weight - again, am I just destined to failure at bf

[Anaiasmum]

apologies for the typos, I'm one handed typing whilst attempting to feed.
DD2 is now nearly 12wks and I've been watching/reading the other weight posts so know I'm not alone and wondering if someone can help.

DD2 was born at 41+5 by elective cs, i was told induction would fail and as DD1 was breech and also elective cs at 38wks cs was the only remaining option suitable for me.

DD2's birthweight was 3.72kg which fell over the following 9 days to 3.29kg triggering phone referral to paeds and a saga of topping up with ebm (for 6 days) and formula (2/3oz in 3 days) and domperidone for the following 10 days. (inc 48hrly weight checks. From about 2wks DD2 continued to follow the 25th centile. However at wk 6 DD2's weight gain began to fall and has culminated today in being told I need to see GP (she now weighs 4.3kg and is on the 9th centile).

I was at the bf support grp this pm which is where she was weighed after voluntarily contacting them as I had started to become concerned at her lack of weight gain, though all other signs are that she is a healthy baby. (urine and poo output are fine imho). All those that see her (inc the feeding co-ordinator who has dished out this advice today) comment on how long she is, but also how alert etc. (I took her to see my colleagues yest (all nurses with DCs) and they also agreed that she was healthy.

I don't know what I'm asking really. I'm falling apart at the seams. We got to this point (only sooner) with DD1 and she eventually was referred to paeds and we were admitted until her weight was back on track (i.e. formula fed) from 12 wks.

I don't know whether to bother fighting my corner with bf. I know I'll really struggle to express and top up (I'm rubbish at expressing) and I have DD1 to consider. I'm already a wreck after this meeting this pm. I expressed some milk a couple of weeks ago as we've a family wedding tomorrow and I didn't want to be feeding during ceremony. (3oz in total after feeds - took me 3 days, as I couldn't do it after each feed!) I don't think supply is a problem, I'm not a leaker (xcpt sometimes from one side at night) but DD2 does seem to feed well, we get sickly burps, I can hear swallowing, so I know the milk is going in.

DH has said he'll take time off work but thinks she needs to be topped up if that's what "they" all say. I fell out with DM who, at 3wks, insisted that my baby was "starving" so I don't have any family support locally who coul take DD1 off my hands.

Sorry for the length, any thoughts?
TIA

So she's fallen down the centiles but is still gaining? She's otherwise well and not dehydrated?

Honestly? I would stop having her weighed for a bit. I would go to the GP and ask him to confirm that she is healthy and then I would give it a bit longer of you feeding her and see if her growth pattern sems reasonable. Any concerns go straight back to GP and get a referral but it seems to me that YOU don't have any concerns. Dd is well. All the concerns come from outside interference in what she should be doing. She isn't starving, she's just not following the chart. So you get her health checked by the GP and then you keep on doing what you're doing.

Thanks northern, that's what I think but I (nor some close rels) have much confidence in my judgement after last time but this baby is so dif from her older sister.
I think all the hcps see me 5'8" and size 14/16 and think she should b huge. Her dad is 5'7 and only 10st. Dd1 is slim but tall.
I'm supposed 2go back nxt wk and think I might b hound ed if I don't.
one of the bf peer supporters lives across the rd and I bumped into her in the park, she too thought she was fine so I might take her up on her offer of a coffee on mon after gp appt.
Feeling better, I just have so little self confidence when it comes to this after past experiences.
X

Sometimes HVs need a reminder that the centiles represent the full range of NORMAL. Of course, falling through the centiles can be a cause for concern but 25th to 9th is only one line in the chart! If:

DD is gaining weight (even with the 'drop' in centiles)
She produces plenty of wet & dirty nappies
She's alert & content

I'd carry on doing as you are doing! I learned a good phrase on this forum: if in doubt, get one out; just feed, feed and feed again.

There's also research that suggests that babies born by CS retain a lot of fluid after the birth so any weight loss appears more dramatic where it might just be the baby "catching down" to where they should be. I'm almost certainly paraphrasing, and someone who knows more will be along to confirm!

For what it's worth it sounds like you're doing brilliantly. Keep the faith!

My bf babies all started of huge:

One started off on 98th centile and stayed there (still is for height)
One started off on 75th and increased to 98th (is now 65th for height)
One started off at 96th and dropped to 25th over a few months (is now 75th for height)

All long/tall but all very different babies, the youngest never had cubby legs or anything like that and even though the other are slim (have to buy gap slim fitting jeans etc) the youngest is just super super slim, small framed - just like I was until I got old

I just want to say if your baby is alert, weeing, poohing and content they can't be starving - it could well be catch down.

SIL (Dh and his family are all really tall) had teeny babies her first started off at under 7lbs and was on the 98th centil within a couple of weeks - she clearly was meant to have been born bigger and was catching up.

