ok, i simply have to share my experiences on this one, could write a book on it (going to be a long one here, sorry but feel so passionate about the subject)
i had dd 6 weeks premature and she weighed 3lb 4oz, the tiniest creature i have ever seen. the hospital was very very supportive about breastfeeding (University College Hospital, London) neonatal unit is brilliant and dd was fed breastmilk through tube for a few weeks. She did so well that she was released from hospital at 3lb 10oz.
Came home and had the health visitor visit every week to follow up. HV suggested i give a bottle of formula milk because dd was on the lowest line of the growth chart (0.4%). i wasn't too keen to introduce formula because history of allergies on my side and asthma on dh's side but every week HV came she kept on mentioning formula and the fact the dd hadn't pushed onto the 2% line (making me feel very inadequate and selfish for not introducing formula).
I had a follow up appointment at UCH where I asked the pedeatrician (sure sp wrong, will refer to as pd) whether i should introduce formula, his response ... no, if one can continue with breast than breast is best, especially for premature babies. HV called me to find out what pd said and when i told her it seemed she was a bit offended and said 'yes, breast is best but not where one isn't getting anough calories.'
Next, dd was due for her 6 weeks check up at doctor's and here I was told that she is really tiny for her age, most babies MUCH bigger by this age, and i should introduce formula because it may impact her bone development. I had a panic attack and felt sooo selfish for pursuing with the breastfeeding thinking i may be affecting my baby's physical development.
Decided to call UCH and take advice from pd before giving the bottle. When pd heard what the doctor said she became really irate and said 'oh, for God's sake!!' (which i interpreted as this advice on bone developement is pathetic!) pd advised me not to give anything until hospital had a look at dd. When pd saw dd who was smiling, talking and having a whale of a time with pd, she said to stop weighing dd every week and only every 2 weeks. she then sent the most wonderful letter to my doctor and HV saying that dd is a happy alert baby who is right on target developmentally. She made a point of writing that she advises not to give formula but to rather introduce solids as soon as dd is ready. i have been back to pd again since and now she has advised that dd be weighed once a month! She has been very happy with my dd putting on about 4oz a week and being on the 0.4% line on the chart! She made me feel so proud about the fact that dd has tripled her birth weight in 4 and 1/2 months although she still only weighs 9lb 5oz. What matters here is that your child be growing along his/her own growth curve and not those lines on the chart.
So many mothers give up breastfeeding because they are made anxious about their child's weight gain and those stupid charts, I have been shocked with the lack of accurate information about bf and the tendency to push formula at the first sign of a hurdle with bf. Anyway, hope this helps some of you who want to continue to breastfeed. I also contacted La Leche League who were brilliant and sent me lots of helpful pamphlets.
It all sounds so easy as i write it now but to reject the advice of your HV and doctor and persevere with bf was one of the most difficult challenges in my life so far. I lay awake night after night wondering whether I was pushing my own agenda and neglecting the well being of my child. Anyway, to end this story of mine i think bf poses a lot of challenges but once you have crossed all the hurdles it suddenly all falls into place and works beautifully.
Finally, the lesson I learnt from this experience .... always go with your own instincts and make the decision that works for you!!!