second child failing to thrive just like her sister.

[beanymum]

My 16 wk old daughter is now on the 2nd centile line (75th at birth) and I have been told in no uncertain terms to give her a bottle by my doctor. The odd thing is that her older sister followed exactly the same pattern and I ended up giving her solids at 16 weeks (which did increase her rate of weight gain). I want to wait before giving solids this time and feel I have to top up. I just wonder if anyone else has had this happen to them of knows why it would occur. Both girls are happy, healthy children and with my first I did all the things to increase milk supply etc. but it didn't seem to do any good. It would be nice to talk to anyone who is going through the same thing and is reluctant to add formula feeds. I am so scared my supply will go down and I will end up giving more and more FF.

Is your doctor using an up to date chart for breast fed babies? Lots of people will advise, Good luck with your dd.

Yes - BF baby chart but wt gain so slow would not really make any difference

My ds1 was always around the 9th centile and I had all that pressure too and he is a big strapping 3 year old now. Obviously you need to consider the medical advice but bear in mind those charts are not really correct for bf babies as they are based on expected weight gain for formula fed babies not bf babies. They have actually been replaced by better ones by the world Healt Org for bf babies but the red books still have the old ones. If your first daughter has grown up happy and healthy I would have though there is possibly no need for concern? (though I am not a doctor obvioulsy) and if both have been similar weights/patterns perhaps it is genetically how your children are meant to be? Are you petite or slight frame maybe?

I thought that nowadays most health visitors would say if they are happy and developing well - meeeting milestones like rolling over etc then there is no need to top up?

x post on the charts - someone on here has a good link to the WHO cite with the correct charts - might be worth checking your doctor knows about this.

my second daughter was also classed as 'failure to thrive' - she was born at about 50% centile and dropped below the 0% line, and hovered around 0 for her first year. I didn't do anything differently with dd2 from dd1, and I weaned her later ( closer to 6 months but dd1 was 4 months) I listened to hvs and paeds and duly had her weighed every few months, she even had blood tests twice.

I did give formula, but not because I was told to, and I didn't until she was about 5/6 months - she didn't go up the charts once weaned either.

fast forward to when she was about 13/14 months, took her to be weighed as wasn't sure she could turn around in her carseat (she was rear facing for a loooooong time!) and there was great concern that.........she was now gaining weight too quickly as she was now at about 12% and I should have her monitored every few months
ffs I though and she hasn't ever been back!! nor do I take dd3 to any clinics for weighing etc etc.

you do have to go with your instincts, but also have other things ruled out that might be out there. but don't stress, and you've been through it with yhour first

dd2 is slightly plump now with the most gorgeous pot belly - she is almost 3 now

Me and DH are both tall and I'm certainly not small. But MIL and SIL both short and SIL very slim. Would like to think it's genetics but doctor hasn't mentioned this. I do have the new chart in my red book if i'm not mistaken.

I don't think you would have the new chart unless you'd downloaded it from the WHO site and put it there yourself - as far as I know the NHS aren't using them yet - unless your doctor is a private paedritician maybe.

I agree with the other posts - if she seems happy and lively I would tend to take the advice with a pinch of salt - obvioulsy being aware of ruling out any medical conditions - with the benefit of hindsight in my case of course.

Saying that I finally gave in and gave ds1 1 bottle of formula a day at 5 months and I still managed to bf for a year - made no difference to the charts either, so maybe it wouldn't be too bad. Only if you feel comfortable though.

Has anyone got any tips on how to top up best to avoid dd taking formula in preference to breast feed. Doctor sugests give one 6 oz bottle but saw a midwife at a bf session today who said it would be better to top up in small amounts after two or three feeds during day. Would like to ditch bottle ASAP.

thanks for advice barbamumma - will look for new chart tomorrow.

beanymum, I also bf dd2 til about 13 months, giving her a bottle every now and then didn't mess up my supply at all

Top up only after a bfeed, and vary the feeds when you do it so your DD doesn't expect a bottle and feed less from the breast (as my DD did).

I mix fed for FTT from 7 to 14 weeks but managed to ditch the formula in the end, once I'd got my confidence back up. It took me a couple of weeks of constant feeding and night expressing before I got my supply back, but I managed to hold out to 25 weeks before weaning and am still bfeeding now 2 years on.

