No poo, no weight gain, two weeks old, help!

[CatEast]

Little Mia was born two and a half weeks ago, weighing 3.5 kg, dropped down after a few days to 3, then climbed after 9 days to 3.25, but after 16 days she dropped back to 3.16. And hasn't gained weight since then for nearly a week.

She's really angry quite often on the breast and clearly frustrated, particularly at night. She comfort sucks for hours at a time - and the growing suspicion is that she's tired, but wants that little trickle of milk because she's so hungry. Plus her poo is still runny brown, not yellow. And she's pooing every four or so days - which the bf counsellors are concerned about more, if anything, than the lack of weight gain.

Her latch seems OK and has been looked at by several breastfeeding counsellors. But we're feeding her any expressed milk through a thin tube taped to a finger to mimic breastfeeding, and she seems to have a weak suck (judging by how high we need to hold the bottle to get her syphoning the milk) and easily gives up if she doesn't get milk straight away - which is causing concern about my milk supplies.

This is backed up by the fact that expressing after feeding (with an Ameda Lactaline double pump) isn't delivering much breast milk so far - got 65ml total today from expressing on both sides after four feeds plus one double pump when she was sleeping. Am taking More Milk Plus capsules, drinking Fennel tea, squeezing my breasts to encourage milk while feeding, expressing at the end of each feed, have tried switch-feeding etc.

We're about to a) move to ten feeds during the day, expressing each time at the end of the feed, b) try and get our hands on some Domperidone, c) use some formula to top up feeds to make sure she's getting at least 500 ml milk total a day (we currently estimate she's getting half that). Which we're really upset about, but want her to grow and poo!

Any help/advice/thoughts gratefully received!

CatEast

[FLIER]

Sorry can't help, but thought you could do with a wee bump

[flibertyplus2]

No expert but it sounds like you are doing really well at a really difficult time, a great Mum already!

Sounds like you're already doing everything and I'm hoping she just needs a bit of time. Hopefully the experts will be here soon with more ideas. Have you tried the Kellymom site?

[flibertyplus2]

Here's the link www.kellymom.com

[SpawnChorus]

Ditto everything fliberty has said

[RuthChan]

I want to say hi and give you some moral support rather than substantial advice, to be honest.
It certainly sounds like you're getting lots of advice and help from your HVs.

From my experience, pumping is hard work at the best of times and it can be difficult to extract large volumes of milk that way. However, pumping at the end of a feed, when your breasts are pretty much empty must make it even harder. Is there any way that you can pump a short while before you feed her, or first thing in the morning when your breasts will be at their fullest?

With regards to the poo, there is a really wide range of colour and you shouldn't worry too much if it's more brown than yellow.
It's also considered normal for a baby to poo anything between four times and day and once a week. As long as your DD is pooing about every 4 days, she is within normal limits. Does she seem constipated or you're just worried about the time gaps?

I guess that the weight gain is what you're most worried about. It's good that you're getting lots of support. Establishing your milk supply can be hard work in the beginning, especially if she doesn't suck strongly. However, if you persevere, your supply should increase. Don't worry if you need to supplement with a little formula in the beginning, you should be able to go back onto BF only after a few weeks.
However, if you do use formula, make sure that she spends as much time feeding as possible so that your full supply comes in.

[Aitch]

My God, i could have written that post 20 months ago... i was in EXACTLY the same position. i even had the poxy medela drip tube thing as well...

many people told us we were doing well with bfing but we weren't. domperidone helped, but in the end i got it too late. i know you've contacted bfcs but it was a specialist bfing unit who really helped me.

they identified that she wasn't really sucking hard and shifted my latch a bit and suddenly i could see her little ears wiggling and that it was really working. unfortunately by that time she was 7 weeks old, had been topped up from about 10 days and i couldn't get my supply back up to scratch. the medical bfing team also told me that my PCOS and beta-blockers for high BP may factor against bfing.

so my advice is to keep doing what you're doing, and to access the absolutely highest level of care you can. get dh onto the case, you'll be too knackered and if you're anything like me, feeling too fiddled-about with already.

as for the formula, well, there's not much you can do about it, is there? like you say, you just want her to grow and poo. i'll stick to my guns a bit more if i have another baby, but it is hard when it's your first, you just want to do what's right.

the one thing i would say is that i became so focussed on 'getting milk in' that i think i forgot that all the expressing and topping-up wasn't as good as actual bfing for my supply, so try to have a balance between bfing and bottle once she gets settled with feeding, with a view to slowly (and under supervision) starting to cut back the extras and concentrating once again on the bfing.

whatever happens, Cat, things will be okay. i promise. we're very lucky to live in a country where formula is available. you are doing great work already and obviously taking bfing very seriously, so i hope you access the help that will make it work for you and dd. congratulations, by the way.

[ib]

Another one here who could have written the exact same post. Topped up for a bit, then cut it out after two weeks. Formula did not agree with him, he put on weight and pooed but was not happy.

We suspected dairy allergy, so I cut out all dairy from my diet. It helped, but still not putting on weight. By now was 4 months old and severely ftt.

I went on a total elimination diet, which again helped initially but not that much. I expressed whenever I wasn't feeding and topped up after the feeds. Never got more than about 100 ml in a day. Saw millions of doctors, everyone said I did not have enough milk.

Eventually got to a paediatric gastroenterologist. He tested ds for reflux (ph probe). He was off the charts. Gave us meds. Ds immediately started gaining 250 g a week (from max. 80g beforehand).

