weight

Also I wouldn't expect a private paed to know anything more than a GP about breastfeeding to be honest.

(Sorry to keep banging on...)

To illustrate a little of some GPs' ignorance of BF, I was told when Howie had a vomiting bug around 5 months old to stop breastfeeding and give him Ribena instead. Ribena, ffs!

Jesus. Yes, I think I'll call La Leche or somesuch later today, if I can somehow find a minute. We're now off to the private Dr to pay £££ for *15 minutes* of this big shot's time.

I would imagine that if your baby *does* need to top up, a first step could be for your wife to try expressing between feeds and offer that in a bottle.

Our first child was really small at birth and was slow to gain weight. The doctor & health visitor kept worrying us about his growth rates and how he was in the bottom x percentile etc and (being new parents) we were really concerned. I remember my Mum saying that if he was eating properly and healthy in every other way we shouldn't worry about his weight & growth unless he was obviously malnourished or wasn't growing at all. She was spot on. He's now nearly 10, as tall as most of his classmates, and still skinny as a rake.

Our second child ate & grew at an average rate but we weren't concerned at all and were only getting him weighed because it was the done thing. With our daughter we haven't even bothered with weighing her since she was a couple of months old. She eats ok and looks fine and a growth chart won't change that.

good luck w/the big shot g00blar - i know how worrying this can be, regardless of the number of people telling you it's probably fine

that said, it IS probably fine, because everything else sounds like it's on the up and up. if she's eating and pooping and all those other things, then dude - healthy baby girl! if she was crying all the time, or sick, or something then yeah, but..

we've decided to stop weighing our little guy at all for at least another six weeks just cause we don't want the anxiety

We've been supplementing breastfeeding with formula since nearly the beginning, after a significant weight loss the first ten days. Only now, at 14 wks, does it look like my wife's milk supply (which has never been that high) is tapering off. Even if the breastfeeding hasn't been the be-all/end-all of our daughter's nutritional intake, it seems to remain an important and comforting ritual for both my ladies.

Formula happens. Before Lil was born we were dead set against it, aghast at the idea of it. But it turns out we needed it. And our little girl is healthy and happy (sometimes).

I'd second Meg's advice to get your wife to express if you want to try supplementing then you can supplement with that. Has the added advantage that you can build up a freezer stash that will let you go out to the movies etc. later, or let her go out shopping for the afternoon and you can stay home with the baby.

Yes, you are right -- mixed feeding is the beginning of the end of breastfeeding in 99.9% of cases.

I'm sorry but I totally disagree with this statement. I know plenty of cases where women have mixed feedings and it has not hindered their supply at all. Actually I have yet to hear about this. Of course it will lessen, but it'll go down to the amount needed. What is a "risk" is that the mother will quit, not due to lessened milk supply, but because bottle feeding is "easier." (Working and breastfeeding is hard work.) I am not against La Leche League, but they do instill some feeling of guilt when women decide to bottle feed. I tried mixed feedings but Ophelia didn't like it one bit. FIrst bottle was taken... second one was refused. Roffle.
That said, I'd wait a while with bottle feeding. How far under the curve is the baby hanging? My colleague also BF and her baby was at the bottom end but she never really bothered with formula. In fact BF exclusively until six months. Here they say that unless they do a dramatic drop then there's no need to worry.

Good luck! Follow your heart and gut feeling. If your baby needs something extra, why would you deny it? Health and growth is the most important thing to consider.

There are several potential problems with mixed feeding:

baby is lazy and prefers the bottle, breast feeds drop probably unwittingly and supply dwindles at the same time as demand increases as baby gets older

Demand increases but bottles are increased rather than BFs

Often with mixed feeding breastmilk is expressed and given in bottles as that's what baby prefers, but pumps are not as efficient as babies at getting milk out and supply dwindles that way.

The thing with supplementing - for every oz baby gets from forumla your breasts produce an oz less. So you supplement with forumla on top of breastmilk, but soon your breasts produce that much less - so you end up with baby eating the same, it's just that some of it is now formula... That's why pumping and supplementing works better - the breasts produce more milk, rather than less.

I'm not saying that successful mixed feeding will not work, but that it can be very challenging and a lot of time and thought needs to go into doing it successfully. Form my personal experience mixed feeding has led to paranoia about supply and the formula gradually takes over as time goes on.

Goodness, the emotion that the BF/Formula debate creates!

I'm with Meg, I'm not anti-forumla, I only wish that people could get correct advice so that they've been able to give breastfeeding a fair shot before they supplement/stop.

Hey thanks for all the response, folks! This stuff is indeed fraught. So we ended up going to the private pediatrician yesterday, and it was really reassuring. An older (arrogant) (American) doctor heard us out, checked Alice over, and told us in no uncertain terms to ignore whatever the GP told us. We should keep doing what we're doing. She's a healthy baby, has enough subcutaneous fat (why didn't the GP check for this?), feeds regularly, cries and sucks strongly, is in no danger of malnutrition or dehydration, so why use formula? He spent most of the expensive appointment making bad jokes, to show how confident and not-worried he was. We came out feeling almost vindicated, with regained confidence, ready to stick to our plan, etc.

