Breastfeeding
Monitoring baby's growth
In the experience of the women who talked to us, the most common method of monitoring their baby's growth was by regularly having their baby weighed. This is usually done by the health visitor, and checking his/her progress against standard growth charts. Most women found it reassuring when their baby put on weight as expected.
She was reassured when her baby put on the weight that she was supposed to.
She was reassured when her baby put on the weight that she was supposed to.
However, not all babies put on weight at a rate that matched the growth charts and this worried their mothers. Many found themselves under pressure to introduce infant formula (see 'Getting Support for Breastfeeding') or solid foods such as baby rice and this increased their anxiety even further. Others questioned the knowledge base and belief in breastfeeding of their advisors and the accuracy of the growth charts in use prior to 2007, which neither reflected the normal growth patterns of a breastfed baby (because they were developed for infant formula fed babies) nor took into account regional, genetic or ethnic differences.* (Footnote 1)
Her baby's weight gain slowed at about four months of age which she thinks is typical of exclusively breastfed babies.
Her baby's weight gain slowed at about four months of age which she thinks is typical of exclusively breastfed babies.
What about his weight and his growth?
Well he, I've since found out that he followed a growth pattern which is very typical of exclusively breastfed babies, round about four months, for I think seven weeks he put on, I think he put on eight ounces in seven weeks something like that, which of course the graph in the book goes up and his just.
Plateaued?
Yes actually. And I wasn't going to go to the clinic and have him weighed every week because that would just, you know, it's just another source of something to worry about, but we were having baby massage classes and the babies were all naked and they said well we'll weigh them all seeing they've got and I just didn't want to say, 'Oh no I don't want him weighed' so every week, you know, it was like, 'Oh he's put on a gram this week' [laughs], you know, not, not quite but. And the health visitor did, I think he was about twenty weeks and she started saying, 'Well, you know, perhaps you should think about baby rice' and I was adamant that he was going to be exclusively breastfed for twenty-six weeks, he didn't need anything else other than breastmilk until twenty-six weeks. Baby rice has got fewer calories in it than breastmilk does, so I didn't understand why she was suggesting that I expose him to a potential allergen before the twenty-six weeks and I just ignored her. And then, I think twenty-four, twenty-five and twenty-six weeks he put on, I think he put on a pound in a fortnight just on breastmilk.
How did that make you feel?
[Laughs] smug [laughs].
She didn't want to supplement her baby and thinks that health professionals have different views about weight gain and different levels of training in breastfeeding.
She didn't want to supplement her baby and thinks that health professionals have different views about weight gain and different levels of training in breastfeeding.
I mean obviously I don't know how much milk my daughter has off of me and that can be very daunting in the beginning, but you know, we've been doing this for millions of years, babies know what they're doing and I just leave it to her. If she needs a drink she's going to let me know, you know, and one day she might not have so much but the next day, you know, she'll have what she needs, and it's like us isn't it? If we feel thirsty we'll have a drink so I leave it to her, so I don't know exactly how much milk she does have but she has three meals a day and plenty of milk in-between.
When [daughter] was probably, maybe about six weeks old, so, she was still having the treatment from the chiropractors, we'd been going to [support group], she, her weight was increasing but it wasn't a huge amount, might be one ounce a week, two ounces a week. Although she was feeding all the time, the weight just wasn't piling on as much as the professionals wanted it to. And that was when I first started getting a bit of pressure about supplementing. I didn't want to supplement.
Because?
