Grr HV has started already - how do I avoid being told to mix feed?

[GoldenSnitch]

DD had her 6 week check with the Health Visitor yesterday and already "topping up" with formula has been suggested!!

DD was 7lbs 1oz at birth but lost a lot of weight quickly (she was an ELCS at 10 days early) and was only 6lbs 4oz at her 5 day check. It took 3 weeks for her to regain her birth weight. She's been hovering just below the 25th percentile line ever since but yesterday she had dipped a bit. She was 7lbs 13oz on the 18th and 8lbs 1 oz yesterday - 9 days later.

I was really pleased with the way feeding was going this time. I had such problems with DS and had to mix feed him very early on as it took a while for my milk to get going and instead of supporting me, the midwives gave him formula which in retrospect actually made things harder as my boobs didn't get the stimulation they needed to make more milk and it took a while to drop the bottles again.

I'm loving breastfeeding - it's so easy and feels so wonderful and natural to just whip out a boob an feed my baby without all the hassle of sterilising bottles and boiling water and choosing formula and getting the temperature right (no offense to bottle feeders, I just find it a pain to do) and I really want to avoid mix feeding. I know I'll feel like a failure again if I end up having to top up. I also read somewhere that formula damages the lining of babies intestines and I don't want to do that to DD. The Health visitor said to just look at is as medicine but that doesn't make me feel any better.

So - I'm demand feeding, resting as much as I can when I also have a 2.9 year old who's struggling with the idea of a sibling to care for, I'm up-ing my fluid intake and eating well - is there anything else I can do to up my milk supply and get DD back on that bloody line on the graph to ward off the HV and her bottles?

Just don't go to the HV again. You sound confident in your feeding and as long as DD is meeting milestones, doing lots of wees and poos then you can be sure she is thriving. I have hardly taken DS (maybe once since his 8 week check and he's now 9months)
Good luck and congrats on the BFing.

LOL - the last thing she said to me when we left yesterday was "I trust you to come back in 2 weeks for a weigh in"

She has been almost 3 days without a poo now too but HV seemed unbothered about that and said it was normal for BF babies to go up to 10 days.

She's bright and alert with longer and longer awake periods and pee-ing loads though...

Ask what are the options and say you planned to ex bf. In a similar situation my HV was very reassuring and just asked us to come back in 2 weeks for a re-weigh. Maybe this? if more serious, referral to paediatrician?
I agree it sounds as though all is well but she is the one who has seen your baby and (in theory!0 knows what she's doing.

Just don't go. It's that simple. Have confidence in yourself

As back up, make sure your DH/P has been told to tell you if things are getting out of hand - i.e. the baby is looking emaciated. Hormones and determination can make you blind to that. But otherwise, if the baby is well, then it's fine - despite what the HV says....

What about expressing?
I exclusively breastfed my DD for the first 16 weeks and I only think that I managed that long because I expressed. It will increase your milk and give you more flexibility.

Get an electric pump though, hand pumps are too much like hard work.

You could take this with you to the next appointment
www.loveyourbaby.com/baby-height-and-weight-chart.html
The weight chart the HVs use is based on formula fed babies who gain weight much quicker and is highly innacurate for exclusively BF babies (leading to the advice to top up feeds), hence why the WHO issued this one.

Are you sure about her birthweight - dropping over a pound in 5 days seems a bit odd to me.

If you want to increase her milk intake, then giving more than 2 breasts at each feed, and giving her a feed at least every 3 hours, if not more if you can manage (wearing her in a sling so that she can feed while you are doing other things might help) would be useful.

Is there a baby cafe or breastfeeding support group you could drop into for some support ?

Don't see MW. You are doing bloody well, go girl!, and yes, if you express it will stimulate your milk production.

(but if your DD is feeding well and you don't want to "share" feeding her by letting your OH feed her with expressed milk then I don't see a reason to express, your supply will increase naturally as she feeds more. Takes about 3-5 days.)

DH would definitely tell me if he was worried about DD.

DS is 75th percentile height and only 25th percentile weight - he's long and thin just like his Daddy. Looks like I am destined to be the only short, fat one in this house

We've got 2 weeks till the next weigh in Stealth I'm tempted not to go but I have a feeling she'd probably chase us up!

The midwife who came out on day 5 actually suggested that her birth weight might have been wrong CMOT She said that if DD had lost that much weight in such a short period of time then she would look ill - which she didn't. The midwife that came out to re-weigh her next said that the weight loss was possible though as she had been early and so may have had a poor suck (although it certainly didn't feel that way!) and was a section which would have delayed my milk by a day. She was very tiny at birth and was drowned in the clothes that we'd used for DS (who was only 8 ozs heavier at birth) and I do know another baby was was definitely mis-weighed. The first midwife said it wasn't the first birth weight she had queried that week!

I'm giving her both breasts at each feed - she becomes uninterested after a while at the second and won't feed anymore even if awake - and asking to be fed every 3-4 hours during the day, which I'm doing. She also has a cluster feed between about 6 and 10pm where she feeds almost every hour.

