Health visitor said I need to top up with formula

[Moonshine160]

DS2 is 7 weeks only today. He was born at 38 weeks and was dinky at birth, only 5lb 13oz. He’s been weighed today and now he’s 8lb 15oz. The health visitor has been out today for his 6-8 week check and she said he hasn’t gained enough weight and I need to be topping up with formula. He is quite a snacker and only feeds for about 10 mins, but I have a very quick and forceful letdown and he gulps rapidly, this has caused some issues with wind. I don’t think a 3lb 2oz gain in 7 weeks sounds bad but she said from looking at his chart he was gaining weight quicker in the first month than what he is doing now. He suffers with reflux and she also mentioned early weaning which I don’t want to do. She said that if things carry on the way they are she may suggest switching to formula or exclusive pumping so I can see how much he’s taking. It’s all really upset me, I was enjoying our breastfeeding journey and now I feel like I’m not doing good enough for him.
I find expressing milk too difficult as it takes me ages to get a substantial amount and I have a toddler to look after too.
Has anyone been in the same situation and what did you do? Did you switch to formula?

So glad you’ve got some better support OP, based in her reference to early weaning I’d ignore her completely. I was recommended to early wean my dd as she was a terrible sleeper, I followed advice and it was a) stressful and b) had no impact on sleep whatsoever. Later I did some actual research and found there is no evidence in favour of early weaning and a some evidence it causes harm. My HV told me WHO guidelines were for ‘African babies’ which again was complete BS. Dd is just about to turn 15 and I’m still annoyed when I think about it! No idea what training they give HV but they definitely aren’t experts in infant feeding.

Health visitors get almost no training on breastfeeding. She may well be talking out of her backside. Contact La Leche League or another source of expert advice. And, if you have the energy and they agree there are other options, complain about the HV

Isn’t that shocking, it really baffles me and saddens me because it’s just so important. Once again the needs of mothers just not supported. I get so angry. We deserve so much better.

Oh my goodness, they caused so much stress and worry for me with saying things like that! My LO was born on the 50th percentile, then was on the 25th for a few weeks, before dropping to 9th. The health visitor was weighing him every week or 2, sometimes after 3 days! She mentioned formula top ups, but I told her I didn't see what good that would do as if he won't take more breast milk, he's not going to take a bottle (he also refused bottles anyway). It wasn't that I had a supply issue, so I didn't see why formula would help. He is now 1 year old and still on the 9th percentile, so he just took a couple of months to find his curve. The pressure to feed him more caused a feeding aversion, and no end of stress and upset. The GP told me a baby will feed when they're hungry, and to not worry about weight gain as they won't starve themselves. I stopped getting him weighed so often and went with the flow, and my LO stopped feeling pressured to feed and was much happier. I think the health visitors put far too much importance on the growth charts (which are for formula, not breast anyway). Babies all grow at different rates, if baby is happy, developing well, and hitting milestones, and gaining some weight then I personally would ignore HV!

Oh, also I had a very strong let down and baby had terrible gas problems. I started expressing a little off before feeding him, which helped massively with his gas.

@Frazzled37 thanks for this - the feeding aversion is what I’m worried about. This happened with DC1, he ended up with a bottle preference and I tried so hard to get him back to the breast by offering it constantly that he eventually developed an aversion. I’ve found I’m doing the same now and constantly offering DS the breast instead of just waiting for his cues. I’ve got some digital baby weighing scales from DC1 and I’ve resisted the temptation to weigh him this week and I’m just going to try and go with the flow.

take baby to see an osteopath. They will sort out his reflux easily. My baby had awful reflux. I used to sit him up slightly during the night and I stayed awake in case he choked on his sick.
The osteopath was the best £80 I spent and also worked for the babies of a few friends of mine.
I had bottles, powders, different types of milk. All a waste for us.

Cranial osteopathy

Your baby’s weight is absolutely normal. The birth weight centiles and the later centiles are from different data sets and cannot be used together, Your baby didn’t go up to the 9th centile and then drop to 2nd because the two data sets are incomparable and can’t be used like that.

