Please help baby not putting on weight.

[Pancake12345]

Hi this is a long post. I really need advice on what to do. This is my dd3 and she is tiny. She is ebf, 10 weeks old and I have been advised today to give her one bottle of formula by the health visitor. We are currently waiting on a referral to see peadiatrition for lack of weight gain.

She was born at 37 weeks and weighed 2.88kg. She then lost more than 10% of her birth weight and took about a month to put it back on, thankfully I had a very patient, encouraging midwife but at one point I had to take her to a and e because she wanted to get her checked...everything was fine. She has put on weight since but very slowly and has fallen quite far below the 0.4 percentile line. I had her weighed today and she is 3.4kg. Her previous weigh in was 3.36kg so she's only put on 4g since last week!! I am very worried I'm sure she should growing more.

My dd1 was supplemented with formula since birth at the hospital long story but I didn't really know what I was doing and my milk supply became non almost non exsistant although I carried on expressing until six months and gave her what drops I could get out sometimes it would take days just to get one full feed together, interestingly when the milk separated in the fridge more than half of it was fat!!

With dd2 I was determined to get it right so read all the books to figure out where I went wrong Clair Bryan cook etc. Ebf for six days and had to top up due to slow weight gain went back to ebf once she'd regained birth weight but then she actually lost weight!!

Dd3 is fed on demand for as long as she wants to. feeds for 30 mins to an hour is quite settled for half an hour and then gets cranky because she wants to sleep. She sleeps about 5 hours at night. I thought it was going really well but today I feel like I've failed....again! I tried to express this morning feed on one side and then express on the other got 2 oz using a madela swing ( old knackered pump btw) which I thought was not bad I was trying to figure out my milk storage capacity.
I don't want to give her formula or a bottle for that matter definately don't have time to express a feed but at the same time she's tiny and is not growing. (Still in newborn clothes). I know that this one bottle of formula is going to start a slippery slope to ff as it did with the others. I take fenugreek, eat porridge etc.
I feel like I've done everything right and am still unable to feed my baby. Why don't my babies thrive on my milk? I just don't get it. I am angry and exasperated. It's really drummed into you to bf but when it doesn't work out their answer is to give formula. I want advice on when is the best time to give this bottle so it has the least impact on my milk supply which I know will diminish once I start. Thanks for reading this very long post. X

How often does she feed and has she been checked for tongue tie?

She feeds from approx 8-12 times a day, approx every 2 1/2 hours (I have an app where I log everything and reminds me when she's due her next feed so I will wake her up during the day if she due).

I asked about tongue tie today and the health visitor said no but I think poss posterior tongue tie as she didn't have a feel in her mouth. She definitely doesn't have an anterior tongue tie.

Sorry that you're going through it, it's so difficult. You're right in that we get mixed messages - it's all about breastfeeding, to the extent that you feel like a failure if it's not working and you hate the thought of giving formula because it's been drummed into you that it's not best for the baby.

My first child lost 15% of his birth weight in the first 5-6 days, they wouldn't let me leave hospital until I agreed to give him formula . So we went home on formula and I kept trying to breastfeed and also expressed milk in an attempt to get my production up. I found it really hard, I remember at 9 weeks I wanted to throw in the towel. However I kept going and combination fed for 11 months in the end. So, giving formula won't necessarily jeopardise breastfeeding, it just supplements it if needed.

My baby seemed to take in loads - I remember one time he fed from both boobs, had a bottle of expressed milk and then a carton of formula - but his weight gain was still slow. I think it's just like that for some babies (& he takes after his dad who can eat forever and not gain an ounce!).

Is it worth asking to be referred to a dietician who might be able to suggest potential changes to your diet to increase the calories in your milk? It was drummed into me when expressing that I needed to eat well to get decent milk out.

Btw - we always gave a bottle of formula at bed time, then offered it after each breastfeed if he was still hungry

Do you have a local la leche league meeting op? They can have a look re: tongue tie and might have some suggestions for getting more milk into her. Have you tried breast compressions? Alternatively they do have a 24/7 helpline

I don't think you need to change what you eat to try and change the calories in your milk, I don't think there's any evidence that it makes any difference unless you are severely malnourished which I'd assume you are not.

