- Breastfeeding a baby who is failing to thrive - our story by Sophie, Mum of Isaac
During pregnancy
8-10 weeks, I had the same pg symptoms as I had with my miscarried baby (feeling more tired than sick, craving the same things) and I was convinced something wasn't right. The midwife managed to get my dating scan a bit earlier. The scan showed a baby with a beating heart moving around but he seemed a lot less active than Jeremiah had been at the same age.
20 weeks, scan showed healthy baby although asleep and breech at the moment. Plenty of time and room to move although I start worrying he will stay that way as he isn't moving very much still.
34 weeks, midwife confirms he is now head down, phew!
40+2 weeks, waters broke but no contractions. I am given 48 hours to go into labour before I have to go into hospital to be monitored.
40+4 weeks, contractions start; go into hospital, contractions stop. Arrgh! Baby fine on trace, no signs of infection apart from slightly raised temp but it was boiling in there. I refuse induction, I want to have baby at home. Come out of hospital, contractions start up again and temp goes down. Midwife comes out, I refuse induction again but I agree to go into hospital at 40+ 6 8am if not in established labour.
40+5 weeks, it's finally happening! Get in the pool, put friends on the DVD player and phone midwife. 2-3cm dilated refuse induction again.
40+6 weeks, 2am phone midwife as contractions are stronger. Still 2-3cm but baby's head is slightly lower. Refuse induction yet again but agree to get out of pool and go to bed.
8am contractions are stronger so pace up and down for an hour. Phone hospital and ask them to send out community midwife, she comes and I am still 2-3 cm, feel like screaming. 1 hour later and the good news is I'm 3-4cm and the bad news is baby has pooed, oh and baby is back to back as well. Midwife calls ambulance and we go to hospital with blue lights and sirens. DH follows in the car and somehow manages to be back with me as we go into the maternity unit. DH is fantastic telling the midwives that I want as natural a birth as possible with minimum monitoring and intervention and the baby is doing his bit by kicking off the monitor! At 12:30pm Isaac is born. He doesn't breathe on his own straight away so is given oxygen. His apgar scores are 5 and 9 and he weighs 8lb 10oz.
After birth
5 days old: weight down to 6lb 8oz, still pooing meconium
8 days old: weight up to 7lb 13oz still pooing meconium. We spend the afternoon on the childrens ward.
10 days old: weight 7lb 10oz, midwife won't discharge us. This is the 4 th different set of scales he has been weighed on and dh and I are wondering if the problem is with the scales. Midwife wants us to supplement with formula but we agree to give ebm instead
12 days old: weight 7lb 13oz
15 days old: weighed by HV, 7lb 12oz. Midwife phones us from home as she is concerned. Says we have to either go into hospital or use formula if weight doesn't pick up
17 days old: weight still 7lb 12oz but he has gained 10g so after consultation with a paediatrician the midwife says that we don't need to be admitted. Isaac continues to slowly gain weight and at 1 month old exactly, he is back to his birthweight of 8lb 10oz and we are discharged by the midwives.
Isaac gained weight steadily on the 9 th centile until at 9 weeks he gained nothing for a week. He stayed more or less the same weight for the next 2 weeks and at 11 weeks he was on the 2 nd centile. He stayed on the 2 nd centile for another 3 weeks and then he lost 4oz in a week so the health visitor referred him to the GP and the GP referred him to the paediatrician. Isaac's weight went up and down and at 18 weeks (Tuesday) he went below the 0.4 th centile so the health visitor phoned the consultant and we were told to go to the childrens assessment unit (CAU) on the Friday.
We spent 6 hours on the CAU while Isaac had an ECG, chest x-ray and blood tests. We were told to come back on Monday to be reweighed. The following week we went to the children's outpatients for a cystic fibrosis test and then back to CAU to be weighed again. At 21 weeks we met Isaac's consultant in the children's outpatients and she prescribed breast milk fortifier, I had to add fortifier to 50mls of ebm 5 times a day, and asked us to come back in 2 days to meet the dietician and yet another weigh in. DH came with me this time which was good as it was another 6 hour appointment. Isaac had a ct scan and more blood tests.
