Reassurance-baby weight gain, bf and top-ups...?

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Hi

Mu ds is 11 weeks old 10ld 1oz. He dropped from 9.th centile (birth) to 0.4th but has gained weight steadily since regaining his birth weight at 14days old.

He had as week in scub after birth for infection and poor feeding/sucking. Because of that he's been mix fed from the start. And because of that (Ithink), I had trouble getting my milk established. I was advised to give top-ups after every bf. I've given top ups but tried to balance this with giving him lots of time on the breast. Ds is not a quick feeder so giving him a bottle could take 2 hrs which is all time he's not bf -ing,especially if he falls asleep after his feed.

Anyway, past few weeks he's been taking less formula until we are now at stage where he just has one, last thing at night. He takes anything from 60-100ml (he can have more of course, he just doesn't want it). When he wakes in the night I bf him.

Anyway, saw hv today and she said he should regain the 9th percentile. She also said I should increase top up frequency again. I explained that he won't take it/spits it back up. She suggested waiting 1 or 2hrs after a bf then giving him a top up. This makes no sense to me as surely if he's hungry then it makes no sense to top up, rather I would just bf again? I'm taking fenugreek and my let down seems fine.

Sorry for essay. My questions are:

1. is it ok for baby to follow a lower percentile line than birth line
2. more top ups ?

(FWIW lots of wet and dirty nappies. Ds is active, alert, smiling, cooing etc)

Thanks for reading, sorry for epic post

Second opinon, definitely, apple.

Too many dodgy assertions from your HV to be absolutely sure she is the one with the answers.

No, it is not essential that babies re-climb to their birth centile.

Yes, if he needs 'topping up' then you would normally simply bf again....fitting in more breastfeeds gets more milk into him and has a good effect on your milk supply. What's not to like?

If your HV thinks any different from this, then she should explain. She may have reasons, but she should share them with you.

A good give away would be something like 'because your breasts won't have had time to fill up if you breastfeed him again after an hour'...if she says that, then you know she should not be in a situation where she is required to support bf.

Thanks tiktok (just seen you on the cake thread which is similar).

Are there other possible reasons for topping up hv might have, other than slightly dodgy views on bf? I had been feeling quite pleased that we were less dependent on top ups but now feeling fretful again. Want to do best by my ds but feeling confused by hv stance. Thanks for reassurance re birth centile...

Oh I do feel for you apple it can make you feel quite fraught in those early weeks trying to bf when everyone around you keeps pointing a growth charts.

I combine fed my first, but have ebf DDs 2 and 3. DD2 was the smallest I think never moving passed the 9th centile having been 25th at birth. Not sure about DD3 as have only had her weighed at clinic once and that was months ago.

It's perfectly normal for a baby not to regain their birth centile.

You're instinct to bf rather than offer more formula top ups seems good to me.

As long as baby is gaining weight things are fine.

You don't have to take DS to be weighed at all, I have found life to be much more relaxed by not having DDs 2 and 3 weighed much. They were growing, healthy, interested in their surroundings, interactive etc. There are many other signs that a baby is developing well other than simply weight gain. Though as your baby started off in scbu naturally you might feel it's more important to have the HV weigh him but don't feel you must.

If your baby needs topping up then yes do it with bf, as for following a lower percentile that is fine. My dd went from off the chart to the 50th percentile in her first year. I had a very sensible hv who just said well shes pink, alert, eating and happy, she is just going to be a tall skinny bean!!

I don't think anyone can ever say 'don't do what your HV has said' - though it does sound odd. You can ask for a second opinion, or ask her again for her reasons why she thinks topping up with formula is a good idea. She may say 'of course you can breastfeed instead of formula - I just thought you'd prefer to give formula' or some such! Or she may have some unknown reason for thinking it should be formula- ask her :)

Thanks for replies. When I'm being rational I think ds is happy, active etc, just a long, lean baby. But when I'm feeling emotional I worry I've done something wrong. Have felt hv don't really look at baby, just at the charts. Grr.

This is exactly how I feel flip flopping between its fine and what's going wrong as you have seen my cake thread you will have seen the advice I have had. I am going to try and feed as often as I can but DD very clear when she does not want more at the moment.