Overfeeding - breastmilk

[balletmoo]

Hello all,

Can I pick your collective brains?

My DS was born 6 weeks early and is now 8 weeks old. He was 1.9kgs when he was born, weighed 3.6kgs 2 weeks ago at the health visitors drop-in and when he went to see the neonatal consultant on Monday his weight was 4.16kgs...

Up to now the HVs have been very happy with his weight gain, but the consultant expressed concerns, saying that he was overfed. But I breast-feed him. Granted, it's expressed breast milk via a bottle, while I continue to establish breast feeding (struggled a bit as he was so small, but persevering), but I thought it was impossible to overfeed on breast milk!

Basically, he is a happy baby boy with a voracious appetite and I don't feel comfortable denying him food when he's rooting for it. I was also told that I shouldn't use cooled boiled water either - just to use a dummy to calm him...

I know that 1.9kgs to 4.16kgs in 8 weeks is a big jump, but is it really that bad? He's also on Infant Gaviscon and ranitidine for reflux, if that makes any difference. He's also got a cold at the moment, and seems hungrier than ever...

I feel like I'm going mad and constantly doing stuff wrong!! Grateful for your thoughts all!

Thanks,

xx

meh. if you're feeding him and he's happy, what's the problem?
ds1 weighed over 16lbs at 10 weeks, when he contracted rsv. the paed was delighted he was so robust, and called him 'fatso' with a big grin on her face. she was relieved not to have to worry about him losing a bit whilst he was getting over the (double) pneumonia.

if it helps, ds1 is 8 now, and built like a beanpole. i certainly didn't cut back - i fed him on demand until he was 10mos and i got fed up of being awake at night.

I agree with you,I've always been told you can't overfeed a bf baby. I'd ignore them and carry on with what you're doing-as long as lo's contented no problem!

I'm pretty sure you can't overfeed a bf baby, but I would be inclined to phone laleche or NCT to feel thoroughly confident with that idea.....ensuring that the next time anyone medic or otherwise said that you were armed with the facts!!

I would just feed as and when, I had the same problem with ds2 - told i was overfeeding him (excl bf?!) He shot up from the 9th centile to the 98th centile by about 6wo! I'm glad I never listened to the 'advice' to restrict his bfeeds as from bout 9 months old he gradually started to slim down

Also ds1 was 6 wks prem and I managed to EXBF him too. He was born way below the centiles , 3lb6 and shot up to the 75th centile. Slowed down a lot when I introduced solids at 6 months. Hope that helps...and weld done for doing so well

I also think the paediatrician is talking nonsense. He doesn't sound like he knows how breastfeeding works. Keep calm and carry on.

I had similar discussions with my prem ds (11 weeks ) about whether he could be overfed BM, as he often had bottles and there was a concern that overfeeding him would make his reflux worse. My completely useless GP told me to cut down, the paed, neonatal dietician, and speech and language woman who concentrates on feeding issues fo rthe neonates all said no feed him what he wants, he'll tell you if he's had enough (shortly before he vomited down the SALT's top)

He was never that big though, but I'd say carry on

I would second a conversation with a bfing counsellor. I'm not sure whether the 'you can't overfeed a bfed baby' thing extends to bottlefed bfed babies (and, wow, congrats on all that expressing!).

I'm just wondering if overfeeding might arise because of the method of feeding, ie babies can get a fast unlimited flow of milk through a teat, rather than having to suck hard to get the hindmilk and increase your supply? Not certain either way but definitely worth having a chat to a bfing counsellor. If you don't have a local baby cafe, the NCT have a national phone line you can call.

Congratulations on the arrival of your son.:) He sounds like he's doing very well and you are certainly not doing everything wrong! How big are his feeds and how often are you feeding him? Maybe someone can advise on what would be about right? I think their tummies are pretty tiny at his age so little and often can be the key. I'd keep going on getting him taking the milk directly from the breast if possible. It's a different action from bottles and quite hard to overfeed babies that way, I think. As his weight gain has been so brilliant it could be a good time to really work on getting him breastfeeding well without worrying too much that he needs every calorie going.

