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

She was a bit of a whopper at birth, so I wouldn’t worry. Keep on BF if you want to. Weigh in a few days.

hi, just to add to the voices of the others. I had 3 babies over 4kg. each of them had severe tongue tie as well. The doctor I used to cut the tongue tie, who is an expert in all things baby feeding related, told me larger babies usually lose more weight and take longer to put it back on. The only time you need to be worried is if they are unsettled and if they are not producing enough wet/dirty nappies.
your baby sounds like she is happy and settled, so don't worry. also, stress effects the ability to feed successfully, especially at the beginning.
you sound like you are doing a fabulous job. keep it up!!

Absolutely ignore HV. Lots of them don’t really understand breastfeeding and if you start expressing/bottle feeding now you will mess up supply and confuse the baby. Seek advice from La Leche League or similar. The growth charts in the baby books are also not designed for bf babies. If baby seems fine and is feeding and producing wet nappies I would ignore.

Just to say too that it can be a scale calibration issue too? Different scales were used to measure baby at birth and now.
It sounds like you are doing fine!

I went through this with with if mine (now teens) my eldest I gave up and bottle fed. My youngest I said no, I'm feeding him.

They were both 4kg+ at birth. They both dropped to around 75% in a few days. My GP said some babies are 'born big' I.e. bigger than they are meant to be and will naturally drop. Where were her head and lentlgth measurements at birth? Has the HV checked those? They'll probably tell you they don't do that now... my consultant with my eldest did the head measurement as first off and said her tracking matched her measurements at birth her birth weight was an anomaly.

What will they do? Is baby alert and responsive for considerable parts of the day? Is she waking you at night? Yes? Then the answer is not alot. If they are not happy they can refer you to paediatrics. Take that referral- they will be much more aware and supportive!

Noticed you said you have painful breasts... pumping a bit will help here. You can bag it and stick it in the freezer- use it for dad to give you a night off later on. Also check your overfull boob is not smothering baby - you might need to pull it back a bit... but if baby is latching well for 15 mins that isn't a problem.

Health visitors are a nightmare. Let them weigh on Monday but then tell them you don't want her weighed until the following Monday. They shouldn't be heaping this pressure on you provided baby is alert!

Good luck OP. You are doing fab!

No they aren't. That changed years ago!

Keep going with the breastfeeding! I wouldn't be adding pumping into the mix as she's content and gaining weight. I'd try breast compressions as you feed just to give her a helping hand. Well done!

It was on a carpet yes, does that make a difference?

If you are in fact in either of these roles, you will know that advising a specific course of action based on very limited information from an online post is highly unethical and irresponsible.

We don't have enough information to know if "feed, feed, feed" is an appropriate response for this dyad.

OP, I'd suggest asking for a referral to the infant feeding team, as they will have the highest level of training available in the team. You could also call the National Breastfeeding helpline, who can talk through whether or not your baby needs any help, and give you the information and support needed to decide your next steps
0300 100 0212

This is not accurate. The UK red book has been based on breastfed babies measurements since 2009.

You are making very absolute statements here that show a lack of recent training, and purporting to be saying it with professional authority.

Expressing may be pointless, but you do not know the context.

If you use your counselling skills, you'll realise that simply saying do this or do that in opposition to previous advice doesn't help her make an informed choice on next steps, it's just two conflicting statements. That isn't useful.

“What will they do on Monday if she isn’t at weight though? I don’t think I can mentally cope with anymore negativity on the subject”

The only thing she should do is refer you to a breastfeeding adviser but I think the service might be patchy.
Besides, since your baby is already gaining weight it is extremely unlikely she won’t be above birth weight by Monday if you carry on as you are.

I had a huge baby (10.5 pounds) that really really struggled to gain weight. He was my second baby, I was confident in what I was doing, he was happy, wet nappies etc. My health visitor was freaking out that I wasn't concerned. Made me an appointment with a GP (who had no clue about breastfeeding), who then sent me to a paediatrician about my 'failure to thrive' baby (her actual words in my notes)...
Luckily I had some great breastfeeding support around me, because I damn near lost my mind during those first couple of months. I pretty much got accused of not feeding him and not caring. I cared very, very much, I just knew that he was finding his curve.
Lucky for me, lockdown hit when he was 5 months and I never had to see my health visitor again 😅
He's now 4 years old and 100% fine. He's totally normal sized, but if you saw him now you'd never believe he was so big at birth. I think that sometimes they come out a bit chunkier than nature intended and have to level out.
If you can keep going as you are, and keep your head up, please try.