I didn't want to supplement because it wasn't natural, you really don't know what's in formula milk. I mean these companies aren't doing it out of the goodness of their hearts, they're going to make money so, you know, you've really got no idea of what's in it, and obviously from the asthma point of view. And I started to get a huge amount of pressure, a lot of pressure, not only was I getting pressure from people saying about giving up breastfeeding because it obviously wasn't the right way, but now I was starting to get pressure about just supplementing. And, eventually I think, the lady down at [support group], the lactation consultant, I think she started to get a bit of pressure as well because obviously she was in touch with my health visitor. My health visitor was having pressure and, it was coming from the doctors because, they work from a different type of view, they're very much, gain your weight within three weeks that you've lost when you were born and obviously this is now getting to six weeks and she still hadn't got back up to her birth weight. And, so I gave in and started supplementing her, then we had to go in for, I think it's an eight week check something like that they have, and, the doctor was adamant that I should supplement more and he told me, three times a day, five ounces, and I was just absolutely shocked because I thought, 'That is really going to affect my milk'. We're not talking about just a few ounces now you're talking about quite a bit during the day, so I was a bit upset and I phoned up the lactation consultant at [support group] and I said, you know, 'I'm not really happy'. And, basically they weren't happy with the advice that I'd been given and, it worked out that they ended up having a chat with the doctors down at the surgery because they don't have any, they just have the basic training in breastfeeding, they don't have anything more. And really if you haven't got the training to back-up what you're giving as advice you shouldn't really be giving it. And, so that was when, I've lost my track'
You went to the doctors and they said to give three bottles of five ounces a day.
That's it, yeah they wanted her to have three lots of five ounces and, down at [support group] they're saying, 'I don't think that's a good idea, she's fine, she, okay she's not putting on huge amount of weight, but she's putting on weight.' So the doctor said three lots of five ounces which I was quite horrified about because I thought it's going to really affect my milk, and so I spoke to the lactation consultant at [support group], and it actually worked out to be a different one to my usual one because sh
When their baby seemed not to be putting on enough weight, many women began to question their milk supply and sought help from health professionals or breastfeeding counsellors who often recommended increasing the number of breastfeeds in a day. A few women mentioned the idea of a 'baby-moon' as a way of increasing their milk supply or really teaching a baby to breastfeed. This meant going to bed with the baby for a couple of days, doing nothing but breastfeeding when the baby wanted and having someone else look after them both, the housework, meals and other children. A few women used breastmilk expression and medication in an attempt to improve their milk supply.
She began to question herself and her milk supply when her baby gained weight slowly and got help from a breastfeeding counsellor and reassurance from a paediatrician.
She began to question herself and her milk supply when her baby gained weight slowly and got help from a breastfeeding counsellor and reassurance from a paediatrician.
What made you worry that you didn't have enough milk for this baby?
I've got, polycystic ovaries, which, I'd read that can affect your milk supply and I'd had a friend who had quite, terrible problems with milk supply. and then when she was, the first twelve or, sort of twelve or fourteen weeks of her life she didn't put on as much weight as the health visitors said she should, she wasn't following the correct line on her chart, in fact this was about, this got to, it was about six or eight weeks and she'd not really put on any, any weight at all, although to me she was fine, and I was happy with how she was doing she, the health visitor said that she wasn't putting on weight at the right rate. This made me start to feel that perhaps, perhaps I wasn't making enough milk, although I've since learnt that, that wasn't, that wasn't the case at all. I worried about it, we did have a phase when she was, I couldn't tell you exactly, but around sort of two, two, three months where she started sleeping a bit too much for a baby for her age. Going large, long gaps between feeds and I was a bit worried that, well I wasn't really worried, but I did contact, I contacted an NCT breastfeeding counsellor, who was absolutely brilliant and said that sometimes, sometimes baby's who, who aren't getting quite enough milk they sometimes don't have, you know, enough energy and they can become sort of more lethargic. And she suggested something so simple that I was amazed that the health visitors hadn't suggested when, she said that if I felt the baby wasn't getting enough milk, or if I felt the baby was sleeping for slightly too long then, wake her up and feed her [laughs]. And looking back now it seems so basic and why on earth was I getting referred to consultant paediatricians for a baby that was failing to thrive before attacking the basic, the basic options of, you know, maybe feed her a little bit more and then she might put on a bit of weight? So we did that for, I think two days, woke her up, I was waking her up every two to three hours.
Night and day?
