i feel so discouraged, thought everything was ok

[chibi]

I went to a bf clinic at th hospital today to check that bf was still going ok as my ds who has been gaining along the 9th centile has recently slipped a bit below it.

he was 5 weeks prem.

the hv there was concerned that his birthweight was on the 75th centile, and 'we need to get him back up'.

she also said i should express after every feed + top up.

i am already feeding every 2 hours or so in the day, as many 'sides' and as long as he wants. i also have a 2 year old.

i should say for the 1st 3 weeks of his life i expressed every feed for him. my dh was here to help with dd while i expressed for the first 2 weeks, then we sent her to the child minder for a further week. my mother came to stay for nearly a month then to help while i transitioned from expressing to bf directly.

i am on my own with my dc now, and i just don't see how i can do this.

is there any chance at all that this growth is ok, and if not, how do i introduce formula so as to keep bf to some extent?

i am v happy that i have bf him this long, and am trying to put my feelings of sadness at maybe stopping aside to do the right thing for him.

thanks for reading this far.

why haven't any of the hv/gp at my surgery said anything? i feel guilty that i may have been starving him/harming his health cos no one said anything.

he is usually up before my dd - if i expressed first thing, + after she goes to bed/at night would this yield enough to make a difference?

How old is your son now?

I'm no expert, but as far as I know there is no reason why a baby has to get back up to the centile line they were on at birth. I thought that the concern was around regaining birthweight and then sudden drops below the line they are generally tracking around.

I am sure someone knowledgeable will be along soon.

he is 14 weeks old, 9 corrected for prem. he has been on the 9th centile for most of that time.

chibi, sorry to hear you're worried. I still don't understand fully why the HV is worried. I'm assuming your baby did gain weight?

It sounds like you had a difficult first few weeks.

You seem to have bounced back well from that and to have transitioned to full direct bf from expressing is great.

If your baby needs more milk - maybe she does - then you can feed more often. I know on your other thread you explained how hard this might be, with your other dd needing you, too. But you said she feeds four hourly from 7 pm which is not very often...could you keep her skin to skin and offer more feeds from then onwards?

is he happy ? does he seem hungry ? If not - as long as he is sticking to his curve then I wouldn't worry that it isn't the same one as he was born on. I thought (no expert though) that the birth weight is not particularly relevant to the growth curve they end up on.

I have one that sits about the 9% line too - he still does at 6.6 yrs. He was a month prem.

I would maybe try and fit in another feed in the evening if you can.

I also think you need a second opinion on getting a baby who seems happy on the 9th back up to the 75th, which was a 'snapshot' of his weight only.

chibi - i tend to feed my dd for an hour, sometimes two, when the other two are in bed. Could you do this? She seems to tank herself up at this point - drifting off to sleep then waking for more. I lie in bed \with her and read a book. Might help?

thanks tiktok.

he has gained weight! he gained 8.5 oz over the last 2 weeks, and 9 oz the two weeks before that. (he is weighed on metric scales, I converted it with the conversion table in my red book for my own comprehension)

i don't wake him up now, but feed him when he wakes, whether that's 3-4 hours or whatever.

he feeds mostly every 2 hours from 6am - 7 pm, so he is getting probably 10 ish feeds a day.

i don['t know how i can feed more and still cope.

i am sorry if this sounds selfish.

my dd used to feed throughout the night (coslept as she was such a dire sleeper) and i have really been enjoying the amount of sleep i am getting.

I am not an expert either but just wanted to say that my dd2 was above the 50th centile at birth but has slowly dropped to the 9th. She is now 41/2 months and the HV doesn't seem worried about it.
It might be worth looking at the newer weight charts from the WHO for breastfed babbies as the ones in the red book were based on mainly formula fed babies www.who.int/childgrowth/standards/chts_wfa_boys_p/en/index.html
Also well done for getting this far

chibi - it sounds to me like you are doing fine. Please speak to your normal HV and get a second opinion. Mydd1 was on the 50th centile when born but rapidly slipped down to the 9th centile and has stayed on that ever since - she is now nearly 9 years old.

Tiktok may be able to help more - but I can't understand why you need to express as long as you are exclusively breastfeeding on demand.

smallorange i do this already from about 5-8, with the odd break to put dd to bed. my dh is home at these times.

he seems happy to me, he is very smiley, seems satisfied after feeds, has at least 5 properly heavy nappies a day, poos once a day.

if i wasn't having him weighed i wouldn't have worried.

this is the thing - i went to clinic thinking i might get told 'aha just adjust x slightly..' and instead got 'defcon3! CATASTROPHE!!'

Ach, I know. I find those charts very stressful myself. It's like going into an exam!

I would trust your instincts - if he seems happy and is feeding well, having lots of wet nappies etc - leave it at that - but keep a watching brief over the next few weeks to make sure you aren't missing anything.

Newer charts won't help - they are virtually the same as older ones until the baby is 4-6 mths old.

This is a slow-ish weight gain, that's for sure, but it does not seem to me to present a major issue....yes, it's sensible to check the baby is thriving and gaining and feeding well, and not being prevented from feeding or anything daft like that, and those boxes seem to be ticked perfectly ok. So he's healthy and doing fine. Seems to me if he needs more milk, then bf direct would be the easiest option, because it can be done with least fuss - expressing or topping up with formula are both hassles.

Second opinion from someone you trust seems to be the next step

no kidding - anything below 50 is a fail har har.

i spoke with the lactation consultant i was seeing to help transition to the breast = she said i could go back on the domperidone. i very gradually weaned myself off of it but can't remember when or if that coincided with the slight drop in rate of weight gain.

i think not, but am not 100% sure. she said that it could't do any harm, and as i had no side effects, i think i will.

i just feel frustrated that every hcp sings a different tune.

if it were anything else, i could see a gp and know whatever the advice, any gp would say much the same.

here, i have his gp/my surgery's hv saying one thing (he's ok) the bf clinic's hv saying another. i am also bringing my experience of bf dd for 18 months to bear here too.

when i had him weighed at my surgery on weds. the hv said there are growth charts for prem babies coming out soon.

could the fact that he is prem have anything to do with it?

the lactation consultant also said don't wake him to feed as he may not feed as effectively as he would if he woke on his own and 'asked'.

he sleeps in a moses basket at my side.

one of the hv at my surgery is lovely and also had a prem baby herself + understands what i have been through and why this is extra fraught for me (i couldn't really put it into words without sounding stupidly overdramatic.)

i will call her + see if i can see her about all this.