Weighing should always be done on a hard surface - they will appear to weigh less on carpet or rugs etc.

My tuppence worth is that I think you're doing a great job, and there's every chance this is totally normal, and you don't need to change anything.

But I haven't seen you and your baby, so that's why I think a face to face evaluation of how things are going for you is a good plan: if all is indeed well, you can push back safe in the knowledge you've been properly supported, and you have a BF expert in your corner.
If the HV is stroppy on Monday, you can ask to be referred to the infant feeding team before adopting any feeding plan.

May I ask if your baby was preterm, at term, or overdue?

It sounds like if you insist on a hard surface for the next weigh in you will see a fantastic gain 😀

Remove your feelings and supplement her feeds.

Give her 1-2 oz of formula a couple of times a day for her sake then breast feed as usual. She may need more than your body can do at this moment. It is no reflection on you.

My GP said some babies are 'born big' I.e. bigger than they are meant to be and will naturally drop. Where were her head and length measurements at birth? Has the HV checked those? They'll probably tell you they don't do that now... my consultant with my eldest did the head measurement as first off and said her tracking matched her measurements at birth her birth weight was an anomaly.

^^Because this. One of mine was 'over dates' and it was only much later that I realised what had happened, and that all the fuss about nothing had made matters worse; also met another Mum who had had the same issue. Eventually this child tracked up a lower centile perfectly; always fit and well and thriving. This isn't the case for all 'over dates' babies of course (and conversely could also be the case in some born around term) but sometimes a very healthy placenta has provided very good nutrition before birth, if you see what I mean. How stupid if they are no longer measuring head circumference and length; honestly we seem to be going backwards.

(I note that there are other reasons for babies to be quite heavy for dates and/or for their length and head circumference, but this is the one I am specifically discussing that fits my situation and that of the other Mum.)

OP CLEARLY stated that she doesn't want to supplement

And has been given some cracking advice on this thread

This comment isn't cracking advice

I would take what the health visitor says with a pinch of salt - it really does seem quite hit & miss in terms of their knowledge & advice they give!

I also had a big baby born via c-section, with a similar length hospital stay, and she took a while to get back to birth weight. As long as she is steadily gaining weight and having plenty of wet nappies then I would carry on as you are - sounds like you are doing a brilliant job!

I'd just ignore the HV, smile and nod if you don't feel that you can refuse her visits,

Jaundice makes weight gain after birth slower. You also need to breastfeed more than you think you do to flush it out.

I agree with the others that say keep going with breastfeeding, but latch every time they are vaguely fussy, don't think 'oh well, they've only just been fed, they can't be ready to go again' because they might be! It won't make you engorged if your baby is suckling vs if you pump it might.

Good luck. I breastfed for 14 months. First 6 weeks were challenging but it all clicked into place after that.

How is the daily weight gain going?

The average baby gains 20g a day during the first few weeks. A 3kg baby dropping 5% (150g) might take a week to gain this back and be back at birth weight. A 4kg baby losing 5% that's 200g and 10 days an extra 3 days. For 10% it would be 300g 15days with average weight gain with a 3kg baby and 20days for a 4kg. You can see quite quickly how for a 3kg baby its easier to be back at birth weight by 2 weeks and for bigger babies or those where there they have issues in the first week or so so the weight gain is slower in those early days. Sussex nhs have a pdf that says baby should be at birth weight before 3 weeks so there's still time

There are also errors in measurements and the surface can play a role. Try weighing yourself on carpet and a hard floor if you have scales. Obviously the impact would be less with calibrated and professional scales.

Expressing was waaaay more trouble than it was worth for me in this situation. So much extra time and stress for a struggling new mum! Our midwife suggested we supplement with an ounce of formula per kg of weight (I think it was, but please do double check) after each bf. Worked really well and we were soon able to drop the supplemental formula. No issues and it helped DD finally start gaining weight. Also had the added benefit that she didn't mind a bottle, so DH was able to take her out and give her formula or pumped breast milk as needed.

Thanks guys again for all the support on this

I don’t need to ‘remove my feelings’ for her sake as she isn’t dropping weight, she’s a very healthy size and very content. Just isn’t piling it on as quick as they’d like/by the book

I’m waiting until her weigh in on Monday then going from there. Of course if she’s dropped/stayed the same then I’ll look into topping her up. But right now I just don’t need the added stress. I’ll up the breastfeeding as much as I possibly can (even more so than usual!!)

This is her right now, boob drunk and completely happy