17wks, bf, failure to thrive - 'Give him solids' ?

[Pesha]

Its me again

I know I wasnt going to get him weighed but with the paed appt I have still been going to give them an accurate picture of his weight, assuming that the hvs would leave me alone as something is being done. I am only going every 2 weeks though.

Ds2 is now 5.2kg so well into the blue at the bottom of the chart (his length is around the 50th line although I know that's never very accurate). HV is going to try and bring my paed appt forwards as its not till 20th sept.

And as he is now 17 weeks today she wants me to try and give him solids. I told her that I thought solids contain less calories and fat than breastmilk but would fill him up more, so he would feed less and it wouldnt help at all. She said that wasn't always the case and it seems like he's not getting enough calories atm. She suggested giving him just a little bit of something after a feed, hardly anything just a taste really she said. Well if it is only 'just a taste' then what's the point in that anyway?

I weaned my other 2 at this age but really wanted to wait till 6 months this time and try BLW. I thought solids at 17 weeks was against recommendations and a Bad Thing. Is it necessary in these circumstances though? Could it help? And if not then how can I argue my case to the hv in 2 weeks time? Or shall I just tell her I tried him but he wouldnt take it?

It sounds like you need that conslutants appointment brought forward. You are doing everything you can on the bf front so please be proud of yourself. Some Babies are genuinely FTT and need professional help - and by that I am not referring to HV who tell you to wean

kiskidee, I agree with what you say about feeding more, however, constant latching makes very sore nipples! If you express ontop of full feeds to ensure both breasts are empty then supply will increase. At 17 weeks many babies do not have 2 full breasts. Also you asume the baby is properly latching on and isn't falling asleep before the feed is completed and therefore 'bit'feeding. This means that the baby doesn't get the hind milk quality feed. Expressing after the baby has finished will ensure the hind milk is taken from a bottle (and this does contain more calories)

From what you say Pesha the baby is bit feeding, therefore, not getting the hind milk and is exactly what happened to me. I fed regardless also but if the baby is fed so often it is basically getting a drink, not a full feed.

Sorry ladies but I think there is lots of MAD advice going on.
Tree hugging and natural parenting! Great if you want a clingy baby and lots of sleepless nights. Not to mention backache from carrying them round and no life until they are physically unstrapped from you.
I'm all for breast feeding but not at all cost. You will end up with a baby who will not go to sleep unless rocked, cuddled etc. CRAZY!

PS piffle what a load of piffle from a healthcare professional. How do you think under weight babies were brought on before supplements were invented?

Pesha, is he actually losing weight or just gaining very slowly?
There is a huge difference between the two.

I have weaned early with some of my children and waited with others it really depended on them at the time. (I have 5) But giving solids never helped them gain weight more than breastfeeding. 17 weeks is very early and it's quite clear that your instincts are to wait and so please follow them

I think the visit to your paediatrician will be very helpful, to provide a more objective opinion regarding early solids/b feeding as they have great experience in managing these scenarios. I think it is important to try and be aware that the health visitor's intentions are wanting the best for you and your baby as they appear to be trying to find a solution that works for you and your ds. People who post overwhelming negative comments regarding them are not doing you any favors because ideally you would want to work together and not be terrified and filled with dread at their next visit, as they are obliged to keep visiting you whether the centile charts are representative of babies who are bottle fed in the majority or not. It sounds as if you are doing a great job with the breast feeding and are 100% committed, However a weight gain of 2.5 oz per week is not great and does need further investigation to ensure your ds' growth and development is not affected. Duocal is the extra calorie paste used to increase the calorie content of breast milk this can only be given by recommendation of a paed doc or dietitian. I wish you the best and feel for you its so distressing for you

tori, a lot of what you say is not very helpful, or based on a good understanding of bf....though it's clear you mean well. You have a lot of misconceptions, sorry.

I've only had time to scan this thread, but I think my experience with my dd2 is relevant.

She was born on the 91st centile, but was nearly down to 9th by 10 weeks, (only gained 1lb3oz in that time - sorry not good a metric). Best gain in a week was 2oz. She did have bad reflux, so this must have been partly to blame.

My HV was v supportive and pro-bf but was encouraging me to start weaning at 20 weeks. dd2's lenghth stayed at 75th centile and she was gaining weight, slowly, but steadily. And she was happy. So I stubbornly hung on til nearly 25 weeks, when dd2 starting helping herself to dd1's food!

