Any advice - very unsettled and want the best for my DS

[Afsgh]

I've posted here before about my DS' slow weight gain. We're at 9 weeks now and having had a tongue tie revision 12 days ago (which had seemingly been missed by four health professionals), he has just been weighed - he's put only 100g in two weeks and has dropped below the 2nd percentile line.

Up until this point he has been EBF and the advice has been to stick at it. I now think this could be cruel and hindering his growth. It's been suggested that I try to express a top up bottle, but he is so unsettled he tends to spend hours on me, either feeding (although seemingly not very effectively) or wanting to comfort suck/be held, which doesn't leave much space to try to express. I do have a Medela hand pump but I've never been able to express more than 1oz after a feed, at best.

I seem to have an overly emotional attachment to breastfeeding, such that the idea of even one formula feed makes me feel like I will have failed. I know this is irrational and I have never judged anyone for feeding their child formula, so I don't know why this is a hang up for me. Anyway, after the weigh in today my DH and I have decided it's time to try to give DS a bottle in the evening.

I feel like I have done everything to make exclusively breastfeeding a success, but the weight gain is so slow, he is increasingly fussy and unsettled and I'm getting no more than 3-4hrs of unbroken sleep each night. He also is very gassy and I think may have silent reflux.

I'm not really sure why I'm posting, but I'm finding the whole thing pretty brutal at the moment. Others I know with little ones this age seem to be starting to emerge from the newborn fog, whereas it seems to be getting harder with my DS. I just want what's best for him. Any tips/suggestions, anyone who has been through the same?

I was unable to BF my LO and I remember being absolutely devestated when I moved to formula but it was honestly the best decision when it settled LO and they started to gain weight.
Just remember BF isnt the be all and end all, there are plenty of ways to show your love and nurture your baby. I'm sure you'll feel better about this decision once you see the benefits. Be kind to yourself x

Absolutely agree that BF isn’t the be all and end all.

DD had a tongue tie snipped at about 14 weeks (also missed by numerous HCPs) and I think improvement in feeding took about a week-10 days. They have to relearn a new technique when it’s snipped quite late. Have you noticed any improvement in latch or in windiness since the tt snip?

We also thought DD had silent reflux but with hindsight I’m pretty it was all issues caused by the TT - effects can be similar to reflux.

I cried long and hard about this exact issue with my first baby. With the weight gain issues I would absolutely offer a bottle and see if he settles better after it. I know it’s very very hard to give up the “ideal” that’s exclusive breastfeeding. But if you look at it objectively, it’s not at all ideal to have a hungry and unsettled baby.

I was so upset when I had to decide to switch to formula, but in all honesty I don't really know why now. A baby which is nourished and happy is better than one that can't settle or sleep because it's so hungry.

You have given your ds the very best start. I think you are absolutely doing the right thing moving to formula. He doesnt sound happy and you don’t either.

Mix-feeding is a totally normal way to feed. My DD was EBF but I'll probably mix feed when DC2 arrives because i don't want to pump and want DH to be able to feed, so we will introduce a bottle quite early probably.

At the moment, feeding seems like the most important thing in the world because it's basically the only thing you can control. In a couple of years it will be so irrelevant that it doesn't matter. DD is 2.5 now and is so far removed from those days that I wonder why I stressed so much!

Mixed feeding is the best of both worlds.
It gives his dad a lovely chance to spend time with him and maybe you a chance to get some rest to be an even better mum!

Thanks everyone, truth is that the rational part of me knows that you're right; who cares how he is fed so long as he is fed? My DH is also very keen to help in anyway he can, particularly given the toll that trying to EBF has been taking on me.

@minipie ironically whilst the latch seems to have partially improved (DS can open his mouth wider at least) since the TT revision, the wind and being unsettled when he's put down in his cot, seems to have got worse. We also have a range of weird and wonderful nappies, which are more frequently a dark yellow/brown/green colour with mucus, rather than the yellow curdy output that is considered "normal". We have though seen much heavier wet nappies since the TT division.

There is very little support in my area for breastfeeding, with the health visitor referring me to a FB page when I asked for assistance. I'm considering paying to see a lactation consultation (most probably in addition to introducing a bottle of formula a day) but don't want to be throwing good money after bad.