Yep night and day and, that week she put on about six ounces so, and from there on in she was great, it only took two or three days to get her, you know, back to, back to herself, so and she's not, not had a problem ever since and has put on weight at a wonderful rate so. But I did have a worry, at the time when, and when you think there is something wrong with your baby and when you've got somebody saying to you every week, 'Oh she's not put on enough, how long was she feeding for?' and, you know, you do start to doubt yourself, and this was the first time and, you think, 'My third baby I shouldn't be having these problems I should be' and to some extent I think that the health professionals thought that, 'It's her third baby she's done it enough, she doesn't need any kind of support, we can, you know, we're better off channelling our energies somewhere else'. So I was pretty much sort of left to it, but as I said, I spoke to the NCT breastfeeding counsellor and she sort of said, 'Well let's get back to basics here, what are you worried about?' and I said, "Well I'm worried that, you know, she's having these really long sleeps in the day, you know, sort of five, six hours sometimes' and she said, 'Okay have you tried waking her up?' [laughs] and I thought, 'Well there's, there's an idea'. And once we started that it was absolutely fine, and she's put on weight. Although, I stopped going to get her weighed, I decided that.
So you were saying that something just as simple as feed her more often, wake her up and feed her more often?
Yes I think that when, when there is a problem, which, which there was, it was a problem, the, your instinct is to look f
Her baby failed to thrive so she tried extra breastfeeds, expressing breast milk and medication to improve her milk supply.
Her baby failed to thrive so she tried extra breastfeeds, expressing breast milk and medication to improve her milk supply.
Breastfed yes from birth, not totally because we did have a problem where his weight was declining quite a lot and the difficulties with breastfeeding as well, meant that we did have to supplement with one or two bottles of formula which I wasn't happy about but was advised by health advisors to have to do that because his weight was just falling off him.
Okay.
Which is very, very worrying. And to be quite honest we tried so many different positions, [son's] weight was going like this, he might put some on then he, it was like a roller coaster and he was constantly along the bottom centile of the charts, so we always had the problem with the health visitors saying, “Well what is your problem?” and if you, in your practice, your GP's practice you have professionals that say, “Well what is your problem? My boys were bottle fed it didn't affect them” you think, 'Well no, I am trying to do this because I believe it's the best for my baby, I feel I've got support from a really good breastfeeding counsellor, I'm meeting other women that have problems, I want support to continue', 'He's only put an ounce on this week' but it's again, and to be quite honest I don't think really until [son] started to be weaned that suddenly the breastfeeding got better. So when he was weaned at six months and he started on baby rice that's when he started to put weight on consistently, the breastfeeding got better, everything just got better, and it was like we were struggling to get to this six months.
I was having to put him to the breast quite a lot in order to increase.
What does that mean, quite a lot was how much?
Well quite a lot for me I mean I was always one of these mothers I suppose that liked to leave quite a bit of gap between each feed so that he could digest. So I, he wasn't feeding on me like twenty times a day or something, I would always try and leave a couple of hours between each feed, for him. So as long as he was having five or six feeds within twenty-four hours everybody was happy but of course once his weight stopped it was a case of cramming all these feeds in, in the day. Because I didn't want to disrupt his sleep pattern because he slept really lovely, he would go to bed about seven-thirty, eight o'clock and would not wake up till five for a feed, so I didn't want to then start waking him at ten-thirty for a feed if he was sleeping okay. So I would try and do a lot of my feeding from five-thirty in the morning till seventy-thirty at night so that he could sleep as he wanted to sleep rather than be woken up and put to the breast. So I was doing about seven or eight feeds between five-thirty and seven-thirty at night.
So you were counting the feeds you were doing and doing them regularly, were there other signs that you were looking for that he was okay, that he was thriving?
I was constantly paranoid about his soft spot on the top of his head and that he was dehydrated that really, really did worry me and one day it was just so, so bad that I did end up having to give him a bottle of formula.
So how could you tell what were you looking for?
It was inverted, it was like a divot and even now I still look at it now and again and, but it was really, really low, we knew that he wasn't well, we.
Any other signs of him being dehydrated?
He, he was always having wet and dirty nappies but the problem was that we knew that he wasn’t feeding properly because he’d never had a nice bright yellow poo, at times it was green, bright green, emerald green and, and so we became obsessed about looking at the nappies and we knew that it wasn’t right. And again I think, I think once he was shown a position that he liked feeding in and he had weight gain we started to get regular nappies, but I don’t think they were ever as bright as they, they should have been. I mean my breastfeeding counsellor always said, you know, happiness is a bright yellow poo and a soft round nipple. And sometimes we’d have green poo and nipples that came out like witches hats, so, we knew that it wasn’t right but we were still breastfeeding.