And her weight gain in first 2 weeks of solids (which she lapped up) - 1oz... Speaks for itself, I guess. (Who gets fat on a diet of fruit & vegetables?)

She has done some catching up over the last 6 months and is now over 50th centile again. But I would not change a thing and still feel holding out on the weaning was this right thing to do.

My DD was also a FTT baby, we tried everything, even mix feeding but it didn't make any difference to her slow weight gain so ended up dropping the formula. I weaned at the recommended 6 months, but despite 3 square meals (laced with olive oil for those extra calories) and several bfeeds a day she only actually put on about 400g in 3 months, which was the same as a month's weight gain prior to weaning. It wasn't till she was over 10 months that she started to get ever so slightly chubby. God knows what would have happened if I'd weaned at 17 weeks.

I suppose this just proves that solids have fewer calories than bmilk.....

Tiktok I can only speak from experience and working with children in paediatric clinics who FTT. Acting on paediatric physicians advice! I can also say that I have a 19mth old who did not FTT but probably would have if I had continued to battle with breast feeding (she had stopped gaining weight). Also if I hadn't weaned at 16 weeks. She is advanced in all respects and very rarely ill, has slept through the night from 3mths from 7pm-7am. So I think obviously I did something right. But total apologies if what I say is not helpful.

tori, glad your dd is fine

When breastfeeding is not working well, it can be fixed.

I don't think 'battling' with breastfeeding is as good as fixing it!

When it is fixed, then early weaning is not necessary.

Your judgemental and dogmatic comments about 'tree hugging' and carrying babies meaning a mother has no life and is crazy are not professional - it's fine if you want to make these remarks purely as a mum (though bear in mind some people might be offended at them) but not if you justify your comments by describing your professional background and experience. Do you agree?

The stuff about weaning before 6 mths to differentiate between taste and texture is totally non-evidence-based. Again you can say what you like about it as a mother, but then explaining you have paediatric experience makes it appear as if you are giving this advice professionally

Your description of 'bit feeding' and not getting the hindmilk are not based on a good understanding of how bf works....short, frequent feeds can be totally physiological (as can long, infrequent ones!). You are talking as if one size fits all and it doesn't.

I don't want to get at you - you mean well, I am sure. But I have to set the record straight

From a physiological aspect and someone who has worked in orthopaedics as well, I can categorically and with evidence state that carrying a child around all day is not good for your back. From speaking to numerous people who have done this I can also say that the majority have had separation issues with their children once they could be independent i.e. not happy to be left for short spells playing. I also need to stress the point that I actually am in agreement that breast is best when it works, however, not all feeding problems can be fixed. Several physiological issues play a huge part in milk production such as stressful deliveries, baby feeding technique i.e. it is very difficult to feed a baby after it has been delivered by cesarian section under a General Anaestetic due to drowsiness caused by the drugs. As we obviously know that the more often you feed in the early days the quicker milk supply will increase. It is a fact that higher birthweight babies are likely to require more per feed as physiologically their stomachs are more developed.

Discussing this with you is to highjack the thread, tori, which is probably not a good idea.

I did not argue about the backache thing - I can believe this is possible in some circumstances. I did argue with your dogmatic judgement on 'no life' and 'crazy' and so on. You really need to read more up to date research about separation issues. You should also think of reverse causation with this topic, too.

I agree not all feeding problems can be fixed - most can.

A GA with a section should not make much difference to the drowsiness of the baby - not as much as pethedine. The GA is out of the baby v. quickly.

Look, I am not here to fill in the gaps of your bf knowledge. I just want you to keep the judgemental stuff about people's lifestyles in the category marked 'Tori's ideas as a mum' and away from 'Tori's paediatric knowledge'....I mean, you don;t tell mothers whose babies you are caring for that they are 'tree huggers' and that they are 'crazy' do you??

Oh goodness me, it's not the carrying of the child that's bad, it's how it's done. And as someone who has worked in orthopaedics you will agree that most of us in the west have appalling posture even before a baby is picked up, caused by sitting around on our bums far too much (not a natural pose for the human skeleton)and subsequent back problems are traceable back to this and NOT child carrying.

