Is he just bad at breastfeeding?? Long feeds, slow weight gain.

(8 Posts)
MyNameIsSuz Sun 30-Dec-12 08:24:09

So, my son is now 13 weeks old and we've had problems from the start - his first week he was too sleepy to bother feeding and I had to strip him off and wake him up every two hours, combined with visiting our local midwives every morning, while he lost 15% of his birth weight (6lb7, so a bit wee but not tiny).

We've struggled along and he's still EBF, he's had reflux which has been greatly helped by baby gaviscon, but still rarely goes more than two hours between feeds. He was also checked for a tongue tie. I took him to a specialist who runs a breastfeeding clinic up at the hospital, she helped with his latch and things got better - I'm no longer so sore that I dread his next feed.

We've sort of fallen into a routine - he sleeps for 8 hours at night, 10.30ish to 6.30ish, and then has eight feeds during the day. Only, his feeds last for an hour, half an hour on each side with a gaviscon in between boobs. He's lazy, he goes on and sucks slowly and half heartedly, I don't know how to speed him up. Or even if that's possible. Occasionally I pump if I get a chance, so I know my supply is ok, and give him about 100ml in a bottle if we're doing something where I'd rather not be feeding for an hour - Christmas dinner for example - and he's fine with a bottle but it doesn't really buy me any time, he's still ready for a breastfeed pretty quickly afterwards.

He's also not gaining as much weight as the HV would like - about 5oz a week, last week he was only 9lb2. She said we would talk about it again after Christmas and I have a horrible feeling she's going to tell me to switch to formula which I don't really want to do.

I think it could be that my latch still isn't right, we do struggle with it - he doesn't open his mouth very wide, and I had pretty bad carpal tunnel during my pregnancy which hasn't completely gone so I find manipulating him into position quite hard and sometimes painful. I can't go back to the lady up at the hospital as my husband will be back at work after new year and I won't have the car, and it's too far to get to by bus.

MIL keeps telling me I should start introducing food, which would bring his weight up, but I'm reluctant to do that without the advice of the HV and my mum is also dead against that (doesn't help that she is very pro-bf and fed all of us until we were at least a year).

Any suggestions for how I can fill him up, or what I can do, would really be appreciated!

Welovecouscous Sun 30-Dec-12 08:39:06

Suz, wow that you are still ebf with such a difficult start!! Hope you are very proud of yourself, because you should be smile

I'm no expert, but AFAIK feeds of that length can be absolutely normal - my DS used to feed for a long time sometimes and particularly when he slept a lot at night - seemed like he was tanking up on milk to sleep smile

Are there plenty of wet and dirty nappies?

If you want to up the amount of milk taken in, the following are always good places to start:

Offering more often and before you think baby is hungry - looking for very early hunger cues like fidgeting, fist sucking and rooting rather than waiting until baby cries, which is a late sign of hunger. you could aim for 10-12 feeds a day as a minimum.

Making sure you always swap sides at every feed until baby has had enough - sometimes this will mean baby has 2 sides, sometimes 4-5.

You can do breast compressions - you can google them - which increase milk going in.

Cosleeping (following all safety guidance) can increase milk transfer

Skin to skin and carrying baby lots also encourage frequent feeding.

If weight gain is problematic you could always wake baby at night to feed, as well.

Babsjansen Sun 30-Dec-12 08:49:57

In my case I was swapping sides to early and not letting baby reach the hind milk. I was advised to put baby to the same breast twice before swapping.

I would stop seeing Hv for a while. Unnecessary pressure! He is gaining isn't he?

RubyrooUK Sun 30-Dec-12 08:50:05

Hello

It sounds like you are doing a great job.

Hopefully Tiktok or someone with specialist knowledge of breastfeeding will be along soon.

It's hard to tell about latch etc but if he sleeps eight hours at only 13 weeks, he may be trying to stock up with long feeds during the day as that's a long time for a small baby to go without feeds in my experience.

For example, my son fed at 12 weeks around every two hours (often less) during the day for at least 40mins or so. And then he would have at least 3 or 4 night feeds. So he was probably still having about 12 long breastfeeds in 24 hours. And sometimes he'd still cluster feed from 6-11pm non-stop.

