BF & Low-Birth Weight Baby

[babybun]

Hi... sorry if this is going to be a bit long! I've been getting worried lately!

I am expecting my second DC in July, so this is still a theoretical problem (preparing for issues w/ bf). This baby has been measuring small throughout the second and third trimesters, and we expect a small baby at birth (how small, of course, we don't know, although at last estimate the baby was 1.7kilos at 32 weeks - a bit under four pounds, I think.)

Two of my friends have recently given birth to small babies - both around 5.5 pounds, and they both had different BF problems. One "had to" give formula so that the baby would weigh enough to be released. The nurses encouraged her to BF to, as much as possible, and she now nurses and supplements w/ formula. The other "had to" give formula also, and was too worn out to BF and had no encouragement from hospital staff. Her baby stayed in for eight days, while she had to be released after two, and she hated pumping, so... there went BF.

I am very pro BF and my DS never had an ounce of formula. I am nervous that I will be pressured into giving formula at birth and that worries me because it's such a crucial time for BF, and I don't want to do anything to jepordize the success of nursing. However, if the baby needs to gain weight, how much will formula impede nursing? What can I do to ensure that I get off to a good start w/o risking the health of the baby (and getting us both out of the hospital ASAP!)? Is it possible to give some formula at the beginning and then phase it out?

Thanks for reading this far, and for any responses!

[JamieCatheryn]

Many health professionals, even those who call themselves lactation consultants, will push formula for every issue or irregularity with your baby. My son's pediatrician pushed formula for weight loss the first week and normal jaundice, luckily DS couldn't keep it down and I just pushed more colostrum and then transitional milk on him til he gained weight again. Anyway, unless you have real issues with breastfeeding and have exhausted every other option then take their advice regarding formula with a grain of salt.

If your baby is measuring small, you might get lucky and have like a 42 week pregnancy giving the baby time to catch up - make sure they don't induce you just for being postdates!

As you know, the first few days your dc will lose some weight whether exclusively breastfeeding or not, but if baby manages to keep formula down then obviously he or she will lose less than if only getting colostrum. Anybody know the URL for that article "Just one bottle"? It does cause problems in the gut. But, if you do formula feed the first few days for whatever reason then you absolutely can cut it off abruptly if your milk supply is sufficient (it should be overabundant when it first comes in), or gradually if it's not yet.


ETA: You know that all decisions regarding your DC are up to you, no matter what they pressure you to do. Also, if you choose to formula feed for weight then use an SNS or syringe so baby doesn't get used to artificial nipples

[babybun]

Jamie - Thanks!

"You know that all decisions regarding your DC are up to you, no matter what they pressure you to do."

It's so important to remember that!

[MaryJaneLouise]

Is there a specific problem that you know of, that is leading to the low birth weight (IUGR -- intrauterine growth restriction)? Also you might consider stocking on some galactagogues (milk making food, herbs or drugs) or trying to line up donor milk in advance, to avoid having to feed artificial breast milk.

http://www.kellymom.com/bf/supply/low-supply.html

[babybun]

Nope, no problem than we know of and the growth has been steadily a week behind since about 17 weeks. I've been telling them that I am a week behind, because I got pg while nursing, so their commitment to the importance of my LMP (which was my first pp period and in no way "normal") is misguided.

I finally switched docs and my OB now agrees with me, although even after the adjusted dates the baby is still small - in the 20-30th percentiles. I don't think that's small enough to warrant concern for IUGR, especially since development and growth have continued (not slowed) and we are both small people.

Thanks for the link to kellymom. She has everything on that site!

[MaryJaneLouise]

Also -- line up a good ped who won't push the formula / weight gain issue unnecessarily. If you don't have one try the "find your tribe" area for a recommendation in your geographical area.