Why do HVs suggest weaning at 17 weeks? Just linking to a thread I started today about this very topic - the info is as clear as mud. Not trying to hijack but just trying to explain why some HVs persist in the 17 weeks and 20 weeks nonsense.

here

"kiskidee, I agree with what you say about feeding more, however, constant latching makes very sore nipples! "

• Tori, constant latching does not cause sore nipples. Poor attachment causes sore nipples.

"If you express on top of full feeds to ensure both breasts are empty then supply will increase."
-Breasts are never 'empty' you make milk all the time. I speak as a mother who expressed for a year at work.

"At 17 weeks many babies do not have 2 full breasts."

• True. I could never make my daughter take both breasts, not unless i wanted to strangle her to do so anyway. But she wanted to feed every 1.5 hrs during the day and was and is always content. Life was just too exciting for her to sit still long enough to have both. It seemed like that to me anyway. It is just more likely that she has a small stomach capacity.

"Also you asume the baby is properly latching on and isn't falling asleep before the feed is completed and therefore 'bit'feeding."
-No, i am not assuming that the baby isn't falling asleep or 'bit' feeding. Different babies feed differently and i have to respect that. What is important is if a baby is transferring milk effectively and there are simple ways to evaluate that.

"This means that the baby doesn't get the hind milk quality feed."
-This statement is based on poor understanding of the foremilk/ hind milk issue which only serves to stress out mums for whom bf is working perfectly fine.

"Expressing after the baby has finished will ensure the hind milk is taken from a bottle (and this does contain more calories)"
-In addition, some women cannot express and being stressed out about fore/hindmilk will make it even more difficult to do so. Some babies refuse bottles - more reason to stress. So this scenario will simply turn a perfectly happy bf relationship into a battle.

and the thing about carrying and tree hugging. Brangelina's answer addressed that. Plus, there are good baby carriers on the market and less good ones. there are also good carrying techniques and less good ones. As a mum who always answers her dd's calls for attention asap and has always carried her a lot because that is the way my home culture brings up children, I have been told by her nursery staff and her HV that I have a very confident and well adjusted child.

anyway, hijack over, sorry Pesha.

Oh Kiskidee, You have pretty much posted what I was going to

Tori I am sorry but you sound like a very dangerous health proffessional

After 5 children some which b/f some didn,t. 3 were always carried, 2 were not, all 3 that were b/f were bit feeders for much of the time but they somehow managed to get the right kind of milk! 3 were weaned early 2 not, none gained weight quicker when weaned. They are all healthy, well adjusted, non clingy children!

Pesha I am sorry for hijacking too

There always exceptions to a rule, but as we used to do paediatric health reviews for children of all ages I can safely say I have seen a far wider range unless you happen to be in a similar profession. Therefore I stand by my opinion. I will also give you the name of the HV who advised me about breast feeding along with the midwives where I had dd1 since my apparent understanding is so lacking iyho. All the points that I raised where things that I have been told by them. I stand by what I have said and am entitled to my beliefs on this. I have not ever said that they are my professional opinion, just that my experiences formed my opinions. Tiktok I think its about time you got to grips with your self and start to be more civilised when you disagree. I believe I am not the only person you have hacked off recently. Its fine to have strong views, just don't try to ram them down others necks.

I should be keeping my nose out but had to butt in here, tiktok is one of the most knowledgeable and helpful posters on MN imo and I've never seen her force her opinion on anyone

Well she managed to bully someone off a thread yesterday and is now trying the same with me. As I said anyone is entitled to an opinion and to have a barrage of attacks for not agreeing with someone is out of order.

i don't see anywhere TikTok has attacked anyone or been uncivil.

she works extremely hard to impart her knoweldge and to address common , sometimes dangerous misconceptions about breastfeeding and weaning

Its fine to have strong views, just don't try to ram them down others necks.

Exactly what you appear to be doing on this thread

you may well then not know that HV, midwives, GPs and even paediatricians are not the first people many if not most mumsnetters who have successfully breastfed would turn to for advice.

you simply have to search the words 'Health visitor (or other HCP), loon, bollocks' in the mumsnet search facility etc to see what i mean.

BTW, is the idea of expressing to reach hind milk and then feed in a bottle something you read in one of Gina Ford's books?

Pesha,

Just had a look at my charts, i have DS2 between 0.4th and 2nd centile on the standard chart from a pead and above the -3.5mean line on the one from the kellymom site.