What can a HV "make" you do?

[Hadeda]

My DD has slow weight gain issues - I've posted about this before under the name BWMum.

Well, was just at HV to try to talk about weaning (she's 23 weeks). Different HV was there and naturally just wanted to focus on the weight gain issue.

DD is currently 12.3lbs (dropped to just above 0.4th centile but has stayed there for last 2 "weigh - ins"). She is still gaining weight - and actually gained quite a bit for her over the past month. But HV of course first off advised me to top her up with formula. Been there, done that - I said I don't want to do that. So got full lecture about how I must have poor milk supply (no one has ever check if this is actually the case, I just get told it every time - except by the BF counsellor I saw) and that slow weight gain can affect DD's brain development (thank you for the free guilt trip). Then said if she hadn't stayed in that centile "I'd insist you topped her up".

We are seeing the paediatrician on Friday about this issue but I really don't expect him to find anything wrong with DD. She's like so many of the slow weight gain babies here - happy in herself, producing wet and pooey nappies, meeting the milestones but just not meeting that chart. So, unless paediatrician says there is something wrong can the HV really insist I give formula? What would she do if I didn't - refer us to social services or what?

AN, Milk has more calories than food anyway, a lot of babies will slow down their weight gain when starting on solids if they decrease their intake of milk too. (obviously best way around it is to offer the breast before any solids but if baby gets full up for longer with the solids it could cut down milk feeds)

Starlight, can you do me a favour? I'm off to eat my dinner soon, can you just put

Re: Charts.

When my DD was having weight issues, I was going to the surgery every other day to get her weighed and was generally frantic about it all. (my health visitor had to tell me to only get her weighed every other week for my own sanity)

My health visitor showed me another chart based on breast fed babies and we plotted DDs weight which still followed a similar line, but nowhere near as far down the scale.

When DS was born with low birth weight, I asked if he could be monitored on this chart and was told it was a trial and the red books would be revised. I don't know if this is true or not.

mom2ava, please read my link.
It answers your most recent post.

At least it's because you don't care enough an not because you aren't clever enough

My totally uneducated response is that if your DD is 23 weeks and her only 'problem' is maintaining a low centile line and she has been more or less exclusively breast fed your milk supply can't be that poor.

Thanks VS - put me in MY place. Just relaying my experience, but clearly you've got it under control.

"was just at HV to try to talk about weaning"

Presumably the OP wants to start feeding food. So, why not????

It's a tad early for weaning, and weaning will not address this possible issue of low weight gain. Maybe the baby's growth is fine - the paed will have a view on that.

But solids don't give the baby extra calories at this stage. In fact, they might even ensure the baby's net intake of calories actually lessens - and that's explained downthread.

Hadeda, if you say that dd is happy in herself, meeting milestones and crucially many wet and pooey nappies, I can't see any issue with your milk supply.

Byall means offer the breast more often.

I have been through the whole rigmarole of a slow weight gain bf-ed dd, HV, paediatrician, dietician ...
If your dd is physiologically small, going on formula is not going to make much of a difference besides possibly making your dd fatter and increase her risk of obesity re: formula. I wish I could take back the months I spent 'forcing' fortified formula into a screaming dd who wanted none of it on the advice of HV, dietician etc.

It made absolutely FA to her weight gain.

When I finally told the health professionals to bog off at 5 months and went back to exclusive bf-ing, dd and I were never happier. hth

Interested in the comments re solids - I wanted to find out about weaning as we're 3 weeks off and DD managed to eat some carrot yesterday (stolen from DH). My HV said we should def start weaning now to deal with slow weight gain as I'm refusing to top up with formula. I understood "food is for fun" until they're one, and (as the posts here have said) that milk has the most calories. So do you think waiting the extra 3 weeks to wean would be ok?

Hadeda, waiting for weaning for three more weeks would be fine, IMO.

