Not gaining weight, help! Barb??

[Jennifer13]

Hope you get some answers hun. Has she grown in length at all? And I'm assuming her weight was checked on the same scales each time?

[Laranna]

Thanks all, we have seen the paed and it sounds like a UTI just waiting on the results and what happens next.

Jen, same scales at the GP but different scales at the hospital (actually showed her lighter than GP scales this morning!) and length and head growing normal.

[onthefly]

Hoping you get some answers and reassurance.

[Laranna]

Well we are finally home. There was no UTI after all although there were some white cells but on it's own nothing to be worried about. They also took bloods (DD was even smiling at the nurse as she was poking a needle in her arm!) which came back clear. Paed did say a couple of them were slightly abnormal but on their own don't really mean anything.

Senior paed came and saw us and basically said feeding 2-3 hourly at this age is too often and therefore is not getting enough from me and I should top her up after every breastfeed and give her solids 3 times a day as solids have more nutrients than milk(!) and referred me to another paed outside the hospital.

So, is feeding 2 hourly at 5.5 months too often? At the end of the day she would be taking in the same total volume of milk?

Gah, this morning the GP tells me I'm not a great jersey cow. He wont give me motilium because he doesn't think it will help since the top ups of EBM havent helped. The senior paed immediately assumes I have no milk when I told her about feeding dramas with DS like this time is no different despite DD showing all other normal signs.

Why does this have to be so difficult?

[kelebek]

Senior paed came and saw us and basically said feeding 2-3 hourly at this age is too often and therefore is not getting enough from me and I should top her up after every breastfeed and give her solids 3 times a day as solids have more nutrients than milk(!) and referred me to another paed outside the hospital.

So, is feeding 2 hourly at 5.5 months too often? At the end of the day she would be taking in the same total volume of milk?

My DS fed 2-3 hrly 24 hrs a day for the first 12 mnths and more often then not it was 2 hrly. Breastfeeding works on supply and demand the more she feeds the more you fill up (even if you don't feel it especially by 5 mnths as your bb's are use to the cycle) I think I would question his credentials in regards to his breastfeeding knowledge if he is telling you this.
I think I would be starting solids before trying to top her up with formulae (although no judgement from me if you do), I started DS on solids about the same age from memory.

Can you go to another GP to get a script for the motulim - who is he to decide it won't work for you shouldn't that be your choice!! and didn't you say it did help last time?! grrr so cranky at your GP for you.

Unfortunately reading other ladies experience it seems that it is hard to find many professionals who take breastfeeding and it's capabilities seriously anymore

Why does this have to be so difficult?

I wish I had the answer for you but you are TRULY INSPIRATIONAL (and sorry to other readers but yes I meant to yell that ) for being so passionate about what you want for you and your DD and to do this with a toddler I take my hat of to you.

There was no UTI after all although there were some white cells but on it's own nothing to be worried about. They also took bloods (DD was even smiling at the nurse as she was poking a needle in her arm!) which came back clear. Paed did say a couple of them were slightly abnormal but on their own don't really mean anything.

As I have said before I am not a medical expert and I don't mean to worry you but if the white cells (I'm assuming in her urine) and some of her bloods were slightly abnormal wouldn't they look at that together not on it's own as such? I don't know what it does or doesn't mean but it just had me thinking hrmmmmm IYKWIM?

I do think your DD is amazing to smiling at the nurse while getting blood - what a brave little girl she is. Does she have a high threshold to pain?

[Janie]

Oh sweetheart, I have been thinking of you I'm so glad your little girl is okay, but I'm sorry that you have been made to feel this way

You are doing all of the right things. 2-3 hourly is very normal. I don't have time (I'm sorry) to expand on all the other things, but I wanted you to know that you're doing so well.

Hang in there, things will get better xoxo

[Jennifer13]

hun, sorry there were no answers there. At her age, breastmilk contains more nutrients than solids, so that's a furphy. If you want to increase your supply, then feeding more often will probably do it, but it sounds like she's otherwise healthy and happy (except for the white cell count).

I might change your thread title to catch Barb's attention - hopefully she can help you out. Have you considered seeing a LC (JIC this is a feeding issue - although I suspect you are doing everything absolutely right!)?

[Laranna]

Thanks Janie. Kelebek, yeah I would have thought the results would mean something but apparently not. The white cells in the urine could still grow something and they said they would call me but since DD was not febrile they weren't concerned.

I've started offering solids and she has been great with tasting but not swallowing all that much but I expect that's quite normal?

Jen, thanks for changing title. I've spoken to ABA who said it all sounds right and so now I'm thinking of calling an LC. My MCHN has seen me feed and said everything looks correct.

I'm not sure what else I can do. I wasn't worried about my supply before but now I am. I don't know what's changed to drop it off. I'm not pregnant, no AF yet. I've increased feeding, expressing (only get around 30-40mls at a time though), drinking lots of water, taking fenugreek. My boobs feel lighter after feeds and feel full before feeds, although softer in the evenings. So yeah don't really know....