I'm looking forward to finding a solution to all of this. It's really starting to take its toll on me and spending time with DS. If introducing a bottle of formula is going to help, I know that it's most likely to be worth it.

My son had terrible weight issues as a baby. He dropped from the 91st to below the chart.

We added in a bottle of formula every day as per HV advice. But after every bottle he'd scream and then be violently sick. He also wasn't putting on tons more weight as he was throwing it all up.

I tried pumping but I've never pumped much (what you can express has no indication of supply and i EBF my daughter with no issues but never got much out)

Eventually after 16 weeks of various paediatric appointments including a screen for cystic fibrosis we got an appointment with a paediatric dietician. She was amazing and said my son was the clearest case of cows milk allergy she'd seen. He was always fine on my milk (I'm dairy free anyway) but so sick after formula.

She encouraged me to combi feed and keep as much breastfeeding as possible. We used specialist allergy formula for 2 feeds a day. We also weaned early.

Finally he was keeping the extra milk down and the weaning with high calorie foods made all the difference.

Along with this, he's also just a lanky body type. He's almost 5 now and on 91st for weight but over 98th for height. He has a six pack and no fat anywhere. He's just long and thin and that's him.

Good luck with it all and happy to answer other questions. Get to see a dietician as soon as you can.

So so sorry you’re going through this. I went through the exact same thing with my son who was on the same centile and I just obsessed and obsessed over his weight! I started to top up with formula because, like you, I didn’t have time to express, and when I did I didn’t get much. I bought a haaka pump and would be that in the other boob when I was nursing him everytime I fed him and by the end of the day I had enough for a whole bottle. When I wouldn’t use the pump I would jump top up with a bit of formula. He was so unsettled and I think because he was constantly on my boob and fussing I thought I must have supply issues. Topping up with formula actually didn’t make him any more settled unfortunately.

You can try introducing a bottle, if it helps and you’re happy with that - great!

Also remember that it doesn’t have to be one or the other - you want to be careful to not diminish your supply but for the time being you can top up with formula if you feel you need to and then get him weighed after a week and then see what the results are.

I was so desperate to breastfeed and like you was upset everytime I used formula - breast milk is bloody amazing and tailored for specifically for your baby - there’s no shame in wanting to give them that!

I would actually pump every time I gave him a bottle of formula (I’m not recommending that because I think in the early days I was actually on the verge of a breakdown with the pumping and feeding etc).

I went from formula top ups and eventually got back to ebf. What you do now doesn’t have to be forever.

Please be kind to yourself! Xx

It's so, so hard. I had issues with e
feeding both of our dcs. I managed mixed feeding one of them and the other I exclusively pumped with. That is an option too fwiw. It can be hard work, but I personally found it OK.

But there really isn't anything at all wrong with formula. It is a literally life saver. Pretty sure my dcs would have starved without it!

Try to think of the switch to formula as you doing what's best for your child and that's the main thing. Put your feelings about it to one side.

Breastfeeding is great but only if it works. Society has such a preoccupation with breastfeeding that it makes women feel failures when it doesn't go well but that's so unfair.

He's so young, you must be so exhausted and worried - I am super pro breastfeeding but really think you should switch to formula, at least partially.

My sister had exactly the same as you and everything went so much better when she started giving a bottle.

You're doing really well - the first few weeks are insanely hard x

I had similar issues. Just wanted to offer some hope. Ds is almost 14 weeks now and still EBF. He's only just above 0.4th percentile but is tracking along now well and is putting on about 4/5oz a week. For us what worked was getting a hakka as it can be put on whilst feeding on the opposite side and it collects milk hands free, sometimes I only got 10ml, others I'd get 3-4oz but whatever i collected I'd give at the end of the feed as a top up (if LO would take it, anything he didn't seem to want I'd put in the freezer so I started building a bit of a stash). Then I introduced a pumping session with a manual breast pump each night once LO was asleep for his longest stretch of sleep. And in that session I'd power pump (pump for 20 mins, rest 10, pump 10 rest 10 etc for an hour) just to increase my supply a little, I did this for around 3-4 days at first then afterwards just did a normal pumping session each night.

My official advice from HV was to powerpump and try to top up each feed with 30ml of expressed milk. I found after a couple of evenings of power pumping I was able to reliably get at least 30ml during a pumping session and was able to top up with that.