Fully breastfeeding at this stage?
Fully breastfeeding, I’d say he only had a couple of weeks where the five-thirty feed was a formula one to keep the health visitors happy and the fact that he, he hadn’t had gain, he hadn’t had weight gain for a couple, of weeks [Baby noises]. You like talking, and all, you know, within that time I would express so whilst my husband would give him that bottle I would express that milk off then and put it in the freezer.
And did you use that?
I eventually used it when we stopped the formula feed after a couple of weeks I would then just give him that then, but then I just thought ‘Well this is madness, why am I giving him this now when I could be breastfeeding him?’ so we came to the decision straightaway well right well this is just silly we, we’ll breastfeeding him at the five-thirty feed this is, was complete madness he’s, you know, trying to be a breastfeed, breastfed baby, we will breastfeed him. But all these things I wasn’t aware of, I just didn’t it was going to be like that.
Were you getting pressure to introduce formula and solids and things?
Not from my breastfeeding counsellor at all and I think she was very realistic about the fact that that little bit of intervention was going to be needed because he wasn’t thriving and a lot of that was down to unfortunately the use of the nipple shields, so we knew that we had been (a) on the nipple shields too long, my milk supply had gone down, he wasn’t thriving, he wasn’t putting weight on, and we weren’t having yellow nappies, and, you know, my nipples weren’t as soft and round as they should be. So all the indicators were that some little bit of intervention was required, the pressure I think came more from my GP practice, from the health advisors and the practice nurse that I should be doing something to help this baby which in their eyes was introducing more formula feeding. and it’s difficult, it’s difficult when you’re aware of that pressure, but I was lucky that after each time it happened I was able to phone the breastfeeding counsellor and just say “Look this has happened” and she would say to me “Oh don’t worry, we’ll be alright, come and see me tomorrow morning, just get through tonight and we’ll see what we can do, we’ll try another position”. getting off the nipple shields then was the best thing that happened because he did then start to get a gain, the nappies did improve although I don’t think they were ever as bright yellow as they should have been, but it enabled us to then have a window of opportunity to carry on breastfeeding until we got to the stage where we’re going to be discussing weaning, and then once he was started, he started to be weaned suddenly the breastfeeding wasn’t a problem any more, it wasn’t a problem it became a pleasure.
Well, when I was using the nipple shields and I felt that my milk supply was reducing considerably and the baby wasn’t gaining weight it was suggested that I could try taking a drug called domperidone, I think it’s used predominately for people with stomach upsets but one of the sort of side effects of it if you like, is that it can increase lactation, so I was to take, I think between four and six of these a day. Now there are some GPs who understand that this is done obviously under the guidance of a breastfeeding counsellor supervisor, and they will put it on prescription for you. Unfortunately my GP didn’t believe that any drugs should be used in order to increase lactation, just constantly putting the baby to the breast, but I did notice a difference by using it, you can buy a product on, off prescription which is domperidone it goes under another marketable name and it’s about four pounds eighty for a packet of ten so you can imagine it’s a bit like smoking if you like, you know, that, that’s the equivalent of the money that you would spend on it, and we stayed on it for about three months. So financially it was sort of quite expensive but I found a real difference straightaway, it did help increase the lactation and because it was coupled with taking the baby off the nipple shields at the same time the improved latch plus taking the domperidone meant that the milk supply did get better.
Did you notice any side effects or anything from domperidone?
Not for myself no not at all I have to admit that I didn’t feel as a person I don’t think that I felt any side effects from taking domperidone at all, one could argue that was coming off the nipple shields and the better latching that increased the lactation and not the quantity of the domperidone that I was taking?
So did those two events coincide?
