all ye women with slow-gaining babies... come and sympathise with Aitch here please...

[Aitch]

oh bloomin' heck. she's only put on an ounce and a half in 6 days.

I know it's not the same as dd was not prem, but she was so slow to gain at the start, 1oz in 18 days at one point (eeeeek), but she caught up in the end.

eeeeeeeek. did you top her up? i'm getting told to give expressed ebm beforebfing, which seems arse about face to me.

thats ok though isn't it??

i thought that babies were "allowed" to lose a little of their birthweight in the first few days, nd then were going in the right direction if there was some weight gain after that??

maybe its different if your bubba was prem?

she's not losing weight...is your mw/hv/doc concerned?

my ds was slowwwwwwwww to gain all over the first year. i was treated as if i was withholding food from him, so you have my sympathy...hope you're doing ok.

try not to panic, know it's hard not to, but she will get there. DS & DD were slow to gain weight until well over 2 months old, their curves didn't match the lovely exponential type shape of the ones in the book...but once they started they got there... (DS was around 25th centile and followed that from around 3 months old after an initial dip, DD fell down to 0.4th centile (but due in part to her CF) then gradually crept to 25th, sat there for ages- then once they both hit 1yo they both shot up to 75th centile)

How's the feeding/expressing going? Trust your instincts if she seems alert, happy, settling well after feeds (even if not for long), plenty of wet nappies etc. you're doing fine. Remember the effect of her cold will take a while to stop affecting her "scope for growth"- once she's well clear of that I'll bet she'll start piling it on.

My only tip would be try to get them to feed for over 15 mins on each side (by all means necessary, e.g. keeping her cool, tickling cheeks etc) to make sure she gets plenty of hind milk...But sure you're doing that already...
Realy feel for you x

am shocked they suggested offering bottles of EBM first- if your DD2 is anything like mine they'll down loads quickly, fall asleep and then not respond to the boob at all. If they want you to top up I'd have though after a BF...surely? Still think if her latch is good and you can keep her awake to feed for fairly long sittings then you shouldn't have to top up..but not a professional here just my opinion... (having not topped up my prems once they got the hang of BFing)

Is she happy and otherwise fine if so then I say 'sod the scales!'

Just got back from getting DS weighed, put on absolutely no weight in a fortnight and has now dropped from well over the 75th to just under the 25th . He has been feeding almost non-stop for 48 hours so where is it all going? ARGHH.......

If it's any consolation, both my daughters (now aged 11 and 13 and in thumping good health) gained 2oz week from birth. If she seems alert and otherwise healthy (enough wet nappies a day etc) and is (broadly) meeting her milestones, please try not to worry too much.

she's only little isn't she - it's early days isnt it?? Maybe she is still getting used to bf and your supply is still regulating. I know you have to be careful when they are really tiny, but as somone who had 2 bf babies who were constantly around the 6-9 percentile and are now massive, chunky, boys I am tempted to say trust your instincts too. As long as she is alert, pooing, not dehydrated seems a bit premature for topping up. I do sympathise, the HVs were always on at me and honestly, if you could see the size of my boys now and how much they eat you'd laugh! I think bf babies can follow a different pattern from what the charts etc suggest. I think ds2 had a few weeks early on when he put on nothing (though didn't lose) when he had a cold and was snuffly. All worked out in the end. keep an eye on her and offer boob a lot is what I would do.

maybe check nothing like tongue tie going on which might be slowing feeding down?

Also, I thioughtitwas best not to express in the early days so your milk supply settles in naturally without getting "fooled" by the extra demand. I wouldn't do EBF. She is your second child right? (sorry can't remember)

Hi Aitch,

Sympathy with your LO. My DD was slow to gain weight, though not premature, indeed HVs still get very antsy about her 4th centileness. But she is a very healthy, happy, smiley baby so I'm beginning to think (at 9 months today)I just don't care anymore. (Proof of general well-being on my profile!)

But it's not a nice feeling at all and I sympathise.

She is gaining weight, so well done! We did top up but AFTER a feed. To give her a bottle before sounds like craziness to me, unless you want to bottle feed? I think, on this trust your instincts.

When Dh and I were in the middle of all that craziness, he did a little experiment as my bf was being seriously undermined by HV. DD was weighed every four days, so we did formula top-ups for four days and then breast milk for the next four days and she put on double with the breastmilk which made DH and I relax, stop agonising over strategies etc and do what we wanted (which was to give formula at times BTW). Maybe a little experiment along those lines of your own?

I feel for you because I found it so rotten. But the 'proof'we had of the way we wanted to go made us feel stronger.

Both your DCs are delightful, BTW. Had a nosey.

DD lost nearly 1lb in first week of life, put on 7oz for the next 2 weeks after that then only put on maybe 2oz a weeks for a couple of months after that. I was demented with worry, particularly as new Mum and Fucking stupid HV (sorry about the language- but it still makes me mad) taking about failure to thrive like I was some kind of abuser. .

In desperation I tried to 'top her up' with a bottle which she refused and it then made me want to give up BF to at least be able to monitor what she was getting. I ended up putting her on solids far too early and continued to feed her until 6mths. I now have a healthy 4.5 yr old who sadly has real issues with food that I firmly attribute to my anxiety (compounded by her overly anxious father indulging her as and when, to get her to put weight on).