After LOs TT division it did take around 1-2 weeks to see any dramatic improvements but he was weighed just 2 weeks after his division and was finally following a percentile so it's definitely helped in that sense and he's now having plenty of wet and dirty nappies now. Also around 2 weeks after the TT division the reflux and gas is much much better now and he hasn't even needed his infant gaviscon recently.

You could always top up with formula if expressing isn't for you, and you absolutely can go back to exclusively breast feeding once LO is up to a suitable weight by slowly dropping formula amounts down and offering the breast more, however absolutely no shame in formula feeding at all!

Good luck OP!

Hello there! this was informative.. got so many suggestions :)

You can mix feed and see how you get on, you don't ha e to choose between them. I did that for 3 months, after a tongue tie snip and poor latch I pumped and bottle fed that for 3 months and combined what I produced with formula to top up the bottles because he couldn't suckle from me. His latch improved, my supply improved, we got onto EBF in the end but I would often top him up mid afternoon with a bottle of formula when I was mega tired.

Feeding a bit of formula doesn't mean you have to stop breastfeeding if you don't want to. We started mix feeding and my ds was so much more settled, before he would spend all afternoon feeding or crying, his weight was dropping centiles; I think he was just hungry. He still gets all the benefits of breast milk but with some additional calories from formula. If I want to go back to ebf at a later date this is possible.

Just based on the nappies I was wondering about CMPA . Just many similar symptoms that my DD had. Also in terms of pumping I hired a hospital grade pump from Medela direct and that was great in my journey with feeding . Good luck with it all . I shed a lot of tears over the challenges of feeding and I remember how hard it was.

Your situation is very similar to ours when DD was born.
Ended with 2 tongue tie divisions (first grew back), silent reflex & under hospital paediatric care for a few months.
We moved to combi-feeding when her weight wasn't going up enough & it took the pressure off me & meant I could continue breastfeeding (until she was nearly 2) as well as bottle-feed when needed. Pumping didn't work for me.
When DS was born we already knew we'd combi-feed as we felt it had some many benefits.

My son was 50th centile at birth and dropped to below the 2nd by 3 months. He also had a late diagnosed tongue tie and would typically feed for 45-60 minutes for each feed. He was unsettled, gassy and always seemed hungry. I had a really awful time stressing and worrying about it all, I'd wanted to ebf and felt like a failure. I ended up giving one bottle of expressed milk and one bottle of formula each day - I could only express enough for one bottle. To see him very quickly gaining weight and absolutely thriving put all my worries to rest. I'm now weaning him off the bottles as he's eating solids really well (7 months) and he's very efficient at breastfeeding now. You're doing a great job and I hope it's of some reassurance that others have been there too.

Thank you everyone for your responses, I'm so grateful that you've taken the time to respond and it's so reassuring to hear that others have been in a similar situation.

My DH gave a first formula bottle last night after I had fed. DS took some but not all of it and seemed settled afterwards. If nothing else, it has allowed my to get a bit more sleep for the first time in weeks and to approach the issue with a bit more clarity. It's also reassuring to know that whilst I'll continue to offer as many feeds as DS wants, I don't have to battle endlessly to get a good latch with effective feeding if he will get the chance of a top up. That in itself I think will give me the chance to worry a bit less.

There are some great suggestions above, some of which I will definitely try over the next week or so (I've just ordered a haakka pump, which looks almost too simple - I will give that a go).

Hopefully he is still relearning after the TT division and there's a chance we'll both get the hang of it again! If not, it's great to have options

I had to top both of mine up but only after a bf every 3 hours and I was given an exact amount of formula to top up with (30ml). Could bf on demand in between the 3 hour feeds.

Both switched to only bf once supply had increased and weight had been gained.
They should calculate how much you need to top up.

I would say that 3-4 hour unbroken stretches of sleep at night is amazing for a 9 week old, and formula is unlikely to resolve that. But in respect of the rest of your post, there is nothing wrong with switching to formula of if that is what works for you.

You can also carry on combination feeding if that suits you - it doesn't have to be all or nothing.

Wanted to send hugs. Have been in the journey of battling to feed and the guilt with it not going how you planned.

This doesn't have to mean the end of breastfeeding just a way to top him up and as he grows he might get more efficient at feeding.