"Failure to thrive" - hints to make milk fattening!!!

[BWMum]

Please help!
My DD is 14 weeks old. She weiged 3.6kgs (8 lbs) at birth but has put on weight very slowly since then. She was last weighed at 8 weeks and weighed 4.5kgs, now had her weighed today for first time since then and she's 4.975kgs. So in 6 weeks she's put on 500g-odd and has dropped 2 lines on the growth chart.

The nurse said I need to think about topping up with formula. I am really reluctant to do this. Apart from not meeting the line on the chart DD is a very happy girl. She smiles and laughs, eats well and seems to be developing at the same rate as other babies her age. So I don't feel she is "failing to thrive" - perhaps only failing to get fat! However, I don't want to put her health at risk. We agreed to give it a week with me topping up with expressed milk - I get about 2.5oz a day. If she hasn't put on 150g - 200g by next Mon we will have to top up with formula.

Anyone been in a similar situation? Ideas for "fattening up" my milk? I have gall stones from pregnancy (which is very painful when they move around) and have to follow a low fat diet until I have my gall bladder out so pigging out on icecream and cream buns isn't an option. Would a calcium supplement help?

Thanks in advance for your help!

I had similar issues when my DD was a little younger than yours - lots of pressure from HV, MiL & even DH about giving formula. I checked out with our GP (who was very supportive) that she was healthy, chatted with the NCT breastfeeding counsellors, and added in another feed when she usually didn't ask for any milk as Tiktok suggested, and generally fed her as often as possible. This seems to have done the trick, she's still light but following her percentile so everyone's happy.

Starlight - thanks for your suggestion about increasing feeds. Stupidly, it hadn't occurred to me that every 3 hours might be too few!

I've fed DD more often today and woke her up just as I went to bed last night to give her an extra feed. So, about 24 hours in I have naturally come up with some (probably dumb!) questions.

1. At her evening feed DD wasn't very interested in one side, which does feel very soft. Presumably my body will just "catch up" with the extra feeds so there is something for DD?

1. I've been expressing because I'm storing up milk for when I go in to have my gall bladder removed. So I thought I might use up some of my store now by giving DD extra in the evenings after she's fed from me. How many oz would a "top up" be - 2 or 3oz? I know some thought bottle top ups weren't a good idea and I should top up by bf to increase my supply, but what about if I'm feeding more and topping up?

Thanks also for the bf links. I've found the number for the local La Leche League here in South Africa and will get in touch with them to check latch etc. Just takes so long with the dial up modem we have here - takes 10 mins to navigate to this page from the minute home page! I do miss my broadband!

Thanks Starlight. I do offer DD both sides at each feed and she always seems to want both, although sometimes a bit less from the second side.

I had a real boost this evening though. My mom chose to ff both my brother and I and says she'd do the same again if she had a baby now. So not the world's biggest bf supporter! Tonight though she told me she thinks DD is fine and she doesn't think I should give her formula. In her words "what would formula do that your milk isn't?". And she brought it up herself, not on my prompting.

Hi BWMum, it sounds like everything's going really well and I'm glad to hear that your mum's being supportive. Do carry on coming on here if you need backup, and I hope it all goes well next week.

BWmum, if you do decide to top up with EBM, offer 60mls (2oz) to start off with, see what she does with it. The good news is you can keep EBM that you've offered but she hasn't taken - it's ok at room temp for 10 hours or so, and in the fridge for 3 days. So you don't have to worry about wasting that precious stuff.

FWIW, I did everything i could to increase my supply but it wasn't enough and my dd did need supplementing. Mostly via EBM - I pumped all the time and it was pretty tough - but I also had to give her formula which upset me at the time but now I look back I'm glad i made the choice to give her what she needed. She fell to the 2nd centile and she's now on the 75th at 7 months, and looking at her it's clear that this is more where she's supposed to be.

So if you do choose to supplement, try not to beat yourself up about it. You just need provide what your daughter needs to grow, however you do that it will be the right answer for the 2 of you.

Haven't been able to post for a few days - we're having power cuts here for 4 hours at a time which is NOT fun!

I've stuck with feeding DD myself only although added in an extra feed just as I go to bed. I gave her a top up of EBM one night but she wasn't very keen - arched her back and wriggled a lot. And since my formula-fan mom and completely clueless but well meaning dad have both taken me aside to say they think DD is fine and I shouldn't get worked up over a mark on a page, I've decided to just leave us doing what we were.
Only real bother is that DD has started waking a lot more in the night than she was before (barely goes 4 hours now), but might not be linked at all.

Monday is d-day and I really really hope she's put a bit on. They weigh the babies with their nappies on here so I could always slip a few stones into her nappy to weigh her down....!

Thaliablogs - thx for the info on how long the EBM will keep. I always feel very annoyed if I have to waste my hard won milk!
I still honestly believe DD isn't underweight - she has a small head and little hands and feet - but if there are any signs she's hungry/not thriving on bf only then I will top up with formula. It's just that I don't believe I've seen any such signals and the nurse couldn't tell me anything either (started talking about impaired brain function in malnourished babies - which is absolutely not us).

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bwmum it sounds like you are doing really well. I would echo what verylittlecarrot said-these health professionals could ruin your breastfeeding with ill informed suggestions and not give it a second thought.
La leche league or any of the breastfeeding organisations will give great information and support.

Don't be bullied, and you don't need to do anything you don't want to. Just don't go to get her weighed next week - that is what I started doing. Then she can't interfere.

Are you getting enough rest? Personally that is what I think forced me to give up, I just didn't have enough rest and my milk was just not enough for my DDs.

I would try the babymoon that someone mentioned, and the referal to a peadiatrician if they are pushing. And of course, the normal checking the latch, to ensure the baby is getting the hindmilk - i.e. the fatty stuff.

But DO NOT follow her advice about topping up if you want to carry on and you are happy that she is coming on fine.

How did it go today BWM ?

Da dada daaaaaaa!!!!! 125g in one week!! We are officially off the hook!
Done with bm only, although I did give her two 2oz top ups with EBM - one on Sat and one on Sun just to try ensure we met the target. Don't need to go back to the nurse here at all and we don't see the HV back in the UK until she gets her jabs at 4 months. So lots of time to get back on the dratted red line!
Cmot - thank you so much for remembering about us!

[Dances off to get box of choc biscuits to celebrate...]

Whooot ! Go girl !

Chocolate is an essential part of the bfing diet you know