EBF baby gone from 91st to 9th centile in 8 wks

[bergerac]

My third DD is 8 wks old and weighed her birth weight at 6wks then only put on an ounce in the next fortnight and has dropped to the ninth centile. The HVs have advised to keep going with the BFing but the GP has advised formula to "get some nourishment into her".
Having successfully BF'd DDs 1&2 I'm struggling to understand why DD3 is so so skinny! She seems well in every other way - is alert, pink in tone, plenty of nappies etc. the only thing is that her poo is often green rather than yellow and it has been like this for approx 4 wks. The other thing is that she has had a dummy at night and I'm concerned she may not be latched correctly and therefore not be sucking efficiently (although there is no pain for me when she feeds).
With such a drop through the centiles I'm seriously considering giving her 1 bottle of formula a day but ideally I would like to stick to EBFing. Any advice or similar experiences would be gratefully received.

Okay, no expert advice re possible feeding problems, but my DS went from the 75th to the 0.4th in 6 weeks. I stuck to bfing because he seemed fine, actually, and although we had had some problems they did sort themselves out. It was pretty horrible and I came on here for support to get me through the self doubt, etc. But he had hit the 91st at 6mo so it worked out for us.

I would say (1) get your latch checked and (2) isn't greeny poo associated with 'too much' foremilk in relation to hind? - in which case try block feeding - one boob only per feed. And (3) stick around here as some posters are real experts and I'm not so sure my advice is good.

Good luck x

Could you try expressing? With my first, she was a bit lazy for the first few weeks and would put herself to sleep before she got to the hindmilk. So I expressed and gave her the milk in a bottle as that way it was all mixed up....

Has she been checked for tongue tie?

I'm sure you don't have to give formula if you don't want to. And 'get some nourishment into her' what a stupid thing to say. Your milk is by far the most nourishing thing for her. It's just so easy for them to say give formula, no expertise required. Can you get a second opinion from a lactation consultant? I hate to say it but I have a gp in the family and she was taught jack shit about bf... She had to go to several bf clinics to get her own bf issues sorted out. As long as baby is alert and plenty of wet nappies I wouldn't have supplemented. Some babies 'catch down' and smaller babies catch up, so birth centiles shouldn't be worried about as long as they don't keep dropping and dropping centiles. DS went from 87th down to around 50th and stuck there around 50 for a long time. Someone will hopefully be along with more expert advice...

What do you consider is the down side of giving formula exactly? If she drinks the formula and gains weight, wouldn't that be a good thing?

That would be a good thing Black but if the op prefers to bf then then best thing she can probably do at the moment is to discover why her Lo isn't thriving on BM.

Thanks for your responses.
Boots - when I spoke to NCT BF line they said to feed from both sides or even do switch feeding as I had been focusing on one side at a time to try and get all the hind milk out.
Kelly - I have some expressed milk which my DH has been giving her when I've been out so I cld try and do more of this so she gets more this way
Swan - I'm reluctant to give formula just to fatten her up as there are no other symptoms that something is wrong, surely my milk should be able to nourish her. I'm also concerned that missing a feed will affect my supply and it may be difficult to go back to ebf if she no longer needs the formula. It seems to me that the GP just wants her to have formula so that she moves up the chart - no other reason.

Not checked for tongue tie but she gained weight quickly in the first few days then I didn't have her weighed until 6wks. How would I be able to tell if her tongue was tied?

Can't do links at the moment but try googling "milk matters tongue tie". They have some great information on the site and do a virtual diagnosis service too. A local BFC should be able to check for you too, although it can be easy to miss.

What other symptoms does she have?

No symptoms at all part from some green poo. Will have a look at milk matters, thanks.

I had this with DS3 after 2 babies ebf with no problem. After a few weeks of stressing about it he just started putting on weight. He is now a tall thin 3 yo having been a long thin baby.

So - obviously worth following up on any possible problems with your baby or feeding, but it may just be a temporary thing.

Have you tried going without the dummy and sticking her in bed with you for a couple of nights? It may encourage her to feed more.

If you have a look on YouTube dr jack Newman has a couple of good latch videos or try googling biological nurturing, it may help with the latch.

You can check for tongue tie, however it is best checked by a breastfeeding counsellor as posterior tongue ties are notoriously difficult to identify. Can you DD stick her tongue out? does her tongue appear heart shaped? these are classic signs of an anterior tt.

