4 week old EBF slow weight gain

[furryleopard]

Hi all, I'm worried about my DDs weight gain. She was born by EMCS as she was breech and my waters went at 37+3 weeks. She was a big baby at 9lb 1oz! I latched her on no problems in recovery and with MW support I thought I was getting it. She had 3 glucose tests all within normal range. Then at 1am on day 3 (going into day 3 from day 2 I mean) the doctor thought she was jittery, I couldn't see it myself but agreed to a glucose test and it was 2.4 and I think 2.6 is normal. The mw told me that the doctor had decided DD had to have 40ml formula every few hours after a bf. I was to pump at the same time (literally nothing came out it was humiliating). I was extremely upset and felt like a child being told off. I am intending to put in a complaint (not about the formula more about not having issues properly discussed with me).

Anyway she had 3 top ups and the next day she had a normal glucose test and I managed to latch her on myself and we escaped the hospital when they said I could leave. That night at home I couldn't settle her but they'd told me she should only feed every 3 hours and I didn't realise she was still hungry so DH gave in and went to 24/7 Asda for formula. She had 10ml via cup and seemed ok. I thought it was that my milk/colostrum wasn't good enough going on what they'd said at the hospital. I think I should have just fed and fed her.

The next day the MW came to visit and DD had lost 7% so I was told to just keep going feeding. She was jaundice on that day. By day 8 I think it was she'd gone up to whatever worked out at a 5% loss since birth and MW said everything was well so just to keep going. By day 14 she'd gone up to 8lb 14oz and was jaundice still so we were sent off to the hospital. The hospital doctor thinks it's breast milk jaundice but did further tests and her bilirubin was up so we had to go back today (4 weeks + 2) her "yellow'' has gone down but lots more tests done. However she was weighed and was at 8lb 15oz so only put 1 oz on since 2 weeks ago. I am gutted, why has she not put more on? HV and MW have all ok'd my latch and at 3 weeks she started cluster feeding so I've fed her loads on Saturday I did 5pm -11pm! The doctor said she wasn't concerned as DD was so big at birth and is still 50th centile.

We get plenty of wet & dirty nappies.

What is worrying me that my breasts don't feel any different. I've seen the milk round DDs mouth so I know it's there and on the odd time she's sick but I have no feeling of my boobs being heavier, they are already big (34jj normally) I had a thing on the weekend when my right nipple went flat and the skin felt thick, there was no pain but google seemed to say it was engorgement. It went away after DD fed that day. I don't know what it was. I get a chompy pain when she latches but it stops and I don't get any other pain, I get the odd blister but lanisoh clears it up.

I feel like I'm extremely disheartened now after just 1oz with all that feeding. I'm thinking of doing 1 formula bottle a day but how much and when do I do it? I'd like to express but I don't know when to do it so I'm nervous in case I do it at the wrong time. I've just got 0 confidence in my abilities to feed and I'm worried I'm letting my daughter down. My Mum's telling me I am feeding too long blah blah... My DH is worried sick about me now. I am finding it all so tiring and relentlessness and I've had 2 silent migraines this week which I've never had before. I'm close to throwing in the towel and I was so keen on bf I just can't enjoy it with this worry. Help!

[cookiefiend]

It is very easy to get fixated on weight gain. I was obsessive about it for several weeks and was often in tears with frustRation. But your doctor is not concerned and your baby seems to be thriving So try to relax if you can.

All babies are different and the growth curve factors in children who are exclusively FF. Also when they are so small, being weighed a different length of time after a feed or before a wee can make a big difference to their weight- it is possible she artificially weighed more the first time they did it. You need to look at the overall curve over a period and try not to get too anxious over each individual weigh in.

I know how all consuming the worry about BF Can be. My family were similarly concerned about me.

If you want to express many people find the morning good. If you want to top up that is fine, I had to as DD lost a lot of weight. Do not feel you Have to top up though, just because she is not gaining weight quickly. You are in such early days. Try and get a decent stretch if sleep if you can- even if it means missing just one feed for a top up given by your DH. Just once it will not affect ?our supply, but a five hour stretch of sleep can really alter your perspective.

Be kind to yourself. You have done so well to get so far. Eat cake.

I am in the middle of something so have not much time to respond properly, but I will check in tomorrow and see if I can be any help.


You are doing so well. I thought about giving up, but DD is now 13 months, breastfeedding like a demon and weights over 20 pounds. It was hard going in the first six weeks, but I am glad I stuck in a bit longer. However, if you do give up- do not beat yourself up. Formula is not poison and your baby will thrive either way. Do what is right for you.

