HV says formula,I want to bf.

[LimeFlower]

Where to start...

DS is 5 weeks old.I intended to breastfeed him,unfortunately things didn't go smoothly.

Health visitor said he wasn't latching properly,got dehydrated and wasn't putting the weight on quickly enough according to centiles in his red book.
Yes,latching was a problem as everytime i tried to put him to breast he was going bonkers-if he didn't manage to find nipple quickly his hands were flying everywhere,head bashing,body wriggling and screaming in frustration.At this point I just used to shove the boob into his wide open mouth-he was taking big mouthful of breast and sucking.
He had a trapped wind problem-screaming for hours in the evening,not burping after feeding.Last week he was given reflux medicine-things got much better on the wind front since then.

2 weeks ago I had a mastitis and got some antibiotics to clear it and ibuprofen.DS not to keen to latch on sore breast so HV has called and said to top him up with formula(due to his dehydration and slow weight gain)-which I duly did.DS has gulped 2oz in seconds then promptly vomited-i suppose this was due to the speed of his consumption and no burping.Started to take the bottle away a couple of times and try to burp him.No luck,more vomiting.

I'm attending the bf clinic later today because I'm desperate to not to give up with bf.So-last night DS had no formula at all and spent most of the time hanging off my boobs-on average about an hour every time.

I don't want to get into war with HV but I don't want DS to be fed formula either.Of course DS is the most important here and if I have to top him up with formula to give him adequate nutrition I'll do it.

How do I know whether my milk is good enough for him regarding to quality and quantity?

Dirty nappies-is it always 10 of them?DS had 6 yesterday-50/50 poop/pee.Anything to worry about re quantity(not enough?)?

Thanks for any help.

It sounds from the nappies like he is having plenty! Anyway it's not a great gauge past the immediate newborn phase but usually 6 wet nappies and 2 poos (the poos may be in a wet nappy btw) are the 'ideal'. Did the 3 pooey nappies also have wee in them or were they dry with just poo? If the poo is liquidy and not hard or like adult poo then that should be fine (just to note formula fed babies poo can be more 'formed' but it shouldn't be hard or dry as that's constipation).

Has the HV told you 10 wet nappies or baby is dehydrated?? Never heard that one before I have to say! What is baby's weight gain like? Has he lost weight once he had regained birth weight (initial weight loss of up to 10% is usual but weight loss once BW is regained isn't) or is it he just isn't climbing the centiles?

If baby is vomiting up formula regardless of how you feed it to him, it may be an intolerance/allergy to the cow's milk it's made from. If that is the case bfing would be much better for him than the extensively hydrolysed or elemental prescription only formula that would be the only other alternative.

Is he a 'sicky' baby as well as windy? Some babies who can't tolerate or are allergic to cow's milk also need their mum to cut dairy out of her diet as some women pass cow's milk proteins through their BM which can cause a reaction in baby (not all women find this to be the case though so it's not a given that if he is allergic/intolerant of cow's milk you would have to cut it out). As he is already on reflux meds it might be worth giving it a trial run (look in the MN archives for help on cutting out dairy while BFing).

Biological Nurturing may also help with the fussing while feeding/arms thrashing as baby latches themselves on using their feeding reflexes (these are the 'woodpecker' head movements, 'Jack Russell with a bone' head movements, 'kitten kneading' hand movements and general unco-ordinated looking movements that imped bfing sitting up all come together and help baby latch themselves on when mum is semi-reclined and they are skin to skin with you.

Get yourself along to some really good bf support - la leche league, local hospital clinic or Nhs group. Sounds Luke you need chance to give it a really good go before quitting completely.

LimeFlower - difficult and stressful for you....hope mumsnet can help.

I am a breastfeeding counsellor with NCT.

Your milk will be fine in terms of quality - this does not differ much between women at all. If your HV has said anything to suggest your milk may be lacking in quality, then it throws doubt on whether she is the right person to support you with the decisions and choices you make.

The nappies sound normal. Nappy counts are not very helpful in babies beyond newborn.

It's good you are going to the clinic.

Dehydration is potentially serious in a young baby. 'Not following charts in red book' is almost always not. So the clinic will need to help you work out whether your baby's situation is worrying or not. Latching on needs to be calm and easy - they may be able to work out what's getting in the way of that.

