Will I be reported if I refused to put Callum on formula??

[sparklygothkat]

The SCBU nurse just phoned me and said that if Callum hasn't gained weight in 2 weeks, I have to put him onto formula. Apparently the consultant has said this.
I have 30 bottles of high engery formula here which I still haven't given to him (am supposed to topup with 30ml once a day via the feeding tube) but I really really don't want him to have formula...
If we refuse, will be reported to SS for not doing the right thing??

but why doesn't he gain enough without the tube.. is he just not taking enough?

Is his latch definitely OK, sparkly? If he's sucking inefficiently he could be burning calories while feeding without taking enough in? Might it be worth seeing a lactation consultant to check it out? Mind you, 2oz is still a gain, and I'm sure his weight can fluctuate depending on what's in his bladder and digestive system.

yes latch is fine, he fed at clinic and HV came over to check his latch and heard him gulping down his milk

Is he having a growth spert (sp).

thing is that the milk isn't going down the ngt tube, it can take 1 hour sometimes to get 50mls down.

Hi SparkylGothKat,

I just wanted to lend my support. My DD2 has been thorugh very similar things to your DS for different reasons (she was born with a major abnormality). She had an NG tube for many moons and I fed her EMB. Weight gain has always been an issue with her and she dropped from the 50th centile at birth to the 2nd where she has just about bobbled along.

We were given a milk supplement for DD2 as she was having to use so many calories in recovering from surgery etc. (This was within the last two years).

NG feeds are a pig - I well remember those night time tube feeds which seemed to take hours and were a stark contrast to the lovely cuddly breast feeds I used to give her big sister. I did however become an expert at making sure that DD2 couldn't pull her tube out with those tiny fingers...

Good luck. I hope that your DS does well.

Patsy x

Thanks PC, I have found that babygros with roll over mitts stop him pulling the tube out, but as soon as we take them off for bath time the tube gets pulled out..

I am seriously thinking about the formula now, but will I regret it?

yes i stopped bf dd at 6 weeks and still regret it i didnt get the support you have and didnt know about mumsnet then
keep trying if it is what you want to do!
also take hi to get checked out if you are worrying theres something wrong!

I am thinking about just topping up with the formula, and still breastfeed every feed. I know there is chance he will be sick on it, but atm I am getting so worried about it that I know that I may have to do it.

I know I am going to moaned at by the consultant for going against his advice.

sparkly, I really feel for you.

When a baby who is being responsively breastfed, with no restrictions on timing or frequency, and being given
'extra' ebm, does not gain weight as expected, there are four possibilities:

1. the baby is growing physiologically, ie the growth is normal for that baby

1. there is something organically 'amiss' in the baby such as underlying infection, a heart defect, a rare and non-obvious metabolic disorder

1. the breastmilk supply is maxed out, because of a difficult start (there is some evidence that capacity is calibrated in the first weeks, and for some women and babies, that might mean supply is capped at a level lower than the baby needs)

1. the baby is not transferring milk as effectively as he should be because of less than optimal positioning and attachment

It's only in scenario 3 that formula would be appropriate, and even then you would have to factor in the known risks of formula, your own preference to bf exclusively and the possibility that the cause of his slow weight gain is really reason 1.

Reason 2 would almost certainly show up with other symptoms by now, including weight loss.

Reason 4 needs an experienced person to judge.

Does any of that help?

where can I find a breastfeeding perosn to come and check his latch and position?

Ring one of the lines Sparkly.

Should i phone the ABM lady, she gave me her direct number but she lives quite far from me, at least 1 hour

They have a rota for answering calls so if you ring, thry might find someone who lives near you or hopefully point you in the right direction.

0870 401 7711

tiktok, sparkly is expressing and breastfeeding so doesn't it seem unlikely that her supply is "maxed out"? After all, he gained 9oz last week just on her milk alone whether by tube or by breast.
sparkly, I would feel that you should only go to formula as an absolute last resort. He won't make the same gains every week. Would think a second opinion on the latch might do no harm either.

my supply is fine, apart from the low supply on my left side, but the right side is full all the time and can express 300ml a day for him from that side and still feed him.

I agree - I think scenario 3 is unlikely. I wasn't 'diagnosing' anything! Those are the four reasons why a baby may not gain weight, and sparkly, you can work out which boxes you tick. If your baby is having the breastmilk he seems to want, and then some more, but is not gaining weight as he 'should' or as it is thought he 'should', how would formula help???

I think its 1 or 2 TT. I am very small myself (4ft 11 and weigh 7st 9) and as a child i didnt gain weight as i should have done. He is now having huge explosive poos, and they are no longer green, so i know he is getting enough breastmilk. And he is alert and feeds well.

sparkly, in my experience, I do come across the very, very occasional baby whose slow/non-existant weight gain is liked with something 'not right', but there are always other symptoms (miserable baby; sleepy/lethargic baby; baby whose weight gain turns into loss; baby looks ill to a lay person - not always to the mum, has to be said).

I guess these checks have been run on baby sparkly?

It does rather look as if it is scenario 1, on what you have shared here. But I am loathe to make any sort of conclusion as you have medics and others who can see him, check him, track him, and that is all justified.

But if it is just calories they are worried about, I don't see the logic of them coming from formula, given he has breastmilk ad lib.

the consultant checked his heart, lungs and muscle tone. he does have another cold (3rd one since he has been home) which does worry me a bit, and he does sleep a lot, but so did dd2 and she was premature too.