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?

Just to add, comix, supplementing with formula is prob not a good idea at this very early stage - where's the rush?:)

You don't know how much of an impact it would have on your supply - going several hours between breastfeeds is not good for breastfeeding in the newborn stages, and it's irrelevant if there's a bf toddler also in the picture. It's the length of gaps between feeds that damps down supply.

You could call a breastfeeding counsellor and talk it through.

about waking him up to feed him, when he sleeps 8 hours (you shouldn't wake him btw)...well, you are approaching the 4 month sleep-regression so everything is likely to change - feeding patterns, sleep patterns/length etc. as he hits a big developmental leap

just a friendly heads-up

I wasn't actually trying to have a go at ZZZZZ. I was trying to say that TikTok knows her stuff without directly attacking anyone else.

But I can't resist a good line

Vintage

No probs with the hijack, they were all questions I had too!

He's always been weighed naked. So hopefully if I up his breast feeds to more regularly and from both sides he should start gaining and no formula required.

Thanks for all your help and support

I don't think it is good that a 14 week-old baby who isn't putting on weight is sleeping for 8 hours at night.

/i think you should wake him at least once.
just to make sure.

there's every chance that he's not waking to feed because he doesn't have the energy, not that he doesn't need it.
:(

I'd agree with Nick on that one adding in a night feed if he's sleeping for 8 hours is defiantly a good way to fit in another feed and make sure he's not going to long without milk.

If you start waking a baby who wants and needs to be asleep you are risking trashing a great routine and ending up with him using more calories being unhappy and unsettled than he is now without getting any extra milk down him.

While the OP herself feels that he is alert and healthy and has no concerns she would have without his weight having been plotted on a graph she should carry on doing what she's doing.

Healthy babies grow at different rates. They are individuals. This baby's weight is still within the bounds of normal for his age and he'd be higher up if his weight were plotted against only other EBF babies.

His weight is being plotted against only other bf babies, all the red books now use the breastfeeding only graphs and have done for a couple of years.

Plus he's not gained any weight in four Weeks, I'd say that's a good case for waking a sleeping baby.

what *Mig said - they only use the BF babies chart now.

he hasn't gained weight for 4 weeks - that's not going to be different whichever chart you're plotting on.

i would probably try to wake him gently at a time when he seems to stir - DD can dream feed, i'm sure most babies can.

There is definitely a case for waking the baby or safely co-sleeping so the baby will almost certainly 'ask' for a feed in the night.

Maybe the OP could discuss it with her HV or a breastfeeding counsellor. OP - 8 hours is a long time without a bf. It may not be necessary to feed more often at night, but it is unusual for a baby of this age to go that long - so it's worth thinking about.

No one can be certain on here - no one can be sure his long 8 hrs without a feed is a 'great routine' that risks being 'trashed'; no one can assess how many calories he'd use up being fed in the night.

No baby in the UK has their weight plotted on anything but the bf baby chart - this has been the case for a few years.

Not that this would make any difference. Breastfed babies' growth does not differ significantly from ff babies' growth until after about 5 mths. The notion that bf babies grow more slowly than ff babies in the early weeks is false. If anything, bf babies grow v. slightly more quickly, at first.

Thanks tiktok. Waking him for a dream feed won't do any harm will it, so I'm going to try adding in this additional feed at night.

Thank you maples. Another idea for me to try.

Hi tiktok, just to answer your questions to me re supplementing with formula - as you indicate this is early days still so why do it? Well, firstly because after DS had been cluster feeding for much of the evening it seemed like something that would give me a break and let me go to bed for a couple of hours' kip before needing to BF him again! It's not meant that I've gone for any more than 3 hours before the next feed, it's just guaranteed me those few hours if you see what I mean. But after the latest weighing where he'd only put on 10 gms the maternity care assistant suggested that I should give more frequent top-ups during the day; following some b'feeds by 30 oz or so of ff topup. I haven't been doing that (though we have given one or two daytime topups since that suggestion). I notice that her suggestion definitely falls foul of your statement "Any suggestion of a 'feeding plan' from a doctor or HV that does not include this simple way [using both sides at least each time] 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."!

Anyway he's just had another cluster feeding session and looks like I'm being called again for more feeding...

If you are giving a baby of 2 weeks 3oz top ups after some feeds a day that's a HUGE amount of formula to be giving!

Even if you only did it 3-4 times a day that's 9-12oz of formula when a baby might be taking much less than 25oz of milk in total a day (1m-6m old babies take on avg 25oz per day on a range of 19-30oz so a 2 week old would be taking less). So 3 top ups might be half of baby's intake a day which could lead to bfing winding down pretty quickly.

To clarify, I'm not in fact giving that as top ups, but that's what the MCA is suggesting because of DS's slow weight gain. I'm interested in your figure as to how much a baby takes at this stage: is that more or less the same volume whether ff, ebm, or bm?