Need to give top ups but baby refuses!

[MrsCT]

Paediatrician has real concerns about DDs weight gain dropping centiles and we have been instructed to give top ups, the problem is she completely refuses point blank to take bottles (four different types of teats), syringes, cups and even the medela supplementary nursing system! I’m at my wits ends trying to give her tiny top ups that stress her out completely and take up the whole day I could be spending playing with her.
I have breastfed her since birth and no one ever explained to me that an emergency c section birth can be so traumatic for baby that they carry so much muscle tension in their head and neck that it prevents them from latching properly. We’ve been to a lactation consultant, a tongue tie clinic, a craniosacral therapist and cranial ostepath which was utter nonsense!
ultimately she just doesn’t have a great latch but she seems well fed, she’s alert, happy, energetic and developing on track with everything and she just doesn’t seem to need or want more, I’m so confused and obviously I want to help her gain weight if it’s what she needs but I don’t know what to do because she seems fine and all it’s achieving is stressing her out and causing her to associate feeding with stress!

[DingleyDel]

Some babies are small. This sounds like my slightly prem dd who lost a lot straight after birth and regained it slowly. If she is alert, lots of wet and dirty nappies, no jaundice and is gaining weight albeit slowly I really can’t see the problem. Feed every three hours at a minimum and every 4 over night. Find your local breastfeeding support group. At the moment you’re adding a load of extra stress and pressure for no gain when you could just be feeding her more breastmilk which is more calorific and nutritious than formula for her. Do Loads of skin to skin contact. Literally spend the day with her on your bare chest in front of a good series as often as possible. Her latch will improve as she gets older and more practiced. You’re at the point where feeding is about to get easier and if her weight was of real concern it would have been flagged by now.

[DingleyDel]

a craniosacral therapist and cranial ostepath which was utter nonsense!

errgh it’s makes me so mad that these charlatans have somehow wormed their way into the world of breastfeeding support. It’s always the neck thing (whether vaginal or section birth it seems) and it’s complete and utter bunk but someone is advising news mums to part with their cash. It’s seems to be a right of passage now for breastfeeding mums to see a ‘cranio’. Our local hospital were even suggesting people go to a particular private clinic. So corrupt of the NHS. Just a way of absolving themselves of responsibility for breastfeeding issues.

[RosieBdy]

Hi,
My DS was tiny when born and I had to feed every 2 hours. Breastfeed. then top up with expresses milk, but the hospital advised me to use a tiny cup.
Sounds mad, but it did work! You have to be careful obviously to hold it at the right angle so they only have a tiny amount at a time.
It was like a small medicine dose cup if you get me?
Maybe try that and good luck.
DS is now taller than me. but it's a stressful time when they don't put on the weight!

[BertieBotts]

Has she been checked for tongue tie? A friend of mine had a tongue tied baby and he couldn't feed any way except at the breast.

[Justyouwaitandseeagain]

I agree with others about night feeds, night milk is higher in fat content than milk in the day. If she prefers shorter feeds but your supply is ok, could you try hand expressing off a bit of milk before some days feeds meaning she doesn't fill up on the fore milk and gets more of the fatty hindmilk?

are you part of a local breastfeeding support group? The support of other breastfeeding mums really helped me.

it does worry me about you being encouraged to offer top ups - this ignores the fact that your milk production adapts to demand. if your baby seems to otherwise be developing well and you are comfortable with your breastfeeding I would be focusing on supporting that. any chance of some lazy time at home, lots of skin to skin snuggles on sofa/in bed, giving her as much access to you and your milk as you can?

sounds like you are doing brilliantly and listening to your baby and your own instincts.

[jackstini]

Sounds just like dd

She was 8lb9oz born but was way overdue and we are all small, so she dropped down to the second centile and pretty much stayed there, gaining at a steady pace

If she is happy, still producing wet/dirty nappies, healthy (not dry) skin, gaining weight slowly and alert when awake then just keep breastfeeding on demand

Some babies are just smaller than others - they can't all be mid-centile!

[RedRobyn2021]

Are you able to see an IBCLC lactation consultant? If you can afford it you could book private consultations, they will be able to help you. Most doctors are not trained in breastfeeding.

[RedRobyn2021]

I also agree with the comments about waking your DD for feeds in the night

My daughter started gaining fast when we started co-sleeping at 4mo

Before that her centiles went 50th, 25th, 9th

She's now 15 months and has been consistently around the 95th since she was 6 months

[MrsCT]

Thanks all for the continued responses. To those saying about the night feeds i am trying my best and she does have them but they aren’t significant feeds I’d say.
As I’m typing we’re doing a skin to skin feed as she’s almost fully asleep but she’s taking it, she just takes it if she wants it regardless or being sleepy or awake.
she is developing perfectly, she’s alert, happy, responsive, she loves people and faces and has a new obsession with staring at her hands working out what she can do with them, she doesn’t look small at all particularly because me and my husband are petite so she actually looks quite a sizeable baby so I think her weight will balance somewhere on the lower centiles.

[MrsCT]

Trying to answer all the questions- she has 6-10 wet nappies a day and usually at least two dirty soft yellow nappies which all seem totally normal.
Yes I’ve parted with lots of money at this point, the lactation consultant was fab but unfortunately it just hasn’t really helped because we cannot resolve this latch problem.
the craniosacral therapist achieved nothing and the osteopath was the most ridiculous thing I’ve ever experienced.
yes we’ve tried the cup method and syringe and medela nursing system and she won’t take to any at all she just gets stressed.
maybe the answer is to have more skin to skin at night to up those feeds because trying the top ups just isn’t working.
I’ve expressed mostly from the start so that initially DH could feed her as well but I only expressed once a day and my supply is still well established so I can’t think her feeding is so bad otherwise I would have a really low supply by now.