They coincided, so scientifically you wouldn’t be able to say it was one or the other, but together it worked and it helped improve things. Maybe it could have even been a psychological prop, who knows. I would probably have to read more and more about it but I had seen in some breastfeeding literature that introducing a small quantity of domperidone could help increase milk lactation, I’ve also heard that there are some types of teas that you could take that could increase lactation as well. and I think once you’re in the whole area of having problems is that you’ll look and try anything if you’re really serious about establishing it, but because it is a drug I think you shouldn’t just take it anyway. And I do wonder of when I mentioned to some mums that I was taking it whether they did go and buy it just to boost up their milk supply because you don’t know how people’s minds work, they might think ‘Well if I take this my milk supply is going to increase even more so the baby’s going to sleep through the night if I gave him that at the last feed and I’ve been taking domperidone for a week,’ you don’t know but I would always advise that if you’re going to take domperidone it should be done in conjunction with seeing your breastfeeding advisor, counsellor at the hospital because it is a drug at the end of the day.
So you took this for about three months? Any problems coming off it?
I didn’t notice any problems coming off domperidone, I did wean off it very gradually it wasn’t something that I just cut off straightaway. We’d agreed with my breastfeed, it was agreed with my breastfeeding counsellor how many tablets I would drop off each day and that’s why I was on it for three months because it took that period to come off it, to eventually go down to just one tablet a day. But I believe it helped me and I believe it helped increase the milk supply for the baby, but it was expensive.
Paradoxically, some women even questioned their milk supply when their baby was gaining weight, usually because he/she seemed fussy and dissatisfied at their breast. This often occurred at busy or disruptive times of the year such as Christmas or summer holidays and when the mother was also very busy with a toddler.
Both of her babies became fussy at about three months of age which she thinks is because she didn't have enough milk. She felt like a failure.
Both of her babies became fussy at about three months of age which she thinks is because she didn't have enough milk. She felt like a failure.
After about three months, I remember it was, it was Christmas Day, Boxing Day I felt my milk supply was going.
Why, what made you think that?
Because he was on, actually it was about a week or so before, as he was about three months old and I used to express every evening a bottle for him.
Why?
So that my husband could feed baby or if we wanted to go out my mother-in-law, father-in-law could feed baby and look after baby so every night I'd express a bottle for the next night which gave me a bit of space and I remember one night and I was struggling to express two ounces whereas previously I'd be able to express six or seven ounces and that to my mind I thought, 'Ok something's not quite right' contacted the health visitor and they were like saying, 'Oh well it's just probably the baby is feeding a lot more during the day and you've not got as much milk during the night, but carry on and your milk supply will come back' I remember persevering for about three weeks and I couldn't express more than, it was a struggle to express more than two ounces at a time and I remember over the Christmas period because I remember it being the four days bank holiday and not having anyone really to speak to Shivam was on my breast every hour nearly and he was gnawing at the breast as such because he, you knew he wasn't getting enough I remember digging out all my leaflets that I'd got from the hospital and my own personal leaflets, getting all the telephone numbers out and ringing people and everyone saying to me, 'Just carry on as normal, it's fine your milk supply will come back' I think I persevered for another four weeks after that and nothing changed and then eventually I bought formula.
Do you have any sense of why that happened?
No.
How did you explain that to yourself? How do you explain it now?
I was distraught I, well at first I thought, that baby didn't want to be fed but then from speaking to other people 'cause he was actually pulling at the breast and gnawing at the breast it was as if, well no he does actually want to be fed I felt like a failure it was horrible 'cause he was just about four weeks, four months stage when I bought my first packet of formula milk for him and all my friends around me had breastfed for so much longer and I thought I really wanted to breastfeed longer and there is nothing. I'd not planned to go back to work for a long time I was going to take the full twelve months maternity, there is no reason for me to stop breastfeeding but it felt as if I had to so I was I was very upset and buying that first packet of formula and giving that first bottle was horrible, I didn't enjoy it at all but he took it fine and he was very happy which kind of made me feel better and the stress went as well but at least he's fed but I wasn't happy about it.
Where do you think that feeling of feeling a failure came from?
