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Infant feeding

Failure to thrive

13 replies

bakerbump · 09/09/2013 21:03

Background story is that I've had a really rough journey BF my 18wo DD. It took just over 3weeks for my milk to come in due to tongue tie and with me being ill with a virus and anaemia from a large blood loss. We've had oversupply with her choking, tongue tie being snipped a second time, blocked ducts, and I don't get a let down unless I distract myself with my iPhone. Feeds have got shorter all the time, now at 2-3mins, and although BF councillor assures me DD is just efficient I can't help but think she's not getting enough.

My lovely HV is keeping an eye on me as I have a history of anxiety and panic attacks and am showing mild signs of PND, which I'm attributing to the stress of feeding. She paid me a visit to weigh DD today and she's about to drop her 3rd percentile since birth. The dreaded failure to thrive was mentioned together with the suggestion of early weaning (not sure about this)

I'm not looking for answers really, just wanted to get this off my chest. I know that 18weeks is an amazing achievement considering everything but I can't help thinking that I've failed her. After tonight's 2min bedtime feed I felt heartbroken as I watched her contentedly gulp down a bottle of formula afterwards.

Ultimately I know that stopping BF is for the best but the emotional attachment to it makes it so hard Hmm

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hettienne · 09/09/2013 21:08

If your HV actually said failure to thrive then that is appalling! I don't think that term is even used anymore, and it doesn't mean slow weight gain in an otherwise healthy baby.

Is your baby still gaining weight? Is she alert and content between feeds?

I wouldn't worry about short feeds, but I would try to feed really frequently, at least every 2 hours, and also switch feed and do breast compressions to get more milk into her.

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tiktok · 09/09/2013 21:29

Usual term these days is 'faltering growth' - not good to use 'failure to thrive'.

Hard to say what's up, from the info in your post.

Not enough detail.

But it's good your HV is supporting you, and has an eye on your emotional well-being as well as your baby's weight.

2 mins per feed is not in itself a concern, but combined with weight concerns and the fact we don't know how often she's feeding, how much formula she has, it may be significant her feeds are short.

Hope things work out for you and you have some real life support for this difficult time :(

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bakerbump · 10/09/2013 08:36

Sorry if my OP lacked detail. She's fed every two hours since birth and I try to feed her at every hunger cue as opposed to clock watching. She is usually happy and content between feeds. With regards to weight gain she usually puts on 12oz every 3wks, when she was weighed yesterday she'd put on 8oz in 3weeks.

Sorry if my OP was misleading, the HV warned of failure to thrive rather than saying that she is failing to thrive.

If she has a bottle of EBM or formula by DH it can be anywhere between 3-5oz. We've been giving her top ups after each BF since her nursing strike last week. At first she'd take 30-50ml after being on the breast, now she's refusing the top ups.

I take Fenugreek, do breast compressions, switch sides, pump after each feed.

For her first feed this morning she acted like she wasn't hungry when I tried to feed her, and this escalated into her scratching me and screaming. When I tried her with the backup bottle I had with me she happily took 3oz

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tiktok · 10/09/2013 09:52

Thanks, baker but still not enough info :)

At 18 weeks, rate of weight gain has already slowed in most babies - you simply would not expect the same rate (you can see this on the charts - the curve of each centile is less steep).

Having said that, you say she is 'about to drop her third percentile' - what does this mean? It is considered within normal to drop up to 2 centile spaces, so that might mean three lines.

Have you got the chance to talk in real life about the amount of formula you are giving? If she gets a 3 oz 'back up' bottle more than just occasionally, you could be undermining your breastmilk supply and her intake. It may be there is a supply issue, it's not clear, but it prob needs real life assessment and a plan.

Sorry you are still struggling - 18 weeks is a long time for it to be hard work still :(

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bakerbump · 10/09/2013 19:38

Hi tiktok, I've only been doing top ups since she went on strike last week and she has pretty much stopped taking them now when offered. Whenever she has taken extra from a bottle I've always pumped to minimise any effect on my supply.

With regards to her weight gain she was born between 50-75th and is now bang on the line for 9th but looking at her curve she will be in 2nd within the week.

