3 oz average weekly gain in ebf baby - is it ok?

[guendalina]

HV suggests I should offer ebm or - if not possible to express - ff to DS because he's only gaining 3oz per week (weighed at 8, 12 and 16 weeks) and he's sliding down the charts. Is it really necessary? I don't really want to give him formula and I hate expressing. Can there be any long term consequences if I don't?
TIA

of course she's talking tosh!!

your milk is fine.
Your baby is gaining weight, not losing it, not keeping stable, gaining weight.

He is passing all the other milestones and your HV is making you feel bad.

You must call her on this - ask her when the last BF course she took was, how up-to-date her knowledge is. And if she can't answer those questions, then ask for a different HV.

if she's worried then she must refer you to a paediatrician, not keep making wrong wrong wrong assumptions about your feeding and milk

yes, definitely talking tosh - my DD is gaining more weight a week than your DS (sorry), and I am the one that "does too much" - I'm running a book shop 6 days a week, and have church on my day off!

Yes a load of tosh, otherwise how would have humans evolved if only women who rested lots made 'good' milk? Hunter gather lifestyle isn't really compatibly with sitting around on your bottom given that they are on the move constantly

It is good advice in one way though, it's showing you just how limited her bfing knowledge is. Now you know not to rely on her advice - you wouldn't take you car to a mechanic who asked you my your automatic didn't have a clutch would you? (I think that's correct - my car knowledge is confined to what DH tells me about cars that I actually retain [i.e. nil!]).

It may be an issue if you have a massive oversupply if you also have very large capacity to store milk (which surprisingly isn't related to cup size) as you may find baby is only able to drink part of the milk stored so the milk is stored for longer than a woman with a smaller capacity. As the longer milk is stored in the breast the lower in fat and the higher in lactose it is, sometimes women with large storage/over supply find their babies have green frothy poos, grumbly/distended tummies, issues with wind (this is because the baby isn't able to make enough lactase - the enzyme that digests lactose - and instead the good bacteria in the gut digest it causing the green poos and the wind/distended tummy. Also it's often associated with massive weight gains unless the baby is refusing to feed due to the 'hit in the face with a hosepipe' effect....

Does any of that sound familiar to you? You haven't mentioned green frothy poos or massive amounts of wind but you have mentioned that baby takes both sides (why would they if they were full to bursting on the 1st), has a sleepy drunk look post feed, seems content between feeds, etc.

Could you ring up on of the bfing helplines to get a RL discussion on your situation or ask for a referral to the Infant Feeding Lead (senior HV in charge of baby feeding - our local one runs all the bfing support groups in the county [in a managerial role] and is training to be an IBCLC)?

If that 's the case, then the best thing you can do, guen is to see a specialist lactation consultant, or someone at LaLeche League for advice - there's block feeding that could be discussed, but you definitely need to talk to someone who actually knows their stuff on breast milk

and while you're at it, complain about this woman.

nickel said it better (and with about 500 less word )

Yes, absolutely a load of rubbish, doing 'too much' does not affect the quality of your milk. What a stupid thing to say to someone who's confidence you've already knocked

If your lo is gaining, has lots of wet and pooey nappies and is alert then chances are lo is just fine.

Both my ds's dropped down the charts gradually from birth, neither of them ever lost weight, just gained it slowly. They are both perfectly fine, small but really healthy and full of energy

All you can do is offer as many sides as poss per feed but if lo refuses to take any more then lo must be full.

Honestly, I'm sick of hv's not knowing what they're talking about regarding breastfeeding, the wrong information can be so damaging.

Never ever seen a green poo so that rules out her theory completely I guess (in the sense that my milk IS fatty enough).
I wonder where she got that info from...is it myth or just a random thing to say?

Sounds like she was clutching at straws to me and whipped out the standard reply she probably gives to every mum whose baby doesn't conform slightly to what the book said. She obviously doesn't know enough about breastfeeding and as a result has made you feel completely inadequate which is so wrong - I'd be writing a strongly worded 'letter of advice' if I were you. I'd recommend a lactation consultant, who will hopefully boost your confidence which has been trampled on knocked and re install the belief that you can do this. And I would ask to see another HV if you can

Myth - going back centuries that some women don't make 'good' milk - why depends on the prevailing customs/folklore in that culture.

At one point in history in the UK, brunette wet nurses were in demand as their milk was 'richer' than blondes and a good wet-nurse had to be placid and docile too I have no idea where red-heads came on the scale though or those with a more perky outlook on life!

