So.
Could've been worse, could've been better.
The paed was a kindly, soft spoken chap, who looked her over. I made the poor child perform like a monkey (look, she stands up! look, she giggles! see how alert!) and he said that, whilst very skinny, there was nothing obviously wrong - she looked well.
And we talked about the unlikely causes, he thinks her heart is fine, no sign of a murmur or any problems such as breathlessness. Didn't mention need for ecg or sats. Thinks thyroid problems are very rare and unlikely, but he will test anyway. Wants wee and poo samples, but thinks absorption problems unlikely as no diarrhoea. Checking for infections, anaemia, vitamin deficiencies etc.
And yet, he keeps focussing on the breastfeeding. The infant feeding specialist had clearly brought him up to speed on my feelings regarding formula! He was sensitive and encouraged me to continue bfeeding. So far so good...
He suggested that dd just has a tiny appetite, and has got used to only taking small amounts because her tummy is tiny. Like being on a diet. She perhaps can't deal with more volume. I have explained that she feeds quite frequently, every 1-2 hours during the day, more frequently in the evenings and several times in the night.
But.
Then he started to talk about it being OK not to wait till 26 weeks to introduce solid food. I could wean now if I wanted. And had I considered babyrice?
My heart sank.
And I hesitantly began to explain that I really wanted to wait a couple more weeks, especially since she was born 3 weeks early. And that I believed that babyrice had far less nutritional value and calories than breastmilk. In fact almost all early weaning foods had less calories. And that solids tended to replace comparative volumes of milk feeds so I was concerned that if I shovelled baby rice into her it would decrease her calories. And had he...perhaps...
...heard of baby led weaning?
So I stumblingly tried to do a precis of BLW for him. (I was appallingly incoherent) And I asked him to speak to the infant feeding co-ordinator who knew all about it and recommended it. Gave him the references of Gill Rapley and Unicef. Apologised for sounding like a know-it-all self researching pain in the bum mum. Offered to start expressing again to add to her intake (not that that has ever made any difference and is almost impossible for me to manage).
And watched his kindly smile as he probably thought - God, woman, just be normal, for goodness sake, and get some proper baby food into that skinny child. What is wrong with you, you hippy idiot?
And he says sometimes babies prefer the blandness of baby rice to strong flavours. He asked questions about how babies managed to get the food into themselves with BLW. And I said, er, you kind of have to not worry too much, it's about tastes and experience at first. Milk is the important thing to keep up with. The main part of their diet for their first year.
But if she's not taking enough milk, what then?
And I don't know. Because if I can't get "enough" milk into my baby I have no idea how I would get food into her. So he says we could supplement with ?powders? that were ?like sugars but not very sweet? to increase calories rather than volume. I?m pretty sure we are talking cow?s milk derived, which I could live with after she?s weaned, I suppose.
We agreed another appointment in 6 weeks, and they took her blood - horrid - (I cried like an idiot).
I was feeling very uneasy about how I had ended up drawn into a conversation about nutrition with this lovely but not terribly well read chap and could see that he was concluding that the problem MUST be - Not Enough Milk Into Baby. And there was this worrying thing he said about how if she continued to be such a slow gainer that it could affect her brain development in time. Which I already KNEW but now the words were floating above our heads in that tiny room. Tick tock tick tock - get food into baby quickly. And he waved the weight chart at me, where her little dot sits miles underneath the bottom centile. Although her head circumference and length look fine still.
And I just managed to ask him before he went - would it be acceptable with him, if, provided all the nasty medical things we were checking for were not a problem, would it be OK for me to get my nutritional advice from the infant feeding co-ordinators and dieticians? Instead of via paediatrics? And he said yep. Great, thanks says I. Doctor, just finally, can I suggest tentatively; is there any chance at all that her weight gain is ?normal for her?? And he says Hmmm. She is very small though. Which I think was his way of saying ? nope, no way could a baby this small be normal. She?s too skinny.
Still, hopefully I by going on to the infant feeding co-ordinators I still have a chance of getting feeding advice that won't go against all my instincts and everything I have read up on.
So now, we await results of tests, I go back at the end of February, hopefully BLW will allow me to truthfully say that she?s eating some ?normal food? and we can carry on breastfeeding.
God I need some cake now. And a drink. As I?m sure you all do, if you got to the end of this post!
Thanks everyone for well wishes!!!!