[squizita]

I met up with a friend who mentioned similar worries at the start of her BFIng
.. her normal size, healthy, bilingual 3 year old was exclusively bf in the end and fed till over 2 years of age.
So a tricry start can definitely end up ok!

[PetaPipa]

Don't worry about weight gain if your baby is otherwise healthy and thriving. She is maybe just not meant to be as big as she started out! My dd was born on the 91st centile, similar weight to yours. By the 6 week check that had dropped to the 50th and 2 weeks later to the 25th, which is where she then pretty much stayed. She's still on that line now, at age 3. She was absolutely fine. Breastfeeding is really hard, try to get as much support as you can and be kind to yourself. Rest as much as you can and feed your baby whenever she wants. the every 3 hours thing is good advice, but only once you're confident that feeding is established. Give her lots of cuddles and keep offering the breast. giving formula feeds will mean that your milk.supply will then reduce, even if you express (as expressing is never as efficient as a baby feeding). of course, that doesn't mean you shouldn't do it if need be, but is something to bear in mind if ebf is very important to you.
I really hope things work out for you. this is such a tricky time!

[flymo79]

Hi furry, just wanted to say I know how you feel and it will get better! You have had such a difficult start and will still be recovering, agree with pp's that you need to rest and look after yourself. My dd was 9lb 5 at birth, lost 8% and didn't re-reach 9lb 5 til week 6. I topped up with one ff at bedtime from 3 or 4 weeks, DP loves having the chance to feed dd, I could get some kip and pump for the next day (this took a couple of weeks to build up to a decent amount) and then dd had two bottles (one of ff one of ebm) each day. it was SO encouraging to see her weight gain, and although I found it a huge emotional tug of war to give formula it was the only way to do it. DP said to me one day when I was in tears about my 'low supply' and whether to give formula, you are normally so practical, why are you being stubborn about this when all the advice suggests it is the right thing? I realised that I was caught in a corner, trying to find ways to keep ebf-ing but her weight had plateaued for two weeks and that made me feel twice as guilty as giving her formula eventually did. She went from 91st centile and now pretty much tracks 25th. I am glad we supplement as have had a couple of bouts of thrush and having 2 bottle feeds a day gives my poor nips a rest on these occasions! There are thousands of mixed feeding mums out there, for different reasons, and I wanted you to know that, 12 weeks in, it is something that I still think I will look back on and be glad we did to get over the constant feeling of worry about weight and development which I carried on my shoulders because I was fixated on 'exclusively' bf.
all that said I should probably add in the disclaimer of if you want to work towards ebf-ing that is totally doable, I just don't have the experiential story for you!
Congrats on your little one! You are doing so well and you need to look after yourself too. Sleep deprivation will make you so much more prone to the emotional onslaught of decision making around feeding, but on a rational day I found I was able to justify my choices and not feel half as guilty, I am doing what I (and do ) consider to be best for dd to help her grow.
Best of luck

[furryleopard]

Thank you all. I just didn't expect it all to be this hard, it's felt like I've had barrier after barrier and I'd just started to feel confident as we seem to latch well every time now when I hit this and my confidence is gone again. I really thought she would have been up to mid 9lbs at least.

I don't think it helps that I had a section and I'm still in my 6 weeks recovery time so I'm basically stuck in the house until my husband gets home from work as I'm not able to push the pram. I think I'm going a bit stir crazy. I think as of next week (week 5) I'm going to try to go out each day, I feel totally fine so I think I will be fine to push the pram.

My husband doesn't see why we don't just do one feed a day of formula or expressed milk so I can sleep. I think I'm coming round to the idea as I'm totally exhausted. I think I'll have a bash at expressing after my DDs morning feed. My husband sterilised everything for me to take a barrier away so I should be able to just do it. So if we do a ff tomorrow would I pump then while we do that? Or could I literally just sleep for a few hours? It all feels really confusing I think I'm too tired to figure out what to do!

I was wondering how much breast milk is a feed? And how much formula is a feed?

I have been worried about nipple confusion as my niece had that after accidentally being given formula in hospital and wouldn't latch on afterwards.

Thank you all for your help. I struggle more in the night time, it's very lonely so it's great to have support.

[Zebrasinpyjamas]

I found bf so incredibly hard at first. So you are not alone. My ds lost 8% and took 5 wks to put it back on. However he was happy and producing lots of nappies. (I still worried though).

