"Switch feeding" - a good idea or not?

[verylittlecarrot]

My tiny 9 week dd is very slow to gain weight, averaging just under 3oz a week. She has a good latch, and feeds enthusiastically for the first few minutes of each feed, but then she settles into lazy sucking with the occasional swallow...this can go on for 20-30 minutes, then repeats with the second breast. In the very early days of bf I worried about this "comfort sucking" but have subsequently chosen to go with the flow, as I believe she's still getting some milk when she swallows, and I guess it's still providing some stimulation to me. Feeds can take a long time but I just let her get on with it. I've never had sore nipples or discomfort from this, and during a long feed I'm aware of at least 3 or 4 let downs which get her gulping again for a little while. I tend not to interrupt her, although I try the usual tricks to keep her awake. Fedds roughly every couple of hors, sometimes goes a bit longer.

I have been advised today by a lactation specialist to "switch feed"; however I've tried this before and instead of awakening dd's interest each time I switch, she seems to get bored more quickly, if anything.

Is it really better to try to switch feed or should I just keep going at dd's pace, allowing her longer feeds on each breast and letting her tell me when she's done before offering the other side?

I just managed to speak to the hospital lactation specialist and she has agreed to join us in the paed ward when we go in, to ensure any feeding advice is from her, not a paed.

The daft thing is, no-one seems to be able to follow the basic logic. They all seem to be OK with the concept of a consistent gain of 3 oz a week, BUT not happy with a descent of the centiles. I can't believe that they don't comprehend that one inevitably means the other - the centiles curves require more than 3 oz a week.

I feel so stressed that I've just been feeding the baby and I couldn't feel a bloomin letdown.

Aarghhh

Oh VLC you poor thing you know my ds has been dropping down the centiles since birth - erratic weight gain, sometimes as little as one ounce, once or twice (to my huge ) as much as seven or eight ounces!

And my HV has always been fine with it as he's always seemed healthy and my dh is smaller than average height for a bloke.

Why are some HV's so obsessive about those bloody charts?

Is there any way that if they do prescribe you formula you could just simply say "yeah, okay" and then not go again to weigh-in, or does it not work like that?

on your behalf.

It seems I was vey fortunate with the consultant peaditrician I saw - he was very supportive of breast feeding, told me that ds would evevntually start to move back up the curves - but not to worry about when. In fact, the only real comment he had was that I should stop the "faff" of expressing (which I was doing to "supplement" my ordinary breast feeds).

Indeed - he was more interested in what my dad, who used to be a colleague of his (paediatric radiologist), had been doing since his retirement!

But then, ds was the picture of health - happy, healthy and alert, if by ow just underneath the charts.

As my dh used to say though, he wasn't worried, as if my dad had thought there was anything wrong with his first , and long awaited, grandchild, he'd have been the first to whisk him into his former colleagues!

Thank goodness I kept away from HVs like the plague!

Well! Now I've had 2 GPs and 2 paediatricians give dd a clean bill of health, and the lactation consultant was very happy with the latch, the feeding, thinks I have plenty of milk and so on. I'm glad I arranged to see her first, as she helped to sidestep many of the concerns the paeds may have had. I've asked the paed to be very clear about dd's weight gain being satisfactory in her discharge notes to the GP so that I don't have to go through this pointless worry again.

And I'm DONE with my HV. No more visits to her.

On the way home from the hospital, dh and I bought a set of baby weighing scales from TK Maxx for £30. We'll take care of the weighing ourselves from now on, thanks!

Thank you all for your reassuring words of advice, solidarity and support. You are all superb and I salute you, you lovely Mums!!!

Good news

VLC, I've been following this and wanted to say well done you!

Enjoy the bfing and your dinky baby - I've had 2 dinky doos and they're way better tham blubber babes IMO.

Thanks!!!!

Feeling much more relaxed tonight.

Despite being wee, everyone who has examined baby carrot has exclaimed how gorgeous she is (like I didn't know!) She smiled winningly at the paed today - that helped I'm sure!

VLC that is brilliant news. So pleased for you!!

