Thought breastfeeding was going great - apparently I was wrong!!

[Freddie15VES]

My little one is 17 days old and still 100g below her birthweight

We ebf and she always seems content and full but health visitor isn’t happy with how slow the gain is even though she is gaining and wants me to start expressing/bottle feeding

I feel so deflated like I’ve done something wrong

I want to ebf I don’t want to start introducing bottles into the mix 😔

Just feeling like I’ve failed massively

Feel like I should just move to formula and take the stress out of it

Best thing someone told me as a new mum was "no one has had your baby before, so no one else knows exactly what's best for them".
Trust your instincts as her mum and the one who spends most time with her, and try and be confident with the health visitor about how YOU want to feed your baby. You got this!

Keep going! She sounds perfect. Some HVs are utterly useless when it comes to breastfeeding. I swear mine had shares in Cow and Gate! If your baby is happy and alert and producing wet nappies, trust her and your boobs to work things out between them.

I too thought she'd have quite a high birth weight. IME, this kind of drop/slow regaining of birth weight is more typical of heavier babies. I had small, light babies. My youngest and smallest was just over 2500g at term + (nothing wrong with her, just familially tiny), had her birth weight back on within a couple of days, and gained excruciatingly slowly thereafter. Because I'd done it twice before, and understood this was a perfect storm of HCPs' anxiety around light babies/slow weight gain (as if these things were always linear) and suspicion of bf as an unquantifiable process, I knew the drill and managed to weather the fretting. Baby is 8 now, still tiny, an absolute picture of health and very much ahead at school. And was ebf for 6/7 months and bf for 3.5 years.

I was in a very similar position, DD was born at 6lb 15oz and lost 8% which they weren't worried about. However, then she did not gain any weight until day 22.

Obviously by the 4th (I think) weigh in and still static the midwives became concerned. They ended up ringing CAU for a consultant's advice and we were asked to top her up 20ml of formula. At this point I must add we were being dragged out every 2 days to either the hospital or medical centre for weigh ins which is a totally other frustration of mine.

Being first time parents we trusted the advice of the midwives and Dr's and did the formula top up. This still didn't help to gain the weight they wanted so they then told us to make a full 3oz and offer this after every breast feed and let her have what she wants. Suddenly at day 22 she gained enough to be back at just above birth weight.

Now, I understand their worries as she was 9th percentile blah blah blah but looking back part of me wishes I hadn't let them worry and stress me out enough to do the top up as even though she still breast feeds we have to do the top up still at 10 weeks as she either isn't satisfied as my supply suffered massively or its habit.

If you want to ebf stick to your guns. Don't let them guilt you into anything!!!
We had our 8 week check couple of weeks ago and the nurse was so frustrated at the advice we had been given and says its all too easy to give that advice too quickly and ebf babies can take 3+ weeks to be back to birth weight and its absolutely normal. She said I could go back to ebf if I want but it would be hard and possibly hard on my mental health as it would mean a lot of crying from DD. Honestly don't make the decision lightly!

The reason you are getting so many replies to
this post is because for so many people that HV’s comments are red flag nonsense. Really take with a grain of salt and if you are worried get advice from someone who has credentials in breastfeeding.

Wish my HV has known this - none of mine born on large side followed the centile but had peaks and toughs but general downward trend. Youngest was only one not to drop any weight first week bf - other dropped 6 and 10% first week - and even she tracked down over first year.

Ironically DSis ff baby did the same but she wasn't questioned any where near like I was.

Also just to add, don't be bullied into pumping either. They had me hooked up every hour and the most I ever produced was 1oz. Majority I was giving 5ml. Its not a true representation and it may well just stress you out more which is not good for bf. I think the pumping really f'ed with my emotions and I did a lot of crying over it!

Despite my previous suggestion I do kind of agree with this. However, if I could go back in time and pay for a knowledgeable professional to reassure me and improve my confidence I would in a heartbeat. My MH really took a beating after feeding issues, it's a small miracle that I'm still going at 17m

As a midwife and a health visitor, I'm shocked you're recommending that she ignores the HV's plan. The HV has met this mum more than once, has the full hx in front of her and has completed a full assessment.

I don't reckon you'd be suggesting the same if it wasn't an anonymous forum and your pin was on the line.

Please be more mindful.

OP, I think a chat with the infant feeding team and second opinion from them would be really beneficial. Sounds like you're doing a wonderful job so far.. wishing you all the best.

I don’t think I’d have that HV back in the house, she’s not helped your confidence.