[MrsCT]

I recommend a lactation consultant to anyone btw because even though we’re still having problems they are amazingly knowledgeable and supportive and it helped enough that I didn’t give up breastfeeding at about 5 weeks!

[Branleuse]

I think many babies are just small. It doesnt sound like failure to thrive at all. You cant forcefeed a baby. If shes breastfed then unless shes actually losing weight or not pooing or peeing or lethargic, then just keep doing that

[MrsCT]

And tongue tie yes we’ve had checked she has a minor posterior tongue tie which isn’t very significant at all and would reattach if they cut it. So no luck there either

[Seeline]

Is she actually gaining weight steadily? Tracking a percentile line?

If so I would carry on with bf, stop top ups, but try feeding as much as possible, particularly through the night.


My DD never took a bottle nor would she ever drink milk from a spoon, syringe or cup. She liked a boob! She happily drank water, juice etc from a cup once weaning started but not milk.

[Mummy2C]

instagram.com/feedeatspeak?igshid=YmMyMTA2M2Y=

This lady on Instagram has information on how to introduce bottle to BF baby. Shes very good.

[MrsCT]

She’s gaining about 15 grams a day and they want her to gain about 30. So far she hasn’t stick to a centile line, if she stays where she is now then that’s fine

[Gingermoth]

My Ds was on the 2nd centile and still is. He is healthy and strong but very tiny.

[catsnore]

Health visitors seem to be a bit obsessed with weight gain - I've just had this with my baby. She dropped quite a few centiles but was feeding regularly, growing and looked absolutely fine to me. They were insisting on regular weigh-ins, 2 or 3 hourly feeds, waking her at night etc. She was sleeping very happily and waking maybe once. 3 months down the line she is piling on the weight and is going back up the centiles! I've told them I'm not coming back until her one year check unless I have any concerns 😂 They are just doing their job but it was a lot of unnecessary worry at a difficult time.

[Howmuchwood]

OP you sound like you've done everything you can. Some babies are just small,my DC2 is 25th centile, DC1 is 95th and I spent far too long worrying about it. I still have a wee niggle but both my DC are perfect in their own way!

Keep going with lots of skin to skin and try to keep regular night feeds if you can. Also make sure baby empties each breast as towards the end of a feed is when the milk is fattier.

[XrayFish]

Obviously feed her as much as she wants at night, but I don't agree with waking her more than every 3-4 hours. Sleep is really important too and being over tired won't improve her latch. People would happily let a bigger baby sleep through the night at that age.

Honestly she sounds absolutely fine, I would slowly take a step back from the HV and paediatrician. You both being stressed is not helping.

You clearly have sought out help and would do so again if you were worried about her. But at the moment you're not worried about your daughter you're worried about not being able to follow instructions. Are they actually worried about her or do they just want weight gain to get you off the books? I understand needing to monitor babies not gaining well but it's supposed to be as an indicator for other things, it's not necesarilly a problem on its own and you don't necessarily need to do anything.

[MrsCT]

Yeah I mostly agree with all of this, essentially a low centile isn’t a problem, it’s the dropping centiles that’s a problem and I do understand them doing their jobs and making sure there’s no problem.
I just really wanted to take on all professional advice but I think at this point I’m going to have to drop the top ups and go with my instincts, and try to rouse her a bit more at night but I do agree that sleep is so important and I don’t want to mess that up because that won’t help anything it will just cause more stress xx

[RandomMess]

This is so difficult for you. I was lucky my youngest got weighed twice between birth and 6 months.

I had 3 huge babies 10lbs but she ended up way down the centiles by 6 months and lower still by 12 months when the other 2 hadn't, she has remained slim yet tall her whole life. Has she been weighed regularly I would have probably had the same issue of saying her weight was a problem.

Ultimately I am petite framed and so is she - narrow hips etc

[MrsCT]

and the thing is that we wouldn’t necessarily have had this paediatrician appointment and then we wouldn’t have known she’d dropped to a lower centile because there’s no other indication so it seems almost silly to stress about it when we wouldn’t have otherwise thought there was a problem

[Bumblebee413]

I just wanted to say that you're doing an amazing job. Your love for your daughter shines through and she sounds very lucky to have you as her Mum. Trust your instinct and your baby. Don't feel pressurised to bottle feed. Your boobs adapt your milk content dependent on what she needs. If she needs more calories it will become more fatty. Its magic stuff.

Please never put rusks in bottles, it's a potential choking hazard a really old fashioned advice. I can't believe people are still pushing it!

X

[Bert2e]

@MrsCT

And tongue tie yes we’ve had checked she has a minor posterior tongue tie which isn’t very significant at all and would reattach if they cut it. So no luck there either

PLEASE see a qualified tongue tie professional (find one here) I've seen SO many babies over the years like this. She needs a proper tongue function assessment (the paed wont be qualified to do one). A "minor posterior tongue tie" can have a major affect on latch - you even say that she doesn't latch well. A "minor" tie does not always equal a "minor" effect on feeding. I'm also not aware that there is any evidence that the tie would reattch if it was cut - this screams mis information from someone who is not qualified I'm afraid. I presume that the paed has also done a full health screen including heart function? Posters please don't perpetuate the myth that babies are simply small. This is a baby that is showing faltering growth that needs to be investigated.