But then (and now I'm just venting) (and this, of course, just shows how difficult these decisions are, because we obviously have no interest in our baby not growing as much as she should, and we're sooo tired and emotionally spent all the time anyway) today we've flown to M0ntenegr0, Alice's first big trip, to spend some time with my in-laws, as well as get UK visas for both K and A. And of course, Alice has been totally overstimulated, hasn't really slept since the morning, has been on a weird feeding schedule (lots of feeds on the plane to avoid ear pain), so naturally she's been *really* cranky this evening. And my not-calm-at-the-best-of-times in-laws seem to think that every time the baby cries it means she's in horrible pain and/or is starving to death, and before I know it, my mother-in-law has nipped out to the shops and bought three brands of formula.

GRRRRRRRRR. Anyway: it's ok. It's ok it's ok it's ok. It obviously wouldn't be the worst thing in the world if we gave the baby a bottle and K gets 3 or 4 hours off in which she can sleep, recover, and have enough time for her breasts to fill up for a proper feed again. In fact it would be great for her to get that time off--she's insanely exhausted of course. So it'll be fine. If we use a bottle tonight, or some other night, it's fine. But I just really don't want to be the sort of parent who's so easily led into the trap of hysteria and overreaction. We've got a healthy baby. And yes, even healthy babies are supposed to cry and be fussy and yes, sometimes even after a feed.

Uh sorry, I got a little carried away. I should probably take a nap (which, thankfully, is what K and A are doing now, let's hope it lasts).

Oh crikey -- ignore the MIL!

Hope you got your nap :)

dude.. my MIL and FIL are french and they are also convinced that any crying is indicative of some deep-seated problem. they swear up and down that when my wife was a baby she "never cried". wtf is wrong with people?? babies cry! that's one of the main things they do!!!

People forget. In fact we're probably programmed to suppress the memories, for our own sanity.

Tracer Hand truth-bombing.

baby is lazy and prefers the bottle, breast feeds drop probably unwittingly and supply dwindles at the same time as demand increases as baby gets older

Problem is that people forget that there's a time frame: You have to wait a couple of weeks and only BF exclusively to avoid this problem. But you also have to introduce it before a certain time because they'll refuse the bottle.

Goodness, the emotion that the BF/Formula debate creates!

Hah. Sorry if I seemed to rag on you both. I really don't want to but I know from (personal) experience how emotional it is. With Elisabeth I had the experience of breastfeeding so quickly settled in it, but with Ophelia I was in such turmoil as it was extremely painful (popping painkillers like mad). I felt sooooo guilty even thinking of supplementing. I never did though. I'm a martyr as my husband would say. haha It was so paiful, even my clothes/bra hurt my nipples. :-((((

From a personal level I too know how difficult it can be. Hell I ended up in A&E when Aidan was about 6 weeks with an abscess in my left boob after a really bad case of mastitis. The only reason I didn't need surgery was because it was right at the surface of the skin and was easily drained.

I think that's why I've gotten so keyed up about it - if I'd had the support I'd needed I'd have known that there was a serious problem with his latch on that side and I'd have had help sorting it out. Instead I was told that pain wasn't unusual and I was feeling so crap and in pain from the latch that I failed to notice that I'd got mastitis! It's all about managing expectations and having the support available.

we took the baby in for her six-month checkup and she had only gained one pound since her four-month appointment. moved from the 25th percentile for weight to the 10th percentile. mostly i'm not too worried because she's energetic and happy and is doing good on all the developmental milestones. but it's hard not to worry at all. the doc said we should go ahead and start supplementing nursing with solid foods (which we had been talking about anyways) and see if that helps her bulk up some more by eight months.

Damn these wretched weigh-ins for making people fret. I'm sure she is absolutely fine. Have fun with weaning though :)

No food is as calorific as breastmilk, so she's not going to fatten up on solids. It's hard not to worry when it seems to be going against medical 'advice' but if you weren't worried before the checkup then I'd take it all with a pinch of salt. For a start, what weight chart was he/she using? weight increase is very different for breastfed infants than it is for formula fed ones, it's very normal for them to slow down around the 6 month mark. http://www.kellymom.com/babyconcerns/growth/growthcharts.html

Sorry, rant over! Go ahead and start solids, it's fun! But don't be surprised if it doesn't pile the weight on!

yeah, I guess the idea is we're supplementing with solids, not weaning, so she's still getting about the same amount of breastmilk, plus a small amount of solids. that chart has her at mean -2.5, so I don't know what percentile that is, but I'll bring that up with the pediatrician next time we meet. like I said, I'm not that worried, as she seems good physically and developmentally

ahhh, in the uk we refer to the introduction of solids as weaning, as it's a gradual transition. As soon as you introduce solids the milk intake decreases. In the US, as you know, weaning is intentionally withdrawing milk.

ah

I didn't know that! Sorry for confusion.

Do US babies get a lot more frequent weighing, medical check-ups etc? Over here you don't see a paed unless your kid is ill, took me months to get to see one for Howie's eczema.

I don't know what the normal is, I think we had one-month, two-month, four-month, and six-month checkups. Next one was supposed to be nine months, but we're going in for a weigh-in at eight months to see if she's moving up at all.

Crikey. Here you get an eight-week check-up but after that it's completely voluntary, I went loads with Howie as I didn't know better but hardly bothered with Archie.

"I don't know what the normal is, I think we had one-month, two-month, four-month, and six-month checkups."

It's two weeks, two month, four month, six month here for my medical group.