I have a sling and have fed her in it once so far. I have to support her head still though so it's not perfect. It's a Moby wrap.

Will chart her on the BF chart now and see how she's doing... Thanks fibilou

Goldensnitch on the first thread I posted on mn about breastfeeding (or rather, my lack of it!)you seemed so passionate about it you made me completely change my mind about it to the point where I am now adament I will succeed at feeding my next dc. I've spoken to soo many people who've been advised by hv to top up but they haven't and their babies have been fine. They really need to change these weight charts! I know I'm not much help lol but saw your name and wanted to say hi and congrats on your dd

Wow! Thank you Yummy It's weird thinking I've had such an effect on someone I've never met!!

I hope I've set you up for a wonderful experience. I am loving feeding this time

I've just printed out the BF graph and she's sticking to a line (the 15th percentile one) a lot more closely than the FF graph. Will stick it in the book I think and make sure her weight is plotted on both whenever she gets weighed.

GoldenSnitch - it may be that your dd would benefit from more feeds, though it's clear she is basically fine from what you are saying. 3-4 hourly is not very often for a young baby, even with the cluster feeds and night feeds - could you start to keep her close and offer feeds whenever she twitches a bit and shows these early feeding cues?

The HV should be exploring this with you - if she thinks your dd needs more milk, why should it be formula? You have the 'more milk' in your breasts. You could also offer three or four breasts rather than just two, per session.

Hope this helps

Fibilou - breastfed babies gain weight very slightly faster than formula fed babies at first. It is not until babies are about five months or so that bf babies start to gain more slowly.

Older style charts are based on babies whose feeding is not differentiated - many of them would have been formula fed, of course.

The newer charts are based solely on bf babies.

It's not really the charts that are misleading at this stage - there's very little difference between the centiles on either chart at 6 weeks.

Thank you tiktok I love the comment about why the extra milk needs to be formula! I will use that one

I am happy to offer 3-4 breasts but she becomes uninterested before I feel like she has "finished" the second and won't feed anymore. I'm sure there is still milk left as it's usually dripping (sometimes squirting!) but she won't latch on anymore even when awake and alert so I have to assume she's full.

She's a very clingy baby so I do spend a lot of the time carrying her round but will definitely try even harder to feed her at the very first sign of her wanting to.

It can't be that unusual for babies to lose a lot of weight in the first few days. DS lost nearly 2 pounds in his first week.

You could try switch nursing - so changing to boob 2 when she's been feeding for, say, 5 minutes, then switch back after another 5, and so on. They get a faster flow when swapping onto the other breast so drink more

My HV seems very sensible this time around. She told me that if my DS looks fine then he probably is. She told me to trust my judgment, to look for his clothes getting smaller etc. As a result I've barely seen her and I'm so much more relaxed this time around. DS2 is exclusively breastfed, despite his tongue-tie. DS1 on the other hand, was weighed religiously once a fortnight and we were kind of obsessed with his weight. He ended up mix-fed.

Oh she's definitely growing. We needed "tiny baby" clothes for the first few days, then "new baby" and she's now too long for those and needs "0-3 months" baby grows already. She's 6 weeks old today.

I think losing weight in the first few days is normal Cuppa, it's only flagged if it's more than 10% of their birth weight, which DD's was. She lost 13 ozs.

Sorry Tiktok, I am happy to be corrected

On another note entirely I don't suppose you know anything about a charity called Maternity Worldwide do you ? I'm heading up our international fundraising committee at Rotary from July and want to support a birth charity in the third world and saw this one doing work in Uganda and Ethiopia. As you are the fount of all knowledge on these things I thought you might know

Never heard of it, Fibilou, sorry - they may be wonderful, for all I know!

How about this for a charity doing maternity-related work in Africa (and elsewhere)?

www.whiteribbonalliance.org/

I can vouch for them, for what it's worth.

Well, just fed her. She spent a good 15-20 minutes on the first boob with a half-time wind but couldn't be persuaded to have the second. I burped her some more and sat with her cuddled up with me for another 15-20 minutes with free access to the boob and kept trying to latch her on but she must have been full.

She's wide awake still so I'm going to read the children a story then maybe try again.

I got told to mix feed as my ds had a latch problem. I just smiled and ignored the advice, topped him up with ebm instead (electric pump, yes definately good!). We went to a cranial osteopath, who got rid of mouth tension and improved sucking, and although he was long and thin at birth, by 8 weeks ish, when the head control kicked in he was up on a big centile. Just smile and nod, and then ignore the hvs, as long as she's getting fed somehow.

Well I followed the (same) advice from my HV who was so worried that DS2 hadn't regained the 2lbs he lost off his 10lb birth weight by day 10 & suggested I was putting my baby at serious risk of dehydration. This was of course total & utter bollocks but being somewhat hormonal & sleep deprived & having MIL bleating the same message all day every day, i took it to heart, rushed out to buy some formula for 'urgently needed top-ups' and within 2 weeks had stopped bf altogether

Sounds like you're doing a grand job so just keep up the good work. Mixed feeding is the worst of both worlds & rarely works for any length of time IME.
LCN