I was shocked by the constant overnight feeding as it was literally constant from 8 or 9 at night until 4am. No one had warned me! The lack of sleep adds to the guilt/worry feelings too.
However about 6 wks in (for us) gaps in the feeds appeared and at 8wks got even more manageable.

I then had more confidence in my abilities to sustain him.

If you want to top up then do! But don't base your feelings out of worry as I think that is unfortunately a normal reaction for new mothers.
P.s I found expressing v hard and didn't get much so would have found it impossible in the first 3 months as it took too long. My son is now massive so it isn't reflective of low supply (another worry I had at the time!).
Hang in there. I'm sure you are doing well for your child whatever you decide.

[Booboostoo]

Take a deep breath. It sounds like you are doing great but perhaps overthinking things a little bit.

Birth weight is a factor of how well the placenta worked, whereas weight gain after birth is governed more by genetics. So it is perfectly fine for a baby to be born in one percentile and move to a completely different one before settling as inthe case above. If your doctor is happy with your baby's weight try not to worry.

There is no rule that says you have to feel engorgement or let down nor is expressed milk an indication of how much milk you are producing. Babies are much more efficient than pumps at getting at the milk, some people don't get on with some pumps, and some people don't get on with expressing altogether. I find expressing while breast feeding has the best results for me.

If you can't express there is nothing wrong with mixed feeding, so you have a lot of options. If your DP can take over with a bottle I think you are better off sleeping and taking some time for yourself rather than worrying about expressing.

Have you been advised to stay at home and avoid pushing a pram post CS? Does it hurt when you walk or push a pram? Each person's recovery is completely different and if you are in pain you should take it easy, but if you are not in pain avoiding pushing the pram as a precautionary measure seems excessive. Take the baby and go out; it's one of the advantages of bf, you can go anywhere without worrying about bottles. Take a walk, go for a coffee, meet up with friends...resuming normal life may help you feel more positive about everything.

[Zebrasinpyjamas]

One more thought-regardless of how you feed-your husband can help in the night by winding/settling your dc after some feeds so you can jump back into bed quicker. This really helped me get through.
For more advice google "kelly mom" as there is loads of info on feeding.

[furryleopard]

They told me to do nothing for 6 weeks except lift the baby I've even still got to wear my hideous compression socks until 6 weeks. They have been my main focus of hatred as they make me itch and I hate them. I am going to take great pleasure in chopping them up into little pieces! I've felt absolutely fine since week 2 to be honest (or even earlier) and I was planning on going out today with a friend and sharing pram pushing but she has a cold and had to postpone till next week. I might just go out anyway into the village near us if it's not chucking it down.

My husband has been very supportive - he does pretty much every nappy and settles the baby with a bizarre leaping around the bedroom movement which you need to see to behold (it works though). DD very rarely cries except if she's hungry and during a nappy change so there's little support needed, I really thought we were away and getting into a bit of a routine until weigh in yesterday. I think I was so upset because it was unexpected that her weight was what it was. DD seems totally fine to me she's a really happy baby.

Thanks everyone for your thoughts and support.

[MigGril]

Hi your doing so well, but sounds like you could really do with some more real life support. I think speak to a breastfeeding counciler would really help you right now. Either on the phone as you say you can't currently get out and maybe latter popping into a local support group of your lucky and have one. a lout of areas do now. You could ring the national breastfeeding helpline 0300 100 0212 or one of the charities like BfN or NCT. They will listion to you and really help.

In the meantime consider this. If your baby is producing lots of good wet nappies, then you've no immediate worry and have time to sort out any feeding issues without topping up If you don't want to. Many mum's can mix feed successfully, but for some it could mean the start of the end of breastfeeding especially if you start this early. No one can tell you now if it'll work for you or not, you have to be prepared that it may not as it can adversely effect your supply. I know you've had some lovely positive stories here but that isn't always the case and it good to be aware of that first. This can be fixed with just feeding really it can, I can't tell you on an internet forum what the issue is but it could just be a slight change in latch, the feeding pattern you are using the number of breasts per feed ect. But I can tell you that it is a issue that most likely can be helped.
Another point that possibly nobody has mentioned to you yet but your baby was born by csection I'm assuming you had a drip in place during Labour? this is now will know to artificially increase babies birth weight. If they are weighted straight away then they are also carrying excess fluids. if you have any photos from straight after birth this maybe noticeable. They are seriously considering changing weighing to 24hours after birth as this can add a few extra lbs which is just fluid.
Your breasts not feeling full or hard isn't something to be worried about either as long as baby as lots of wet nappies. I know lots of mums talk about it but in established breatfeeding breast don't do this and some mums just don't get that early over full feeling right from the start.
So overall sounds like your actually do really well and just need some more good breastfeeding support to get you going. Well done as its sounds like you had a bit of rough start.

