Dropping centiles

[Tittie]

My 7 week old was weighed today and has dropped 2 centile lines, from a bit over the 75th to a bit below the 50th. The HV has advised to top up with formula,. The thing is I don't want to top up with a bottle (whether that be formula or expressed milk) as I find the whole process to be a faff and would rather sort out the actual issue. Or is this not really an issue, are Hvs a bit obsessed with growth curves?

Baby is very alert, feeds frequently (sometimes cluster feeding, sometimes 0.5/1/2/3 hours between feeds, there's no pattern), her nappy is always wet when I go to change it, she does big poos every other day, she's meeting milestones...do I need to worry about the centile drops?

But she is quite fussy when I think about it. At night she feeds and goes back to sleep, and some feeds are absolutely fine in the day, but with some feeds she pulls off a lot and cries, and the only thing I seem to be able to do to keep her calm is keep switching sides. It's worse when she cluster feeds in the evening. Does this sound like a problem or normal infant behaviour?

I'm feeling so disheartened because I thought it was going really well, I've just come home and cried

Sounds like normal behaviour for a 7 week old. Some hvs can be a bit obsessed with the numbers rather than looking at the actual baby.

Could you get along to a group with a lactation consultant? They will be able to check latch and milk transfer.

My first thought is to get good advice from a lactation consultant before you do anything else. Whereabouts are you? Someone may be able to recommend someone.

DD was slow to gain weight and dropped from 25th centile at birth to 4th. My milk was slow to come in and then we were slow to establish feeding. I felt forced by the medics to top up with formula which I did. I wish I hadn't as I believe it meddled with getting breastfeeding going even further and has saddled DD with a type of dairy allergy seen only in formula fed babies.

At around 6 weeks I made my own decision to stop the top ups and within a couple of weeks feeding had settled into a really good rhythm.

I would stick to your guns at this point as long as your baby IS gaining weight, albeit slowly and resist introducing top ups.

With the cluster feeding, I would wind thoroughly before switching sides in case this is causing the fussiness.

You could also try nipple shields in case this makes it easier to latch.

Personally I wouldn't worry about an average weight baby, if baby drops again definitely start thinking of something else.

How about cup feeding?

Also congratulations and well done getting through these early weeks breastfeeding! Tiring isn't it?!

That sounds disheartening - you thought things were going well but now you’re feeling less confident after these comments from the HV.

The behaviour you describe sounds pretty normal. Lots of babies have fussy times (particularly in the evening), and switching sides is a perfectly fine technique to keep them interested, and boost milk supply by removing more milk from the breasts.

This article from La Leche League GB has some helpful info re: dropping centiles: www.laleche.org.uk/my-baby-needs-more-milk/

Have you got any support in person? Whether it’s with a lactation consultant/IBCLC or a drop-in group such as LLL, you might find talking it over in person with someone helpful to get your confidence back, as it sounds like you’re both doing really well other than this blip.

Thank you for the advice and links. I've contacted a lactation consultant and I'm waiting for a response from her, so hopefully that will be useful. Apart from that I have no breastfeeding support in real life - no one I know is doing it/knows much about it, and the area I live in isn't very well provided for in that respect. I learned that from experience with my first baby (who ended up formula fed as no one knew why he wasn't gaining either - but he LOOKED lean whereas dd looks chunky). The local group is peer led which I'm sure is fab and very supportive, but the next meeting will be after dd's next weigh in and I think I need something a bit more specialist/qualified, in case the latch needs work or if there's a tongue tie maybe?

My instinct is telling me to wait it out a bit, but I am worried that when baby gets weighed again in two weeks time that she won't have gained and I'll get a telling off. I just agreed to top up before the hv left, as I felt I should just do what I'm told, so that's what she thinks I'll be doing. You wouldn't think I'm a grown adult would you!

@Tittie it sounds like you’ve got a good plan there for what to do next, and trusting in your instincts is important.

In case you wanted anyone else to speak to in the meantime, here are the LLL contact details for phone or online chat with a trained Leader: www.laleche.org.uk/get-support/

And congratulations on your new DD!

Disclaimer - I recommend LLL because they were most helpful for me, but other helplines are available too :)

Thank you @gothicsprout  it's a shame that the nearest LLL group much too far away for me, but I shall give them a call for advice as well!

Just in case anyone comes across this thread with similar issues, as a thread without an ending/knowing what works can be frustrating!

Seeing a lactation consultant a couple of weeks ago was SO helpful and I wish I'd been able to do this with my first baby. I definitely recommend giving this a go if you can afford it (it didn't cost as much as I thought for a consultation), or if there are free consultant led groups near you. I also had a good online chat with a breastfeeding peer counsellor which was also really helpful and supportive.

The consultant believes there is no milk supply issue, and I do not need to use formula  she thinks the likely cause of the issue is the switch nursing, which is causing a lactose imbalance, which is probably giving baby tummy ache, so she cries, so I keep switch nursing, and so the cycle continues. I was doing this too much, so baby was only ever snacking. It does explain the crying, fussing and frothy poos. Breast compressions, decent burping technique and stopping the switch nursing has definitely improved things and I have a calmer baby already. Also, instead of alternating which breast I offer, I've been offering the one from the last feed first (so L then R, R then L, etc, instead of L, R, L, R), always offering both sides, to ensure baby can have as much of the richer milk as possible. All of the above has led baby to have more decent feeds, rather than lots of snacks. Everything the pps said above is correct, there's some great advice here.

Also the drop in centiles is quite normal for babies who are big at birth, as they find their natural weight. Hvs can forget this, and forget to take a step back and actually look at the baby, as a pp said.