'Trapped wind' is a wobbly diagnosis! Babies are upset and distressed for many reasons. Not burping is not a pathology and does not have to mean 'trapped wind' . It could be your baby was upset because he needed to feed more often/more effectively/longer/more comfortably or just needed the closeness and comfort of cuddles and the breast. He seems better now, you say, so maybe it was the wind, maybe he would have got better anyway.

Without more details of his weight gain it's hard to say much more, but as I said it's good you are going to the clinic and I hope they have some good people there. Report back :)

btw and fwiw, I heard that the red book centiles are based on bottle-fed babies and that bf fed ones will always weigh less...good luck with the bf I hope it works out for you

mumeuro - that's not correct, and it never was, actually, not in the UK.

Current charts are based solely on breastfed babies.

Bf babies tend to gain weight slightly more quickly than ff babies in the early weeks and months and then after 5-6 mths they tend to gain weight more slowly, and by the time they are a year old the average for bf is significantly less than for ff.

Thank you for your support.

DS had a problem with vomiting since I got the mastitis-he didn't want to latch onto sore breast.
Poop is liquidy-it's not solid.

Heard also about centiles in book being for ff babies.
Weight-he was 3485 g when born,down to 3220g 4 days later and 3600g at 4 weeks old.BF counsellor didn't have any issues regarding his weight.
DS has definitely grown a bit-he outgrew his newborn sleepsuits-he couldn't straighten his legs into them and his feet got bigger.

Dehydration was mentioned when his HV saw that his front fontanelle was sunken.No solution offered,I gave him a bit of boiled water when after speaking to my friend realised he didn't wee this day until afternoon.

Now he farts and burps,no screaming in the evening,happy to take a boob and no vomiting since yesterday(no formula).Still on the reflux med.

With him being my first child I have no clue whether I'm doing right or wrong so asked my friends.Was told one of them had the same situation-not enough weight gain and formula suggested by hv-friend lost her milk by the time her DS was 6 weeks old.
I'm eating yoghurts,cheese and drinking milk.

Will see what they'll tell me at bf clinic today,6 week health check next week,if everythings fine i'll challenge hv because so far i'm nodding my head to her but making my own judgement.

Thank you for your help x

You are perfectly within your rights to ignore the HV. Or not see her at all! Some HVs are great, but unfortunately lots are a bit rubbish when it comes to bf advice, so don't assume she is an expert. Definitely keep going to bf clinic and maybe consider seeing a bf counsellor who can talk you through weaning him off the formula.

There is nothing wrong with your milk - except perhaps you might have to work on improving supply because of the formula, but that is totally doable.

limeFlower thanks for more detail :)

"Poop is liquidy-it's not solid." - sounds normal.

"Heard also about centiles in book being for ff babies" - never been the case and definitely is not now; bf only charts been in the red book for a few years.

"Weight-he was 3485 g when born,down to 3220g 4 days later and 3600g at 4 weeks old."

Early weight loss normal, but subsequent weight gain slow....not necessarily a problem but definitely an indication to check things are ok and that milk transfer is as good as it can be.

"Dehydration was mentioned when his HV saw that his front fontanelle was sunken."

Oh dear....sunken fontanelle very difficult to diagnose and a truly dehydrated baby has other signs and symptoms than that.

"No solution offered" - poor practice.

"I'm eating yoghurts,cheese and drinking milk." Nothing wrong with any of that but they are no better than anything else at supporting milk production :) Eat them if you like 'em :)

Good luck at the clinic. I think it sounds as if you could be helped to ensure your breastfeeding is happier and more comfortable for both of you. If your baby is thought to need more calories, you have them already - in your breasts. Frequent feeding, offering at least both breasts every time, is the first and easiest step.

If anyone tells you 'he needs to empty the first breast' or 'only offer one breast per feed' or 'he needs to stay on longer to get the hindmilk' they are giving themselves away as under-trained and under-informed....ditto anyone asking about your diet and implying you need to eat more/differently.

Limeflower - it sounds to me that your HV is not the right person for you to be talking to. The best thing for you to do if you want to continue breastfeeding successfully is to feed, feed, feed. There is no need to give cooled boiled water to a breastfed baby. Also, what you eat has no impact on your milk whatsoever. I hope you get some more accurate information at the breastfeeding clinic today, they will be able to watch you feed and assess whether milk is being transferred effectively. Hopefully they will talk to you about switch feeding, how introducing formula can impact on supply, and the mechanics of how breastfeeding actually works. If you have any questions at all, then there is a mountain of accurate info waiting for you here. Good luck.

sorry - xposts with tiktok.

