Weight gain problems at 2 weeks

[violeta]

I had problems at the very beginning with breastfeeding as I wasn't getting lo to latch on properly. This led to sore, cracked and eventually bleeding nipples. I then used nipple shields for 4 days last week to carry on breastfeeding, expressing when I couldn't feed on one side or the other because she was making me bleed even though the shield. Since Fri now, nipples have mostly healed, lo is latching on properly (m/w checked latch yesterday) and I've chucked the nipple shields (hated them though they served their purpose...). Problem now though is that at 2 weeks, lo is still to put on weight (3364g at birth, 3200 at 5 days, static after that and now at 14 days has lost another 100g). I'm feeding every 3 hours day and night, getting plenty of wet and dirty nappies, baby bright and alert and pink but she's still not putting on the weight .
If there's still no weight gain at m/w check tomorrow, I'll be told to top up. I'm not keen as that's going to affect my supply and I'm scared it'll be the beginning of the end of breastfeeding for me. But of course I want the best for my daughter as well...
Help!

[nailpolish]

bump for you ...

[Egg]

Hello violeta my Feb chum .

Just checked DDs weight chart and at 2 weeks old she was only 60g more than at birth. Ok she wasn't less than at birth but was a lot smaller in the first place (2140g at birth) and I formula fed from the start.

Also with DS1 he lost over 500g in the first couple of weeks due to poor latch / bleeding nipples etc and I was being urged to do formula top-ups (I never did) and then we turned a corner and he was fine. I was told to express as much as I could and give him 60ml of expressed milk after EVERY breastfeed. However this led to him puking it all up as he was being overfed and me sobbing at all my wasted breastmilk so don't think it really helped.

Just stick to your guns, if your DD is weeing and pooing and looking healthy I don't think you need to start worrying.

[tiktok]

Violeta - hope we can help. Starlight's questions are good ones.

I think you are right to be concerned about this and any baby who is truly losing weight needs careful assessment.

I'd also ask about the accuracy of the weights - was she weighed naked each time on digital scales? Are you sure her birthweight was accurately recorded?

The worry with a baby who is actively losing weight is that she doesn't have the energy to feed effectively...and that of course contributes further to the weight loss.

In the short term, your baby needs more milk - this can be expressed breastmilk if your supply is ok and your expressing technique is good. Feeding every three hours is not normally enough to build up and maintain a milk supply when there have been problems (as there have been) and a baby in this situation may need to feed a lot more often than this, on both sides, and may need extra expressed as well...but this is for someone who can see you and your baby to discuss with you. It's good you are seeing the midwife tomorrow, but this doesn't stop you increasing your baby's feeding in the meantime, and I'd suggest now is better than tomorrow

[Egg]

I nearly put in my post "hopefully tiktok will be along soon as she knows everything there is to know about bf". Glad she is here now .

[tiktok]

[Egg]

Sorry, me again, just thought i would add that when I was bf DS1 I was feeding him ALL the time, there was no pattern at all (I had to write down all the times and how long for and if he had been sick etc). When I looked back at the list of times months later I was at how often it was. Sometimes more than once an hour, and only occasionally as much as three hours.

It did settle down though, and he was on approximately every 4 hours when he was about 6 weeks old so don't despair that the round the clock feeding will go on forever.

[violeta]

Thanks Starlight.

1. During the day, she usually feeds for 30-40 mins, though it can sometimes be longer. This is shorter at night, usually 15-20 mins.
   
2. Yes, from one breast each time.
   
3. Since Sat, when I started feeding every 3 hours at night (was more like 4 before and m/w suggested this to boost supply and get weight up), I've had between 1-3 dirty nappies each day and they're usually damp when I change (before every feed). Before that, it had been 3 days since she pooed though damp nappies had been the same. Sat was also the first day I'd had yellowey/orangey poos as before they had been brown/green. They've been yellow/orange since Sat.
   
