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Infant feeding

Get advice and support with infant feeding from other users here.

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Original poster

DS 3 weeks old. Slow weight gain. HV advice to give formula! Help please

23 replies

pintofmilk · 25/03/2015 18:00

Hi there,
I am after some sensible advice as my Health Visitor is rubbish and really not helping.
DS is 3 weeks and 1 day. Birth weight was 7lbs 12.
He lost weight on day 5 and 10 so have been told to get him weighed again.
Today he is 7lbs 11.
I was happy that he is gaining weight (although slowly) and put on 3oz since he was weighed last week. HV was not and said that I should introduce a formula feed to get his weight up! I told her that I thought that was a really bad idea and would not help milk production. I have been reading 'kellysmum' and various posts on here so know that he needs to BF to produce more milk.
He has several wet nappies and poos each day, not vomiting and is alert etc.
He is feeding on demand, he doesn't sleep more than 2 hours at at time-this is very rare anyway. Latch has been checked by MW and HV and not tongue tied.
Just after some reassurance that I am doing ok. Felt like telling her to piss off, thought HV were supposed to support BF!

OP posts:

TelephoneIgnoringMachine · 25/03/2015 18:09

All the factors you've mentioned do indicate he's feeding ok, & as his weight is now going back up, and if there are no other issues to consider, I'd be inclined to ignore the advice to FF. A surprising number of HVs appear to be very keen to push FF. (Although my HV was great & supportive of my struggle to continue BFing.)

Ultimately it's your choice, don't be pressured by anyone else. It's damned hard to get your milk back once it goes. (voice of bitter experience)

mousmous · 25/03/2015 18:14

your ds sounds beautiful.
if your ds has

plenty of wet and dirty nappies
is alert in his awake phases
keeps gaining weight

what is feeding like? glued to the sofa with a contend baby is about right.

try not to worry, babies find their centile at that age.

Theshister · 25/03/2015 18:21

It sounds to me that your ds is fine - he is gaining weight (even if it's just a little), having lots of wet nappies and is alert and well. I'm surprised your HV has resorted to suggesting formula top ups already - as you say this is unlikely to help and will certainly not help your milk supply. Do you have access to midwife drop in clinics or a breast feeding support group? I think I'd be looking for a second opinion here.

sophie150 · 25/03/2015 18:44

My hvs were obsessed with formula top ups! Id ignore for now, but you might want to find an nct or lll breastfeeding group and get some advice there.

Mamab33 · 25/03/2015 18:46

Think baby led rather than on demand. Keep offering. Eat lots and stay hydrated. You are doing really well.

NoPinkPlease · 25/03/2015 18:52

If you need top ups (not saying you do), why not breast milk? I was in exactly this situation. If I was you - see a real life breastfeeding counsellor - probably at a group. Get latch / hold checked. If you need to top up, you can always express and then use a non-teat way of getting it in - finger, spoon, doidy cup.

So knackering when early days, easy to feel pressure from HV - I found countering that with expert bf advice worked well. Good luck!

NoPinkPlease · 25/03/2015 18:52

Oh and absolutely agree - just feed feed feed. All the time - sofa, box sets, snacks - feed!

Petallic · 25/03/2015 18:54

You are doing fine! My DS was born at 9.9 and took 6 weeks to get back to birth weight - midwives weren't overly concerned although they didn't sign him over to Hv until he got back to birth weight. I was told it was obvious there was no "failure to thrive" in my DCs case as he was happy, alert etc and was putting weight on - just slowly. If you are happy with your current feeding regime, then I would stick with what you are doing.

FloJo151 · 25/03/2015 19:48

Do you know if there is a bf group/café near you? I would suggest popping along to one and just getting them to double check your latch and also double check for tongue tie as most midwives/hv's might not recognise a posterior tie as they are quite difficult to spot.
Are your nipples sore t all? Fro what you've said it sounds like baby is just putting on weight v slowly but obviously we cant see your baby in rl so its important to not just ignore professionals but definitely seek a second opinion.
the best way to up weight gain is to get more bf in. How many 'sides' do you offer at each feed? If baby is happy to once you've feed both sides offer the first one back (does that make sense?) Obviously if baby doesn't want any more then that's fine.
HTH

ChaiseLounger · 25/03/2015 21:36

I am Not of the bf'ing 'brigade', but this so makes me so cross. Why are they so quick to suggest formula?

tiktok · 25/03/2015 22:23

I can understand your hv's concern, pint. It's not sensible, sorry, for posters on an Internet forum to be so sure you should ignore her. Your Hv has seen your baby and has been involved since the start. No one should be certain you are doing ok, based on the few lines written here.

