. It sounds like your friend has a HV who feels a bit clueless in how to support her and is going for the easy option.

nannyl · 29/02/2012 09:10

My EBF baby took 3 weeks to regain her birth weight

she NEVER put on 50g a day, and I dont think she ever did 1oz (28g) a day either.

she slowly dropped centiles til 3m when she caught them back up again.... she is now 5.5m and almost made it back to where she started at 3 weeks

I never gave her formula... i could see she was fine, happy and healthy, and she has then benefited even more from breast milk by still having a virgin gut, not a gut unnecessarily 'polluted' by formula.

I TOLD my midwife and HV that "if i was a caveman i would not be at all worried, I am NOT at all worried, and will therefor follow my instinct and continue to EBF" and they didnt harrass me after that....

(she never lost weight, just put it on slowly the way nature intended her to do so)

worldgonecrazy · 29/02/2012 09:21

Is the 50g before or after a poo? Is your friend able to phone the midwife at anytime of the day or night and say "Quick, come with your scales, he's just had a poo"? Has your friend been told to collect poo and wring out wet nappies so that the MW can do some fancy maths to work out actual weight gain versus weight gain plus poo less wee? If not it just shows that the MW is talking out of her backside rubbish. What about if the baby only puts on 47.58 grams? (Sorry, I couldn't help showing how daft the MW is to give a set figure for growth.)

Babies gain weight at different rates. Growth spurts aren't always physical - the mental growth spurts take up an awful lot of calories so babies don't put on as much weight when they're having mental/brain growth.

Give your mum the links to mumsnet and kellymom.

chandellina · 29/02/2012 09:29

It really depends on the weight loss. My baby lost 17 percent of her birth weight in two weeks and though I was BFing constantly there was little choice but to put her on formula. (i still breastfed before each feed.)

It may need only be a temporary measure and it certainly doesn't have to mean the end of breast feeding.

mummytime · 29/02/2012 09:38

Call the HVs bluff and get referred to a paediatrician, who will be able to tell if there is a real problem or not.

duchesse · 29/02/2012 09:38

I have 3 daughters, all born weighing 7 and a half pounds give or take a couple of oz.

Not one of them ever, ever, EVER put on more than 2 oz a week from birth. They were all born more or less on the 50th percentile, and doggedly dropped from birth to 4 months onto the 2nd, which they then followed thereafter.

DD1 is now a gorgeous, willowy, 5ft 6 and still growing 16 yo.
DD2 is now an equally gorgeous, 5ft2 and still growing 14 yo, slightly more curves than her sister but still slender.
DD3 is a gorgeous and slender 2.5 yo, extremely active and healthy.

So I wouldn't say on my limited sample that 1oz a day is any kind of standard to follow. I don't actually know many babies who grow 7oz a week- it is extremely varied.

I suggest that your friend tackle her HV head on and request a referral to a paediatrician if HV is that worried. After all, if the HV has genuine and founded concerns, then she baby should be seen by a Paed. And if her concerns are not founded (ie baby seems happy and healthy and is having the right number of dirty/wet nappies her day) then she should reconsider her stupid undermining advice.

duchesse · 29/02/2012 09:38

x post with mummytime!

YankNCock · 29/02/2012 22:25

My EBF DS at 2 weeks old was down 11% from his birth weight. He took until 5 weeks to get back to his birth weight.

He was born on the 75th centile, dropped to below the 9th and followed that till about 6 month. Then by a year he was at the 25th, and just before he was 2 he was on the 50th. I looked now, at 2.6 he is on the 50th for weight and height. My scrawny baby is no longer so scrawny!

ThisIsMummyPig · 29/02/2012 22:41

My DD1 was born on the 9th centile. Within 4 weeks she was on the 2nd, a couple of weeks after that on the 0.4. My health worker gave me absolute shit about it - she accused me of deliberately starving her by breastfeeding, and I tried every type of bottle under the sun. My daughter was too stubborn (thick) to take a bottle and we went to the peads. By this time she was 4 months old and under the 0.4 curve (just).

4 hospital appointments and 6 months later the consultant told me that they would not do any tests as there was clearly nothing wrong with her. I feel so betrayed by the HW insistence that DD1 followed her chart which was made for bottle fed babies, and was so blinded by her not following the chart that she couldn't see she was alert, healthy and well cared for.

She is now 4, and a picture of health but still very thin - she runs around lot and eats lots of fruit and veg- but nothing can get me back those precious early months where I was worried sick about her not gaining weight as the health worker wanted.

I don't think she ever put on more than 2oz a week either - 50g a day is 14oz a week - or 3/4lb - If she started at 7lb, and maintained that weight gain for 8 weeks, she would be 13lb at 2 months. According to DD2s red book that would be 91st centile, and born on about the 2nd. (I know this doesn't allow for the weightloss that occurs in the first couple of weeks). If your friend's baby acheived this she would be referred for obesity before you knew it.

Sorry this is a bit ranty, but I feel so angry when people are so stat obsessed they can't use common sense about something so important.

chandellina · 02/03/2012 18:57

Yes use common sense but I am glad now the baby clinic advised me to go to the pediatrician at A&E. My daughter seemed contented but she was dangerously underweight and the midwife and health visitor had if anything erred by not addressing the weight loss sooner. So it is not always dud advice.

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