Thanks for all ur replies. I've seen the gp today and have been told to top up and if her weight not better by fri then I'll b sent into hosp. I really didn't think it had got that bad. :(
apart from knowing that this is the beginning of the end of bf for us which I'm really struggling to come to terms with I've got to realise I need to be sensible and play the game.
I've tried dd with a bottle today and I'll really have to persevere she just pushed it out. So stressful when putting her to breast stops the crying that ensures when a bottle is put in her mouth.
I've spoken to v sympathetic hv today who will see me on wed and perhaps someone else in rl can support me with this.

:( sorry this is so hard for you, anaiasmum :(

On paper, there's a concern that needs investigating, for sure - but I have no idea why they would send you to hospital - if this is 'just' a baby who looks like she needs more milk, this is not a hospital case, usually. Are they investigating something else???

You had problems at the start and from the sound of it, not brilliant care - only at 9 days did anyone think this needed some attention, and that's late.

So it may be that your milk production line did not get the best of messages in those early days. You don't say what you have done more recently to help your body catch up - night feeds are really important to build up supply, and you need to try switch nursing and breast compression. If there has been any history of deliberately feeding only one side per session, then that could be a contributing factor to supply issues - you could start switch nursing and breast compression now to try to counter any of this.

What's been happening in the past few weeks? Can you start doing something different from today?

Am confused. Some weight loss is normal initially. The figures for what this should be are averages. Sounds like cs can have more weightloss still without it being a problem. Topping up with milk baby maybe didn't need maintained desire position on chart. Once tops ups finish baby regulates weight GAIN back to lower centile where maybe it should have been before without all the overfeeding? History of other baby doing the same- so genetic. Baby well in all other respects and not seeming hungry. I would think just carry on bf. Could be wrong but just think you should monitor weight, offer feeds very frequently and it baby actively take or actively leave and forget top ups.

whenwill - you could well be right, OP has not given enough info, really. We still don't know why hospital has been suggested, for example, so there may be stuff going on she has not told us, or that she is not sure of herself.

No evidence that CS babies can lose more weight as far as I know - I got the impresh the baby was still losing weight at day 9, but if the baby's weight was actually going up by that time (not clear from OP's description), then yes, unnecessary topping up can interfere with the baby getting into the 'right' weight zone, and skew any judgements of what the baby 'should' be doing weight wise as a result.

Hi tiktok, thanks for ur response. At 5days the mw was concerned and there was intervention from then on-mw s were weighing 48hrly and at 9days when dd wasn't gaining sufficiently I was asked to top up. This lasted about 5/6 days when I was told things were on the up and I could stop. hv took over from mw s and continued weighing weekly until 7wks. At 7wks weight gain not as expected but hv was prepared to ignore 'blip'. At 8wks dd had check at dr s and imms. Weight seemed acceptable. I took her to b weighed at 9wks as neither I nor dh concerned but thought best check. Hv noted that dd had crossed 1 centile but was ok for me to continue without top ups as all signs ok. I phoned bf co-ordinator to try to get some advice/support and the result was friday's post. Between wk 9/10 and now I have been following posts on here and tried switch nursing and breast compression as a result
. I also offered more feeds. Dd either refuses or is sick.
I always offer both sides and nothing has changed from weeks 2-6 when she was deemed to b doing well. The night feeding pattern has also remained the same.
I think gp was trying to scare me today as when this happened with dd1 I fell out from under their radar same bf co-ord then as now so it really took me all I had to contact her this time.
there don't appear to b any other medical probs with dd2.
gp didn't really impress 'not all women can bf'
Just v low cos invested so much at the beginning and was prepared to give up then but things picked up and seemed to b going well. I have even fallen out with mum over this and we were close. (She has bf 10 dcs to 3mth) so was expecting some support.
Not sure what's left sadly. :(
(Last wk I even got to weighing nappies such is the obsession.)

When they said you'd need to go into hosp, what were the reasons given?

All you have said here in your recent post is pretty reassuring, unless there is some underlying worry (hence the hospital thing....). Was your baby gaining at 9 days, or continuing to lose? If she was gaining, then I am not sure why they were worried - it's normal for weight loss to happen until day 4-5 and then for weight to start going up, but to be a few oz off birthweight at 9 days is not normally worrisome, as long as weight is clearly going up.

She's now just above the 2nd centile as far as I can see, so yes, you'd expect some ???? just to ensure all is well....and it does seem to be, doesn't it? Unless the doctor or HV can tell you why there is a concern (and the reason for the hospital suggestion which is still puzzling), then it would seem to me to be fair enough to explain to them you are trying to address her intake (you could feed her more at night, maybe?), and could you return for another weigh in after a couple of weeks?

