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Infant feeding

Weight Gain Worry - Help

5 replies

Fosco · 09/01/2015 16:14

Sorry this is so very long. Basically, after a long period of slow weight gain, followed by a few weeks of good weight gain, my baby has just dropped two centiles over three weeks. Feeling very worried considering how difficult it was to establish bf and achieve weight gain.

Baby was 8lb5 at birth (75th percentile) but lost just over 10% of his weight in the first three days. We had a difficult start bf. There was a long, long delay between his delivery and first (successful looking) bf, as I had to go into theatre, then we were both very tired from a long induction - and I didn't realise how important it was to wake a newborn up to feed (feel terrible about that now). Bf was not going well and I was advised to fingerfeed DS drops of colostrum until my milk came in.

In retrospect I believe I showed many of the risk factors for delayed onset of lactation and I never experienced my milk 'coming in' as typically described - even weeks later. I had no discomfort, engorgement, let down etc. When using a pump in hospital on day 4 I only expressed a few drops.

On day 3 were told that unless DS's weight stabilised over the next 24 hours we may have to stay on the postnatal ward longer for blood tests, so, as DS was clearly very hungry (and fractious) by this point, I began giving formula top-ups. I understood this could reduce supply/delay bf further, but at that point there seemed like no reasonable alternative. He showed some weight gain, and we were put on a plan of three-hourly feeds with forumula top-ups. I did have help from the hospital lactation consultant to assist with latch, discuss the importance skin to skin and feeding between 12-4 am.

I also believe that I showed many of the risk factors for delayed onset of lactation. I was advised to fingerfeed DS drops of colostrum until my milk came in, but I never experienced my milk 'coming in' as typically described. I had no discomfort, engorgement, let down etc. When using a pump in hospital on day four I only expressed a few drops.

With formula top-ups, he just managed to regain his birthweight within 10 days. We were trying to keep top-ups relatively minimal, while expressing a lot to give as many bm top-up as possible, doing lots of skin to skin etc, in the hope of moving to exclusive bf in the long term. By week 3 he had fallen below the 50th percentile, though hvs were conservatively satisfied with his slow weight gain, and at some point they said we could let the formula top-ups go, and move to feeding on demand with expressed top-ups. By week 4 he had fallen to the 25th percentile and I was feeling really concerned. I tried lots of things to get my supply up, including fenugreek capsules - which coincided with him being very gassy, so I dropped them. I got from a private lactation consultant who helped me with latch and positioning again. From then his weight gain continued to increase steadily (I was happy to weigh him at a fb support group every week) and by his eight-week check he was on the 50th percentile. I felt really happy with this, especially as I was actually expressing less (and I found it really hard to get the chance to express considering how often he wanted to feed) and just bf.

As clinics and groups have been closed over Christmas, we took him to get weighed for the first time in three weeks, expecting equally good weight gain, only to find that he has put on just 8 oz in three weeks, and has dropped from the 50th percentile to the 9th. In December he had put on as much as 5 oz in 6 days. I thought that he was feeding well over the Christmas holidays. He had been going longer between feeds - which I thought was a good sign, as he seemed content, and happy to be entertained without feeding all the time.

Perhaps this slide down percentiles could be due to slight illness? He has given us nothing but green poos for the last week, as a slight rash which the hv thought looked viral, and had swollen glands at the back of his head, as well as being quite sniffly, coughing and sneezing. Apart from these symptoms though, he seems very happy. Everyone tells us he is a very alert baby. He hardly naps during the day (unless on me) but sleeps a lot a night.

But dropping two centiles over just three weeks really worries me, and overall he has dropped from the 75th centile at birth to the 9th centile at 11 weeks. The hv has advised me to give him two 60ml top-ups of expressed milk, and if he hasn't gained weight at a better rate, then start giving him formula top-ups. I'm very concerned with the overall drop from the 75th to the 9th centile, and if ff is what is best for him, then that is what is best, but I'm posting here as I'm frankly just baffled as to how he could have slid down two centiles when he appeared to be feeding well and was generally content.

Considering how difficult I found it to establish supply and achieve good weight gain, perhaps mixed feeding really is the best way forward for us. But given that he climbed a centile in December, it would seem that bf was actually starting to go quite well - so I don't quite know what to make of this sudden tumble down to the 9th centile or how to proceed.

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squizita · 09/01/2015 16:48

I would go to your GP and ask to be referred to a pediatrician (or if there is a GP who specialises in babies they may help). I found it very reassuring when mine had slow growth (albeit much slower rate).

I have heard a slight illness can slow growth.

My DD only tends to gain 3 1/2 oz per week ... but this is OK.

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Fosco · 28/01/2015 21:52

Thanks, Squizita.

He's been seen by a GP and HV, neither of whom feel there is any real cause for concern. He has been weighed again and had gained at a better rate, but is still on the 9th centile.

I'm still really unsettled by the fact that he was on the 75th centile when born and is now just tracking the 9th, with a daily formula top-up.

In this position, should I top him up with formula more? What can I do (other than pump) to keep my supply going if mixed feeding?

And if my supply has not been meeting demand, would there be any long-term impact on his growth/health/development?

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squizita · 29/01/2015 08:06

If they are tracking the 9th there isn't a problem. Babies that drop centiles don't always pop back up to the original! More often they track the new one.
There are no health problems caused by that. Smile Smile

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Imeg · 29/01/2015 09:02

Mine was born on the 9th and after spending 12 weeks on the 0.4th centile has spent the last 6 months on the 75th - I know this is the opposite direction to yours but just as an example that they don't all follow the line they were on at birth.

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MouseInTheSkirting · 29/01/2015 11:45

If you look at the difference between percentiles- it's very small. My little one was also kept in due to weight loss. She's now two weeks old. In that time she's gone from 50th to 9th to 95th percentile even over a matter of days. If your baby has lots of wee and poo coming out and is gaining weight (ignoring percentiles) then all is well.

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