Should I formula to fatten?

[FootprintsInTheSnow]

because in other respects we're quite happy to bf.

We're at 8 weeks now - feeding well, sleeping well, wees&poos, smiling and alert - and gracefully slipping off the centiles week by week. Top of the charts for length; bottom of the charts for weight; really looking quite skinny now.

If I'm feeling insecure, I'll focus on the fact that the feeds are long - and she's sometimes a struggle to get down into a daytime nap - but overall she doesn't seem stressed to me.

She's been checked and ticked up by various HCP.

I can't tell you want is best only what I did. I didn't in the end - had a similar dilemma. I just kept going with the BF and was happy to do it as often as needed day and night . DD for me was a relatively fast feeder though - maybe 10/15 mins a time about every three hours roughly.

I took the decision that if she was clearly hydrated, alert and happy for periods when awake between feeds and had wet and dirty nappies then she was probably fine.

Sure, what's the harm in it? If her weight is headed one way - why not give her some formula too. Mixed feeding isn't the devil.

Also meant to say I always thought she looked skinny - but looking back at photos now she looks quite chubby!

I am now on formula and has not made a jot of difference to my dd's weight gain as she still feeds like a BF baby - little and often... I would work of making sure your supply and latch is good and go with it...

If I was you i'd be looking at getting more profeaional breaatfeeding support. whearth that is through the infant feeding cordinator at your local hospital, through a volantry orgernisation, like NCT, BfN or LLL or with a private lactation consultant. Is up to you. But all mums should know that while formula isnt eveil there are risks to using it.

Try to keep your baby as close as possible and feed at every cue or snifful.

Definitely agree with Mig, get someone who knows there stuff to look at the graphs and talk to you.

Mixed feeding sounds simple, but it isn't always.

DD1 gave up BF because she found bottles much easier.

DD2 wouldn't take bottle of anyone including the lovely paediatric nurse.

HVs say to me that length measurements aren't very meaningful in babies; although I like to do the same as you and ensure they are roughly in line with weight, I would still be inclined to not FF and stick with BF.

HPs are usually concerned if weight crosses two centiles (gah! Gentiles from autocorrect) from birth weight. If this happens they will probably advise top-ups. There is a phenomenon where babies lose weight after birth to a more 'natural' level then grow up that centile; perhaps this is what's happening.

I had to top up but my DD wasn't pooing and had a tongue-tie that was probably checking my supply. As yours is perky and pooing/weeping normally I think you are prob OK. I had a friend that got down for the same reason but she stuck with BF and her DS was fine.

Just wanted to say am not a blinkered BF enthusiast as I FF both mine from earlyish on. As others have said, go to a few BF cafes or speak to a counsellor at weighing time and check things are OK. I'd review at 12 weeks.

DD was / is BF and slipped down the chart at every weigh in for 3 months
She started between 75th and 50th, and ended up almost at the 9th... she started to rise up the chart from 4m old and by 7m was almost back at 75th

she has never had formula, was / is extreamly healthy, and grew as nature intended with her virgin gut preserved until she started weaning

my "mummy instinct" told me she was fine.... and she was (/ is )

No reason to give formula - if you think your baby needs more milk (and maybe she does, no way of knowing from your post), you have the milk already, in your breasts :)

Why go to the hassle of bottles and the work involved in them and making up the powder, when for a smaller investment of time and effort you could just breastfeed more? That way, you retain all the health impact of exclusive breastfeeding, you keep your money in your pocket, and you don't risk overfeeding her.

Intro'ing bottles will undermine your choice to breastfeed, because your supply will be impacted, and it won't be mixed feeding but full formula feeding that results.

What would be the point? :)

I don't BF, as I really struggled, but is there a way of making your BM more calorific? Milky drinks, a Mars bar etc, might help get a few extra calories into your DC.

A friend of mine who BF is incredibly skinny, and was advised to add the above items into her diet to maximise calories in ehr milk (her diet is that of a small bird). Not sure whether it would work?

My reasons to start FF would be (in order)

• her health;
• her happiness;
• my sanity;
• and, family life.

My reluctance to start FF is to with (in order & based on previous DC experience )

1. health - reactions to formula (although with previous dc we did finally alight on a brand of formula that didn't give them rashes & colic) and also immunity/ability to feed through gastric illnesses etc (lots of bugs at home courtesy of older DC).

2. happiness - if there is one thing more miserable than 'breast solves everything all the time' - it's when feeding is disrupted & they start becoming frustrated at the breast. I end up juggling to find the right level of top ups that fattens without disrupting bf.

3. my sanity - despite the drain of bf - I tend to feel much worse when weaning (hormones I guess) - and frankly this little girl is easy compared to her siblings at this age.

4. family life - dh says we're coping & dc are mainly in school/self-entertaining - so housework!