Hi.

I bf both of my dds (although dd2 was mix fed). From what I remember neither of them ever got burped after feeding.
But I do remember being told to ff dd1 by a not so helpful HV, I attempted to give her formula 3 times in total (on different occasions) and she projectiled the lot every time.
Also the growth charts don't follow bf-ing, perhaps you could ask your HV if she has a bf specific growth chart.
To up your milk supply feed little and often, making sure that ds feeds during the night (1-4am).
It sounds like you have more of a clue than your HV does.

Sorry I should have been a bit more explicit:-

IF your baby has a Cow's Milk Protein Intolerance (CMPI) or allergy, and this would be diagnosed by a Dr/Paed., then you MAY find cutting cow's milk and cow's milk derivatives from your diet helpful in managing reflux symptoms (if indeed baby has reflux symptoms) but not ALL women need to do this.

I hope my reply didn't read as 'cut out cow's milk now' as that wasn't what was intended!

Hope you get great support from knowledgeable bfing folk at the group today.

frustrated - see my posts about what the charts show :)

There seems to be a persistent MYTH than the current UK charts show formula fed babies' growth.

They never did, and they certainly don't now.

limeflower, I don't know if this helps or not and you have already been given good advice on this thread.

However, my DD's front fontanelle has kind of been a bit sunken since she was born. In the early days (very early!) I was paranoid about dehydration and such things and kept checking online as I felt hr front fontanelle was sunken. It seemed that this was a very late sign of dehydration and by then the baby would be noticably lethargic/sleepy, amongst other things. I did get the HV to check and she said it was a bit sunken, but not to worry.

It is still like that now and she is 13 months, so I'm assuming it is just normal for her.

Perhaps your HV isn't very experienced?

That's odd tictok neither of my girls followed the chart. They both dropped a centile. And strangely was shown a bf chart by my nct bfing councillor.

limeflower I won't try to add to the excellent advice tiktok is giving you - as she gave me in very similar circumstances 2 1/2 years ago

I just wanted to add that my DS3 went from 91st centile at birth to a positively scrawny 6 week old, and HV. was worried / suggesting top ups.

I gave the odd bottle but couldn't be doing with the faff and after a couple of weeks stopped and continued ebf.

Another 2 weeks and the weight started piling on - no idea why he had a dip.

At 2.7 he is very tall, and still relatively thin.

Hope you get the support you need.

frustratedpants odd or not, what I'm saying is 100 per cent correct!

A few years ago there were some 'breastfed babies weight charts' to contrast with the ones used in clinics which at that time were from data on babies whose feeding was not differentiated (there wd have been bf, ff, mixed fed babies in the data). Maybe that was what you saw. No need for them now - the charts in the current books are from WHO data on bf babies.

An update:

Went to bf clinic yesterday,they plonked DS onto the scales,weight gain:0.Null.Nothing.They said"oh well,at least he hasn't lost any weight,nothing to worry about,don't beat yourself,you've been through quite a lot since birth,you're anaemic and so on."

I got upset and asked what the hell they expected-I was anaemic due to a blood loss at labour so it should be anticipated,asked them to get this hv off my back as i've had enough to deal with in the last couple of weeks and don't need her to bring me down.

The plan is to top him up with formula after every daytime feed and get his weight checked again on Tuesday.
I left gutted,said to DH "what's the point in feeding him non stop,having no life at all if it's not working".

Yesterday spent 2 hrs feeding DS after coming back home.Quick break to have something to eat leaving DS screaming and top up with formula.He threw up a few minutes later but took a second helping and kept it down.
So now I'm waiting till Tuesday,fed him with breastmilk this morning-him sucking and managed to express 1oz which he was given later.A bit of formula and boob for comfort to send him to a land of nod.With a bit of throwing up in the middle but nevermind.

I know I can't give up but it's so disappointing that there's no good results.I'm told not to worry but getting fed up-stuck in one room all the time,feeling like a prisoner either feeding DS constantly or trying to catch up with some sleep.No life at at all.
DS is much wanted and loved baby but if i could get away from him just for an hour-to have a cup of tea not feeding him or not listening to him crying.
MIL comes twice a week to help with chores-i'm grateful but i'd be delighted to potter about in the kitchen while she minds DS.