Could the hospital referral be to check sodium levels? I was readmitted at day 5 for this due to lo 12% weight loss.

Not at 12 weeks, figgygal - low sodium means dehydration, and you'd get plenty other symptoms at 12 weeks, the baby would be really ill.

Did it all work out ok for you and your baby?

Sorry, there was some cross-posting. 9days was dd's lowest weight. By day 13 she was gaining and regained birthweight at week 4!
there are serious concerns about her slow weight gain (lots of talk about it being detrimental to future health, she's gone through 3centile since birth, and an admission to hosp would take place because of this. It happened with dd1 and I was forced to give her formula under supervision. was threatened with SS if I didn't comply. Nappies were weighed and checked. V worried that same will happen again.
I wrote really comprehensive note for gp b4 attending today as I was bothered that I'd become to emotional to be rational but it seemed to make no difference to her view.
Really appreciate all ur support.

I wonder if you had oversupply issues there would be less fat in the milk that is filling up baby's tummy? i had oversuppy for a while due to pumping and dd would gulp so much down and then be sick and have worse reflux than usual. Trying to get more satisfied by volume, as milk was so watery. Don't know if such a thing is possible or if i imgined it.

I don't know whenwill, I suppose it's a possibility, the symptoms u describe seemed to happen a cpl wks ago when I was pumping. I thought I'd better bow to the pressure this am dh is being v firm. I've fed dd as usual offering both sides and she's taken a bit from 2nd then burped (milky) and refused more. How am I to get her to take formula? I could just stuff it in on spoon but surely that will just make her ill and undo all the hard work.
Dd is v active, constantly kicking, arm waving and bobbing her head but not unhappy. Do I need to try and get her to sleep more? Any tips? So upset this am. :(

:( would it be possible for you to get good real life help from someone who understands how bf works, who understands your feelings about it, and who can support you in your negotiations with HCPs? A breastfeeding counsellor would be able to do this.

I dont get why you are wondering about getting her to sleep more???

There are usually ways to feed more often, by offering more often, but if your baby refuses, this is normally a sure sign she does not actually need it! I can't imagine anyone would think it a good idea to start spooning in formula - apart from anything else there is a choking risk if you are truly forcing it.

(I dont buy the over-supply = less fatty milk = slower growth idea in this situation, sorry, whenwill).

It could just be that your dd is such an active wriggley little girl she is just going to be skinny?

Calories-activety=weight gain.

Babies, unless they are unwell/have underlying conditions are usually very good at regulating their own intake.

How much did she weigh when she was born (and what centile) and how much now (and her age and centile). If she is gaining weight and appears to be thriving on the face of it she seems in good health?

Tiktok is the expert though.

Thanks again. It's clear from my posts I think that I'm no longer thinking v clearly.
I wondered if she was just burning all her calories. But that in turn goes to reinforce my thought that she's not unwell. I can't marry that with the decision of feeding co-ordinator and gp as they both stated how lively she was.
dd's weights as follows (kg)
birth 3.73
9 days 3.29
13 days 3.36
3.2 wks 3.58
4wks 3.70
5.1 wks 3.9
7.3 wks 4.04
10.1 wks 4.24
11.3 wks 4.34
Today dd is 12wks.
dh and I just had blazing row, he's accusing me of not having appropriate milk! More calories in formula so she must have that.
I'm going to try lll this pm though we've no local group and I'll try and speak rationally to hv 2moro.

What centile was she on at birth and what centile is she on now?

I only work in lbs

What centile did your dd1 settle on at 4/5 months old?

I hope you get good support from lll.

Just wanted to say your DH is wrong about formula having more calories. Here's a Kellymom link.

Randommess dd2 was 75th c at birth and 2nd now. 8lb2 to 9lb8 she's always been weighed in kg so trusting conversions are right.
Lll really helpful and if hv who, up to now, has been supportive plays the same tune as the rest 2moro I'll b asking for paeds referral as my sanity is at risk.
Not sure about dd1, but she had formula from 3mth.

I just hope it goes well, I can't imagine how stressful it must be

Thanks everyone. [Thanks]
Hv has just been and weighed dd again. She's now tracking between 2nd and 9th c. She was able to see the bigger picture and is happy to review her in a week with the understanding that I'd top her up if she seemed to need it.
(She did tell me that perhaps there weren't enough calories in my milk
Will spend the next week feed, feed, feed! :o

Good news then!!
Seems to me that they're stressing you out for no reason and your HV is quite ignorant too. She didn't tell you to eat more cake or to rest more to make your milk fatter by any chance?
Your DC has been putting on weight steadily albeit slower than average. I don't understand why everyone is telling you to top up is she's happy with what she takes from you and seems otherwise healthy and well.
Sounds like you're doing a great job

Great news, keep going with the feeding.