So your HV is just spouting centuries old non-evidenced based 'advice'....not up with current best practice in the UK is she. A word to her supervisor/manager may be in order in case she scuppers someone who doesn't have access to MN's bfing.

PS - she didn't also recommend increasing your cow's milk intake or perhaps take up eating cake to 'fatten' up your milk did she? That's another old wives tale too....

LOL truthsweet no she didn't tell me to eat more cake probably because she rightly so thinks I'm fat enough!

My DD was a 3oz (and less) gainer in the first 6 months. She was fine, full of energy etc. Still is at 2.2 years of age. Her growth slowed so at months 6-9 she gained 1lb in total, still fine. We were in the US at that point so standard check-up was with the pediatrician who didn't even mention it other than to plot it up etc. At that point she was down to just above UK 0.4th line.

ps when they say average gain is 4-7oz that implies there must be below average babies as well :)

i was thinking about this - she's observed a feed and knows that your DS didn't want the 3rd side.
he knows he's had enough!

nickel - you can't force a baby to bf but it's not impossible to make a baby have more milk then they want from a bottle regardless of what's in it. Could this be why she is recommending bottle feeding top ups not cup feeds?

Is this a baby or a fois gras goose?

Force feeding is an act prohibited by the Declaration of Tokyo of the World Medical Association btw.....

that's quite a sinister thought :(

I'm not saying this HV is some kind of sadist but she may just be thinking of how bf babies usually take feeds of 2-4oz but bottle fed babies can often manage 7-9oz feeds so perhaps feeding with a bottle may help the baby to get more milk before the 'I'm full' feeling kicks in.

However over-riding satiety cues can lead to over-eating and more weight gain than is 'natural' for the baby.

We don't want overweight children and adults but why do we want overweight (for that individual baby) babies?

Some excellent info already on here for you, guendalina - and I support the idea of truly challenging the HV on her ideas.

It really is a disgrace that someone whose core task in their job is to support good nutrition in young families should be spouting myth and misunderstanding - she is not alone in this, but there really is no excuse when there are plenty of opportunities for reading up on good practice even if she has not had recent training.

Knowing how bf works and how to support it and how not to undermine with poor info is key - just as she makes sure (one hopes) she knows the basics about immunisation and can answer Qs on it, ditto home safety, and knows about child protection, and postnatal depression, and a few other crucial aspects of family health, why is she not up to date with bf support???

When you can, back up your challenge with a letter to the HV management in your area. That sort of thing does get attention, and helps mothers in the future.

New to the thread, but just wanted to offer some positive vibes

I'm in a similar position - LO only 5 weeks old and she had a cold at 2 weeks so didn't put on any weight for a week or 2. Somehow, my HV managed to use just 2 weight checks to extrapolate that my LO was going to fall off the growth chart, so started threatening FF etc To be fair, LO wasn't looking great at the time due to the cold and she did suggest seeing the GP first, but despite me having a science/maths/medical background and KNOWING that what she was saying about the growth chart was a load of tosh, it still really unsettled me. Nobody wants to risk the health of their baby.

The next HV I saw was great - she told me to 'ignore the charts', rely on the baby's look/poo etc and was shocked that the first HV had asked for 3 weight checks in a week.

I did get my latch checked with our NCT breast-feeding counselor, who has been a fountain of knowledge and support. i'd recommend contacting someone similar if you haven't already. The counselor also suggested a great book which will lift your spirits as well as give lots of useful information; it had me giggling away (much to the bemusement of LO bobbing up and down on my chest at the time) Food of Love.

The HV now says that 3oz a week isn't really enough for my LO to 'catch up' . I now just nod sagely and ignore her.

Hope the above helps

tiktok - fantastic post as per usual.

It's not as though the HV said 'this situation is outside my skill set so I'm going to refer you to XXX (Infant feeding lead HV, local BFC, Paed, etc)'. That's not great seeing as she be able to support a mum who is bfing but she could be about to undergo remedial training in this issue (I'm feeling generous).

Instead she has actively undermined Guendalina and told her her milk isn't good enough (in multiple ways - not enough milk, not good quality and blamed her for it [mum doing to much]), her baby isn't growing well, and suggested changing how she feeds her baby without basis for this (has she suggested milk testing to 'prove' Guendalina's milk isn't great??? or anything else that anyone with half a clue about bfing might suggest?).

It's quite awful 'care' really.

Thank you for the posts and for the cheering everyone! I feel much more confident in my ability to feed LO thanks to you.
I'll carry on checking his weight monthly but will try to see a different HV in the future and post again here if unsure. The fact that someone in her position can dish out myth about bf is indeed a disgrace!