Please tell me what might happen next

[LuchaGarcia]

Hi all,

I've had a but of a rough journey with my 8 week old. She wasn't gaining weight after the initial usual weight loss after birth. She had all the classic symptoms of silent reflux at week 2 which I flagged up with midwives and HVs, only to be old she wasn't gaining because I had an inadequate milk supply and she was starving. I was told to go home and immediately top her up with formula after every feed until my supply was adequate. I spent weeks pumping like crazy after every feed, spent hundreds of pounds hiring a private lactation consultant...looking back I actually think my supply had been fine all along, and that I was over feeding DD with the formula top up. She had some weight gain whilst on the top ups but she was suffering immensely- crying during and after feeds, straining and arching her back, poor sleep, explosive poos, mild eczema type rash, excessive wind, etc. I suspected CMPI and I kept flagging these up only to be told it was all normal and that she would grow out of it. Eventually we weaned off the top up formula and have been EBF for a while.

1 week ago it got so bad she refused to feed for a few hours and missed her feed, resulting in my breasts becoming engorged. I raised this with the GP, and after weighing her and seeing that she had dropped percentiles (from 9th to 2nd), she reluctantly prescribed some gaviscon, and when that wasn't having much impact, omeprazole.

DD still isn't feeding optimally- I latch her on properly only for her to slide onto the nipple just to comfort herself. Sometimes when she is on and actually wants to feed, she will latch on properly again, but her feeding schedule has basically gone out of the window.

She is due to be weighed again by the HV in about 12 days. My question is- what happens if she has lost even more weight? I personally am expecting her to lose a bit more weight until the omeprazole takes full effect, before she starts gaining again.

I'm on an elimination diet as I suspect some sort of intolerance and I'm just worried that I will again be cornered into giving her formula, which will trigger her horrendous reflux symptoms again. I really do want to continue BFing but feel it is now in jeopardy due to the weight loss and her reflux being left to go untreated for so long.

Bump

What did the lactation consultant say? Did they give you advice or a plan?

My experience is that HCPs who aren't specifically trained in BF are too ready to tell a BFing mum to give formula- i was very lucky to have amazing support from a wonderful BF specialist who said she sees it all the time, GPs will tell a BF mum her supply is the issue but actually it rarely is and it just makes their job easier if you can say the baby had X amount of formula.

My dc2 didn't gain well in his first 3 months, we were referred to our GP and a consultant for 'failure to thrive' but my HV said to keep on BF even if they said to stop. Luckily the consultant didn't push formula and said baby was bright and obviously feeding well, just slow to gain weight and we'd keep an eye on it. For context he was 91st centile at birth, then dropped to 50th and was below 9th by 3 months, sat just below 9th for a while then exploded around 5/6 months and at 11 months has gained so much he's off the chart. I had a lovely HV and a BF support group with very knowledgeable HCPs and HVs running it.
I'm not saying every baby is the same or that your baby will do the same as mine, but you're clearly doing your best and pushing all the right things. Are you seeing any improvement since starting the new medication or restricting your diet? If you want to keep BF then reach out to any support you can, I'd recommend the breastfeeding network for info and support. Is seeing the lactation consultant again an option?

My baby had CMPA/I plus reflux. It took about 4 weeks to see an improvement after I took dairy and soya out of my diet completely (no traces at all) and she started ranitidine. I was given Neocate formula as a back up by her consultant but didn’t need to use it.

@majesticallyawkward thanks for your reply, I feel reassured :) the lactation consultant was great- after a couple of weeks of gradually weaning DD off the formula and loads of on demand BFing, we are now EBF. We had a follow up and all was well. Latch, tongue tie (which we had snipped at day 3) etc all fine. DD has LOTS of heavy, wet nappies because I literally have had her on my boobs most of the day- even when she is sleeping! Also seen an increase in the frequency that she poops- gone from every 5 days to every other day...surely that means she is getting enough milk?! If one more person tries to suggest that my supply isn't enough, I really will lose it

@Tomatoandbasil that's good to know! I'm about 1 week into being completely dairy and soya free. Really hoping it helps DD as it's horrible seeing her strain and suffer during feeds.

Update- DD was weighed today and although she has gained back what she lost plus a tiny bit more, HV wasn't happy as she has dropped to the bottom of the % chart.

I explained re allergies, reflux etc and was told that none of these things should cause baby to lose weight and that I should really give her formula top ups even if it's dairy free formula. The HV seems convinced that my supply isn't up to scratch- she didn't say it overtly but I could sense that she just didn't believe me. So frustrated. Feel like I'll be cornered into giving her the top ups after all and once DD's weight is up, they won't bother to help me figure out about her allergies.

Push for a dietician referral.

My son had terrible weight issues and I was told to top up. No one ever believed me that he's puke up the formula (we did a separate formula feed rather than top up) but never my milk.

We finally saw a dietician at 16 weeks who diagnosed CMPA. We got some hypoallergenic formula which we continued to combi feed with. We also started solids soon after under her guidance.

My son is still allergic to milk but as soon as we started solids his weight improved loads

Hi @Twizbe
She's already been diagnosed with CMPA by the dietician but HV still fixated on my milk supply. We suspect a possible egg allergy too so I'm eliminating that next to see if DD feels better. I too am hoping she starts gaining better once on solids

@LuchaGarcia

Hi *@Twizbe* She's already been diagnosed with CMPA by the dietician but HV still fixated on my milk supply. We suspect a possible egg allergy too so I'm eliminating that next to see if DD feels better. I too am hoping she starts gaining better once on solids

My HV was the same. Tbh once we were in process with the dietician I stopped involving the HVs. Especially when one told me off for early weaning.

Silly question but can I do that? I've booked a private paeds consultation with a paediatrician who specialises in allergies partly just to get the HV off my back. Can I refuse to see the HV once I see him?

@LuchaGarcia

Silly question but can I do that? I've booked a private paeds consultation with a paediatrician who specialises in allergies partly just to get the HV off my back. Can I refuse to see the HV once I see him?

Yeah, you're not obliged to see a HV.

With my daughter I only went to one weigh in. She is the opposite to my son and the HV didn't believe me that she was EBF because she was too heavy to be breastfed ....

I sacked off the health visitor under similar circumstances. I think she realised i had lost patience with her and stopped contacting me but it could have been that I asked her to refer me back to the breastfeeding specialists at the clinic instead? They were much more reassuring and said that if the baby is sticking to a centile line (any line) then no problem regardless of which line they started on and how big a drop that was. Apparently birth weight and growth charts aren't from the same data set anyway.

@LuchaGarcia you never have to see a HV. It's a service offered to parents. You can opt out.

I was going to say go private if you can afford it.

@WankPuffins had an appointment with a paediatrician today- theyll be running further tests on DD while another dietician goes through my diet in more detail to see if I'm missing something by accident