Oh well,upwards and onwards.

Thank you very much for your kind words and support,sorry for moaning,had to offload some frustration.

DS has just woken up and chewing on the muslin he's covered with...

limefower :( Sorry you feel no further forward.

Some questions:

• he was weighed naked on digital scales on a hard surface, yes? And the weight was recorded properly?
• did they observe a feed?

You can give up if you want, as long as the baby is fed its allowed! But it doesn't sound like you want to. And yes feeding them all the time can be dull and annoying and dispiriting. It does not last forever believe me. I never believed it and found this early bit suffocating but suddenly they start doing 5-10 min feeds and being awake more and you think what the hell do I do with them all day inbetween feeds?

Tell your MIL to cuddle him or watch him sleep while you potter - I bet she is dying to but thinks you'd prefer help with the chores.

I left gutted,said to DH "what's the point in feeding him non stop,having no life at all if it's not working". It is working as he is still alive no? Give it a bit longer to see a gain, as tiktok says depending how they weighed him there might have been a small gain that was missed. Also babies need milk to grow brains as well as bodies.

Come and offload moans here, its what we are for. La Leche also brilliant for this.

It's very hard at first, limeflower - being stuck feeding for long periods of time is very hard, but it's par for the course at first. If you really do want to carry on it's so worth it and it does get easier (this is coming from someone who fed for 7 hours straight - with a few 10 min breaks - during an early growth spurt.

Make sure you have everything within easy reach - tv remote, food, drink, book. It makes it less frustrating.

limeflower I know how cherished your DS is. Have you considered getting a sling, so you can keep DS close by and maybe feed in it and have both hands free? The early days are so hard, but once you pass through them, it does get so much better.

I don't think your friend lost her milk at 6 weeks, there is a big growth spurt then and your breasts change and feel soft and empty instead of rock hard. This means your supply is established, not dried up. When you drop breast feeds and introduce formula instead, your supply will drop.

Good luck!

Hope LImeflower comes back....LimeFlower, it does sound that there is a problem here, because if the weights are correct your baby could prob do with more milk....the concern is to get it into him, and if you do need to use formula it can be temporary while you work on making the bf more effective.

That's why I asked if anyone had observed a feed, 'cos this gives good info.

hi not really much else to add limeflower as some good advice. my ds2 was a nightmare to feed as he was a little and often (as opposed to ds1 who wouuld happily go at least 2-3 hrs!) he used to thrash about and arch and scream when trying to get him latched on and the only thing i found worked was to swaddle him and then feed him as then he couldnt get his hands and arms in the way!

this really did help although he did then go through a nightmare growth spurt (i think it was that) at 12ish weeks where he just wouldnt latch at all so i spent a week finding every position going to feed, even him led on the floopr with me dangling boobs above him!! I also expressed and gave him bits in a syringe/cup/bottle to take the edge of and then he would sometimes latch on for a good feed. it did only last for about a week (although it felt like forever!!) and then he was ok at feeding again.

maybe try the swaddling and the topping up (i had to top up ds1 as he came out of hospital as he'd lost more than 10% and they were't going to let me leave so i went home and every time i bf i gave him a medicine cup of ff. he'd put on enough over that night that i was then able to phase out the top ups over the next5 few days. i know its a faf topping up but it might be whats needed just to get things back on track and it 'll only be for a little bit.
hope things go ok for you

tiktok digital scales on hard surface and DS in his birthday suit every time.

they didn't observe whole feed just adjusted his position at breast and that's it.

Clogs i already asked MIL to take him to give me a break,she said she would

hairy that's what keeps me going-it's so bad sometimes that it can only get better.

LAF i thought about sling but i'd like to go to the kitchen-the floor is tiled and it's a killer if anything gets spilled-i'd dread to have DS in the sling and have a slide.

Sorry for moaning the other day,felt so low.DS has been hanging off my boobs till 3.30 am,went to sleep after having a bottle around 5 so i'm delighted to have 3 hrs of uninterrupted sleep.
Now off to get dressed,hopefully he'll keep quiet,will give you an update tomorrow after the appointment.

Thank you very much for all your help and support