Poor quality breast milk?

[littlemissnormal]

I have a 14 week old DS who was 9,10 born and on the 90th centile. He is EBF but has not put on a single oz in the past 4 weeks and after previously dropping to the 75th, he is now on the 9th. This caused concern with the HV and we saw a Dr today who is also concerned and is looking into primarily whether he has a urine infection causing the lack of weight gain.

She mentioned that we may have to look at a feeding plan for him to help him gain weight. Selfishly I don't want to give up BF as we are doing so well (I thought) but I will obviously do whatever is needed for DS.

So this evening as well as a normal BF I also gave him 3oz of formula which he guzzled down without a problem. I'm now concerned that it may be my milk that is not giving him enough calories to enable him to put on weight, and was wondering if this is actually a possibility?

And if I'm to supplement breast feeding with formula, can anyone advise on how much formula and which feed is best to give it to him at so my supply doesn't dry up and I can continue to BF him? Or should I just try and give him more BFs in one day and not offer any formula at all?

Someone who really knows what they're talking about will be along in a minute but I'd be inclined to say that there's no such thing as low quality breast milk.

Personally and from experience (not with dropping centiles but various bf problems) I would imagine the best thing you can possibly do is feed as often and as for as long as your baby wants, offer the breast at every opportunity and possibly get the latch checked by a professional to check there is a good milk transfer. I wouldn't give formula at all simply because every feed you give as formula is one less your body will make. But that's just me

is it not a possibility that your baby was born big but not meant to be big so is just settling onto the line he's 'meant' to be on? I do think this whole centile business worries us all unnecessarily - there are plenty of other ways to tell if a baby is happy and healthy.

I'm watching to see what others have to say...

This happened to my friend, we baby was over 9lb born and dropped right down, it took a while for her supply to keep up iyswim. My advice to here's feet up, cake, cake and more cake. Her baby is thriving now and right back to where he started. Try not to mix feed though if you can because it means your body won't lay enough milk in. each feed basically tells your body what your baby needs.

Trust yourself too. The very best of luck to you op.

I really hope everything you said there is right. I am so proud of how well we've been going with the BF that I was upset to think that what I'm feeding him with from me isn't enough for him to thrive on.

He's happy, alert and a good little sleeper but the Dr and HV being so worried about the centile drop made me worry too.

Mixing feeding will just drop your supply when, of anythng, it probably needs to increase. It may be his digestive system is taking a while to get going or he may have lost a lot of meconium and some fluid (common in overdue babies) which will have contributed to weight loss.

If he is alert and generally contented and has plump skin and good colour and wees and poos then I'd rely on that far more than on scales and graphs.

Breatmilk is designed for your baby. However good it is, formula is second best so don't think you are going to do him any favours by giving it to him. It will simply replace the good stuff your body is making.

If his digestive system has suffered a bit your own milk is the best thing to help him recover.

I would just continue BFing as you were unless you see something yourself in him that makes you worry. If you need a graph and a set of scales to tell you there's a problem there probably isn't a problem in the first place. If he seems healthy, and happy and is wetting his nappies as he should don't worry.

Breastmilk is actually higher in fat content than formula is, so put that worry out of your mind :)

Have you had your latch checked? Sometimes a slight alteration in latch can make it easier for them to drain the breast.

Personally I would visit a breastfeeding cafe or similar, and have a chat with a breastfeeding specialist before going down a route of regularly adding in a bottle.

How often does your DS feed? Is he a content feeder? Do you offer one breast or two per feed?

RE the urine infection - has this only been spotted and started treating today?

Thanks for all the replies. He is happy, alert and has loads of wet nappies and if it wasn't for them being worried about his weight I don't think I would be.

He feeds 6-8 times a day, is a content feeder and I offer both sides and make sure he empties the side he started on. If it is a bad latch, would that restrict how much he is getting?

Testing for urine infection this week. Dr says that if he has one then he would use the cals from feeding to fight infection rather than put on weight.

6-8 times a day doesn't sound all that much, could you maybe try upping feed frequency?