With hindsight I realise I could have avoided the top ups if I'd had more support and hadn't lost my self confidence, also because my DD never really gained much weight with the formula anyway (she averaged 100g a week). I have since discovered that my DD is a slow gainer, 2 years on and she's a skinny minnie despite having an appetite like a hefty horse, but then you don't know these things when they're newborn, do you?

i'm in no position ot offer advice but i can empathise. a very similar position with 2 dds following almost identical weight gain patterns (fewer weighings w/dd2). i would say the main difference with your story is neither of my dd's have been particularly happy with it. dd1 a round-the-clock-colic baby, followed by constant feeding, dd2 a super happy easy baby who became v unsettled and frustrated at breast during/after feeds - to my eyes clearly hungry (btw this v truncated version, not asking for any advice myself here).

i'm afraid i don't have any answers. have started dd2 on solids this week at 20wks. i wanted to hold on to 6mo(ish) but i'm more comfortable with introducing solids than formula as i feel it's more complementary to bf and doesn't pose the same danger of bottle preference etc. (i carried on bf dd1 til 14 mo and would like to do the same again). also is something i've done before (intro'd solids w/dd at same age) so am more comfortable/familiar than formula.

i have to say that without a behavioural cue i wouldn't have considered supplementing - am fairly immune to growth charts after first time. but i see an unhappy baby and i have to do something. i reached my own personal limit w/making bf alone work and i remember how much dd1 settled with solids, so that's the way we've gone.

i wouldn't presume to offer you any advice all i can do is share how it's been for us. i do at least understand how difficult it can be to be stuck in the middle between people who disapprove because they believe you're starving your child because of some need you have to prove you can bf and those who disapprove because clearly if you just tried a bit harder and were a bit more committed/relaxed/supported/educated you'd be able to exc. bf to 6 months cos it's so damned natural

heh, that was cathartic i hope you find peace with whichever decision you make.

Hang on, she's happy and healthy, presumably producing plenty of dirty nappies and following the same growth pattern as her sister who is absolutely fine... why exactly are they harassing you into topping up?

Someone has got to be on the second centile, it's not a race to the 50th (or 100th)! They show the normal distribution of weight in the general population of healthy babies - some will be on the 22nd, some one the 52nd. Unless there are clear indiciations of failure to thrive - unless she's not 'doing well' then what exactly is the problem?

thanks for advice. will post later when dd1 not here to play with computer and dd2 not wriggling.

puppydavies -actually your two sound exactly like mine - first was very colicky and did seem hungry but second is very happy but does seem a bit fussy when at the breast and after feeding (will not take extra feeds if she doesn't want them but also fusses as if still hungry after some feeds and at night. I also started solids early with dd1 but want to hold out for a bit now.

edam - The problem isn't that she is on the second centile but that she has fallen through a lot of centile lines. The doctor said he would be happy if she maintained the 2nd centile.

Have managed to give her bottle today - 4oz in total but would only take 1oz tonight. Can't say how glad I am at that but was probably because she was very tired.

beanymum i think you should consult a trained bf counsellor not some nitwit in a surgery looking at charts. we all know that gps know nothing about breastfeeding and it is a super easy option for them to say o give a bottle.

why aer you seeing gp anyway, is there any other reason than this crap about centiles?

Hopefully tiktok or hunker will be along soon beanymum, but as I understand it your dd needs to take extra milk if she's to put on weight. Giving formula top-ups is no guarantee she'll get extra as she may well feed from the breast less to compensate. Can you offer extra bf instead?

There aren't extra calories in formula so I can't see that there is anything special about giving top-ups rather than extra bfs? Maybe express if the doctor is adamant about seeing her get a certain number of oz?

second squishie's suggestion of a trained bf counsellor (can you phone nct or lll?) for ideas. tbh babies are often fussy during/after feeds so I wouldn't worry too much about that but see what bf counsellor has to say first

squishie, I was trying not to get dd weighed but hd to go to GP for chest infection. He jumped on me as soon as I came in as HV comments when dd was last weighed was on the screen.

Saw BF councellor last time and am surprised this has happend because have been very careful - switch feeding, emptying breast etc. Have seen no opportunity for supply to diminish. She really doesn't want to take any extra feeds in between - just seems tomake her ratty. - must go to her now as she has woken up crying. Thanks for advice so far.

beanymum - my ds dropped from 50% to 2% over his first 3-4 months, and I think is still there now at 10 months, despite the fact that he was formula fed from about week 6. Formula feeding does not automatically result in extra weight gain. FWIW, db's doctor is not concerned because in all other respects he is doing very well.

oh, and with regards to "extra feeds" - never worked with my ds - he just wasn't interested.

My friend's dd was very similar and the HV and GP put her through hell demanding all sorts of tests for her dd and guess what - she is now a happy, healthy child, notihing ever wrong with her at all!

If you are personally happy how she is growing (and it sounds as if it is 'normal' for your family) then ditch the GP and do what YOU want.

Do not feel forced to formula top up if you do not want to - maybe look at ways to increase your supply, can you express overnight for a bit maybe? I definitly agree that a trained BF counsellor would be an excellent idea if you find one.

But honestly, the GP and HV only know 'average' and generalites, you know your baby better than anyone else.

Don't know anything else about this, but on a video lent to me by the BF support group, it showed top ups being done through a little tube with one end in a bottle of formula or ebm and the other end in the baby's mouth while she was feeding at the breast. It was an american video but maybe its worth checking out if you're concerned?

pdt -did this with dd1 (called a lactation aid i think)- very time consuming and now that i have a toddler too even expressing is too time consuming. will have to take bottle option. at least dd2 has been bf for nearly 4 months.