Slow weight gain and terrified first time mum

[Pushonregardless]

I feel like I need some help to sort out my state of mind. And see a path through all of the advice and opinion being shoved on me.

FTM of 9 week old DD. Born with hip displaysia and currently in a Pavlick harness (for at least until 15 weeks).

Both DH and I are quite small build. DD was 8lbs 9oz at birth which surprised the midwives. EBF from the start and I am passionate about breastfeeding. Maybe too much.

Baby lost 9% after birth. Then began my problems. It took until week 5 for her to regain birth weight. Aside from this she was clinically very well- alert, holding head up from birth, lots of wet and dirty nappies. I had a fantastic, supportive midwife who saw me twice a week and developed a feeding plan. She lent me a hospital grade pump and I expressed after every feed, giving DH this as a top up via cup (I was trying to resist a bottle at this stage). She felt that DD was simply born too big and was 'catching down'.

By week 5 this wasn't working well enough. I saw a different midwife who scared me and insisted on formula top up. I had resisted this all along and was very upset, sobbed for hours when we first did it. I wanted to EBF and still do.

Weight gain began to improve but I was only giving very small amounts of formula a day, which midwife felt wouldn't account for the gain. So I phased it out in the hope to return to EBF.

Weight gain was happening but slow. HV was happy that DD was just finding her own curve (following 9th percentile) but asked me to see GP 'just in case' she had missed something. GP agreed she was well, no tongue tie etc but said it was worth asking the paediatrician anyway. They are hell bent on intervention, so of course insisted I bring her into paeds A&E immediately. I spent four hours waiting to be seen, for them to do blood tests etc and tell me what I already knew-that there was nothing medically wrong with her. Then 2 hrs spent with the infant feeding team improving my latch and putting a new feeding plan in place. Which entailed even more expressing and supplementing with EBF. I was starring to lose it with worry and stress by this point and cried the entire time.

I had to go and move in with MIL for a week to get help as the feeding routine was so intense I couldn't look after myself as I was always feeding or pumping.

At the same time we had problems with baby being unsettled and continuing to feed every 1.5-2hrs, so sleep was very broken. I had accepted that this was normal for a newborn and that I needed to just get through it. However I don't deal with sleep deprivation well. I spent a lot of time crying on the phone to my mum. Hoping for support.

My mum is difficult. I desperately wanted love and support but due to family history of hip displaysia she is obsessed with doing anything to make sure DDs hips heal. Very long story short, she has pushed me harder and harder, saying her weight gain isnt normal. She's been downright horrid to me and she and my sister staged an 'intervention' by inviting me over and talking me down for 6 hours until exhausted from crying constantly I agreed to top her up with formula again. I'm a strong, intelligent 32 yr old woman but have been I completely bullied on this. I have been screamed and shouted at - things have happened that make me so desperately upset. I have spent weeks crying and fighting my corner.

Despite all of us being EBF as babies, my family seem believe formula to be the magic bullet that will improve weight gain and get me some sleep. They believe that from a very tiny ages babies should sleep through at night.

Of course I know this isn't the case. DD isstill only 9lbs 5oz at 9 weeks but is still following 9th centile. HV is unconcerned and wants to weigh her less. She's told me to stand up to my family and be proud I've stuck with BF despite the challenges.

I'm stuck in this rut of formula top ups now which terrifies me as I don't Want to damage my supply. I see it as a slippery slope.

At a hip appointment today they remarked that she hasn't grown much this week in length when they adjusted their harness. My mum was there and made a big scene. She is physically forcing bottles on DD and wants me to give up BF. She literally takes unfinished top up bottles and tries to make DD take them. This makes me so angry i can't speak. I am the boss here. Not her.

I am resisting her on everything and our relationship has completely deteriorated. I refuse to be pushed around by her. All the HCPs are unconcerned about her size but I can't seem to be confident because my family are making my life a misery. DH is furious and we are having to lie about weigh ins and spend less time with my family.

I'm so sorry this was such a rant. I just needed to get it all down. Would you be worried about DDs weight? Am I doing the right thing? The HV told me to be firm with my mum and I've told her that DH and I are committed to BF and that it's not up for discussion. She believes I'm starving my daughter. I'm starting to worry she's right, despite having a happy, smiley baby who is meeting milestones and sleeping 4hr stretches at night.