And guess what - no problem with my supply. My body was just producing only what ds was willing to eat.

He's now 8 months and on almost the 50th percentile again (having been completely off the charts for two months)

[tiktok]

Ruth - sorry, you are wrong about the poo. Cat's decription of its colour and infrequency is consistent with a baby who is not feeding effectively ...and it's great you have people who are helping you, Cat.

Formula in this situation can be a temporary 'boost' to a baby's energy levels, 'cos without energy levels the baby isn't able to learn to bf effectively (and falls asleep and/or gives up as you've found). There are good reasons for not stinting on the formula with a baby who is just not yet bf effectively, too...you can get back to full bf in time.

Good to feed often - 10 feeds a day is fine, just as you describe, both sides, plus breast compression , then expressing and giving ebm (finger feeding is hard work though - I think there is no good evidence this works any better for long term bf than a bottle, but talk about that with your professional carers).

Her attachment needs looking at again, IMO.

It's such hard work at present, and I really feel for you

She lost a lot of weight in those early days - that was a red flag, and that's when it should have been 'action stations...would have maybe stopped all this intense hard work now. Not your fault, it should have been spotted in hospital or as soon as you were at home, by the midwives

[ellitalialea]

i was going to say - what about reflux? tha anger at the boob could be a sign of this. you can get stuff like gaviscon for the baby that you can spoon or drip in before a feed. it worked amazingly for us.
good luck. sleep, eat and look after yourself as much as you can.

[Aitch]

i found this very helpful because you can actually see other women (one of whom has The Most Extraodrinary nipples) breastfeeding. my friends all bfed, by and large, but it was only when i saw these video clips that i realised i'd never seen anything useful because they were so bloomin' discreet.

[CatEast]

Thanks so much for all this advice! And it has really helped.

We don't think it's reflux (although paranoidly we are now worried that she's arching her back a lot). The anger at the breast is more frustration of a "why isn't this working?" variety.

I've been working on the latch after looking at the videos (thank you Aitch!). And that seems a bit better.

And she is feeding all of the expressed, some of the formula, and this afternoon did a great big brown smelly poo. So it's a start to get back in the right direction.

Thanks again,

CatEast

[NormaStanleyFletcher]

Is it wrong that I want to click on aich's link just to see "The Most Extraodrinary nipples"

I mean - she put capitals in and everything!

[Aitch]

did you see them, fletch? they're like builder's thumbs. cat, that is brilliant that things are going better and hurrah for the poo! i was clawed to bits by dd when she was cross with me for being such a rubbish bfer... get those fingernails trimmed is my last piece of advice. and seriously try to get hold of some domperidone, the thing about bfing is that you've got until about 6 weeks or so to establish supply and after that it gets tricky.

[tiktok]

Cat, the arching of the back is done by all babies from time to time, but if it's done a lot, then we have to assume the baby is cross at the breast....and while the poo is welcome I don't think you are out of the woods, to be honest. Poo is not normally brown at this stage.

I'm assuming you're continuing to get good help from someone who knows what to look for and are still persuing all the stuff you said in your first post. I expect she will be weighed soon, as well. You may be turning a corner with this whole thing, but as I say....keep on keeping on

[NormaStanleyFletcher]

How is it going cat?

[absandme]

Well done you for all that hard work!

I was worried about my milk supply at one time & thought about fennel tea as one mum really recommended it and said she could really tell the difference if she hadn't had it.

My hv advised me not to take it as it does contain an oestrogen like substance which can have the opposite effect and interfere with your milk supply, I really don't want to scare you about this and as I said it can really work for some women but have you considered talking to someone about possibly leaving it aside for a few days to see if this helps at all?

Sorry I'm no expert on poo, but sounds like theres some good advice all round already.

I don't know if you're just feeding on demand but it suited me to do this and if she was demanding all day then I'd put my feet up & sit back & feed.

Make sure you're eating plenty, drinking plenty & resting or sleeping when you can, in these early days these simple things alone should help your milk it did for me & also helped my sanity! (I used to spend the whole day in my pajama's even after a shower I'd put them (or clean ones) back on & lay on the sofa or stay in bed)

[Dragthing]

A friend's baby had terrible trouble gaining weight and it was only when he was a few weeks old that they discovered that he was tounge-tied which prevented him feeding effectively... Once it was snipped things improved hugely. You might also find that cranial osteopathy helps - very highly rated by some mums - I'm sure I've seen some uesful posts on mumsnet about it.

[Aitch]

oh yes that's true, good point. i made an appointment with a cranial osteopath (again, too bloody late) and after fiddling about in dd's mouth the woman said 'she'll have been quite hard to latch on properly, she's got a misaligned something or other but i've fixed it now so it should be better from now on'. i could have wept, we'd stopped mix feeding just before.

[flibertyplus2]

Here's some info on tongue-ties, it's worth getting this checked by your GP or bf counsellor of they haven't already. My son had this and feeding is so much easier since we had it corrected.

www.babyfriendly.org.uk/page.asp?page=151

(There's links to info for parents and a section about dividing the tongue-tie on the right of the page.)

[FLIER]

CatEast, how are you getting on?

[Aitch]

cat, i am ludicrously keen to know how you're getting on... i feel like we're bfing sisters or something. c'mon, how's it going? don't worry if the answer is 'shite, thanks', that's what sisters are for.