DD 4 weeks and not regained birthweight...Ebf

[kittykitcat]

Im exclusively bf and starting to panic as dd is not back to her birth weight. She was born 3.34kg (7lb 6) and lost for first 2 weeks reaching a low of 3.06kg. I did get mastitis in week 2 (and not exaggerating when I say I would rather have given birth again than go through the agony of dd feeding on infected boob). She has been putting on since then and is now 3.20kg. But she was 3.20kg on Tuesday and weighed the same again today.

I'm getting shouted at by midwives for disregarding medical advice to top up. I can't get on with the expressing machine (it hurts my already sore nips!!), and don't want to give formula this young.

Dd seems like a perfectly happy baby...

Am I being stubborn sticking with bf?! I have no idea if this lack of weight gain is serious and dangerous for dd health?

My DD spent her first week in SCBU (DD is 10wks now) and they got me to express for her as much as possible, but while we weren't together the supply wasn't meeting the demand so the hospital topped her up with formula.

Don't be afraid of using formula to be sure your DD is getting enough to eat if you're concerned - I've used the odd bottle during growth spurts and when it's awkward to feed while out & about (although I've gained confidence with feeding in public now, so really just keep a bottle & a couple of ready mixed cartons in her changing bag in case someone else is looking after her at the time she's hungry). Keep with the BF if you can - you've done really well to get through the mastitis (thrush was bad enough!), so I doubt you want to pack it in now - but don't worry about being judged on whatever decision you make.

Good Luck & Congratulations on your DD

BTW, I was told by my BF group co-ordinator that the best way to combi feed if you want to be mainly BFing is to keep FFs down to no more than 2 a day - that way, you're still classed as EBF and it keeps your BM supply up.

Do you have a local BF support group nearby? I've found mine to be a real help and made a few new friends as well.

kitty, I can understand the concern.

Babies normally gain weight faster than this.

You need some good help and support with this - not shouting at you to give formula! But if there is a medical reason for supplementing then of course you can supplement with extra breasts/extra breastfeeds.

What have you done/what has been advised so far to 'fix' things?

Have you spoken to any of the bf helplines?

Poor you! Really feel for you. Understand totally your desire not to use formula, but do keep in mind it doesn't mean you won't be able to get back to ebf later.
Re. the breast pump hurting, again I empathise, but could you be pumping too hard in your desire to get milk quickly and get back to baby? Could pumping more gently help?
Another thought - have you a friend who could donate expressed milk?
Really hope all works out for you

Thank you for tips re bf helpline and groups. I've just googled and there are lots near me.

So far the midwifes that visit and weigh her have helped to correct the latch and make sure she is feeding effectively. And I've been taught a lying down feeding position that helps with the nights. And I'm taking fenugreek tablets to up my supply... But the primary advice is to top up and they are not happy that I still haven't managed to do it.

I will try expressing again this weekend - I guess I have been trying it when stressed out after another bad weigh in. And I've had it on max so I'll turn it down to start with!!

This is prob stupid question but why is slow weight gain a problem?

Some babies gain weight slower. I'm frustrated for you that their only solution is to top up with formula - especially when breast milk is actually higher in fat content.

Can you find a lactation consultant nearby?

If your nipples are sore that would suggest that your latch might need adjusting. What kind of pain is it, where abouts, and what does your nipple look like after a feed?

Yes you're being stubborn, but rightly so. Keep with it.

Slow weight gain may not be good for babies, who need to grow for overall health and development. Some babies are naturally slow to gain - this is just the way they are physiologically, and these babies are fine. It's the ones who are missing out on nutrition and who would grow just fine with more of it that we need to worry about....but it can be hard to tell the difference between the ones who are 'made' as slow gainers and the ones who are not, IYSWIM :)

I don't think it's up to a talkboard (sorry, SirBoob!) to say you are right to stick to your guns about not supplementing with formula - in some cases, it is well-justified, and it's also true you can return to full bf after the 'crisis' is over. A talboard really cannot say if the midwives are right in insisting your baby needs this, or not....but there are alternatives to explore eg extra breastfeeding, both in terms of frequency of bf, and the number of breasts your baby feeds from each session, breast compression, supplementing with expressed breastmilk, amending positioning and attachment, checking the baby's mouth for oral anomalies.

Hope you get good help.

Have you tried hand expressing instead of using a pump as it shouldn't affect your nipples.

Has she been checked for tongue tie? It can be a cause of slow weight gain and mastitis:

milkmatters.org.uk/2011/04/15/hidden-cause-of-feeding-problems-however-you-feed-your-baby/

I am a big advocate of bfing and accept midwives don't have all the answers but really a baby bot gaining weight is a genuine concern. If they tell you to top up than really you should. Well thats my view. You know if they become really concerned they can ask for the child to be hospitalised. Don't want to scare you but that is what happened to someone I know.

A bottle a day at this stage isn't the end of the world. As already said, it is not a one way street. I know you want to ebf but medical advice is to give formula.

you could express and top-up with a syringe just for him to gain weight - that way, you're keeping up your supply and preventing nipple confusion by feeding through the syringe. (top-up doesn't have to be formula)

you need to have him checked for tongue tie as well as your latch and positioning (my friend describes tonguetie as trying to drink through a pinched straw)
but you do need real=life help.

try the expressing and syringing first, just to get him up to weight and feed as often as you can (waking him if necessary if he falls asleep on the boob)
(i know you said you can't use the machine - have a look at this video on how to hand express and put warm flannels on your breasts in the middle - it eases the pain)