4. In the eve, it's really more like every 90 mins/2 hours anyway as she cries for more very soon after feeding. But otherwise no - maybe I should try every 2 hours the rest of the day for now as well, perhaps?

[tiktok]

Violeta - who told you to feed only one side?? I don;t know why, but there are lots of cases recently on mumsnet where poor weight gain is a concern and it turns out the mother is only feeding one breast per feed.

This is so not the way to get breastfeeding off to a good start. Some babies and mothers are fine with it, of course, but some aren't, and one-side only halves the stimulation of the breastmilk production line.

You can certainly start offering both sides every time, from now on, and even go back to side one and side two again and again if you want to - the more the merrier in your situation

[Egg]

I sat there going back and forth back and forth. Just ensure you have lots of snacks and drinks close to hand .

[Caz10]

hi violeta
my dd is teensy weensy, lost weight etc so i know where you're coming from. just wanted to say that the advice you'll get here is fab! i was told to feed only one side too, and changing that really helped. dd normally takes a 3rd and sometimes 4th side and her weight is on the up now. good luck!

[violeta]

tiktok - thank you, this is all very useful...

My midwife told me to feed from just one side each time to get both the foremilk and the hindmilk? Trouble also is that dd usually falls asleep after the 30-40 min stints so I've just been assuming she's had enough? I'll try your suggestion though definitely.

I've also been told by a different midwife not to feed more frequently than every 3 hours unless dd demands it? (as it is, I have to wake her up to feed every 3 hours during the day as she will quite happily sleep for 4/5 hours at a time - advice at the beginning from my midwife was not to wake her up and just let her feed when she asked for it...)

Re scales - I can only assume birthweight was accurate - it was done almost immediately after birth and I was being stitched up at the time . All weights since have been done on the handheld scales, either with nappy or without. I assume the midwives made allowances for the dry nappy...

Expressing - have been expressing twice a day or so - would you recommend topping up with expressed milk every feed? Or just in the evening maybe?

Thanks Egg - just 60g makes me think that accurate weighing is really important....

[tiktok]

violeta, thanks for getting back to us

I'm an NCT breastfeeding counsellor, by the way.

I am actually a bit taken aback by what you have been told to do/not to do....and about the weighing. All these examples of not-very-good care are quite common, but most mothers aren't unlucky enough to have a whole bunch of them

Your midwives are misunderstanding how breastfeeding works.

Babies gain weight, and stimulate the breastmilk production line (both important 'tasks' in the first weeks and months of life) by feeding often, and therefore by removing milk often, from both breasts. No one needs to worry a bit about foremilk/hindmilk as long as the baby is being fed responsively ie according to his needs. Babies do not need to be kept on one side all the time. Most babies feed on one side, take a normal little break, and can then happily go back to the second side...only in this way can the breastmilk production system be stimulated to make enough milk. Restricting the baby to one breast only means each breast gets half the stimulation it would otherwise get. This can be crucial to some mothers and babies,and lead to a failing milk supply and a baby who does not gain weight appropriately.

In your case, feed your baby until she shows you by her behaviour/sleep/stopping sucking she's had what she wants. Take her off. Then when she perks up a bit, offer the second side.

From your baby's behaviour as you report it, I'm going to stick my neck out and say she was not getting enough - you did the right thing to wake her to feed her. 3 hourly is not enough, and babies fed in response to feeding cues - not waiting for cries - feed more often than this, in almost every case.

Weighing on handheld scales should be against the law, in my opinion They are not accurate, and as for weighing with a nappy and sometimes without - well, it's just crappy practice. No one can make clinical assessments weighing like this. It means you have no idea of your baby's true weight - she may have lost even more weight, or not as much. The only accurate weight is done with the baby naked on recently-calibrated digital scales. I would suggest you get a weight done on these asap, and then you can tell how serious (or not) your baby's weight actually is.

Your best plan is to see someone who knows about breastfeeding - is there a bf clinic in your area, or a bf specialist? Without that sort of good assessment, it would be wrong for anyone to make suggestions about how often to express, top up and so on. But just as a broad-brush thing - you're doing the right thing in feeding more often and on both sides (at least both) every time, plus expressing and topping up with EBM. You can also try breast compression (google or check mumsnet archives).