In a nutshell - I've persevered so far due to not wanting to replace a small notional problem with a big problem. I'm wondering at what point the slow weight gain becomes a 'big' problem - worth risking all the drawbacks of FF to resolve.

Various bfc, HV & GP have given us the same feedback: weight gain's not great though we're doing everything we should - but baby seems well - so it's my call how I'd like to take it forward.

I tried more frequent feeding before - but she really doesn't respond well to e.g. Being woken in the night or being fed instead of being cuddled to sleep when she's yawning.

The night feed - she takes ages to wake & then sleeps longer at the next sleep, hence not actually increasing the number of feeds (but radically decreasing my sleep).

The daytime naps - she gets tired an cranky without three naps in the day - at which point the latch starts clicking, she sucks without swallowing (I.e. Pacifying rather than feeding).Weight gain seems lower when I've pushed this strategy. Bearing in mind that she's already typically latched for 1hr out of every 3 - to a large extent I think my choices are 'carry on as I am' or introduce supplements.

I wouldn't worry too much about charts if your baby is heathy.

I had big babies - they all fell off through the centiles. DS2 was born on the 91st centile and was on the 9th by 4 months old. I got a bit of grief from the HVs but since the babies were all otherwise a picture of heath, I continued to EBF because that was working for us in every other way.

If I understand you right, you're not otherwise quite ready to switch to formula yet, so why not leave it a few more weeks and re-evaluate then?

Gnocchi, whoever told your friend about making her milk more calorific needs sending for retraining

You cannot make breastmilk have more calories - it is impossible. There is no way the calories (from sugar and fat) of a Mars Bar will be going anywhere except the mum's own bum (or wherever else she stores her excess!!).

Grrrrrr.

If your baby makes it clear she is not interested in being kept awake or woken in order to have another breastfeed, footprints, how on earth are you going to get the extra formula into her? :)

Another way of getting more breastmilk into her would be to offer a third or fourth side at each bf session; another way would be to respond more quickly to feeding cues.

You could try this, but as everyone including you is happy with her health, growth and progress, it all seems pointless to worry!

"If your baby makes it clear she is not interested in being kept awake or woken in order to have another breastfeed, footprints, how on earth are you going to get the extra formula into her?"

Spluttering and complaining with half of it running down her chin - if her reaction to a bottle of ebm is any guide

Long feeds, poor weight gain, clicking noise, bottle feeding dribbling all down her chin. These are signs of a possible tongue tie. Has anyone who knows what they are doing checked for it?

Good call, mawbroon.

Yes - I had the same idea & I went to the local tongue tie specialist bfc who gave her the all clear.

She doesn't have awesome suction - esp if tired or distracted - but she can protrude her tongue - so I think it might come down to a slightly high palate.

The clicking was pronounced her first week - but is now rare. She does however lose a remarkable amount of milk through her nose as she feeds. I'm the only person that shoves a muslin under rather than over my boob!

Footprints, my dd did the same as this - and at about the same age. I watched the latching videos on www.breastfeedinginc.ca/content.php?pagename=videos specifically the one which showed whether your baby is swallowing milk 'Really Good Drinking' and also the YouTube videos - google dr jack Newman video drinking pause (it took me about 30 views of the same clip but eventually I saw what he was talking about). I then adjusted my DD's latch very slightly (as per the videos) and her weight levelled out. It maybe that your latch just need to be slightly adjusted and either the videos or a bf counsellor would be able to help you with that. No doubt you are aware already but your breasts keep up with the demand from your baby which is why some people, when they introduce top-ups, can find their breast supply reduces thus making it more difficult to keep breast feeding in the longer term.

Ah, a high palate? It is possible to have a high palate without a tongue tie, and vice versa, but sometimes both are present. The incorrect swallowing action from the tongue (because of the tongue tie) pushes the palate upwards. DS1 had this, but it went undiagnosed until I fathomed it all out myself when he was 6 (pics on my profile if you're interested).

Posterior tongue tie can be very hard to spot. The frenulum can even sometimes be buried in the other tissues. Did the bfc just look? Or did she put fingers in the mouth?

The milk coming out the nose thing could well be that her tongue can't lift enough at the back to send the milk down the right hole!

I'm in a similar situation. Ds was 8lb 4 at birth, dropped to 7lb 5 in the first week and was 11lb 10 last week at 10 weeks.

He certainly looks thinner than most of his (breastfed) counterparts but has a reasonable covering on him.

He feeds little and often and sleeps well at night after clusterfeeding in the evening. He only wakes up once after that.

I do try to feed him more but it tends to lead to fussiness and sick.

So do I accept that he may well be a bit underweight but will catch up when he moves onto solids or introduce formula incase he is capable of putting on more weight?

He is happy, weeing and pooing (still poos at least 4 times a day)

at milky drinks and Mars bar to ensure an ebf baby gets fattened up a bit! Can't stop chucking!

Chuckling

On a more serious note, have you tried breast compresses to get more breastmilk in at every feed?