[onthefly]

Did you ask to see that Paed's lactation credentials? Sadly so many health professionals are very misinformed. I'm cross that your GP said that too (and really don't understand his rationale for denying you motilium). You've fed your beautiful, healthy daughter for 5.5 months so far - there's nothing wrong with your milk! and feeding 2-hourly is totally normal.

Find an LC and have a chat with someone who actually understands how lactation works - it can only help from here. As for three meals a day - errrr, right. Do they want you to force feed her? I'd be a bit concerned about replacing so much milk with solids at this age too.

It is hard, I'm sorry.

[Lenny]

I haven't got much time, just wanted to say that I am feeding Aidan 2 hourly over night. It's killing me (I look like i'm 90 years old) but it's just his version of normal. I think he is so distracted and busy during the day that he catches up at night.
Keep drinking water - that's a good reminder for all of us.
Good on you for seeking further advice. Solids are fine and all that, but they aren't necessarily going to help DD put on weight.
You are awesome Eluned for all the work you are putting in. I hope things pick up soon.

[Laranna]

marcellus, I know, there's no way she will have 3 meals a day. I've only just started offering last week and to go from that to 3 times a day is just mad at her age.

Thanks Lenny.

Will the ABA have contact details of LC's in my area?

[onthefly]

They might. If you google LC & perth you'll find some pages.
You know who you should contact - Rebecca Glover. She's like the Aus breastfeeding guru and in Perth. Just google her.

And I agree about your awesomeness

[Janie]

Yes, if you can speak to Rebecca Glover, please do! Otherwise call the ABA helpline and ask for details of LCs near you.

It's great that you're checking all avenues, but it may not be a feeding issue, so keep an eye on her

[Kmn]

Pediatric Advisor 2008.3: Making High-Calorie Formula or Breast Milk
Maybe try something like this with an ebm bottle each day?
I also would try for 3 meals a day - in the sense that she tastes things more often and gets more used to them rather than the force feeding sense.
Huge hugs
Kate

[Jennifer13]

Kate - I wouldn't think those instructions were as per the recommendations on most formula tins. I also wouldn't be adding formula to ebm unless specifically under medical advice. If there is an underlying issue, then you'd be best off speaking to a health professional about an alternative course of action.

Too many meals of other food (not bm) will actually reduce calorie intake, as babies of this age absorb far more calories from bm than solids.

[Schmickers]

Sorry I'm coming in late to this. I hope your little one is continuing to do well. If she is developing normally, is settled between feeds, and is putting out plenty of urine, I wouldn't be too concerned. Some babies are slow to gain weight to start with and catch up pretty quickly once they start solids. DD1 and DD3 are both like that.

As far as adding formula to human milk - that is really not appropriate. I know that site comes from a paediatrician, but it's still bad advice! If you really need to fortify human milk, you need to use human milk fortifier, which adds calories to human milk while preserving all of the other contents and without adding anything unnecessary.

[Kmn]

Mick - thanks for clearing that up!
Eluned - let me explain why I suggested the "fortification" option; I'm no expert - feel free to poke holes in the following.
I don't think this is a supply issue - I think you are doing OK on the "dairy cow" front! Amelia is often not finishing side 2, which suggests that there is more milk there for her to take if she was so inclined. Also, supplementing with EBM didn't produce weight gain - implying that whatever liquid she takes in from a bottle she simply doesn't take from her next boob feed - i.e. EBM is just "displacing" BM.
This makes me think that formula top-ups would be a really bad idea - you find expressing difficult, and you know from your experience with DS that your supply is rather "sucking-sensitive", so if the top-up in anyway displaces what she takes from your boob then you are risking creating a supply issue where there wasn't one before. It also makes me think that motilium won't help - since there's already milk there that A isn't finishing.
This is a really long winded way of saying that I think you need to try and add as much extra energy to her diet whilst adding as little additional bulk as you can - and hence minimizing the risk of displacing the BM that she currently drinks. And the fortification seemed the logical way to do that. The other way is high-energy-density solids - but that requires her to get the hang of them first!
hope this makes some sort of sense - and hope you do find an answer that works
Kate

[Barb Glare]

Hi,

Just back from a very illuminating breastfeeding conference. One thing from today that really resonated with me was - babies DRIVE supply. Babies that are designed by genetics to grow slowly take less milk and therefore mothers make less milk. (boys grow faster than girls - thus the 2 charts - therefore they take more milk, therefore mothers of boys make more milk)

Feeding 2 hrly at 6mnths and beyond is boringly normal! You don't need to be a jersey cow - you are not feeding the neighbourhood. Just one small baby. That baby seems healthy and happy. Your breasts are doing their thing - you are doing great! Just to keep everyone happy, the intro of solids is a reasonable idea. Food is available in several orms (breast and food) You are a great, switched on mum- you attend to her needs.
PS - Kate, sorry I don't think fortification is warranted in this situation - breastmilk plus food is fine

Warm regards
Barb