As soon as you fall pregnant you start getting leaflets about breastfeeding that it's the best thing you can do for your child and not doing it felt to me not doing breastfeeding was becoming a failure and knowing that friends around me had breastfed for longer it meant that I wasn't reaching the benchmark of what everybody else had done I mean that's what hurt, but it's everywhere as soon as you go into hospital there's leaflets and posters up about breastfeeding and, 'breast is best' everywhere so if you don't do it you are deemed as a failure, that's what I thought anyway.
Did that come from yourself no did anybody point the figure at you?
No, not at all.
So it was totally internal yeah.
I mean my mother-in-law hadn’t breastfed either of her children purely for the culture, I mean both children were born here but in the environment she was in and the culture at the time, it was like well bottle is easier, I mean this is a good thirty years ago and breastfeeding wasn’t so hot a topic as it is now and for her right from the beginning she was “Well don’t worry” and there was a lot of support there but no nobody said to me “But you’re a failure or” [laughs] or used those such words, it was just myself.
You still regret it, don’t you?
Yeah, very much so.
What about your milk at that stage? Did you have, did it build up, Did your breasts become full?
No, it stopped, straight away really which is another reason why, being a health professional myself and speaking to other health it’s always of the milk supply, is supply and demand if baby is feeding the milk will continue I really believe that my milk supply stopped my mum said it happened to her and that’s why she stopped breastfeeding all three of us but there was nothing I could do, I couldn’t express more, I couldn’t get baby on more but my milk wasn’t coming through. I knew it wasn’t coming through and when I, from the, last time I fed my child, my eldest child I don’t even remember breasts getting full even for the first day which was what I was expecting would happen but it never happened which made me even more inclined to think no I didn’t have a milk supply by that point so I wasn’t uncomfortable at all, it just stopped.
Yeah and the second time I feel I’m going through the same phase again because I’m coming up to three and a half months with this baby and I feel as if I’m getting the same signs again, of not enough milk supply but I’m trying to persevere a little bit longer just in case I was wrong the first time around and I need to get baby latched on a little bit more to get more of milk supply coming through I’ll give it another week.
Have you got anybody to talk to?
Friends and family and the health visitor’s very good in our area as well, but apart from that and I’ve got all the numbers as well the La Leche League and various other ones.
Is there a lactation consultant in the area or a breastfeeding clinic?
Not that I know of. Not that I know of.
Right. So you feel as though your milk supply is going?
Yes.
You’re trying to get the baby latched on as much as you can.
I am, yes.
Right and you’re convinced that he’s latched on properly?
Yes, I think so [laughs].
Are you feeding at night?
He wakes up once at night so I do feed during the night and that’s one time that he actually feeds very well and during the day he seems miserable when he’s attached to the breast now and that’s what makes me think that he’s not getting enough and he’s not sleeping as well during the day as he used to.
Remember with your first baby you found lying down to feed was good for you?
Yes.
Have you tried that?
I do but, I’m just getting the same results during the day, even though I know I’m more relaxed but I am more, I think I’m more relaxed second time around than I was the first time and I think that’s natural ‘cause you think you know what you’re doing the second time around and I’m trying to make sure that I am more relaxed so that ‘cause I want to persevere with my breastfeeding longer, so I was hoping ‘cause I didn’t first time breastfeed for that long, the first time around I’d be able to do it the second time around so I’m even more determined as such but then I know the stress I also went through of making the decision of stopping breastfeeding and going on to formula, I don’t want to put myself through that again because once, because the main concern for me as a mother is that my child is fed, and if that’s through formula then so be it as long as baby is happy and I think I’ve stretched out that period of time for too long the first time round, made myself miserable about it, constantly thinking has he had enough, has he had enough? But when I put baby onto formula, and he drank the whole bottle, the relief that I felt was enormous it’s just a whole weight off my shoulders oh gosh baby’s fed it’s okay. I don’t want to go through that this time round so, it might be pessimistic saying “Oh it might be just another week that I breastfeed for” but I don’t want to go through all that stress again.
What’s happening to his weight?
Weight gain is fine.
It doesn’t add up, does it?
No [laughs]. Weight gain was fine last time around as well I don’t know.
It seems to me like your babies have a fussy period at about three, three and a half months.