Perhaps the best thing to do would be to seek another opinion from another Hv or other hcp. There are ways of increasing your baby's intake which you may not have tried or tried consistently and you need a proper assessment to monitor your baby's growth. Being below birthweight at this age is always something to take seriously. Sometimes supplementing is needed temporarily - as one poster says this can be ebm if you are able to express sufficient.

Hope things go well.

LIG1979 · 26/03/2015 08:08

I would second no pink and say can you express? This will help boost your supply and give him some extra milk.

squizita · 26/03/2015 08:10

Have you a gp who might offer a 2nd opinion or refer you to someone?

Goldmandra · 26/03/2015 08:13

If the baby is happy to feed, how is formula better than BM?

Surely offering formula instead of BM will just reduce the supply?

I genuinely don't understand how it is better to give a baby a different sort of milk if they aren't putting on weight. Is it just about being able to see what the baby has taken?

My gut feeling would be to make sure I was very responsive about offering feeds and ask to see a paediatrician if the baby stopped putting on weight but I'm not a HV.

PrincessTheresaofLiechtenstein · 26/03/2015 08:20

Because it isn't certain in this case that enough BM is transferring from breast to baby, goldmandra. I agree a second opinion is a sound idea.

NotQuiteCockney · 26/03/2015 08:26

How do the feeds feel?

tiktok · 26/03/2015 08:26

Goldmandra, sometimes formula is needed because the situation is that the mother's supply is right down and the baby needs extra milk now. Breastmilk can't be turned on and off like a tap. Increasing supply takes a bit of time. Also some babies are not transferring milk well for whatever reason. Obv that has to be addressed if possible. Some babies are lacking in energy to feed efficiently. The mother can express and should be encouraged to do so but expressing is a technique that not all women can do.

Each situation is individual. But of course in principle it's always the case that if the baby needs more milk and the baby is bf, the more milk should be breast if that is possible.

cherrypiesally · 26/03/2015 08:29

I was in your position in January except it took longer to gain bw back. We did express top ups during the day and fed on demand. He did have a few formula top ups as I don't get much when I expr and ran out at times.

Also we saw a certified bf counsellor and she was brilliant. Checked latch, and gave loads of encouragement . It turned out my DS did have posterior tongue tie despite early checks by doctors etc. That's now been treated and at 12 weeks he is a little chubby thing and ebf well.

Original poster

pintofmilk · 26/03/2015 11:24

Thank you for all the replies and advice ladies.

I have taken your advice and rang up my midwife for a second opinion. She was quite shocked that the HV advised to give formula so soon as she is not concerned with any other aspect of his health. Eg-Awake, alert etc.

She said that she was happy with his weight gain, although small and said she would review him again next week after another weigh in. She said she will refer us to a BF counsellor to come and review him and me to make sure everything is ok.

I am not sore when I feed/no cracked nipples or anything so that is good.

I don't know if I could express any more than I feed him at the moment as he is like a 'velcro baby'. I am feeding him every hour all day and night. The longest he has slept is 2 hours in a row. I'm not sure if I could express inbetween feeds as there isn't that much time when i am not feeding him (does that make sense?).

Sorry bit sleep deprived so hope this post made sense.
Thanks for the support.

OP posts:

Micah · 26/03/2015 11:36

I got the same advice :)

Saw a different HV, who looked at the baby, saw she was well, weeing, pooing, feeding, crying, generally behaving and looking like a healthy baby, and told me to stop getting her weighed, unless I was worried for some reason.

Not weighing instantly solved all the worries and problems .

Expressing isn't as effective as feeding, and won't stimulate supply in the same way, so feed more rather than express.

Sounds like you are doing great :)

tiktok · 26/03/2015 11:47

Micah, expressing is not always less effective than feeding....it depends on the baby and the situation. Sometimes (not saying this is in any way the case here) a baby is unable to transfer milk as effectively as he otherwise might, and expressing is actually better at removing milk. Sometimes, the opposite is the case, with a baby who is feeding well, and expressing gets hardly any milk out.

Goldmandra · 28/03/2015 08:59

Thanks Tiktok. I didn't realise it takes the baby more energy to BF but I guess that makes sense.

Imeg · 29/03/2015 11:48

I had weight gain issues with my baby and after some weeks realised that although latched on for ages he was spending most of his time faffing about rather than actually feeding. Had several feeds observed by HV and they looked fine but with hindsight they weren't.

In the end I phoned one of the breastfeeding helplines and that was really helpful as I couldn't get to any breastfeeding cafes etc.
For us breast compressions were the key to getting milk into him more efficiently, as described on this page, which you may have already seen:
www.nbci.ca/index.php?option=com_content&view=article&id=8:breast-compression&catid=5:information&Itemid=17

I also agree that just ignoring the advice isn't necessarily the way forward. I found the GPs took more of a holistic view of the whole baby rather than just focusing on the weight so an appointment with the GP might be useful to check for any other issues and if all is well help to reassure the health visitors?

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