mothers of bf prem babies pls help i am having a freakout

[chibi]

could you tell me how much your bf prem baby was gaining a week in the first few months?

my ds born 34+6 gains 5-6 oz a week. just came back from weighing, saw a different hv who made me feel like this was unacceptable + that i am starving him.

i want to believe i am doing the right thing by bf him but if this is too low a gain, i will switch to ff.

i just want what's best for him

tia

What does the usual HV say about it? Is he following a centile line, even if it is a low one? Was anyone worried before this particular HV said anything?

I can't say anything specific about premature babies' weight gain but if he seems well and active, is pooing/weeing regularly, feeding well, gaining weight steadily and you/other HCPs are happy with how he is doing generally, then do not let one HV who has not been seeing him since birth undermine your confidence in BF.

no one said they were worried before today. this has been his pattern of weight gain for the last 7 weeks. He is almost 12 weeks now (6+ weeks corrected)

i feel like the centiles are like a grading system - you have to get above 50 to 'pass'. by that standard we are failing.

he is having many (>6) very heavy wet nappies a day, is alert + smiley, feeds every 2 hours during the day, every 3-4 at night.

I don't know what else i can do, I am now starting to worry.

I am not precious about using ff, he had all ff + colostrum for the first 2 fays before my milk came in.

i hate the idea that i am maybe starving him and he could be better off on ff. he would certainly be bigger.

please, if anyone has had a prem baby, is this kind of growth normal?

5-6 oz a week consistently sounds pretty good to me. Is he following a centile line ? Half of healthy babies need to be below the 50th centile line - it's the way the charts work

And did she remember to correct your DS on the chart ? My GP forgot to do that, and commented that his weight gain had dropped off until I pointed his mistake out

Oh love

Please do not feel your BM is not good enough.

The centile charts show average growth patterns - there is nothing magic about the 50th centile line. It simply means that half of all babies will be above that line, and half below. Its simply not possible for all babies to be above average, least of all those born over a month early! Seems like maybe this HV doesn't understand how the centile charts work, or that bigger does not = better.

You are absolutely not 'failing' him, or starving him by the sounds of it. Can you get an appt with your usual HV to disciss your concerns?

my dd was the same, but term.

she was born on the 75th centile and by 4 months was on the 9th, where she remained.

i did not enjoy the first 6 months of her life as a result, could only relax once i started weaning + i could stuff her with high calorie foods.

now i feel it is all starting again + i am failing. i feel total dread thinking of what baby clinic was like, praying she'd have put on enough weight, trying to feed her hourly, breast compressions, nothing worked. the thought that it is starting again makes me shudder.

on another thread there are women worried about their fat bf babies. ha.

Is your DS following a centile though, or is he dropping down the chart too?

I nearly replied to your posting on the thread about fat babies but thought it was going off topic, then I saw this thread. I can't believe a health visitor has made you feel like this. Thats appalling. 5-6 oz a week is fine. My dd wasn't premature, but was very small for dates, (she has always been well below the 0.4th centile) so I know how you feel about taking them to get weighed. At the time we were told that she might catch up in the same way as a premature baby does, over 2 years, so I really wouldn't worry about how much he weighs now. I was just about to say that once you start weaning it can all change very quickly if you put them on a high calorie diet, but just read that you have experienced this before. If I was you I would be very proud of myself for exclusively breast feeding (not something that I have ever managed) and not worry about the weight gain.

Sounds fine to me. After all with prem babies they start smaller so its a larger percentage of their weight.

A lot of HV haven't had much training re weight gain. Have you been signed off from cons. yet because you would be better asking them though from "he is having many (>6) very heavy wet nappies a day, is alert + smiley, feeds every 2 hours during the day, every 3-4 at night." it sounds to me you think hes doing ok.

Gaining 5-6oz a week sounds great - my twins were born at 36+5 and DT2 was only 4lb 8oz at birth and gained only 3-4oz in first few weeks. Eventually she started gaining around 6-7oz per week but was always on the lowest centile line. Some babies have to be or there wouldn't be a line there.

I always felt that as long as she seemed happy and was gaining weight (any amount, didn't have to be loads) then my BM was enough.

Get a second opinion and see a breastfeeding counsellor before taking the advice of your HV. My HV was always telling me "you can top her up with formula if you want" - I think they all say that cos they all just seem to be obsessed with weight gain and centiles

The centile charts in the red books are taken from formula fed babies. You can find a breastfeeding centile chart on www.kellymom.com. It may be worth printing it off and plotting the weight gain on that and comparing the two. It may put your mind at rest a little.

this may help to have a read of too! will look for a direct link to a breastfeeding chart for you.