SA said on this thread weaning can decrease babies milk intake, which will in turn decrease babies calorie intake.
Babies do not need food at this age, the guidelines of weaning at 6 months are because at this time baby's guts are no longer permeable and therefore are able to eat solid foods safely, before this time (between 17-26weeks) some babies will be ready, some won't, so to avoid risking your baby not being ready the guidelines say 26weeks.
However it has also been suggested that once a baby can physically feed themselves, i.e can sit up unaided, pick up food, manage t get that food in their mouth, chew it and swallow it then it's pretty likely their gut is ready, so if your DD is doing this then it's very possible she is physically and internally 'ready' for food, not needing but able to digest, from then the first six months, at least of weaning is meant to be purely to introduce LO to new flavours and textures.

Have you seen Aitchs blog? it's full of great weaning info and also has a forum on with otehr mums going through the weaning process.
HTH

Hadeda, weaning also made no difference to my dd's weight gain. Her growth was slow and steady, but on the same line. You are right that breastmilk has more calories than solids and more importantly, is more readily and efficiently absorbed by your dd's body.

A lot of babies don't take to solids right away, in any case. My dd was 8-9 months before she was eating anything more than negligible amounts in purees.

I would say wait 3 weeks whilst offering the breast more often, even co-sleeping and feeding at night, if you have the appetite for that

It would be obvious to your paediatrician if your dd was dehydrated.

As said not SA said.

SM.

Hadeda - how active is your dd? I'm just asking because virtually the same thing happened to me with my dd (now 2!) She dropped 3 curves I think (?) from around 5 months - cue heaps of hv pressure for weaning, formula top-ups, and once weaning started getting her to eat more food-wise (slow weight gain went for quite a few months - can go and get her book and check her weight at various ages if you like!) I was very stressed about this and spent a lot of time in tears (didn't know about mn then unfortunately). I couldn't get her to take a bottle or a cup and she hardly ate a (solid) thing until about 10 months old - just bf round the clock. Anyway, at her 1 year check at the dr's, the dr was lovely and noticed that dd was very energetic and active and asked if she'd always been a bit like that. I told her that dd had started commando crawling at 4 1/2 months and proper crawling a few weeks later and was constantly on the go - funnily enough, around the same time she started dropping those curves. The dr said that could be a reason why dd had been slow to gain weight, or it could just be that that is how dd is (or a bit of both), and that a thriving baby is interactive, generally happy etc.

As it turned out, dd was bf until about 14 or 15 months and is petite even now, but eating well, healthy, happy and I don't have any hv's on my back

I'm sorry about the guilt trip etc you must be feeling - it's only a year and a half ago that I was exactly where you are now - but I just wanted to add another 'success' story.

Hadeda honestly we were in the same boat - just feed, feed and feed some more, that's all that's needed more than likely. But we did go to see a paed too, and it just put our minds at rest that dd was totally fine on breastmilk, so might be worth getting referred if only for that reason. Re food etc this is good info: here and for the calories etc compared to breast milk here

Ok, have just read through the thread now (people post so fast - or maybe I just type so slowly?) and second the 'feed, feed and feed' advice. It sometimes felt like dd was feeding like a newborn.

Caz - that's an interesting link (the second one) - I actually had no idea that breastmilk contained more calories than formula.

loving your name!!

It drives me MAD the way these HVs are supposed to be advocates of B-feeding but they are soon very quick to suggest you shove a bottle in a baby's mouth as soon as they don't grow as a piece of paper says they should!!!

I have just finished b-feeding my girls (now 7 months) because when I started to wean them my milk supply dropped completely and the milk they were getting wasn't even lasting them an hour so I would say that I totally agree with everyone else on here who suggests that you try to feed slightly more to increase your supply and to get a very little bit at a time more inside her..... you can't force a baby to feed; if they are not hungry, they are not hungry... simple!!! They will just end up getting sick if you try to feed more than their appetite and then the weight gain really will drop off the charts.

How often are you feeding your baby?

Thanks (civilised waking up times seem like a distant memory)