I'm a stubborn cow, with each problem we've had I've refused to let it beat me but maybe now is the time!

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tiktok · 11/09/2013 10:07

baker, well, I dunno.....your baby sounds ok to me :)

If your baby needs more calories according to the HV, in order to gain more weight, then there is normally nothing to be gained by giving solid food this early - more breastmilk is usually the most efficient way of upping a baby's intake.

But the HV can see your baby, can see you, and can have a dialogue and knows more about your circumstances.

Hope things work out.

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MrsDibble · 11/09/2013 14:54

Not to scare you at all, but have they made sure she doesn't have any other problems that would mean she doesn't gain weight? Other than difficulty in breast feeding?

Also, rather than going onto solids, they could prescribe her some high calorie formula (and you can get really high calorie stuff - such as Infatrini) and you could mixed feed?

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Parsnipcake · 11/09/2013 15:13

Hi , I am fostering a baby with a very similar profile to yours. I would definitely ask for a paediatric referral to rule out infections and any other issues, to reassure you as much as anything. It's incredibly hard though isn't it when they don't feed well. My baby is formua fed and still struggling to feed well, so definitely don't blame yourself or breastfeeding, for some babies it is just more of a problem. We have 2 hourly waking too, and 14 week old only weighs 9lb.

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TortillaDeMaiz · 11/09/2013 17:45

If you've had oversupply, could it be a reason why she is refusing to drink? Maybe try to do some block feeding (only offer from one side for 2 hours) to make sure she has "emptied" the breast properly. In my experience, babies drink better when the breast feels comfortably soft and may refuse an engorged breast.

I wouldn't take fenugreek or anything else if she's not taking enough.

Just some thoughts, but definitely try contacting a breastfeeding counsellor.

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Lollypop1983 · 13/09/2013 17:09

I'm going through this with my LO just now, he's 5months.

He's dropped from 75th when born to 25th this week, so almost the same. I got him checked by docs this morning, just to rule out anything underlying. She suggested that my supply might be affected by stress and PND. I'm not eating properly either. Between us, we decided to wean LO off bf and put him onto formula, it means that we can keep an eye on his intake.

Have u had LO checked by doc to rule anything else out? Just to put our mind at rest? I'm starting to think that some babies go through a period of low weight gain.

I'm stopping bf because there are other things affecting me, but if u can keep going with BF, you are doing soooo well to keep it up for 18 weeks.

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bakerbump · 14/09/2013 11:34

Thanks for all your replies, suggestions and encouragement. Thought we'd turned a corner yesterday as we mostly BF and she is happy to latch on again now. But my supply has taken a battering and I've still got my problem of a very slow letdown. Sometimes it takes 40mins.

This morning was going really well until the second feed. As she got hungrier and hungrier I became more aware that my let down hadn't happened (so it didn't) and it ended with us both in tears so I resorted to an emergency carton of formula.

My HV has got me on PND watch... Dunno if that's what I've got, if she has a good feed from me I feel fab, if she doesn't I spend the rest of the day anxious and in tears. Very up and down and it all depends on whether she's fed from me or not.

Spoke to BFN helpline last night and got some tips re helping my letdown and increasing my supply. Have doctors appt in a few days so will get DD checked for any underlying issues as suggested. Hope your transition from boob to bottle goes well for you lollypop

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bakerbump · 17/09/2013 14:16

Well, at a doctors appointment today I was told that a recent blood test shows I have an under active thyroid... with possible side effects including PND type symptoms (check), low milk supply and slow weight gain baby (check), and difficulty getting a milk let down due to reduced oxytocin levels (check!)

When the doc told me I was so happy I could have cried! Now starting meds to get my thyroid levels back to normal which should solve all the issues I've been having! The BF shall continue!!! GrinGrinGrinGrinGrin

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ShesADreamer · 17/09/2013 14:23

Sorry to hear you're having thyroid issues but great to actually find the cause of your bfing struggles Baker!
Hope things get much better fast for you and DD - she's lucky to have such a switched on, determined mum!

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