I'm in such a mess and I can't see a way out. I feel better when I've not seen my family for a few days and it's just me and DD doing our thing.

I just cannot give up BF. I don't believe it's the right thing for her. I am so sad. HV is watching me for PND. Please help.

Thanks so much ladies. It really helps.

Don't worry, a sling is allowed! The ergo sets her legs just right. DH uses it a lot at night to get her down.

If I didn't give a formula top up at night she would be up until about 4.30 am. This is what was happening before and if I try not to do it. As it is we only get her down around 11pm. Is this right? I am shattered from long days and no time at all in the evening. Isn't she a bit old for this now ? It feels like she hasn't outgrown cluster feeding. She will feed about 6 times between bath at 6 pm and 11pm.

Should she be able to go down earlier?

I'm so hopeless at all this. I really don't know I what I'm doing.

You are not hopeless OP, first babies are a massive culture shock.
It sounds like you are doing a great job, your baby IS growing, maybe she's just going to be a dinky child.

My 3rd DC was 9lb born but was excruciatingly slow to gain weight. She also had hip dysplasia although she wasn't diagnosed until 16 weeks so went straight into a spica cast at 6 months as we'd missed the Pavlik window. She is still a slow grower, now 4 and the shortest in her class at school, I think she's just going to be small.

Tell your mum to back the hell off, you are listening to professionals and they aren't worried.

Congratulations on your baby, they are worth the hard work

She's only 9 weeks. If I recall correctly things started to improve more noticeably about 3 months. Mine usually fed at 6.30, then again about 9 and 11, but it started to separate into short feeds rather than constant.

With dd2, I was so shattered we both used to go to bed at 7. I'd just lay down and feed her, or prop myself up on pillows. Anything so I could lay down and rest! I filled my iPod up with box sets and worked my way through them. Eventually it got so I could come back down for a cup of hot choc and a snack about 8, then go back to bed.

Co-sleeping saved my sanity with dd2. I jammed the cot against the bed so she couldn't fall off and had her by my side, dh on the other so I was less worried about us rolling on her.

Hang in there! You are doing a fab job, and it's less than 4 months until she has solids! (Although weaning is a pita, but at least you can shove rice cakes at them rather than yet another breastfeed!)

Bloody hell OP, sounds like you've been in the absolute ringer. I've known babies who've been so slow to put on weight, but nothing medically wrong with them and then suddenly they just fatten up.

Personally, I would stop talking to your Mum and sister. They sound vile and at the moment you need to have faith in your own abilities as a Mother. You sound like you're doing a bang up job. I know you hate the formula top ups, but it won't kill your supply if she has a bottle at bedtime.

It also sounds like she's snacking a lot in the evening. Mine cluster fed for quite a while until we worked on lengthening out the evening phase and sorting out a proper bedtime. I'm honestly not sure how you would go about lengthening feeds to be honest. I'm sure someone will come along with some more info than I have.

Two things spring to mind here - first, an 11pm bedtime and cluster feeding in the evening can be very normal. DS1 did that until 13 weeks, and basically screamed from 4pm til 11pm. It stopped suddenly at 13 weeks and he fell asleep at 8pm.

Secondly, having your first baby can be a massive shock to your family relationships. You are a mother now, and you are the boss so far as your baby is concerned. You are taking goid advice, your baby is tracking her centile line. You need to trust your instincts, and not worry about your mother. Keep her at a distance, and don't let yourself be in a position where she can bully you.

OP my DD is 12 weeks and 9th percentile. Some hip queries but after the scans etc they decided it was just hypermobility not anything requiring a harness or anything but when they were investigating her 9% size was absolutely not a concern. Her weight gain was very much like yours - now I see although she's small she's "in proportion" with little chubby arms and legs and a round face. I know she's just small and the HCP agree.

One thing I wonder is if when you are exhausted overbearing relatives can 'grind you down' and gaslight you till you don't know what's what. Make sure DH helps you rest and eat well. Believe me I have been there, thankfully it was pre baby.

I've had an awful night with her. She just wouldn't settle. I'm losing my mind with tiredness.