[Booboostoo]

My breasts are completely different now feeding newborn DS than they were three years ago feeding newbord DD but that is probably because I kept feeding for three years. I think everyone has different experiences with bf so don't worry about that.

I don't know if you had so e special complications but it is not standard to suggest women do nothing for six weeks after a CS. I was told to avoid lifting anything heavy and wait until week six to resume exercise, nothing else. Can you ask for confirmation on exactly what you can and cannot do because if you can push the pram and go out it might make a big difference to your mental welbeing.

[tiktok]

Shame you have been given such poor and confusing info, leopard :( I agree with the suggestion to ring a helplne - talking it through from the very start and filling in some of the details not in your post will help you, I think. It will be better to do this, than feel undermined by your mother and confused by all the conflicting advice :(

The staff were very remiss in allowing you to think that '3 hourly feeding' means 'no more often than 3 hourly feeding'.....3 hourly feeds are usually nowhere near enough for a newborn baby, and just as you worked out for yourself, the right approach is to feed responsively, and offering more feeds if the baby needs more.

There are all sorts of reasons why the scales say an ounce gain - poor weighing technique, different scales, mis-translation from metric, catch-down growth (common in big babies), baby not feeding sufficiently often.....talk them all through and discuss what to do next.

And yes - complain, when the crisis is over.

Start with the 40 ml top ups on day 3 (!!!!), and the fact they gave you a pump on day 3 (!!! - hand expression is far more effective in those early days). It may have been the case your baby needed more on day 3 for low blood sugar (though there'd be specialists in this area who would disagree), but hand expressed colostrum plus extra bf would normally be sufficient to deal with it.

[furryleopard]

Thanks all, I'm going to continue as we are and have lots of skin on skin with DD over the weekend. I think I've forgotten to enjoy her. There is a baby cafe next Wednesday round the corner from me so I'm going to go there with my sister in law for moral support and ask for advice on my latch etc... I feel a lot more positive this morning, we have had a nice morning on the sofa watching the West Wing and feeding. We are going out in a bit for a walk too. Thanks again everyone for support.

Is 40ml a lot? It was something to do with her weight and a maths formula that worked out the amount.

My health visitor was very upset on my behalf about my experiences in the hospital and said she'd support me on any complaints I make. She advised me to wait for a bit though until I'm in a better place to make that complaint. I think she's right.

[tiktok]

Sounds like a good plan, leopard.

Good news your HV is going to support you in taking this further.

Yes, 40 ml top ups are large for a very new baby, and likely to interfere with the baby's appetite for breastmilk.

There is a calculation, based on the weight of the baby. It sounds to me they have done this, then taken off a guessed amount to allow for breastmilk.

[BakingBunty]

Some great advice here, hope you feel a lot more positive soon. I just wanted to add that I was only told to wear the stockings for three days! And to get out and about ASAP... So if I were you, I'd chop them up if you have no particular complications.

[mrsmilkymoo]

Hi leopard, can't add to the great advice about feeding, but as a fellow c-sectioner, don't feel you have to stay in the house and can't push the pram! After a couple of weeks I was pushing the pram around, it really helps with the recovery to do something active. And those stockings were truly one of the worst parts of the experience for me, I was told to keep them on for 6 weeks but only if I wasn't active. So I ended up wearing them at night but not when I was up and about during the day. This was in august and they were so annoying and itchy!

[Imeg]

I had a section and the advice about doing things was to do what I felt ready to do (within reason) and I'd know if I was doing too much. I remember going to a baby group 8 days later, pushing the massive old-fashioned heavy pram that someone lent us. I'm sure this would have been too soon for some people, but getting out really helped me.

I had issues with slow weight gain, and one problem I had was that we would have very long 'feeds' but after several weeks I realised that although he was latched on he wasn't actually swallowing most of the time. Once I worked out what swallowing sounded like it was much easier to make sure he was actually feeding by listening for the swallows (bit trickier when out and about in noisy environments!)

[Imeg]

PS I wasn't discharged with any stockings so managed to escape that one!