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Infant feeding

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

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Original poster

Friends baby 0.4th centile at 3months old and advised to top up with formula!?

31 replies

Inrockuptible · 26/04/2007 17:19

My friends little boy was three weeks early and has always been very petite.
She has just called me in tears as the health visitor has told her she has to top up her feeds with formula and to consider introducing solids from four months.
Firstly I don't understand why they are plotting his weight from a normal due date even though he was early. Lets not go into the arguement about these bloody charts anyway as I could go on forever.
My friend has been told she now has to take him to be weighed weekly and that forumla twice a day might be a good idea. They also told her to read up on weaning onto solids as they will advise it as soon as he is 18 weeks.
What makes me furious is they said something along the lines of 'we must keep an eye on babies this small as it is a good indicator of neglect'.
Has anyone else been treated this way, or do you have any positive stories so I can try to reassure her? I was lucky in having a really supportive non judgmental health team, and I feel so sorry that they have upset her in this way.

OP posts:

tiktok · 26/04/2007 17:26

That's a sad story.

As ever, if all they are concerned about is his calorie intake, then she can increase it easily and efficiently by breastfeeding more often.

Instead of giving formula twice a day, 2 extra breastfeeds a day would be better for him and have no risk of side effects.

The team also need to know she felt judged and undermined.

Giving early solids to a breastfed baby with a question mark about his growth makes no sense at all - his calorie intake could go down as a result

Original poster

Inrockuptible · 26/04/2007 17:32

The thing is he feeds on demand and very often. She hasn't had a real nights sleep since he was born and she is suitably unashamed of feeding him out and about, be it in the park or on a bus.
I really can't believe they would use the term neglect. I really agree with what you said, she needs to be in touch with their manager and explain how much they have upset her.

OP posts:

theUrbanDryad · 26/04/2007 17:41

for your friend. so long as she is eating & drinking plenty he will be fine. it's fab that she's bf-ing a prem baby at all; the pressure from neo natal and SCBU is often to put straight onto formula.

i had a friend who went through similar problems - she felt thoroughly undermined by her HV because of being forced into giving formula. because she was stressed her milk dried up. because he milk dried up she felt like a failure. because she felt like failure she was put on AD's. HV's often create their own problems. it's a self-perpetuating nightmare!!

is your friend a MNer? and, i know i always bang on about it, but the Baby Cafe and LLL will usually give excellent advice.

moondog · 26/04/2007 17:54

\link{http://www.telegraph.co.uk/news/main.jhtml?xml=/news/2007/04/26/nfat26.xml|Read this Inrock}

Important and very sad reading.

moondog · 26/04/2007 17:54

Here

Original poster

Inrockuptible · 26/04/2007 18:01

She was told that three weeks early isn't considered premature anymore. He was 5'8, latched straight away, and only needed observation overnight. I still don't see why they chart him in comparison to a full term baby though. She has plotted it herself and he wouldn't be so low down if they charted it from 37 weeks rather than 40.
It's sad that there is so little support for breastfeeding now. I don't blame the health visitors, as I am sure they are understaffed and underfunded, but I in some ways believe they think it's easier on them if they advise formula and the baby gains weight.
I'm speaking completely out of my depth here, I just know from my own experience, and from friends in nursing that it all too often comes down to lack of time and resources over actual care and support.

OP posts:

Original poster

Inrockuptible · 26/04/2007 18:04

Moondog, interesting article, but surely the clim that 3/4 babies are breastfed is wrong!?

OP posts:

Mercy · 26/04/2007 18:12

My dd was born 3 days early and weighed 5lb 9oz.

Fortunately midwives/HV realised that any child of mine and dh's would be small - because we are! (although not when I was pg for some odd reason) But I was certainly never ordered to attend clinics for her to be weighed or advised to do anything different.

That's a shocking comment re small babies and neglect. Your poor friend, just what she needs with a young baby.

awayfromhome · 26/04/2007 18:21

My son was born 3 weeks early, not even on the charts and was at the 0.4 centile at 3 months old.