Now your baby has been weighed and his weight plotted on the WHO-UK data set, he should stay within 2 centile spaces of the 2nd centile (because he is small, if he drops off the centile this gets a little more complex but there’s guidance online you (or more pertinently) your health visitor can read)

Frankly from the weight, the only thing the health visitor should have said is “you’re both doing great, see you in a month”

It doesn’t sound like the tongue tie at present is causing you great problems, lots of babies who have mothers with fast letdowns have shallow latches (controls the flow). I really wouldn’t let this one health visitor undermine your confidence in feeding at all.

It's so hard to not worry, and to keep offering when you think they're not having enough! His aversion got to the point I could only feed him when he was asleep. That's when I spoke to the GP who said stop feeding him asleep, and stop worrying about his weight. She told me he'd feed when he gets hungry enough. I also read a brilliant book about feeding aversions by Rowena Bennett (I know yours doesn't have one) but it was very insightful, and showed many cases happened because of HVs pressuring people about weight gain. It was an awful experience and I wouldn't want anyone to go through it. If he's not having actual issues feeding, and is having wet nappies, and not losing weight etc go with what you think is best, but just don't over offer. I got quite annoyed with the HV as my baby was perfectly happy until he developed an aversion. I am also very petite so don't know why they expected my baby to be so big anyway! I hope all works out for you, but don't feel pressured into doing something by the HV if you feel it's not the right thing. They are not experts in feeding!

I read your post a few days ago but didn’t have an account to post and your health visitors comments have really been bothering me!
For context I mixed fed my first because of a tongue tie, currently EBF my 4 week old.

My first DS was also on the second centile and I did lots of work with a dietician after 6 months when I introduced him to solids. He went up to 25th whilst working with her and then slipped down to 9th and stayed there. Some kids just are just a bit smaller! He’s now 4 and healthy. However I carried BFing until nearly 3 years, so even if you do choose to mix feed, it’s by no means the end of your BFing journey! If you do choose to mix feed you could do formula with a cup so that your DC doesn’t prefer bottle. Always after you’ve bf though, or you could offer a bottle but use the PACE method where you keep baby sitting up and bottle level so they don’t get the milk too fast. (I found expressing with a new born stressful and time consuming also).

Also, with 10 min feeds maybe he’s not getting enough hind milk? You’d notice this if his nappies are green. I find my DS2 feeds longer in rugby position than he does in cross body. He also has a deeper latch so it’s more comfortable.

It sounds like you could do with some support, are there any BF support groups near you? The family centre should have details, also, they should also be able to provide you with BF support. Other places that could help are Le Leche League, www.laleche.org.uk they have a support line and sometimes a group local to you. If you did antenatal classes with NCT they also have support you can access. And as another poster says, there are some fantastic BF support groups on Facebook. It’s good to have a community.

Lastly, BFing is hard, there’s all sorts of misinformation out there which doesn’t help when you’re a new mum. You’ve done 7 weeks EBF, give yourself a pat on the back, you’re doing awesome mama!
Whatever you choose, please don’t give yourself a hard time. Good luck!

HV has been back out today and she just gets more ridiculous. When she was here I thought “I’m making a complaint once she’s left” but she then informed me that as of next week she is retiring so I’m going to be allocated someone new, thank goodness.

DS has gained 6oz in a week which she said was ok but she still wants him weighing again next week.

We got talking about naps and routines etc, and I informed her that DS isn’t in a routine at all yet. She then told me that I should be starting to get into one and be putting him down at 7pm at night and she even used the words “sleep training”. When I told her he’s far too young for any sort of sleep training she said “well I mean making sure he does down sleepy but awake so that he can fall asleep on his own and not rely on you so much”. He’s just turned 8 weeks old! I am just baffled!

Do you suppose she wants to go out in a blaze @Moonshine160 by pushing her personal opinions on final few new mothers?! So unnecessary. Glad you didn’t get more pressure on the feeding front though.

I’d have told her to leave, and told her that I was making a complaint about her. Stupid woman, glad she’s retiring

Sorry I haven't rtft but if you can afford it, a lactation consultants could help. Mine used to weigh baby before and after a feed to see exactly how much he took in.

Ps I have a real issue with the inconsistent advice and particular inconsistent advice from HV. I have had all sorts of erroneous advice over the years. It sounds like you're doing well

Sorry, meant to say inconsistent qualifications

A few rare HV are nurses but most I found are just women with their own opinions based largely on the past

Thank god she is retiring.

I'll be sure to tell my 12 week old twins that they should be going to sleep without my help 🙄