Are you going to complain about your HV, to stop her scaring other women too? Her "help" might just be the thing to put someone else off bfing.

I am so sorry you have such an awful HV...It seems to be the only qualification to do that job

BTW my baby was born on the 90 or 95% can't remember which....by 7 months she was down to 50% and remained on that new band.

She was also a velcro baby, she did outgrow it but I honestly can not remember when. I still carry her in a sling instead of a pram but now at 13 months she wants to be running around playing most of the time instead of being carried.

I do remember walking up and down the street with her in a sling during the long winter months.

I would get a water sling...usually made of solarweave or solarveil. You can get them in a pouch, wrap, ring sling or mei tai and they mean you can shower handsfree.

HTH

Well done, VLC, so glad everything has turned out fine. If you have the energy, it might be worth saying something about your HV to the appropriate people - not least the fact that she escalated the whole thing when she had agreed with you not to do so. Not very professional, IMHO.

I have thought about complaining about the HV, but I was so incensed I decided to give myself time to cool off first. I think that she stuffed up royally on this occasion, and her actions have resulted in a complete loss of trust. I expect that at some point she will call me to see when I am coming in, at which point I will calmly (I hope) explain that her actions were both unnecessary and a betrayal of my wishes, and that I have made alternative arrangements for the monitoring and support of my child's health, and will not be seeing her again.

She is far too twitchy and anxious in general, but seems at least a little better informed regarding supporting bf than most HVs, so for "textbook babies" she probably is helpful to "normal mums".

It does irritate me though, that so many health professionals don't ever bother to spend a fraction of the time their layman patients do researching their own subjects. It's so bloomin easy to google topics like bf support, infant weight gain, health recommendations, co-sleeping research and the like, and even easier to discuss them on forums like mumsnet. Why don't they bother? I can't bear the ignorance.

Rant over.

Mossy, if you're around, I tried to email you again...wonder if I'm ending up in your spam folder. I don't think I'll make it tomorrow, sorry, but if you can email me I'd like to reply to see if we can arrange something next time I'm visiting my folks...I'd still like to see your fab bfc too.

My email address is temporarily on my profile.

can I just say vlc how fabulously well you've been doing and how completely chilled you seem for a first time Mum? Baby carrot is a lucky girl and will have you smiling at this when she grows up to be 5'10''!

vlc,
only just read this thread and am so pleased to hear that you have a clean bill of health and have escaped the clutches of your HV!
just wanted to say... this is a minor thing but your HV is wrong on one thing at least - not possible for a baby on milk only to have a gluten intolerance causing problems - it isn't having any gluten! now, I know you didn't have any faith in her anyway... but that's just another thing....

Found this diagram of sucking patterns and the concentration of milk over a feed (the darker purple the more fat globules) which might help. They start off more vigorous to stimulate the let down (the milk is thin at this point like a drink) then 'active' sucking which is slower and steady with intermittent gulps, then slows right down to 'flutter' sucks when the milk is at it's richest and fattiest (the 'meal' if you will). It is really important they get to this bit as this is what will allow them to chunk up.

I was frustratingly told mine was done and just sucking for comfort when she did flutter sucking, and to take her off as she was 'using me like a dummy (don't get me started on THAT phrase lol. Am not anti-dummy, I used one, more mean that a dummy is a substitute boob and not the other way round). Anyway..point is it's not a problem that they have different rates of sucking over a feed, just make sure they get that good fatty milk as this is the key to increasing their gain.

Totally agree that Health Professionals can be too fixated about the graph - I stopped weighing my second baby after a few weeks as I knew she was growing out of her clothes, had some chub about her and was happy and alert. It's worth noting that the graph is based on formula and BF babies so isn't a fair comparison really. The reason it's not separated (other than cost) is that it's really hard to find enough 100% EBF babies - most will have had at least one feed, some are co-fed, some are EBF but then go onto formula at varying points on their journey so can kind of see how it's problematic, however if they're not going to produce a separate graph then it needs to be accounted for and allow BF a larger margin, before scaring the poor Mother into top-ups!

Edit: after writing my answer I have just seen this is from ages ago lol