DO NOT stress too much about this- I firmly believe that some kids don't pile the weight on as they don't need to. If your wee one is growing (length/ head) and is still gaining then it may be that they are super active (as my DD was- walked at 8 1/2 months), or are just not fitting in to the 'normal' limits.

Don't know if prem babies are different (is yours prem?) but I really think you shouldn't be too concerned. DS (BF) put on nearly 1lb a week at one point despite arriving as a tiny baby (DD 9lb). They are all different.

Grrr it's that 'easy to know how much they're getting' line peddled by HVs about formula that drives me nuts. Sorry, will get off high horse and leave you to your thread

Hi Aitch, you probably know this - lots of wet and dirty nappies, baby well in herself. I do a sneaky check of the fontanelle to ensure no signs of dehydration. If everything is ok, then you are doing just fine - keep offering the breast more and if you like, co-sleep and breastfeed at night.

Top ups are unnecessary and counterproductive to successful bf-ing.

My dd was and remains fabulously svelte. One week, she actually lost weight (could she have done a poo just before weighing?). HV panicked and forced me to drop everything and take her to A&E. What an utter waste of time and trauma for my dd.

Have they given you a reason why the top up should be before the bf? Because it does seem a bit odd unless you're finding that she's really sleepy and needs to get a bit in first to give her a bit of energy to get going (I have no idea if this is a reasonable inference, just trying to think why they might suggest that).

Or do you think they maybe know nothing about bf and are just gunning for the measurable intake thing that HCPs are obsessed with?

Sounds like you could do with questioning them over this. Am away to see what library book on feeding prem infants says about topping up.

Couldn't agree more LaTrusha, but sadly only learning th3e hard way and making my and everyone around me's life a sodding misery. Now have FAB HV who knows her stuff and doesn't ever talk pish or scaremonger. What a difference.

aitch, sorry you're going through this, it can be so worrying trying to work out what is best for your baby.

If I remember rightly didn't sparklygothkat have a premature baby who was a little slow to gain, she may have some advice.

My baby was slow to gain and my health visitor kept telling me to top up. I had a different problem as she refused the bottle and therefore all my efforts to get more milk into her. I just latched her on at every squawk in the beginning and if she slept more than 3/4 hours I would dream feed her. She only ever gained about 3/4 oz a week sometimes 1/2 oz. I would try not to worry if she is producing the wet/dirty nappies and seems alert and healthy.

I would think that unless she is too weak to feed or doesn't know how to latch then she will drink as much as she needs. Of course when you have a tiny baby it is difficult to believe this. I would feed her first then top up with ebm. If she is still hungry then she will take it and it can't hurt but wouldn't do it the other way round, seems silly that way, what is the reason they give for ebm first then boob?

Mmm, not much specific. It does mention using a supplementer (that wee tube device) but also states that the evidence for strong, consisten growth as an indicator of health in prem infants is weak.

(book is Feeding and nutrition in the preterm infant by Jones & King btw which you can borrow if you like. I'm on holiday after today but will issue it under my ticket and leave it aside for you if you wanted to get someone to collect it).

No I refused to top up and my hv was shocked and appalled concerned, but as others have said she was happy, settled, nappies both wet and dirty and I just couldn't see any need.

She has mostly caught up as I said but she is still smallish, though she does have the most ridiculously big arse.

Giving expressed bm before a feed is insane surely? After maybe, but if you give it before it will affect your supply.

the reason, OF COURSE, that she suggested topping-up before is that 'then you could see how much she's having'.

grrrrrrrrr

woud be intersted in the book, booky. i fb'd you the other day btw

yes I had the whole "failure to thrive" thingthe first time which of course sneds the fist time mum into meltdown so you do the topping up, bf gets harder - unecessary (sometimes) stress fo rall concerned. At the time I was very angry and convinced it was a conspiracy to get everyone to bottle feed as makes it easier for HVs to measure progress and fit the silly charts (you know these are't applicable for bf babies right and are only based on bottlefed babies).

Second time around I found the HVs more resonable and they did eventually dig out the new WHO charts for bf babies after some nagging and weren't so concerned. i guess they have to upset the majority of us to catch the odd poor baby who does have an underlying problem. I noticed they didnt bany around "failure to thrive" so much anymore either which is good, even though both of mine were 6-9th percentile and are now both 50+. We are all shorties so I am convinced this is why they were always small as babies.

Anyway, early days, I would just get on with as much bf as possible and try not to worry.

OMG this was me a year ago!!!

Do NOT give her EBM before BFs, give it to her afterwards, if she is tiring, then ask for a NGT tube to be put in and use that.

Have to pick up the kids now, will be back later

Aitch just got my book out my dd I think was about same weight as your 4lb3oz.Exclusively b/f till tried weaning (you might remember she was a nightmare to wean) She only gained on average over the first 3 months 2 to 4 oz a week. She is still tiny and at 17 months she was weighed yesterday and is only 14lb 13 oz! Keep feeding, feeding and more feeding she will gain some are just slow at gaining weight! If shes happy, wet/dirty nappies I would keep going unless she actually lost weight then I would obviously look into it more. Enjoy you lo and dont let scales stress you out