I was told to breastfeed, breastfeed and breastfeed a bit more. Not introduce solids until 6 months and not give formula unless I wanted to. Breastmilk is the most calorific food he can have.

Quite bizarre and insensitive comment re small babies, as all I was told at his 4 month review in the neonatal ward, was it would be "nice if he could stay on this centile as we don't encourage them to grow across centiles" - a remarkably stupid comment I thought at the time and asked my consultant how I was supposed to stop him growing in length across centiles!

He is now 27 weeks and above the 25th centile for height and weight (clearly not listening to the doctors! )

I would tell your friend, do what she thinks is best, if her baby is alert, eating and happy to go with what she is doing.. Good luck to her

It also irritated me that they plotted him as a full term baby, his older sister was born 4 days earlier than him at 36+4 and she had the chart adjusted by 4 weeks, much less depressing on trips to the Health Visitor!

MadamePlatypus · 26/04/2007 18:33

I would really, really, really, really like to know what these solids are that make a baby put on more weight than breast milk. Dd is 91st centile (I think because both me and DS were big babies and she has inherited our genes). She has been BF to 6 months, and although I don't go to HV that often, I am really tempted to go there and say look how big she is and all on breast milk!

Is formula supposed to make babies bigger because it contains cow's milk and cows are bigger than babies?

MadamePlatypus · 26/04/2007 18:34

DH, and I were big babies, I meant to say, not DS, (although he was a big baby too).

fishie · 26/04/2007 18:35

poor friend. this happened to me, bf didn't get off to great start which affected my supply a bit. ds was off bottom of charts. in the end i was referred to paediatrician, bloody ridiculous waste of money, first one recommended formula, which i didn't give. in the end i did start solids at 25 weeks which i rather regret with hindsight, but don't expect it did any harm and got them off my back. second paed wrote to gp saying i was neurotic and said it is not helpful to weigh so often (!) of course ds caught up and everything was fine.

tell her to ask for a referral to breastfeeding counsellor if they keep on at her. a properly trained one of course, not a sure start worker with a fact sheet. she could also ring one of the helplines or get her latch checked, wouldn't do any harm.

hana · 26/04/2007 18:36

my second child was similar, but was well below these charts. There was great concern and we had to see a paed for about 10 months, she had a few blood tests during this time and we had monthly weigh-ins at the hospital. I gave the occasional bottle of formula (not because I was told to, it just worked out that way) but started solids at 6m exactly. She was discharged at about 12m. At about 15m I took her to the clinic to be weighed.......and once again there was great concern, but this time I was told it was 'excessive weight gain in a short time' and that she really needed to be monitored
hahahahahahaha! I thought, and haven't been back since, she is 28m now and really healthy. She is still on the small side compared to peers - just perfect.

and re prem babies, things arent adjusted unless they are more than 4 weeks early - my 3rd was exactly 4 weeks early, and was considered a term baby - so jabs, those blessed charts, milestones etc etc are as they would be with a baby born at 40 weeks.

tiktok · 26/04/2007 18:41

Inrock, 75 per cent of babies in the UK start off breastfeeding.

Many of them stop, but those are the initiation figures.

Piffle · 26/04/2007 18:42

i have a dd who has been on 0.4 from 3 wks old (50th at birth 38 wks)
get a paed referral and dietetic referral HV not qualified to advise.
has baby dropped thru centiles or being steaady but small?
does he eat well - frequently and for how long?

once i was satisfied my dd was small but healthy I lied to the hv

said dd vomited all ff tried (never tried her)

said same about solids
they will make fuck all differencedd eats like a horse she is now 4 and is still petite

but do go to gp and ask for referral to paed before changing anything
if her ds is bright, content pooing weeing sleeping and developing otherwise normally then she can relax

laughingduck · 26/04/2007 18:49

for your friend, Inrockuptible. FWIW, I have had three children and one followed the centiles to the letter, one dropped through them (was 100% bf) and one shot up through them (also bf). With my dd (middle child and very petite) I was advised to not feed on demand and that bf past 6 months was merely a drink and that she should have more solids. I ignored the advice and stuck to my guns and she is perfectly fine and very healthy although smaller than her brothers - some people are just meant to be that way. Conversely my first child who followed the centiles correctly (according to the HV) actually had a heart defect at birth and was very ill for a while. Just goes to show that these charts are not always a good indicator of a child's overall health.

