Formula top or not???

[Haribolover]

DD is 13 weeks old, ebf and since 2 weeks her weight has hovered just above the 0.4 centile line. Finally the HV agreed a couple of weeks ago this is probably just the line she is following. This is after spending weeks telling me to do formula top-ups when she was about 3 weeks old - GP and paed said don't do it as she still gaining each week.

In the last fortnight she was dropped to on/just under the 0.4 line and HV has now said we really need to give formula. I am reluctant to do it - both from a wanting to keep ebf and the hassle factor of bottles and whether she would even take one. I will get her weighed next week and see what that is in case this is just a blip.

She is really alert, developing well and has wet nappies and usually one dirty one a day (think we are btw nappy sizes as we seem to always end up needing an outfit change afterwards!).

I guess I am trying to work out whether not giving formula is harming her - if it is I would definitely give it or whether this is the HV ticking boxes (I should add I really don't like her and she has never given consistent advice, just seems to want to be able to tick off boxes).

Hello. Have you had any real life bfing support? I'd bf problematic other than weight gain? It might be perfectly fine but you could check to see if milk transfer can be improved at all. There are ways to try to get more breast milk into your baby if you'd rather not use formula.

Bf babies often gain in steps rather than a smooth curve too.

Can't you express your breast and give that?

Hi. Congratulations on feeding for so long! You're doing brilliantly. HV are obviously very skilled professionals and have very valid advice to give. however, you are right to be cautious and initially I'd suggest (as a PP said) that you visit a bfing support group first of all. Here u can meet people specially trained in bfing as well as other women going through it too. You'll be able to get some good advice as well as get your latch checked and can rule out tongue tie in the baby. You should be able to get details online, if not then contact either NCT, ABM or la leche league on the phone.
Groups can be difficult to get to or u may lack a bit of confidence but I loved mine and am still friends with women from them today!
Good luck!

Trust your instinct, she sounds like she's doing fine! HVs always work to charts as it's the only thing they can use to 'measure' whether a baby is thriving but as a mother you can measure with her behaviour and nappy output (as you have been). I know a few people who told the HV they were giving the top ups but didn't - they wanted to avoid confrontation but personally I'd stick to my guns that she's doing fine and that you plan on ebf. Well done and stay strong!

Oh yes, and please check for lip tie as well as tongue tie!

If there were no scales, are you otherwise happy with your baby's development? Weight gain is just one element of development and as said above, bf babies don't tend to gain in a smooth curve.

There are babies on every one of those centile lines. Yours may just be one of the small ones! They can't all sit on the 50th. They aren't a target, they're a guide.

Sounds like you're doing a great job to me.

If you are unhappy about her gain, there are plenty of things you can do to get more breast milk into her. For example:

• getting the latch checked
• breast compression
• skin to skin
• pumping and giving a bottle
• switch feeding

I used to worry a lot about the charts with my ds who liked to hover at the bottom, but I checked this and remind myself that the weight of a dirty nappy will take them from one side of a centile to the other at this age. It's only when you see the trend over a longer period of time that it is a good indicator.