Continue to EBF even though baby dropping off centiles?

[HarderToKidnap]

Advice for a friend please!

12 week old baby, breastfeeding. Before birth mum wasn't keen on bfing - found it "icky" although resolved she would try for six weeks. Has a horror of feeding long term and had planned to give up long before now. She has given the baby 3 bottles of formula over the last 12 weeks, at a funeral, a wedding and one other occasion.

She feeds the baby five times a day for 45 mins, offering both breasts (7,11,3,7 and 11). Baby sleeps between feeds but is alert, lots of PU and BO. Uses a dummy a lot and displays feeding cues a lot more than she is getting fed - Mum distracts until it is time for the next feed. Baby's birthweight was 7lb 1oz, is now 9lb 14. Has just dropped off her centile (9%) slightly. As I am a sort of baby HCP, she asked my advice - I advised her to add at least one more feed. She will only do so if it is a formula feed - although she enjoys the breastfeeding she does, she doesn't feel she can cope with any more and isn't interested in expressing.

Unsure as to whether to say go ahead and add a formula feed, or to stay stick with the programme to keep the EBF going longer. Baby is so alert and lots of wet and dirty nappies and if I felt she was getting more frequent breastfeeds then I would say don't even worry about the dropping off of centiles. But I do think five times a day isn't frequent enough.

So - add a feed even though it will be formula, or advise her to stick with what she is doing?

Thanks

LD - the OP has explained that may not be an option

sorry, x post

Sorry but I cannot understand how the baby is getting through the night without being fed? At 12 weeks going from 11pm to 7am without a feed seems wrong to me. Neither of my kids came close to this until they were well established on solids and probably a year old.
I am at this. hardertokidnap i feel for you, must be very difficult if you are being asked for advise when seems so clear it's not enough feeds but the mother can't seem to see that

to be fair, humpty, DD2 went from 10 till 6 between about 10 and 18 weeks, but this was probaby because she fed every 2 hours other than that. It's the daytime feeds that the OP's friend needs to up, IMO. i would encourage at least 1 more ff if another bf isn't going to happen. my DD is now 6mo and won't go 4 hours , day or night!

yes, the lack of night feeding isn't a problem in itself but IMO it is if the mum is ensuring no night feeds-what on earth does she do when he wakes and cries at night?
I think she needs to discuss this with her own HV.

olivo I totally agree with you. I think I find it most sad that this girl wants to stick to such a rigid timetable. I realise some people just work like that, but with a baby I think she needs to loosen up a bit and be flexible. Maybe for her dd it's she is getting enough, but if her weight starts to drop off, it would seem that she is not so she needs more feeding, end of story. Very

I agree, humpty, it is when people think 'routine' must be what is best, especially at this young age, and if it may be proving detrimental. I am surprised this baby is sleeping through, with so little during the day.

Oh dear. There is more to this, I think, than meets the eye.

This baby may be being fed adequately - a slight move away from the centile she has been on is not significant. But for most babies - most human beings - eating/drinking 5 x day is not sufficient. Why would a mother refuse to respond to a baby's clear need to feed and stick to a schedule so very rigidly in this way? She is enjoying the bf she does, you say, it's not painful but she is prepared to work quite hard not to feed more often. She sounds as if being in control is very important to her, and that she is pleasing someone/some impulse rather than pleasing her baby....why might that be?

It's not good for babies to be distracted all the time rather than have their normal feeding needs met. In time this baby will give up 'asking' and will 'content' herself with the schedule her mother has decided is best.

That's sad. I think giving formula rather than ignoring these needs is justified on these grounds, even if it isn't justified on purely adequate nutrition grounds.

As for the night feeds - maybe this baby is being fed (just) often enough for her to not 'need' feeding in the night; maybe the baby has already 'learnt' her needs for feeding at night will not be met. You can 'teach' even very young babies this lesson, simply by ignoring them, and they stop asking.

Thanks guys, I feel confident now that addinf a ff is best.

She has some deep seated psychological isues around her body and around brestfeeding. That won't change. She has an idea that feeding every four hours is enough and if the baby asks for more she just doesn't recognise that as asking for the breast - she thinks the baby needs winding/interaction/a dummy. It doesn't matter how often I/others gently point out that a baby cramming her fist into her mouth, shaking her head around madly and eventually crying is a baby asking for food. I think she can cope with the idea of breastfeeding if it is done in a controlled manner, on her terms - more than that and it will have to be ff.

Thanks.

Could you ask her gently to visualise how she would feel if she, a self sufficient adult, was only allowed food and drink on 5 occasions in each 24 hour period? If she had to fast between those five set times, and wasn't allowed a sip of water, a cup of tea, a biscuit, whatever?

Can you help her to empathise with the needs of another, tiny, helpless and needy human being by projecting herself into that vulnerable position?