Weight gain issue but bottle refusal

[Ameybee]

Hi have posted this week already about getting LO to take a bottle - tried all the tips I can find & he's having non of it. The only thing I haven't tried is going out & leaving DH to persevere through the crying. The cup is a no go - he won't lap at it & it takes hours (which I don't have as I have 3 yr old DD).

He's gone from 50th centile to between 9-25th. I do not think he is particularly settled & he's waking during night but feeding for VERY short periods before sleeping again. I feel as though he never takes a full proper feed from me & I never seem to know where I am with feeds all day long. I've tried all the tips to keep him awake during feeds to no avail - all that works is if I put him in cot - he then wakes up 30 mins later for feed (but short again) - he seems crabby to me because he isn't getting regular sleep.
I'm starting to feel very down because I'm so tired & feel really emotional.
So what do I do if he refuses formula but weight continues to be slow & he's unsettled? I can't carry on the way I am . I've ordered a doidy cup & have a cup from mam that can be used from 4 months but if he won't take bottle I'm unsure this will work.

He's 13 weeks, alert, healthy, plenty of wet/dirty nappies (some green).

Any advice gratefully received.

To add - when he feeds it feels like the rhythmic sucking is very short lived, before he falls asleep.

Did you say you'd had him checked for tongue tie on your previous thread? My DS had the same issue with having short feeds & being dissatisfied after them. He had a severe tongue tie. Now 2wks on, he tends to have short determined feeds & goes 2hrs during the day & 3-4 at night (he'll be 6wo on Sun). Worth getting checked.

Have you exhausted all the breastfeeding options to increase his weight gain? Are you worried about his weight gain, or is it coming from health visitors?

Have you tried a syringe?

Not had him checked for tounge tie but he's gained weight well up until 8 weeks.
I'm worried about weight, as is HV - she is coming on 27th dec to weigh him again.
I've just been told to feed on demand (although confused by this as surely this may lead to shorter frequent feeds with less hindmilk?) he doesn't cry for feeds particularly, but tends to feed 2-3 hourly in day.
Would block feeding be something that might help?
I honestly don't know what's the right thing to do. I have a bf counsellor I could possibly try to contact (but not sure how easy this will be over Xmas period) x thanks for reply.

Ps he will take formula from syringe and seems to like it but it takes about an hour to give 1oz (I keep trying bottle intermittently whilst syringing to no avail, he'll chew but not suck) x

My DS gained 1lb in 9 days so tongue tie doesn't mean no gain, but the 'snacking' type of feeding could be down to it, although not necessarily the only cause.

There is fat throughout the milk, but slightly more concentrated in the hindmilk. I read a good explanation on it the other day, I think on Kellymom.com. There are also good tips on increasing weight gain on there too.

Its a good idea to get advice from a RL source too, but have you phoned the LLL or similar. They're experts & can help with weight gain issues.

I also believe that bf babies gain weight in a more step-wise fashion, rather than a smooth curve, so he may have a 'spurt' soon and go back up to a higher centile.

My lo gained weight very well up to 8 weeks then it slowed down she had severe tongue tie in the end so worth getting it checked. She still struggles with a bottle to get ducking properly.

Have you tried breast compressions? Gets more of the hind milk onto them.
www.breastfeeding-problems.com/breast-compression.html

I would be very wary of trying formula as the first course of action.

If you top up with formula, it could lead to your supply dwindling.

I would agree you need to get him checked for Tongue Tie, by an expert (TT often goes undiagnosed, there have been threads on this recently, with mums being told 4 or 5 times their baby does not have TT before it was eventually diagnosed).

I would also agree to feed him on demand. Can you get anyone to help with the 3 yo for a couple of days? Is your partner home this weekend?

The advice for weight gain when BFing IIRC, is to retreat to your bed with your baby and just let him feed on demand. Take some books, films, presents to wrap, whatever, and just hang out with your baby in bed.

I know this is easier said than done with a 3 yo about! But it's important :)

Most importantly, you need to get advice from a BFing expert.

HVs are not BFing experts.

La Leche League would be a good place to start. www.laleche.org.uk

Their helpline is 0845 120 2918