BF Baby Weight Gain

[FrankelandFilly]

Looking for some advice please.

DD is exclusively BF and is 7 weeks old today. She has just been weighed by the health visitor and has lost 4oz since she was last weighed 10 days ago and is now 9lb10oz (birth weight 8lb15oz but she dropped to 7lb15oz before regaining her birth weight by 2.5 weeks). She's dropped 1 centile, from the 50th to the 25th.

The health visitor started talking about formula top ups and has gone away to discuss a plan with her colleagues. I really want to avoid the formula top ups if I can help it, though I know there's nothing wrong with formula.

To give some more background, just before DD's previous weigh in I was diagnosed with mastitis, since the diagnosis I've been unable to feed from that breast as it has been too swollen and tender for DD to latch on. I've been expressing like hell on that side to keep my supply up, probably getting anything between 4-10oz off in a 24 hour period. I think my mistake has been to only give DD one expressed feed per day (about 4-5oz in the evening) rather than topping her up after each feed I've been freezing the rest, if there is any.

She's feeding about every 2 hours during the day, though sometimes it's more like 3 hours if she has fallen asleep. She sleeps very well at night, usually only waking between 2-3am for a feed.

Thankfully my mastitis has cleared up but I'm still struggling to get the swelling down. I've seen a GP, lactation consultant and the health visitor and they've all said keep massaging and expressing and it will come down.

Oh yes, and add into the mix DD had her tongue tie snipped last week, so it's all pretty much a perfect storm!

Has anyone been in a similar situation (ha!) and would I be ok to tell the health visitor I'd rather wait another week or so and re-weigh DD to see if things improve before going down the formula top up route?

Can see why you are concerned, Frank.

Can I just confirm something? You are certain your baby has lost 4 oz? There's no chance of a mistranslation from grams, or faulty scales, or different weighing techniques, at any stage?

Has the HV suggested anything but formula eg more frequent feeding, switch nursing, ensuring at least both breasts are used etc etc?

She was 4.52kg at the last weigh in and 4.40kg today. It was a different set of scales as the last weigh in was at the drop in clinic and today was at home. Each time she's stripped naked to be weighed.

The health visitor said she would call me back this afternoon with their "plan", but only mentioned formula while she was here.

You need to increase night feeding, slip in another two feeds. How long does she sleep for at night? Night feeding is also the most effective way to increase your supply and her weight gain.

BWT- suggesting formula at this stage shows your HV has poor knowledge of breastfeeding support. I would seek out another HV or get in touch with one of the bf charities, LLL or NCT.

Thanks.....it's worrying, because babies should not be losing weight, at least not after the first days.

I think you'd be perfectly ok to discuss the possibility of waiting a further week, if you are confident your baby is transferring milk well now, and if you are ok about feeding often, on both sides (or using the expressed every time, rather than freezing it). Seems to me that if the HV reckons this is a question of intake, and you can address the intake quickly by raising it in those ways, a week to see if she gets on track would be worth discussing with her.

The colleague my HV said she was going to consult with is their "breastfeeding champion" so I'm hoping she'll fight my corner. I've emailed the lactation consultant who did DD's tongue tie so hopefully she can offer some additional advice.

I think you're right about the night feeds, DD seems to be happy to sleep (which I know others would kill for!) but I guess I need to get her up to feed. She normally has a feed at about 10 then once settled sleeps till anytime between 2-3am, so 4-5 hours, she'll then wake again between 5.30-6.30 for the day.

I second the suggestion of more feeds. Whilst it's nice to have a baby that sleeps for a few hours at a time, it is at the expense of a feed. I would slip at least another 1 in overnight and maybe try and offer another feed during the day aiming for a feed every 2 hours during the day.

Feeling a bit better now, the health visitor just called back. Sounds like she's had a bit of a talking to from the BF HV as she's changed her tune. She now says they're not worried as it's only a small weight loss and as her length and head measurements are both in the 25th centile she may just be adjusting.
The other health visitor is going to come out and see me next week to re weigh her and we'll see where we go from there.

That sounds sensible, OP - I am surprised she thought because it was a small loss = adjustment, but your baby is being weighed again fairly soon, and you know to feed more often. So hope all is well next week :)

Hi OP, just checking, were the scales used digital? I had a bit of a scare when dd was 6 weeks but it was due to faulty (manual)scales.
Anyway, glad you have good people on your side,hopefully it will all have settled down next week.

Yes they were digital scales.

The lady that did DD's tongue tie is also a lactation consultant, I emailed her about it and she was pretty mad! She offered to talk to the HV and explain that there are bound to be some issues if I've had mastitis and DD has had her TT cut recently. She's advised me on the expressing and told me to come to her clinic on Thursday where she can can check DD's latch and milk transference and also weigh her herself.