The symptoms are exactly the same this time around as they were last time. My only problem this time is that baby won’t take a bottle in the normal conventional way of holding him, he’ll really fuss and cry before he actually accepts a bottle now at which I’ve tried him a couple of times and whereas my first baby he wasn’t bothered at all, giving him a bottle and he was happy giving him the breast he was ok.
So what are you going to do?
I’ve no idea.
Have you tried feeding through a cup?
A health visitor suggested it, I remember trying that with, I had well I had a first I think first time round you have lots of problems Shivam stopped feeding from a bottle as well in the end first time around, he stopped breastfeeding at about three and a half, four months and he took a bottle for about two weeks after that period and then after that he wouldn’t take a bottle either which was the reason why I started weaning him ‘cause the health visitor said to me that perhaps that he’s ready for food now and doesn’t want to drink milk so I started weaning him. I think he was about twenty twenty-one weeks so I couldn’t wait for the six months period and since then up until he was probably about eight or nine months old, getting one bottle down him was a struggle and the only time he would take that bottle would be when he was asleep so I’d sleep feed him whenever I could, I’d go on journeys in the car with my husband so I could just feed him in the car so I didn’t want to get to that stage again with this baby, but he won’t take a bottle altogether at the moment so I might try a cup, but I tried going back to what you asked originally I tried a cup with the first baby and, it was a nightmare and I’m not really keen on starting that off again, I tried a cup, I tried a spoon and he just didn’t like the taste of milk so I’m hoping, hoping the second baby is not like that.
Several women talked about a “weighing culture” and felt that too much emphasis was put on weight gain at the expense of other ways of telling if a baby was growing well (see also 'Cultural aspects of breastfeeding'). They felt that having their baby weighed regularly was putting unnecessary pressure on themselves. Some said that it felt like an exam that they had to pass and, if their baby hadn't put on the required weight, then they had failed. Several mentioned the effect that health visitors, who do the weighing, had on their confidence with breastfeeding depending upon how much weight their baby had lost or gained. One woman called health visitors the “weight police” and another said that she gave her baby infant formula to keep her health visitor happy. Several women, usually the more experienced mothers, made the conscious decision not to become part of that culture and not to have their baby weighed regularly but to trust their own judgement about her/his growth.
She felt that regular weighing of her baby was a judgement on her so she stopped going. Introducing solids early did not make any difference to her baby's weight.
She felt that regular weighing of her baby was a judgement on her so she stopped going. Introducing solids early did not make any difference to her baby's weight.
I don't go to the health visitor every week and weigh him like I had to do with [first son]. I was told to do that with my first one and, on reflection it was putting a lot of pressure on me, 'cause, you know, [first son] was born very big, he was on the ninety-fifth centile, and then he went gradually down to the fiftieth centile and then it was like, oh my goodness this baby is losing weight, she needs to feed him more and, in fact I was told to give him pots at four months, and, I think it was perhaps possibly too early, [first son] had normal weight, he was always a healthy baby, a healthy boy, and it was such a horrible thing to go every, every week to have this sort of judgement, the weight and the cross of the line and where it would be, it was a pressure on me.
What do you mean judgement?
It seemed to be that, you know, you got this chart and that everybody, every baby has to sort of progress on that line and if you go slightly under it, even like one notch down it's like the end of world and you're doing either something wrong or there is something wrong with your milk, or, you know, you must do something differently, and what amazed me is that my baby, or my boy, was always healthy and happy and thriving in a way, having said that it seemed that this chart was more important than looking at him and seeing that he was happy, so, that was a bit distressing [laughs].
At what stage did you introduce solid foods?
