Breastfed baby losing weight

[hjscho]

I have been feeding my 20 week old DS and since 8 weeks old he has been gaining only about an oz a week, sometimes losing weight. I went to doctor with him as he looked very thin and he had lost 6oz in a week. He is now the same weight he was at 8 weeks old. Doctors advice was to give up breastfeeding. I want instant weight gain and see that as the only realistic option. I did a 'top up' today and now he wont feed properly at the breast, as if he is expecting a bottle. Any advice?

[lazycow]

This does sound like not very much weight. Not sure what to say as I'm no expert Hopefully someone more expert (tik tok maybe) will help out. In the meantime it may help if you give a bit more info.

How often do you feed him roughly (difficult to be exact sometimes I know)

Have you been topping up or giveing bottles of formula or ebm - if so how often?

what are his nappies like?

Can't think of any other questions but I'm sure others will

[lazycow]

NB - others may disagree but if this was the first bottle you have given him - or you have only done so very occasionally he is unlikely to be expecting a bottle if you have bf for 20 weeks I think.

[NotQuiteCockney]

More questions:

• does he seem generally well? Generally settled etc?
  
  
• How long does he feed for?
  
  
• How often does he wee, how often does he poo?
  
  
• Has his latch etc been checked? Any chance he has thrush or similar?
  
  You probably could get him to gain weight faster, without using formula, but I think you'd need to be giving lots of skin to skin, offering the boob often. You might also want to look into breast compression.
  
  You certainly do need to do something about this, if you decide to work on making sure he gets more breastmilk, you want to be checking his weight every week, say, always naked and on the same electronic scales.

[Cha]

I am sure you will get many more messages like I am going to say - and from more qualified people - but I think your GP is a complete arse.
I would go to a breastfeeding clinic or call La Leche, NCT or the like for advice today. Immediate thought is are you emptying one breast per feed? You probably know this already but the foremilk is the thirst quenching one (first few minutes) and the hind milk is the nutricious stuff for the rest of the feed. If he needs more once one breast is empty, give it to him and remember to start from the fuller breast at the next feed.
Whatever you do, if you don't want to stop breastfeeding, don't listen to your doctor. Call an expert or listen to the ones who will post after me. You are doing the very best for your baby by breastfeeding him and changing him to formula is not the answer. IMO. Good luck x

[LIZS]

I doubt he is oncfused just yet but think you do need ot deal with the issue. Is he being weighed on the same scales consistently ? Has he been otherwise well in himself ie. not sickly, no diaorrhea (sp?), virus or infection tbh I'd first start an intensive feeding session either feeding as often as poss(2 hourly ?) or expressing in between feeds and topping up with ebm, and seek advice from a BFC asap to ensure the latch and feed is as efficent as possible in case poor feeding is causing him to be too tired to feed properly and so on.

However if it is really as extreme as him not having effectively put on weight for 12 weeksish then would have thought the gp should be referring him for investigations as a matter of urgency rather than assuming formula would solve it and risk confusing the issue more.

Good luck

[Cha]

My thoughts exactly LIZS.

[Piffle]

If he is taking regualr feeds of small amounts, and generally well and sleeping and happy, then try to relax a little
My dd gained very little weight- it turned out she had a minor heart defect which affected weight gain
If you feel your ds is eating well but not gaining, get the GP to have a listen
It most likely is nothing but should be checked out
I resisted giving up breastfeeding btw but dd was taking adequate amounts.

[tiktok]

hjscho....I can understand your concern. I don't think he will be confused after just one bottle, but he certainly needs to have this weight loss addressed.... quickly.

I don't want to talk about feeding in detail until you are sure this is a feeding problem and not something else.

If it is, then he needs to gain weight fast, and it is unlikely (sorry) you can do this on breastmilk alone, because your supply cannot be turned on like a tap....you need to work hard at building it up, alongside making sure your baby gets the calories he needs. When all is well you may be able to return to full breastfeeding.

But on the facts given here - get him checked out, and quick. Please post again and keep us up to date.

[hjscho]

Thanks for all the comments...I'll try and answer all questions in one go. I feed every two hours and the last feed at night has been EBM for a long while, so he is used to a bottle. He sleeps all night and is alert and seemingly healthy in the day. Plenty of wet nappies, but only poos about twice a week. He is generally comfortable when feeding although he does tend to bob on and off once it gets towards the end of a feed. The earlier feeds in the day are much longer (45 minutes - 1 hour) then in the afternoon they are about 15-20 minutes. I have given him more formula this afternoon and then put him back on the breast afterwards and he is much more calm. I also fed hourly in an attempt to increase fat content of milk (following conversation with La Leche).