All I want to do is call my mum for help but I can't. She will assume I'm not feeding her properly and therefore won't sleep

I don't know where to turn. I feel like this is my life now and I'm stuck. I struggling to believe she will suddenly improve.

I'm so sorry you feel like this. It's so hard and nothing can quite prepare you for it. I had a 9th centile baby too and the fussiness, cluster feeding and crazy nights continued till she was 14 weeks old when it seemed to get a lot easier. DH and I used to frequently pop her in the sling at 9/10/11pm, sometimes later! and pace the streets together to get her to sleep until that point.

Try not to panic too much, this is not your life now, I promise it will get easier. Have you got the support of a breastfeeding counsellor or lactation consultant? I found them really helpful and they showed me some tricks that helped a bit. It sounds like you are doing an incredible job under huge amounts of pressure however you feed your daughter. Know there are lots of people here who have been through similar things and are willing you on.

I'm also really sorry for how low you're feeling. I don't know if it helps to say that what you're feeling is completely normal and that also it won't last forever. In fact, it won't go on more than a few weeks.

I feel like this is my life now and I'm stuck

^^ is exactly how I felt for the first four months or so of my twins' lives. I'd apologise to DH for wanting a family (we both did - I just wanted to try sooner while he wanted to wait a year). I wanted to run away / be hospitalised just for a break.

Honestly, this passes. And I've had so, so many mums tell me they felt this way too. (Which was a relief because I thought I had really lost it).

How has today been? Is there anyone other than your mum you could speak to? Would you call a helpline? (Not sure which one but can investigate for you?).

The other thing to say - and I hope it's ok to say - is that it doesn't matter in the long run how you feed your baby. I know you want to BF - I was so, so, so passionate about it and it was a constant uphill struggle during which I frequently cried through feeds (gawd - I sound like a right moaner - I really can't tell you how lovely my babies are now and how much I now love being a mum). I don't think your LO's issues are down to being BF - but if you do think mix feeding will help (you, that is, you're in charge here, not your mum), then do that. What's most important is that your baby is well, and that you are well.

That read a bit like I was encouraging you to mix feed - I'm not. It sounds like bf is actually going well.

Had mine weighed today - still on 9th centile. They're just not massive babies.

I read through your thread again and I was just concerned above post sounded like encouragement to formula feed, when really, I wanted it to be encouragement to do what you want and what you feel is best.

NCT helpline number here if speaking to a real person might help:
0300 330 0700

Just about every baby I know was fussy at 9 weeks - I think they get windy at that age.

DH and I spent hours in silent tears of exhaustion.

It DOES get better. Jut forget routine, sleep when you can whatever the time of day.

Thank you waffles and gun. Today has been tough. She has a cold which seems to be making our feeding issues worse. Doc have us saline drops last week but at every feed she has screamed today. I don't think I have managed to get much BM in her at all. Have had to resort to bottles a lot. New breast pump just arrived and I'm worried at the small amounts I've managed to express.

I will call that NCT number. A friend also sent it to me today.

I don't want to mix feed but I don't really see another way. I have thought about it all day and I will try a formula feed at bed. I'm sure it won't work and she will still be unsettled but I'm so worried she's not going to have put on any weight this week.

Being awake and night and crying must burn calories.

It's a relief to know others have felt like this. I am worried my doctor will think I have PND. I think I probably just need some time out and sleep.

I do have other people to talk to. It's just nice to hear what you all think.

The thought of not BF makes me feel completely gutted. I know that's dramatic.

Could she have reflux? (Silent - heartburn type pain. Awful.) might be worth investigating if screaming continues.

Have you read anything on the fourth trimester? Loads and loads of babies scream a lot for the first 3 months. The world's a terrifying place. Swaddling, shushing, rocking gently and a dummy might help. Her crying won't make her lose weight.

My babies cried all evening for the first 12 weeks. It was hellish, but I'm told it's "normal". If it wasn't and it led to weight loss much more would be done by health care professionals.

It really sounds to me like her weight gain is good. I'm no expert, but despite my worries for my little, little babies I am now realising that they don't have to shoot up, just grow continuously. (I am a sod for calculating grams gained).