I would get further advice from LLL etc. Both mine have put on weight rapidly early on whilst bf- Ds is now stable on 50percentile, dd is a gorgeous newborn fatty on 98%

I personally would have thought that weight gain in an ebm prem baby should be celebrated, as others have said a robust baby is a result after the start you had, but I'm happy to stand corrected if that's not the case.

I've had two with reflux after being just over 3 weeks early.

There are two types of refluxy babies.
The type that don't gain weight and are very very tough to feed with the arching screaming etc and the type that constantly feed as breast milk has an antacid relief.

I've had one of each (lucky me)!

The rules change when you have a baby with reflux.
I've had all the "you can't overfeed a breast fed baby advice" and this is very true - with a 'normal' baby without reflux.

The weight aside (i personally think a fast weight gain with a prem baby is a good thing), watch he doesn't develop bad colic to go along with the reflux as an over full tummy or not allowing time to digest one feed from the next will cause more aggravation of the reflux. It is ideal (not easy at first) to allow at least 2 hours from the beginning of one feed to the next.
A baby without reflux can cope with it better but a baby with reflux is very uncomfortable if they are being overfed. He is using you like a huge bottle of GAviscon but making the reflux worse IYSWIM.

My DS didn't gain and that was stressful.
My DD overfed and puffed out like a little puffa fish. It looked like she'd burst with a pin!

The colic then kicked in around week6-8 and oh boy, it was hell on earth and she just screamed and screamed and never slept. Once I spread the feeds out a bit (lots of walking up and down and passing to DH/mum/friend/stranger in street, she calmed down as did he weight gain.

Obviously if none of the above seems to be happening to DS and he is happy then carry on, he will calm down in time.
If any of the above start to happen then try spreading the feeds.

Also with refluxy babies. Wedge moses/cot up with books a good amount at head end.

If he starts constantly waking and not happy on back (and you don't smoke) sleep him on his tummy (oh yes, the rules change with reflux, apnea can be more dangerous than tummy sleeping so don't worry about it).

Hold him upright or put him in bouncy seat for 30 mins after a feed.

They are lighter sleepers as they grow so you may have to resort to cot naps as opposed to buggy naps.

Get a wedge to change his nappy and roll him more than lifting from the feet.

Hope his is mild, my two were awful but both easy babies by 6 months and all forgotten about now.

I just want to say in response to sneakapeak, please please don't put any baby on their tummy without medical advice. My refluxy prem was readmitted through A+E after an apnea attack which frightened the life out of me. But even with reflux and a history of apnea he sleeps on his back never his tummy.

oh I would also say is he following a line yet? mine was discharged on 0.04 then crept up and now tracks the 25% line which is where we think he was destined to be. When they are born early the birthweight can be a bit of a red herring and it may well be your LO was always destined to be a big baby but because he was born early the intial info is confusing.

Thanks all, what would I do without you!!

Hildathebuilder: he was also discharged at that sort of level (haven't got the red book to hand so can't remember exactly which line) but has shot up to 75th centile (just like your DS1, mamasunshine!). But not tracking a line as yet. Daddy is quite a big chap (rugby player) so I was expecting ds to have the potential to be bigger although the speed has been quite astonishing!! I expect you're right and that he is just catching up to his destined line...

Sneakapeek: I'm the walking bottle of Gaviscon He does manage 2-4 hours between feeds most of the time, just not always!! And yes, he does have colic, although, if I'm honest, it could be worse (even if it doesn't seem that way at 3am!!). He arches his back in pain, but much less than before he was prescribed the Gaviscon and Ranitidine. He won't sleep on his back so we put him down on his side: much more successful!!

Scroobiouspip: yes, i wondered the same thing! It's very easy to encourage your littlies to finish the bottle, regardless of whether it contains EBM or formula. We've stopped doing that now.

I'm trying to find a breastfeeding clinic near me (just moved) so i can really get to grips with BF'ing proper, instead of spending hours feeling like a cow in a milking parlour!!! Hopefully that will help!! Although how we'll get on with that remains to be seen after todays discovery that teething seems to have started early... !!!

Thanks again all, you've made me feel much better!

xx