[hjscho]

when I say he sleeps all night...that is from about 7 until 11 when he has EBM and then until 7am.

[mears]

hjscho - agree with Tiktok. Has he been referred to a paediatrician for a full examination to ensure there is no other reason for weight loss?

[Piffle]

I agree, given that he feeds and is contented aftr feeding, this would indicate another reason for the lack of gain.
Formula is not the answer - given your baby sleeps and appears well, he is not giving the signs of a hungry baby.
Do ask for a referral, you do not need pressure about the feeding methods, you need more answers.
Good luck and tell us how you get on. I had a "fail to thrive" dd and it is very soul destroying. I know that had it been my firstborn I would have given up breastfeeding from the pressure.
xxx

[NotQuiteCockney]

Is he generally sleepy during the day? Does he have cheerful alert periods? Is he developing normally, other than the weight gain issue? Have there been any health concerns with him?

I think you should be seeing a pediatrician, given all this.

[tiktok]

hjscho, thanks for the extra info. I still think he needs to see a paed.

The other points that struck me: if he has been having an EBM bottle for a while, and then goes through from 11pm with it, this means you have not been 'using' your breasts for 12 hours when he wakes in the morning - is that right? This can have a bad effect on some women's milk supply.

I would also check the weights have been done accurately - naked, on an electronic scale.

However the fact you said he was 'very thin' is worrying. 20-week babies are not thin - they are sometimes small, but they are chubby, or should be.

Hope you get it sorted.

[r3dh3d]

Would agree with the others: changing to formula is a bit of a knee-jerk reaction by your GP. It occasionally works in those cases where there is a genuine supply issue and the baby isn't the type to kick up a fuss. But there could be all sorts of other reasons for this - maybe easily fixed, or actually not a problem. You need to get to a Paed to start investigating.

At minimum, I'd say express as well to keep your supply up; if there's a chance of formula not working you then have the option to go back to the boob while you work out what else is going on.

Good luck!

[hjscho]

I am off to see a different GP this morning and will ask to be referred. I hope this one doesn't tell me that I have 'skimmed rather than gold top'!

The lady GP I have seen is very pro-breastfeeding, but to the point that she wont take a look at him, as she says that he is alert and looks healthy (thats with his baggy clothes on). I am hoping this third one will listen to me more.

With regards to the weighing, his clothes are always off and it is the same scales at the surgery where I see both the HV and GP. The only thing was that the GP moved them to his room to weigh DS this week. I can't see that will change too much.

My Mum keeps 'helpfully' telling me that my milk isn't what he needs and its because I am veggie - that has been her excuse for everything for many years now. Is there any truth in this? I have always just eaten as I want and never really taken a huge look at making sure I get every nutrient every day. However, i do consider that I have a healthier diet than most.

DS is alert and happy for a while after feeding, but he does seem to get tired relatively quickly (between 1/2 hour to an hour). I made sure I fed him last night aswell as the 11pm top up and then again as I was lying awake worrying in the early hours. I am just worried that this wont be enough for him.

Thanks again for all you advice...I wish I had found this site sooner.

[Aloha]

I would be very, very worried if my baby who was feeding every couple of hours during the day was 'very thin' at 20weeks and still losing weight if not ill. I would press for an urgent referral to a paediatrician to check that there is no underlying reason for this.
Good luck.

[alexsmum]

do you have a very low fat diet do you think? i wonder if this could make a difference?

[tiktok]

Vegetarian milk is no different from anyone else's milk. A huge proportion of the world is veggie and they breastfeed their babies just fine

Your milk will have as much fat in it as anyone else's. Quality of milk is pretty consistent, no matter what the mother's diet.

Can't believe your GP not even seeing your baby : (

From what you say, the weights are accurate.

The weight is telling you things are not right, and his appearence is saying the same thing.....I really hope your third doctor gives you and your baby the attention and care you both need.

[MissChief]

ditto the others. IMO yr GP has let you down, don't just ask now, but insist on getting a referral to a paed as soon as possible. In the meantime make sure you have enough support/information to help you get yr baby to stop losing weight - LLL/hv/GP/NCT/mumsnet whatever.

[tiktok]

low fat diets do not make the milk low fat, alexsmum.

The amount of fat in the milk is affected by the amount of milk in the breast. See this sirt for a good explanation.

[tiktok]

we....this site, not sirt/

[alexsmum]

i'm glad you've said that tiktok- i worried when i was b/fing ds1 cos he was such a porker, i wondered whether my chocolate binges were a contributing factor!

[alexsmum]

just looked at that site tiktok-really interesting! some good ideas on there.hjscho might be worth having a look in the meantime before you see doc.

[alexsmum]

while you wait to see the doc. i mean.