I felt awful when I stopped BF - absolutely torn up. So you're not being dramatic at all. It's such an emotionally charged thing! Now, I wish I'd stopped sooner rather than put me and my family through the stress and pressure of it.

But you might not need to stop, so just see how things pan out over the next few days.

I think how much you express doesn't really indicate your supply - some women can't express at all yet BF successfully.

Can your OH take any time off to help you in the day, or do a shift in the night so you can get a block of sleep?

I don't think you need to be scared of Doc thinking it's PND, though I understand why that might feel scary. Many, many mums go through this kind of hell - I think I had symptoms of PND but actually, my emotions settled once the babies got easier and I got adequate medication to allay their reflux. If it helps, the early days now feel like a distant blur. It felt like a long, drawn out and painful eternity at the time, but my memory of it is patchy and retrospectively, it feels like it flew by. This is why people go on to have more babies!

How are things today OP?

Sorry for silence.

Not a great day. She's refusing the breast a lot. Crying and screaming when I try to feed. Been expressing. But she's needed a couple of big 80ml bottles of formula. I'm too scared not to do this because I so desperately want her to put on weight when she's weighed on Monday.

Oddly, she feed really well over night and early this morning when sleepy.

I feel like this is the beginning of the end. How can I deny her what she clearly needs? But I assume it's wrecking my supply? I don't really understand how you combination feed successfully. She slept well last night but again I'm worried that this is because she had a lot of formula in the evening.

I called the HV and she doesn't really know what to do. Seeing her on Monday to discuss.

DH finishes work tomorrow for 2 weeks. Things are much better when he's home.

Am I being too stubborn about BF,to her detriment? I'm not sure if I can pull this back. I've had amazing BF support but I just seem to be failing.

You're not failing, not at all. Failing would be someone who didn't care, and it's so obvious how much you do care.

I am sorry she cries so much when you try to feed her - mine did too and it was heartbreaking.

Have you tried putting her to the breast when she's sleepy? My babies were much better at bf at night too.

I expressed a lot to maintain combination feeding for 16 weeks. It was tough. My parents moved in for 8 weeks to help with everything.

I don't know what else to say - I don't want to put you off BF, but at the same time, if you feel you want to stop and that things will improve if you do, then there's absolutely nothing wrong with stopping.

I'm glad you have two weeks with your OH at home - and your first Christmas!

If you want me to PM you with a bit more about mixed feeding, then I am happy to.

Ok, a couple of things here. The way formula works is different to the way breast milk works. Babies need more formula than breast milk, so if you are looking at the amounts of formula versus breast milk you are expressing, you need a lot less breast milk for the same nutrition. So when you look at how much you express it can be quite disheartening. Its not a question of 'clearly denying her needs'. Do not compare how much breast milk you have in a bottle with how much formula you are giving her. They are different substances and not directly comparable in volume.

I've had loads of problems with breast feeding, so have pretty much ended up exclusively expressing, so my experience is a bit of weird one, but I have learned a bit about the principles of mix feeding/expressing versus either FF or BF exclusively simply because no one could give me any bloody information about exclusively expressing!

If you introduce formula, you can easily end up with a situation where her stomach will expand, so it will naturally make it harder for you to satisfy her by breast milk alone - not because she's not getting enough breast milk, but because her stomach isn't as full as if she had formula. So she'll scream for more food, and you are more likely to crack and give her more formula because you think she needs it. Thus you get a vicious cycle which makes you more likely to end up ff exclusively.

Its not unstoppable, but you need to understand the principles so you can increase your breast milk and cut back on the formula gradually.

From what I understand, a HV may not be the best person to have the expertise to help here - you possibly may need support from a breast feeding group or specialist who is more familiar in how to reverse the process.

I think the big thing is not to panic if you really want to continue. Easier said than done. I've had enough wobbles over my own problems. You'll need patience, perservence and hard work to get back to it, but it is possible. Don't think you have 'wrecked your supply' as its something that is potentially very reversible if you know what you need to do.

Op the advice on here is fab so i won't attempt to add anything!

Just wanted to say that i had my dd weighed today and she's dropped down on to the 25th line and i had a bit of a grilling about it. Formula was suggested. I said no. I bf ds with no issues so i know what i'm doing and that there's no problem. She is just dainty. I agree about 'catching down' too. She was 1lb heavier than ds born so i think she's just finding a line that suits her.