Going off info from another post, would the reason he took the formula so easily be because it's an easier way for him to feed than from the breast? I mean because he doesn't have to 'work' so hard for it?

Look after yourself the best you can in terms of rest, lots of liquid and good regular food- snacks with each feed along with good nutritional food..

He feeds on demand, should I just offer more frequently then?

Disclaimer : I don't know what I'm talking about.

Yes, I would be tempted to offer a lot more often and see if he is interested. When DD wasn't gaining weight the first thing the MW did was tell me to try feeding her more often, I was to never let her go more than 2hours without a feed (although I pushed that to three at night)

also does DC tend to fall asleep when feeding? I used to strip DD off and wiggle her arms and legs and tickle her feet to keep her awake.

Avoid formula top ups unless medically necessary they will mess with your supply.

Do you have time to just sit. I used to ssssspend hours topless with DD. She would feed, fall asleep on me, wake up, feed again..

If you've not done so already, I second the advice to get to a breastfeeding group/ counsellor as a top priority. You're then getting expertise support and advice from a trained person but meeting others, in the same or similar boat...

Ps are they checking weight on the scale designed for ebs babies? The standard one is based on formula fed babies whose progress can be different.

Ebf babies sorry!

I would top up with formula if he has lost that much weight. Not everyone can produce enough - I couldn't and had to use formula. I know this isn't a popular opinion, but it's my experience and that of several friends.

My first was 3 months premature and I had poor quality breastmilk (in terms of calories) and my milk was fortified as a result by the hospital. After this my DD started to put on weight so there is such a thing as poor breastmilk.
This time, my DS who was born at nearly 9lbs has been attached to my breast since he was born. I feed him nearly ALL day and he is now 7 weeks old. If he is awake, within 10-15 mins he wants to nurse. He is putting on lots of weight as a result so I'd go with feeding more often and see if it helps. If not, move to formula. Mixed feeding is just delaying the inevitable IMO.

Hi, I would try and continue ebf. Your baby is 14weeks so presumably up to 10 weeks all was fine? Your milk supply is established so logially shouldn't deteriorate rapidly unless for something major. I am on baby 3 all very different and my advice would be please don't supplement. we are not talking a premmie baby or even a newborn. I weaned mine slowly onto solids between 4-6 months. You are so close to that. He will put on weight then. Let him bf if you can till then.

zzzz - you really don't need to worry about hind milk unless your baby is showing signs of over supply.

Switch nursing is a good way to increase supply and amount of milk baby is getting.

Dippy - Is normal for prem babies to need milk fortifer, nothing to do with you not producing good enough milk.

maples - has given you some good suggestions, and I would go with increasing the no of breastfeeds first before adding formula. As I'd you do this you will effect your supply.

How long does he sleep at night?

It's unusual but not necessarily worrying for a baby of this age to stay the same weight for a few weeks. It does not mean you have to supplement with formula if the baby is healthy and there are no other concerns. I agree it's sensible to check for the urine infection.

The easiest way to tackle a weight issue is simply to ensure the baby has more breastmilk. Breastmilk is invariably 'good quality' - there's virtually no differences in quality between mothers, irrespective of diet, lifestyle. Some 'micronutrients' may be less (Vit D is the obvious one) but they don't affect growth.

While it's important for you to address hunger and thirst and tiredness, NONE of these make any difference to your milk quantity or quality, so doing anything about them will not impact on your baby's growth.

How does the baby get more breastmilk? Just by feeding more often. Using both sides at least each time. This is far easier than faffing about with supplementary formula and of course has no risk of reducing your supply.

Any suggestion of a 'feeding plan' from a doctor or HV that does not include this simple way of getting more milk into the baby is evidence that the HV/doc does not understand the basics of infant feeding, whatever their strengths in other areas of care.

Holding your baby very close as often as possible will mean you can offer more breastfeeds as soon as your baby shows signs she will take the breast. 6-8 breastfeeds a day are not a huge number, so you will easily be able to increase them :)