I note from an earlier post that your DD is alert, pink in tone, plenty of nappies etc. the only thing is that her poo is often green rather than yellow. The poo is a classic sign that she is not getting sufficient milk, therefore if you are being advised to top up, you can do this with your own milk expressed. How often is she feeding and how long do the feeds last?

Have you considered switch feeding? that is offering 10 mins on one breast then offering 10 mins on the second breast and then going back to the first breast and keep switching. It can increase your milk supply

Thanks Maillot, myself and my DH are tall and slim so I wonder whether DS3 is just built that way too but it's such a significant drop I can't help but worry.

Hi, I am having similar issue with my DS, just regained birth weight at 7 weeks and dropped from 50th to 2nd centile.

I've had a lot of pressure to supplement with formula but so far haven't. I found expressing very stressful so have stuck to feeding from the breast as often as poss, offering 2nd breast at each sitting, doing breast compressions and trying to drain each breast.

We've seen a paediatrician who said that sometimes babies don't settle on a centile for at least 6 weeks and to wait & get a bigger picture - as he is healthy & developing in every other way there is no need to panic or supplement.

Separately I've seen a bf specialist who has referred him for a possible posterior tongue tie investigation.

So no concrete answers yet but that's my experience, hope it helps.

Apologies to the regulars who will have seen me post about this before but at 17 wks my LO has been diagnosed with tongue tie. No pain feeding and weight gain v good hovering around/just under 50% - same as birth centile.

Feeds started getting VERY short, green poop, more wind and tbh I think I suspected a while ago but as everything was fine I didn't pursue it. Suppose what I'm saying is pls get it checked - tongue tie seems so common, 4 out of 8 babies in my NCT group have had it.

tiktok one of our resident gurus who we're all v grateful to (:)) doesn't indicate that green poop is necessarily a problem in a healthy thriving baby, so that on its own doesn't seem cause for concern.

Tbh it could just be the dummy and previously trying to use one breast per feed that has lowered your gain though always worth a tt check too.

Spend a week doing switching nursing, ditch the dummy, aim to feed every two hours and as more if possible during the day and you could see a big change.

Ds was born on 91st, took 7 weeks to regain birthweight, dropped to underneath the growth curves but then gradually started to move back up them, eventually following the 50th. Saw a paediatrician (referred by the bf counsellor midwives at the maternity hospital that I went to for a bf support group) at about 8 weeks who predicted exactly the curve he would follow and didn't put me under any pressure to formula feed (in fact, he told me to stop with the faff of expressing and just breast feed).

I now know to define it as "catch down" growth - he was adjusting onto "his" curve.

If the baby is happy, healthy and alert (as my ds was), then trust your instincts. If your gp is that worried, ask him to refer you.

Green poo is not an issue in a healthy, thriving, growing baby.

No idea if it is significant in this case - but a fall from 91st to 9th definitely needs looking at, especially if (as the OP says) the baby is skinny. The green poo may be a symptom of underfeeding here....and if you have been feeding one sided and using a dummy, that's two things easy enough to change :)

It is a BIG MYTH that feeding one sided gets more calories into the baby. The way to increase supply and intake is to switch feed so the baby gets greater volumes, the milk is removed more often, and the breasts make more milk. Feeding one sided reduces milk supply and intake and should only be done deliberately when the mother has an uncomfortable over supply, or if the baby shows this is is clear preference and he is growing just fine.

So - if all that's a concern here is milk intake (and there are no other health issues), getting more milk into the baby needs to start asap

• more frequent feeding, day and night
• consider dropping the dummy so the baby gets her sucking comfort at the breast
• switch feeding - at least both breasts used at each feeding session, and possibly used more than once
• breast compression (google it)
• get latched checked, get baby's mouth checked

Discuss with the HV when to have her weighed next so you can check these strategies are working. If she needs supplementing as well as extra bf, then she can have expressed breastmilk as an option over formula.

But this is not something to ignore at all - it's a highly unusual weight gain, and while some babies gain like this and are fine 'cos that's the way they are, most babies with this pattern could do with more feeding.

Hope this helps.

Thanks Tiktok and everyone else that has shared their knowledge and experiences with me. I've been to a BF clinic this morning and have had the latch checked. It does seem as though she isn't latching correctly probably due to the dummy so as from now dummies are banned! Going to focus on increasing feeding using both breasts and will check out breast compressions.

Sounds like a really good plan. Did you get a chance to google biological nurturing and have you seen this?

Did the BFC also check for tongue tie?