At four months because, as I said, [son], sort of, I think became more normal, he was born very, very big boy, he was over, he was over forty weeks, he was forty-two weeks and a half, and he was born at nine pounds ten, and he sort of, he maintained his weight and then suddenly it just went down gradually over, you know, weeks and that's when the health visitor started saying, 'Oh my god no, there's something wrong with this' and, 'Haven't got enough milk' or, so I, not only had I, you know, questions in my mind about my technique, with the way he was latching on, about how much milk I had and the quality of my milk, I was worried about every aspect of breastfeeding really, because of this little line going down towards the fiftieth centile which is totally normal and he was not underweight, he was happy, he had all, you know, he was chatting, he was, he was, he was well. Having said that, the line was going down, so there was something wrong and I was told to go every week, if not twice a week at one point, and one day I just said to my husband, 'I can't cope with this, I'm not going any more, I know [son's] well, I'm not doing this crazy, you know, monitoring I really can't cope with it', I just had enough, I, you know, it felt like I had to perform some kind of miracle to make this line going up and this line didn't mean anything to me because the baby was fine so. I gave up the monitoring, the close monitoring, and from then on I was much happier and, and the baby was fine so, you know [laughs].
So you introduced solid food at four months...
Yes.
'because of this line?
Going down, yes, yes.
Did it make any difference?
No, not at all and he wasn't really interested in pots so actually I had, you know, I had this, the first period of [son's] life I worried about the breastfeeding and then I worried about him not taking this, pureed carrots and things, I remember struggling with those pots and trying to tempt him and spend, you know, too much time doing this, and, you know, I think probably, for a month or a month and a half he wasn't interested and the
Most women who experienced pressure over their baby's weight were told that their baby was underweight but one woman was told that her breastfed baby was overweight.*(Footnote 2) A few women talked about the temptation to make comparisons between their baby and other babies in terms of size and development and how this could become competitive and cause unnecessary worry. The mother of a premature baby felt that weight gain was a major parameter in determining when her baby could go home from hospital.
Her baby was born prematurely in Germany and she called monitoring her growth a "numbers game".
Her baby was born prematurely in Germany and she called monitoring her growth a "numbers game".
So what criteria were used for you to be able to bring your daughter home?
They, what they're looking for I think was maintaining a certain body temperature, reaching a certain weight, I think with premature babies there's always a possibility of jaundice, they like that to have sort of come and gone it, it's going to, and that they can suck well, and that they're feeding well, irrespective of how it's coming either through a formula in a bottle or, or from the breast. So temperature was a lot, we were forever taking Amy's our daughter's temperature by putting a thermometer up her bottom [laughs], which sounds awful and sort of praying that it, would it, you know, even out and it would all be okay and she could, she could come home.
Can you just talk to me a wee bit about your daughter's weight gain?
Mm-hm.
And how you did or didn't follow that and the importance that may or may not have taken?
It had a lot of importance for us because until she'd sort of reached a certain weight we couldn't bring her home. And they were weighed weekly and I don't know, feeding became a big issue, I think this from the very onset, you know, in order to get her home she had to be certain weight and, and that didn't, you know, that didn't sort of go once you'd got home, there always seemed to be weight limits that you're working up to, you know, when they're twenty pounds they can go in a forward facing car seat and, you know, when you're driving home from Germany you and your daughter's in the car seat looking the other way and you can't turn round and see them it's. So [pause] it's, I don't know I suppose it's all you think about, one minute they're drinking four fluid ounces, then it's six fluid ounces, then it's eight and then they drop a feed, you know, and then they do lose weight after they're born anyway. So it just becomes a big numbers game whether it's the time [laughs] or the amount they're drinking, or what they weigh.
*Footnote 1: Recently-published charts developed by the World Health Organisation (WHO) and based on babies who were exclusively breastfed are now available. They are not yet in widespread use in the UK, though some health professionals will be using them. The new charts reflect a similar growth curve internationally with very little difference between culturally diverse groups. Growth charts tend to show smooth lines but an exclusively breastfed baby's weight does not follow this pattern, especially if weighed frequently (see 'growth spurts' in 'What daily life is like with a breastfed baby'). Recommendations from recent research (2006) call for fewer, better quality weighing sessions and more emphasis on breastfeeding effectiveness and women's satisfaction with their breastfeeding experience. Other ways of monitoring a baby's growth include how quickly they grow out of their clothes, how big they feel (for example, putting your hands around the baby' s middle as the father in Interview 37 above says), alertness, happiness, feeding well, achieving developmental milestones, increasing length and head circumference.
* Footnote 2: There is no evidence that an exclusively breastfed baby can be overweight or will become obese in later life.
Last reviewed November 2018.
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