PeachyChocolateEClair · 26/04/2007 18:53

I was also told this as my son was 2nd at biorth (IUGR- 5lbs 5 oz at 38.5 weeks) and went to 0.4th centile. As a result, I beleive of early feeding (although this ewas before the 6 month things, it was 4 months abck then- DS1 was given foods at 3 months on HV advice) and introducing formula in the belief my milk was in some way causing the problem, he has multiple allergies now including milk and gluten. I know how worried your friend must be but would really suggest a BF counxellot (the ABM are fabulous) would be sa good first base.

fishie · 26/04/2007 18:56

be aware that paeds do not neccessarily know anything at all about bfing, such as the one i saw, similar for nutritionist.

mush4brains · 26/04/2007 20:14

I was told same thing for my DS. Told to wean him at 18 wks & supplement with formula till then. I ignoroed advice as he was bright, alert & had been sleeping through since 8 wks so I felt he was fine. went to see a BFC who suggested a few days of rest for me & almost constant Bfeeding. Did this & didnt start solids till 5.5 months, never tried the formula.(not sure why I didnt hold out those last 2 wks?) He is now 6.5 months, loves his solids, loves his BF & still has as much. Maybe he is a little smaller than some of his peers but he is content, alert & happy. I havent been back to the HV for 3.5 months.

pinkdolly · 26/04/2007 20:46

hiya, my dd was born 3 weeks early weighing 5.12. I have b/f her excl from birth to 6 months when i started to introduce solids. She is very petite weighing 14.11 at 9 1/2 months.
I have never topped up with formula, and have never been told to. Some babies are naturally petite and I am sure this is the case with your friend's baby.

The best thing she could do for her little one is to offer feeds more frequently.

I hope that helps.

LadyTophamHatt · 26/04/2007 21:01

slightly off tangent here but my HV is breath of frsh air compared to one like this ignoramus.

She was saying to me yesterday how there is such a huge pressure on mums to feed baby up and get them "fat" that that is now causing more problems then weeny babies on the low centiles, like you friends.

Get your pal on MN...we'll all put here on the right track

LadyTophamHatt · 26/04/2007 21:04

Also, My ds3 is 3yrs7mths and just about reaches the 9th centile.

Hv has been here when ever he's here and has never mentioned it at all.

Like everyone has said some babies/child are simply just petit.

Blimey wouldn't the world be a boring place if we were all the same!

Piffle · 26/04/2007 21:07

a paed can rule out any condition that could cause a low weight gain or growth problem though
When dd hit the 0.4 she was instantly referred, dietitian can offer you calorie supplements to add to EBM rather than start solids.
HV not always best qualified to advise in such cases IMHE

PeachyChocolateEClair · 26/04/2007 22:01

Agree with the Paed- DS1 was the only one of mine NOT to see a PAed for growthr easons (despite needing it), with the others they took family histories (DH's family V V V slaim) and said it was simply genetic, ds1 has seen a nutritionist as has ds2 since weaning and the diet theya re given is, apaprently, ideal.

So would agree, say to your friend to ask the HV, if they are genuinely concerned, to make an appt. with paeds.

MrsJohnCusack · 27/04/2007 05:37

"They also told her to read up on weaning onto solids as they will advise it as soon as he is 18 weeks"

then get her to read up on weaning onto solids on here! she will be able to find lots of evidence as to why this is a shit idea. Seriously, she should go in armed with the reasons as to why breastmilk provides far more calories than any solids she could get into him at this age, and why the recommended weaning age is 6 months.

fecking charts

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