You sound like you’re doing great. Baby was good weight to start with, hasn’t lost excessively, it’s normal to lose some in first week, important things are wet and dirty nappies, gaining now and content baby. Tick, tick, tick.

id bin her off. Ask for someone else. I do agree that her bf knowledge seems lacking as what she’s said could well make things worse long term.

I hated pumping - took ages and made so little which worried me further. PFB was given it on a spoon - to avoid bottle which was stressful and messy at HV insistence. Next one wouldn't take bottles at all - so sat in freezer till 6 months and weaning when could mix with baby rice.

There was with pfb at lactation service at NHS hospital - which we did try but latch was good and changing position made no difference there was no such service next area we lived in.

This is just outright misinformation. The WHO growth charts used in the UK are based on breastfed babies.

OP, I urge you to be really careful about the advice being given here.

Speak to a breastfeeding mentor, or lactation consultant ,some health visitors don't understand how breast feeding works. Don't give up and and don't give her formula if you don't want to. It is perfectly normal for babies to loose weight after birth and take a while to regain it especially if they had a high birth weight.

The regaining birth weight pressure drives me mad!! EBF both my children, was put on feeding plans with both of them in the early weeks and it really upset me and knocked my confidence.
Fortunately my mum was a trained breastfeeding counsellor and helped. Both children absolutely fine and really healthy.
I also avoided local HV as they were useless.
Get some support from properly trained breastfeeding counsellors. There maybe a FB group or similar locally.
Don't give up!

But as a midwife and HV don’t you think it’s poor advice to tell a mum to express and top up at every feed for a baby that’s lost less than 10% of birth weight, was a very good weight to start with and is now gaining weight? 🤷🏻‍♀️

im sure OP would have stated if baby had been diagnosed with some underlying health condition meaning that faster weight gain was medically necessary.

id really hope the HV had completed a full bf assessment but again I can’t think of anything there which would warrant expressing and topping up. OP says she was told the latch is good.

The best thing you can do is decline the weigh in and the HV. 100g is nothing. HV have no breastfeeding training. She literally doesn't know what she's talking about!

I'm a bf peer support worker. Find your local group now. You're doing great!

Id sit and feed as often as possible for a week, then weigh again. Be absolutely lazy and focus on building up the feeding.

I believe that babies can show as weighing slightly heavier at birth if you were induced and / or you were given IV fluids, this artificially increases their birth weight. This then looks like they're gaining slowly, when they're actually not

Please remember that those guides are just that - guides

100g, IMO, is minimal

Also is the HV putting her scales on a firm surface, not a carpet?

They are no longer based in bottle fed babies

HV does not sound educated in BF. Baby sounds fine and well. Don't worry about expressing. Personally I could never express much in the early days as baby took so much. (I still struggle a bit now at 7 months old and she's a very healthy baby who has absolutely thrived on breastmilk.) Just put baby to the breast as much as possible and you'll be grand.

I know an adult in her thirties. She was a prem baby and her mother was told to encourage her to keep taking more than she needed. During infancy she was advised to give the baby high calorie foods to help her to gain weight. Result- she is now a severely overweight adult but not very tall. She was overweight as a teenager.

Trust your instincts and the advice given here. Contact a lactation expert if you think you need to but I personally feel the HV’s advice was incorrect. Your baby is slowly gaining weight, producing wet and dirty nappies and feeding well. Don’t create problems where there are none. Enjoy breast feeding and your baby will grow and develop at her own pace.

I had to supplement as DC lost a lot of weight after birth but one week was enough and she chonked up nicely and went on to breastfeed for another 3 years! So it’s not always the end of your breastfeeding journey. If you can afford it, a breastfeeding doula / advisor could really help.

Hi OP, sounds like you are doing a great job. If there are concerns about weight gain then the first step rather than stressing out about expressing is to make sure you are maximising milk transfer to the baby. Ensure baby has a nice deep latch, and is swallowing not just sucking.
Global health media attaching your baby to the breast is a good video to watch.
And offer both breasts per feed, sometimes babies will switch back and forth, so will have both then go back to breast 1.
Feed more often including overnight. Night feeds are really important.
Is feeding comfortable? How many poos per 24 hours. Poo is more a reliable indication of milk intake rather than wee. If you are getting at least 2 poos a day and feeding at least every couple hours that's all good.
Offer the breast whenever you can, literally at any squeak. Spend the next few days skin to skin just feeding feeding feeding. Then see when baby is next weighed how things are.
If all the above is ok then there shouldn't be any reason you need to top up however in some situations it may be required.
Seek support from local breastfeeding support too 😊

Breast compressions too can help.