The following week we were back at the CAU and Isaac had lost weight so he was admitted for NG tube feeding. In hospital Isaac started off having 50mls of ebm and fortifier down his tube every 3 hours and gradually increasing to 100mls. At first he was having it during the night as well but he got tummy ache from all the extra feeds (he would normally sleep through the night) so his daytime feeds were increased to every 2.5 hours and we both had a break between midnight and 6am . All that pumping was an absolute nightmare, thank goodness I was able to use the hospital's electric pump. I was missing Jeremiah like mad and I had learnt to do Isaac's tube feeding myself so after a lot of begging from me, we were released from hospital temporarily after 48 hours although we had to come back the next day in time for the ward round so we could be officially discharged. Thankfully, DH managed to get the day off work and came with us because we were there for 5 hours and it would have been so hard with the 2 children on my own. The community nurse arranged to come round the next week to weigh Isaac and she phoned the health visitor to get her to weigh him again later in the week.
Things were going well until 2 days after we got out of hospital Isaac learnt to pull his tube out. After he had done this 4 times in 4 days the health visitor talked to the consultant and the dietician and they decided that it was doing him more harm than good to have it put back down so the dietician said that if we could increase the ebm to 150mls every 2.5 hours then we could do it via a bottle and do without the tube. The dietician recommended that we give Isaac one feed a day of the specialist milk infatrini as Isaac wasn't really gaining weight and I was struggling with all the expressing. I decided that I was going to try and get to 6 months before I introduced formula as by that time I would be introducing solids anyway.
We started Isaac on 1 200ml feed of infatrini at 26 weeks and upped the ebm feeds to 200ml and we started giving him solids at 27 weeks. His weight increased for a couple of weeks and then it dropped off again when we dropped the infatrini feeds as my supply had caught up with the new demand. We started giving him 1 feed of infatrini again.
We were then hit by the season of snot! Isaac had a tummy bug and then a cold and that has made his weight go down. We were not sure what he weighed before christmas because he was weighed on 4 different scales in 2 weeks and he seemed to gain 9oz and then lose 12 in less than a week so something is wrong with someone's scales I think.
On 23 rd December Isaac was weighed by the hv and he'd lost weight again. The hv wanted us to go into hospital over Christmas for ng feeding but thankfully Isaac's consultant said going in on the Monday after Christmas would be fine. Isaac ate loads over Christmas and when he went in on the Monday 29 th December he'd gained weight so Isaac's consultant decided not to do the ng tube and just monitor his feeding. After much heartache I decided to give up the pumping and so Isaac was having 3x200ml feeds of infatrini, 2 solid meals and approx 3-4 breastfeeds a day. Isaac developed a taste for strawberry ice-cream while in hospital and he ate loads, gaining 200g in 2 days! By the Tuesday evening I was going insane and seeing as Isaac was doing well the consultant agreed we could go home the next day. Isaac woke up that morning with a temperature and the consultant said we could still go home but if we couldn't control his temperature with calpol then we should bring him in again. He then started projectile puking although that was after the weigh in thankfully! We finally went home in the evening and we had to go back to CAU for a weigh in the next week.
The next week he'd lost 80g which I thought wasn't too bad considering he'd been ill but the consultant wanted to admit him again. DH had a chat with the consultant and she agreed that we could wait until Friday which was 3 days away to see if he would gain weight. On the Friday he'd gained weighed and was over 6kg, the heaviest he had ever been.
Isaac started going to a playgroup for children with special needs and he has really thrived. He has started babbling and at the last weigh in he weighed 6.18kg.
What I wish I had known/what I needed to be told and wasn't:
That ordinary formula has roughly the same amount of calories as breast milk I wish we'd been referred to the dietician earlier (we were referred at 21 weeks and he'd had problems since birth) That although only 1% (think that's right) of mums physically can't breastfeed there are also some babies who either can't breastfeed at all or who struggle long-term
What I needed to be told and was:
That formula feeding isn't the only option when a baby is struggling with breastfeeding .
Back to 'Failure to Thrive'
