Doc says give formula

[LLL_Sarah]

Dear Crystal88

When you want your baby to drink more milk there are two main ways to achieve this:

A - Get the baby to drink more at each feed

Three things which will help your baby drink more milk while breastfeeding are:

1. Check the latch is optimal - so that baby gets as much milk as possible for each suck

It is always a good idea to review how you are latching the baby. You want to latch the baby in the way that he will get the most milk. If you are worried about this get a LLL leader or lactation consultant to watch you breastfeed and suggest tips to improve the positioning and latch.

Remember the angle of the baby's head when he is at the breast - it needs to be bending backwards. The nipple starts opposite the nose and ends up at the top of the baby's mouth - not the middle or the bottom of the mouth. It doesn't matter what position you are feeding in all these points are valid for all positions.

On Dr Jack Newman's web site there are a number of videos showing what a baby nursing looks like, Breastfeeding Articles by Dr. Jack Newman - Breastfeeding Online
There are some videos under Latching about half way down the page. These show how to achieve the asymmetrical latch, which is the most efficient way to breastfeed.
(But do not to try to pull the baby's chin down! He does this is the video but I think it is more helpful to take the baby off and re-latch.)

2. When baby's deep sucks slow down at the breast - introduce breast compression

Dr. Jack Newman explains how to do Breast Compression on his web site at http://www.breastfeedingonline.com/15pdf.pdf.

He also has video clips on his web site at Breastfeeding Articles by Dr. Jack Newman - Breastfeeding Online which can be useful, scroll down until you find them. Compression and Compression Two under the heading Breast Compression.

3. When baby slows down with breast compression - swap sides.

Switch nursing is changing to the other side when the baby no longer seems interested. Usually when we start feeding the baby is very interested to suck, as the baby slows down we start the breast compression and when the baby slows down with the breast compression we change and get the baby to have the other side. On the other side after the baby starts to slow down we again use the breast compression and when he slows down again swap back to the first side again. We can continue swapping sides as much as we like and for as long as the baby is willing to continue to suck. It is fine to swap sides 8, 9 or 10 times in one feed.

B - Give more feeds.

Up to three months of age most babies need between 8 and 14 feeds a day. Often the difference between a baby only marginally putting weight on and a baby who puts a lot of weight on is the difference e between 7 feeds and 9 feeds. To get baby to gain weight try to get an extra to feeds in every day.

Consider using a Lactation Aid

When you need to give formua\la or expressed breast milk try to give this without using a bottle. When a lazy sucking baby is introduced to the bottle it makes them even lazier at the breast. You can use the soft cup feeder but I have had a lot of success with using the lactation aid, a device to help supplement babies at the breast, this allows the baby to suck at the breast and stimulate the mother?s milk supply while taking a supplementary feed. Look for this under the heading of At-Breast Supplementer on the web site Breastfeeding Articles by Dr. Jack Newman - Breastfeeding Online.

If you have any questions about this information please contact me on 2548-7636 on at [email protected]

Best wishes,
SARAH

 

[aussiegal]

I think that you should get a second opinion and if the second doctor thinks you should give a bottle or two a day of formula do it. I don't see what the harm is. At the end of the day you are not talking about giving up breastfeeding so the baby will still get all the good stuff. 3% growth seems really really small.

Remember, it's the baby that counts, not our desire to achieve some goal we set ourselves. If the baby is hungry and needs more milk give it anyway you can. I have had three children and each has been different. There is no way i could have made some hard and fast rule about what i would and wouldn't do. First was breastfed for less than 4 weeks. Second was breastfed for 6 months with a bottle or two a day of formula from 3-4 weeks (he couldn't handle my fast let down so sometimes we just couldnt' feed properly at all), third (and current) baby is exclusively breastfed, no formula at all. Good on you for wanting to continue breastfeeding but don't sweat it if you have to give a bottle of formula now and then. You can always express when you give him the formula to see if eventually your supply builds up and give ebm instead.