I really think this stupid little red book has a lot to answer for. Your dd sounds absolutely FAB. And you're doing amazing so WHATEVER you decide will be the best thing for you guys.

Hang in there OP! It is doable. We combi fed for 8 weeks.

Actually what you're doing is called "triple feeding" expressing, BF and FF. It's knackering. A lactation consultant told me it's THE hardest thing you can do in infant feeding. It is possible to keep going and come out the other end EBF.

There aren't guidelines on combi/triple feeding as it's hard to know but having been there, I'd say... Give yourself a break, acknowledge its difficult. Try to limit formula using it as a last resort, BF first if you can.

Dd dropped from 98% ile to under the 25% line in her first 6 weeks. She's now 7 month and on the 50% line...

Yes your supply will be affected, but as long as you BF (and express if you can) you will MAINTAIN it, and then you can work to get back to EBF, if YOU want to, once her weight gain has steadied.

The lines on the red

Oh and the lines on the red book are for FF babies, who need to put on 7oz a week.

BF babies put on between 3-6oz a week, so will often struggle to follow the lines. As long as there's always a gain, and ideally 0.5oz/20g a day in first few months and baby doesn't have sunken fontanelle/ other signs of dehydration (dry nappies etc) then baby is ok and HV should be ok with that.

Great phrase, 'triple feeding' ...and it is hard work :(

ClearlyMoo, you say "the lines on the red book are for FF babies, who need to put on 7oz a week. BF babies put on between 3-6oz a week, so will often struggle to follow the lines. As long as there's always a gain, and ideally 0.5oz/20g a day in first few months and baby doesn't have sunken fontanelle/ other signs of dehydration (dry nappies etc) then baby is ok and HV should be ok with that."

None of that is correct, sorry. The chart in the red book is for all babies and comes from data collected on solely bf babies - this has been the case for several years now. Bf babies and FF babies gain weight in the same way, for the first five to six months, and then the bf babies start to gain weight more slowly. There is no expectation than ff babies 'need to put on 7 oz a week' or that bf babies put on less.....not sure where you have got this from?

Babies can be compromised long before dry nappies or dehydration appears - it would be wrong to wait for those signs before any intervention to boost the baby's intake.

Sorry to correct you, but there is so much misunderstanding about these issues :(

...and 20g is not half an ounce :)

Only a small point to add as you've had lots of good advice.
I triple fed for 16 weeks due to weight loss and jaundice. Dd was 50% so growth and dehydration is equally possible with a bigger baby. Weeks 4-9 were almost exclusively ebm via a bottle. I also did some formula top ups for my sanity really so I could skip an expressing session and get some sleep. Also meant I had huge boobs for the next fed/express/sterilizer/BF cycle. God I'm tired just remembering it. She's two now!
Around 12-16 weeks she got the hang of bfing, I think to some extent it's a body weight thing. They reach it and they have the energy to do a really good feed and then crash out. Bliss when you get there. She moved back to bf completely and started to reject the bottle. It doesn't always follow that they want a bottle. There has to be a warmth and security experience with bf. Can't think why else they'd prefer it.
I stressed myself silly even though she was my second child. History of allergies meant I wanted to ebm but I haven't managed it entirely with either child. Dd1 had similar issues but I couldn't express a thing. So she had formula top ups.it killed me and in hindsight it was bollox. My evangelical bf NCT 'friends' all weaned early they were so knackered and TTC again.

Triple feeding is knackering, beyond it.

Move back in with MIL who sounds supportive. Another adult who'll do the sterilising at least and more importantly keep your family at arms length is what you need for a month.
You will get through it, if your baby needs the odd 90ml of formula so you can get your head down and be ready for the next round then please know that it will all be fine. It's much more important that you don't collapse from it all.

Good luck, your baby sounds like she is doing well to me, medical professionals usually are pretty conservative.

Flippin' Nora. The things we do for these babies. I've been stressing myself out with pre christmas stuff but her weigh in was such a shock i think my job is to just feed this child any which way i can until she starts gaining a bit more weight. Breastmilk, EBM, formula, whatever. Christmas prep and housework will always be there.

High 5 OP