Oh and the midwife told me that I should only be feeding for 10 mins on each side but that was never true for me, even as a much older baby. He always liked to take his time (is now an annoyingly slow eater as a toddler..).

Could you try offering the breast more often?

By the way, weaning onto solids at this point would be useless. Tell your MIL that breastmilk has lots more calories than solids (particularly things like baby rice that you would offer at 13wks if weaning) so it would be massively counterproductive. It would fill up your baby's stomach more with less calories, which wouldn't help his weight gain at all.

Will see if I can think of something else and hopefully some experts have come along while I've been typing.

Loislane78 Sun 30-Dec-12 09:04:43

Definitely no to weaning at 13 weeks. Even if you decide to wean early I believe 17 weeks is the minimum, with closer to 6 mo recommended (although all babies will obviously differ).

As seems to be tradition to ask, have you had him checked for tongue tie to make sure milk transfer is good?

5oz weight gain in one week sounds ok to me and within average range. Perhaps he got off to a slow start - how many weeks have you had 5oz gains?

Agree with adding in a feed or 2 at night. I'm all for sleeping through but I noticed when my LO started going longer stretches at night the weight gain wasn't as high (don't have that 'problem' with sleep any more though!).

GL smile

tiktok Sun 30-Dec-12 09:23:33

Hi, Suz - you have had a difficult time sad

First things first, the worst thing you could do would be to follow your MIL's advice. Your baby is too young for solids and there is a real risk with early solids that they replace breastmilk (they take longer to digest, fill the baby's tum, and provide less appropriate nutrition), and your baby's intake would actually be less than it is now. Just explain this to your MIL and ask her to back off smile

Your baby may be perfectly fine - he is gaining weight within normal limits and almost certainly does not need to be weighed every week now. But if you have a concern about his weight gain, then the simplest thing is to feed more often. 8 times in 24 hours with that long gap at night is not all that often for a baby of this age and weight. The length of time he takes to feed is on the normal spectrum - and you're right, you can't speed him up!

My calculations have him feeding about every 2.5 hours for an hour at a time. You could see if he would take a further feed in the night and/or you could see if he would have an extra feed or two in the day(responding earlier to any sign he would take the breast) and/or switch sides after he has slowed down his feeding, so you have more 'sides' per feed. You are doing the right thing in offering both sides each time - this increases volume made and volume taken in by the baby.

OTOH, you could speak to your HV about it, as it does not sound like an emergency. He is healthy and presumably happy and lively. It makes no sense for him to have calories from elsewhere when you have them available by breastfeeding smile

MyNameIsSuz Mon 31-Dec-12 23:15:08

Thanks everyone - sorry for late reply, we're still in crazy Christmas mode...

It's good to be reassured that weaning this early isn't the right thing to do - don't get me wrong, there's no pressure, but I didn't want to discount it if it might help.

I think the sleeping at night thing has been worrying me too, it's great but I had wondered if he might be just sleeping away all that lovely milk. My mum did suggest waking him up and I tried it a couple of times, but again HCPs said it wasn't worth doing so I only did it a couple of times. I think I'll give it another go - perhaps not in the middle of the night, but a couple of hours after his last feed or before his first one.

I've been quite good about looking for early signs of hunger and we've fed a fair bit today, it's a good idea to switch sides more than once and I did do that this morning a couple of times.

Loads of wet and dirty nappies, I meant to say. Sometimes bright yellow but sometimes more green, which is what makes me think it's his latch.

I'd love to co-sleep, but sadly only have room for a standard double bed and have a fairly large husband, so that's out!

He's been quite unsettled the last couple of days and I think I am going to speak to the HV on wednesday at the clinic they run, but won't get him weighed. I took him today and weighed him myself (there's a set of scales at our doctors' surgery which you can just go in and use) and he's put on 12oz in the last 10 days, so I'm reassured. He's almost back up to the 0.4 line!

It's good to know that other people think introducing solids isn't the answer, and you've all made some really good suggestions. Will keep trying!

Welovecouscous Tue 01-Jan-13 00:22:51

Suz, that sounds like a great approach - happy new year and I'm sure you'll be bf for a good while in 2013 smile

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