20w/o DD losing weight

[lizzywig]

Hi mums of mumsnet - I need your advice -

DD was born 2weeks overdue at 8lb 8oz, by day 5 she had dropped to 7lb 9oz, being a first time mum and knowing nothing about how these things worked when the midwife told me this was bad news and I must start topping her up with formula immediately, I did. She also told me to start expressing half way through her usual BF feeds. Being that she was only 5 days old and I was BFing on demand this was near on impossible, but I did it. We were finally discharged from the MW service at 3wo when she had regained her birth weight, plus some more, (she had done much sooner than this but due to what they discribe as their admin errors it took much longer) and was on the 75th centile.

I continued to do all of this, BFing, expressing and topping up with formula until she was 8 weeks old when I was so exhausted from it all that I started feeling like I was getting PND, when I went to just BFing I was much happier (apart from a bedtime bottle of formula given by Dad). I got her weighed 2wks later (10wo) and she had dropped to the 50th centile weighing 11lb 12oz. I felt this was reflective of no longer topping her up and was happy. We got her weighed again at 14wo and she had stayed on the 50th centile and was 13lb.

When she was about 16wo she suddenly would not nap in the day unless she was fed right before. Unfortunately BFing would not work. It seemed that she would only sleep if given formula, perhaps she associated sleep with her bedtime bottle. Since 16wo we have been following this pattern (times are a rough guide as they do change):

7am: wake and breastfeed (and she really goes to town) for approx 15 mins
10am: nap time - 3oz of formula + 5-10mins BF before nap (has to be in this order...I have tried the other way!)
10:30am: wake and BF for 10 mins (she will scream if I don't)
1pm: nap time - 3oz of formula + 5-10mins BF before nap
3pm: wake and BF for 10 mins
7pm: bed time 7oz of formula + 5-10mins BF

It's only been in the last 3 days that she's been on 3oz at nap time, she was on 2oz but stopped napping and since she's been on 3oz she's started again. Today we went to get her weighed and she was just under 14lb 10oz and is just above the 25th centile. I'm worried. She is teething and when she eats she just seems to snack. I'm worried that nothing is established probably, no real formula pattern (because I don't really want her on it all the time, but what if she needs it because she's on it a lot of the time now?) and no real BF pattern anymore.

I know it's been said a hundred times before when women have said this and I know it's not reflective of what baby eats but when I express I don't get much. If I express regulary then I get more but at the moment I'm expressing once a day and I'm getting 0.5oz which is not much. However before these 3oz nap time milks I was expressing 2oz once a day.

DD is teething so this could be reason for her not gaining at the right speed. Apart from her teething she is content and she is happy and she is getting wet nappies so I'm not too worried. I weighed her myself, HV's didn't come over to talk to me and to be honest I've had such a bad experience with midwives and health visitors from the moment I fell pregnant that I don't want to talk to them because so far I've had nothing but bad advice.

I don't want to give up BF just yet but was planning to cut down at 6 months but I feel that I've cut down already but not replacing it with anything.

Advice would be VERY welcome, DH thinks I should just go to formula but totally supports BF. I think he's just saying it because he thinks it's a quick fix and lets face it he doesn't have the BF equipment so doesn't get it!

Is she losing weight or just not gaining weight at the rate you want?

lizzy, does she sleep from 7pm to 7am? Surely that must mean she is satisfied, or she would wake up for a feed?

I must admit though I also mix feed my 2Owo twins and they take quite a bit more formula/ebm than your DD, the smaller twin (11lb6) will bf for 15mins then have 5oz, the larger twin (14lb9) will bf for 15 mins then have 6oz. In total my larger twin has about 1hr bf and 22oz of formula/ebm per day spread over 5 feeds. Of course I have no idea how much breastmilk I produce (I express about 5-6oz each evening).

No actually, thinking about it she's not losing she just isn't gaining much, or what I had expected her to gain. When she was 14wo she weighed 13lb and was on the 50th centile. Now 6 weeks later she is just under 14lb 10oz and has dropped from the 50th centile to between the 50th and 25th. I did read something yesterday saying that babies around 4 months do dip a bit BUT she's almost 5 months now and whilst I appreciate that not all babies are the same I just want to make sure she's ok. She does seem ok and yes she does usually sleep 7-7, although the last couple of nights she's woken up once or twice for a feed which is not like her. I think the reason we've not been giving her so much formula is because to us she is BF and so the formula is extra but what if it's not and she's hanging on for the formula. She used to BF from me for 40 mins and now she takes between 5-10 mins, the HV at last weigh in was because she was getting more efficient at eating.

Thanks ceeveebee for telling me about your experience this makes me think that probably DD isn't getting enough...?

OK - she's not losing weight, that's a big difference!

What you need to know:

• the drop on the chart is within normal limits
• babies typically take less time on the breast as they get older and more efficient
• expressing is never a reliable indicator of what the baby gets
• she's not breastfeeding very often - 6 times in 24 hours is not that often, but it might be fine for her, of course. It does mean you can offer more feeds if this is considered necessary
• she's having enough formula to affect your supply I would say, especially that big feed in the evening, which prob does not leave much room for breastmilk and which means she goes from 3 pm to 7 am the next day without a breastfeed and this long gap may well reduce your supply....so if you think she needs to grow more quickly (and she may not) you could reduce the amount to give your bf more of a chance

But if what suits you is what you are doing now, your bf does not sound all that fragile, and nor does your dd :) But if you want to continue breastfeeding with confidence and not increase the formula, then you would increase your supply and her intake simply by i) feeding more often ii) feeding at night - she's waking more so this will happen anyway iii) ensuring she is offered at least both breasts each session.

There is no need to increase the volume of formula - if you think she needs more milk, it can be breastmilk, and why wouldn't it be, seeing you have worked so hard to make sure bf works well? :)