I would try the one formula feed a day, giving it in the daytime to preserve your night feeds. I would express to replicate that feed to try and protect your supply. You could use what you express to give in addition to the formula feed.

It sounds like she is feeding for a fairly long time which might indicate she's not transferring milk as well as she could. You really need an expert to have a look and double check for a tongue tie, and check your latch etc generally. Would you be able to get a lactation consultant to come out and see you?

I have twins (clearly) that are 3mths old. I have 1 that breast fed beautifully and one that kept losing weight. It was really stressful because breast is best...apparently and I didn't want one to go to uni and the other to use not being breast fed as an excuse! But the fact was the reason she kept losing weight is because feeding from the breast was so knackering she kept falling asleep after about a minute because she was so small and premi. I started expressing, BF, and giving formula to top them up but i still felt guilty because 1 was getting more than the other. I spoke to the GP and health visiter and they both asked me am I enjoying BF? I said no but it's best and they are premi they both said if your not enjoying it and it clearly is not best for her if she is falling asleep so quickly then don't bother because there are plenty of bottle fed babies that go the uni and the GP never asks an adult if their health condition now is a result of being bottle fed. They are both now bottle fed They were right she is now putting on weight, happy and content and so am I. No regrets! Don't be hard on yourself, breast isn't always best. And having a baby is hard enough without the added pressure, do what is right for you and right for baby. Xx

I agree with assasinated. If possible I'd give the "breakfast" feed as formula (ideally given by your partner whilst you express). Express both sides until empty and put in freezer instead of using (if you use it that's just another possible bf session you'll be giving up later in the day and it won't help to up your supply).

If your older kids are cooperative I'd have a look in their mouths and see if there is any evidence of tongue tie. All three of mine have it and interestingly the one which was the least obvious caused the most problems.

Or get a pumping bra and pump and bottle feed at same time.

I'm going through the guilt and 'why can't I feed my baby' feelings of inadequacy. Having been surrounded by messages on the importance of bf together with natural instinct, no wonder we feel so crappy when it doesn't work.
For me, I've been trying to accept that my supply isn't there (poss low thyroid issues - could this apply to you?) and that for the sake of his health it's more important that baby is fed rather than be fed exclusively breast milk.
We use a supplemental nursing system so he's still suckling whilst getting the top-up formula.

If it reassures, the same thing happened with my first dc. He had formula top-ups from early on but we went on to mix feed and are still breast feeding now. Mix feeding wasn't the end.

DS was loosing weight after birth and we started supplementing with formula and/or EBM. I couldn't express enough so ended up only supplementing with formula. He then gained beautifully and he is now healthy, 12 weeks on and combination feeding just fine. He eats loads. I am also able to express more now as I finally relaxed! Plus I had to change pump. Not all pumps work the same for everybody, worth trying another one if the medela swing is not giving results. Doesn't mean anything about your supply. And also sometimes manual is best.
+Check for latch and tongue tie at your local community breastfeeding workshop? They helped me a lot
Good luck!

Thanks everyone. I am going to try to go to a breastfeeding support group to get someone to check for tongue tie the health visitor dismissed the idea straight away with out even checking! I am also going to go back to the Gp and ask if she could prescribe the high calorie formula? It's just a thought I had over night. The health visitor suggested a bottle at the 11 pm feed I feel like replacing this feed is going to really affect my supply. Does any know if replacing perhaps a lunch time feed would be better? I plan to express whilst she has this feed, however it would have to be me giving her this feed as hubby is at work.

My mil was told to offer formula after a breastfeed for her dd. That way it didn't diminish her supply. In your case, I really wouldn't worry about her having formula. Best is thriving in this case. The bloody breast is best agenda drives me potty. The research is, at best, conflicted. I say this as a breastfeeding mother. Do what you need to for your baby and do not feel guilty.

Sorry everyone I got worked up typing away last night this post wasn't meant to be about guilt or lack of support or about ff vs bf. I was looking more for practical advice on how to go forward as her lack of weight gain is something that needs to addressed. I know there's a wealth of experience and knowledge here! Many thanks to those who have taken the time to help so far x