MissBliss I agree the charts on Kellymom are great but not for prems who tend to have their ages corrected but neither quite correlates with 'normal' baby growth charts

www.kellymom.com/babyconcerns/growth/growthcharts.html#growth

I wonder if there is a chart for prem breastfed babies... i will investigate.

it would be good wouldn't it. Then mums can point their hvs in the right direction

looks like there is on one available but you have to pay for it!

www.bebecannelle.com/pages/you-can-use-your-breast-from-birth-chart-for-premature-babies

thank you all.

i worked so hard to be able to bf him, thinking it was best, anyone who has bf a prem will know what i mean here.

i don't want to let him down.

Although i am very pro breastfeeding and ds didn't have any formula. I don't like the use of the term 'artificially fed baby' on that website. Sounds really odd, and undermines others feeding choices.

Sounds like you are doing a great job Chibi!

Might be worth shedding out the £2.99 so that you can shove the centile chart in your HV face and say 'See! We are doing just fine!'

I think you should stick at what you are doing and if you get any further pressure from HV you can always feed more frequently to ensure your ds is getting more calories.

You are doing an amazing job, my dd2 was born at 35+0 and it was such a struggle to breastfeed but we did it. I think your HV is blinkered and is looking at figures instead of the thriving baby in front of her. I'm due dd3 in a couple of weeks and have already decided to try and avoid the whole HV thing as much as poss as I think by now I can see if my little one is doing well or not and I can't stand the whole centile chart thing. DD1 was a buster and I was proud and perhaps a little boastful of the fact that she was pretty well off the charts for weight, dd2 the total opposite and is now a minature 3.5 year old but both totally healthy. I've learnt some humility and know that this next dd will be what she will be. Hang in there, you're doing a great job.

It hadn't occurred to me that my daughter was prem. I thought she was a little early, coming at 34/35 weeks.

Anyway, she weighed about 5lbs when born and lost 10 pct of her weight in the first week, then gaining well until month 4.

This was in Singapore and I had no idea about lines or charts until I got to the UK. My paed and I simply hadn't discussed them and I only found the figures later in the book when I was seeing the HV here for the first time.

I never weighed her that often but remember freaking out when she'd only put on 300g in one four week period. But that was

She's still breastfed, BLW well and frankly, is just small. Somewhere below the 9th line I think.

That sounds

Hi

Great to hear you are still BF after all your early troubles

As one of the "guilty" mums from the other thread - my fat baby is DS, DD was a 33-weeker. I just dug out her red book. She was weighed every 2 weeks for most of her first year (used to go to a baby group that had scales!). Looking at the figures I think she was putting on around 4-5oz per week for most of that, sometimes less, occasionally more.

She was toddling along just above the 9th centile (for her corrected age - think was around the 0.4th for not corrected). And no-one ever said she was failing to thrive. I know charts are different for boys but if she had put on 6oz per week she would have been crossing centile lines upwards!

If your DD was on the 9th centile maybe you just make children of that size? There are by definition as many children on the 9th as the 91st, and as long as he is not dropping off the bottom (as opposed to plodding along below the bottom) I really don't think you need to worry.

Sorry if I made you feel bad - I remember all I ever used to get when I was out with DD was "Isn't she little" "How old is she? Are you sure!"....then with DS all I got was "Isn't he big!" I think people just like to talk about babies' size.

Just to re-emphasize....the charts are for normal children. It is just as normal to be on the 0.4th as on the 99.6th centile. And 50% of normal children are below the 50th centile.

sorry "that sounds fine" I remember my Singapore paed saying something like 150g a week is good. Which is roughly 5-6 oz

The whole 50 centile line and above = healthy is very pervasive. All my friends talk about it that way, such as "weighed him and he was 75, which is great to be above 50...." and so on.

Yes BF is hard to get going with a prem jaundiced small weight sleepy baby. Good on you.

Hello, very similar story here, dd2 born 36+2 @ 7lbs but due to breathing difficulties dropped to 5lbs 10oz in 2 days. Since leaving hosp at 1 week she has put on about 5/6oz per week, she is dropping down the centiles, currently 25th from 50th. She is bf.

However my health visitor is not worried and neither am I because dd1 was term and ff and followed exactly the same pattern. I have no problems with formula, I happily used it with dd1 but I'm always a bit when it is suggested as a solution to weight/sleep 'problems' (it doesn't sound like you have a problem btw) because dd2 is following exactly the same weight pattern as dd1 and sleeps better, if anything. The way I see is that dh & I are shortarses, below the 50th centile for adults so it would be a bit surprsing if we managed to produce 75th centile children.

I know I have found it hard to relax about dd2's weight because I remember her being such a scrawny little shrimp in the incubator with the tubes/iv etc. But when I compare pictures of her then to the happy filled-out little cherub I have before me now I can see how much she has come on.

You've done brilliantly don't forget to give yourself credit where it's due!

You are doing great, also mum to a prem baby of 35weeks born last month. Been told weight gain of 5-6 oz/wk is totally normal; that HV is a wrong'un.
Totally understand how it feels BF a premmie and how important it feels. I think you are doing great, hang in there. Can you ring your original HV for a chat?