 

[mumto2]

I'm not sure about here in HK but I know that in Australia those growth charts are based on formula-fed babies and NOT on breastfed babies so they actually cannot apply to breastfed babies. I would probably get a second opinion and I would try to use my maternal instinct a bit too...do you think you are doing enough feeds, baby is urinating ok and frequently, those kind of things. Some babies are just smaller than others and some are big roly poly babies...

Best of luck

 

[Koan]

I don't see how formula would help your LO gain weight, seeing as though breastmilk is higher in calories and in fat than formula.

Really, so long as your LO is gaining and not dropping down the percentiles dramatically, then the rate of gain is not that important.

If your baby is happy, and peeing and pooping often enough, then don't worry if his growth does not fit the growth charts of formula fed babies. They are irrelevant.

 

[aussiegal]

I don't see how formula would help your LO gain weight, seeing as though breastmilk is higher in calories and in fat than formula.
.. don't worry if his growth does not fit the growth charts of formula fed babies. They are irrelevant.

First, if the OP has not got enough milk then of course formula will help.

Secondly, growth does matter. You don't need to worry about where your child ranks on growth charts but you do need to worry about how much your baby is growing as a percentage to where he/she started. 3% is very little.

 

[Koan]

First, if the OP has not got enough milk then of course formula will help.

Where did the OP state her concerns about not having enough milk? Did I miss that?

you do need to worry about how much your baby is growing as a percentage to where he/she started.

My son was a slow gainer. I was expected to take him in every single day to be weighed. When he didn't gain the 30gr a day that the formula charts used in clinics here deem necessary, the drs said to give him formula and even suggested hospitalisation. I stopped taking him to the clinic. He was gaining (albeit slowly), he was happy, he was peeing enough.

Sometimes the stress on numbers and percentages is quite damaging to a mother's confidence. I was simply pointing that out.

 

[putput]

I have to agree with Koan. 3% may sound small but I had the same situ with my little girl and my mum told me my brother and I were the same. Some babies just don't put on lots of weight but that doesn't necessarily mean something's wrong or that they're going hungry.

 

[aussiegal]

Maybe it's just me but if i were told by my doc that he was worried about my baby's weight gain i'd put some stock in what he/she said as he is after all, a doctor. But whatever, as I said earlier, better to get a second opinion than rely on unexpert opinions here. We haven't even seen the baby after all! If there is any chance at all that the baby is hungry then it should be dealt with.

Oh, and Koan, the OP did state that she bought a pump to have more milk thus implying she doesn't have enough as is.

 

[carang]

my two children were VERY small at birth.

both my son(now 4) and my daughter(now 2) were in the bottom 2%. the doctors at the hospital strongly suggested that i give formula to my son as they didn't think he was getting enough milk. (well, if you know anything about breastfeeding, you will know that you don't produce milk immediately, they get colustrum first!)

i listened to the doctors and followed their advice. my son was always 50-50 formula/breastmilk fed. i don't have a problem with that.

from bottom 2%, it took him until 9 months to get to 50%. he still hovers around there now.

by the time my daughter came around, i was a little more confident in myself as a mother. when they again suggested that i formula feed my daughter, i agreed to 2 feedings for her of formula. i had undergone general anesthesia for a c-section and was too groggy to do anything myself. by the time i was able to keep my eyes open, she'd had the 2 feedings and that was it for formula. i exclusively breastfed her until 6.5 months.

she went from bottom 2% to 50% in 6 weeks! she was at 90% by 9 months.

to this day she and her older brother weigh the same.

what i'm trying to say is that formula doesn't necessarily mean your child will gain weight. if your child seems happy in every other respect, then perhaps your doctor is wrong.

the doctors that i saw were shocked that i was still breastfeeding exclusively at 6 months. most hk women give up long before that. many hk doctors don't know very much about breastfeeding as they don't encounter it very often.

 

[aussiegal]

The op said that the weight gain was only 3%, i don't recall her talking about percentile charts. Perhaps she stated it wrong but my concern is that if a 9week old's weight has only increased by 3% something should be done.