Best of luck!

[Caz10]

violetta i think you have my MW!!

now that i am feeling a WEENSY bit better about bf-ing and dd's weight gain I was thinking back to the early days - the MW who came to my house said to feed one side only and also to leave dd 4-5 hours between feeds!!!

Tiktok's advice is fab as always, you will get there honestly!!

[rozzyraspberry]

violeta - just posted on feb thread but wanted to add I feed from one side until lo has fallen asleep, change nappy to wake then offer second side.

Also midwife weighed lo on day 9 and he was 8lbs 5 (on the handheld scales). Then hv weighed him the next day and he was 7lbs 14. Just shows the difference that different scales can make!

[tiktok]

rozzy, that's a good tip about changing the nappy. The concern with a baby who's not gaining is that they fall asleep to conserve energy - nappy changing is a gentle way to help the baby perk up, it's a necessary task anyway, and is (I think) preferable to the other things sometimes suggested like blowing on the face, tickling or even flicking the feet.

Your experience with the scales is typical, by the way...

[violeta]

Thanks ever so much for the advice everyone. Here's hoping it all pays off for the weigh-in tomorrow!

[Lucyand2]

Hello from another feb person!
Good luck with the weigh in, hope it all goes well!
One tip that has worked for me is wearing a bracelet that I swop over so I always know what side I last fed on. Then I remember to start DD2 on that side so she gets more hindmilk. I have a terrible memory at the moment!

[Caz10]

rozzy i am at these weights! isn't that awful!

good luck for today, i got dd weighed yesterday and she's put a bit on again so i am really chuffed. the advice i've been given here has made ALL the difference, i'm sure it will for you too!

[Tallis]

this sounds excellent advice...and can I just plead with you not to, if you possibly can, let the health visitor get you down by making/allowing you to think you're doing something wrong. Your hv might be a lovely caring encouraging person; here's a cautionary tale about mine though.

My dd hadn't regained her birthweight at two weeks. She was doing tiny gains but not apparently enough. At the first baby clinic, in front of all the other mums, the HV turned to me and said very loudly: "I think it's time you went home and started the hard work, don't you?"

This was two weeks to the day since my Caesarean. To say I was shattered was an understatement. I'd been feeding twice at night, five times during the day, lots of poos and wees etc. My milk had taken a week to come through and it was all agony.

still the hv made me come to clinic (knowing I'd have to walk there) even though I hadn't had nearly enough MW visits at home. I'd put on a dab of mascara - terrified she'd have me down as a non-coping mother - and I could see her looking searchingly at my face thinking i was spending more time on my appearance than feeding my baby! "Start the hard work"???? Oh right, because I'd been lolling on a hammock sipping margaritas.

So of course I burst into noisy, nose-running, full-on, in-public tears. I felt devastated and a complete failure. She was urging me into top-up formula. She turned to someone else's lusty baby lying on the scales and said: "Look, this is what you can achieve in another week!" Stupid crap comparison, frankly, as the other baby's mum pointed out: her ds weighed 9lbs at birth whereas my dd was only 6lb 10oz. Plus her ds was five weeks old!

Now looking back I can laugh ruefully - and i've never been back to that hv's clinic: always avoided her. Plus put in a semi-official complaint to the GP.

At the time, I wept, and I gave dd a formula top-up once a day in the evening. Now i'm really pissed off that I did it, - dd is now back to being excl bf. It did give me a bit more peace of mind, admittedly, but I think if I'd had better advice such as that from tiktok I would have been able to carry on bf exclusively and achieve the right weight gain.

By week three, by the way, dd was back at birth weight and is now on 50th centile at 5 months.

Good luck with it all and try to relax.

[Tallis]

Sorry. That previous posting was a bit long. Quite cathartic getting it out though...

[tiktok]

Tallis, that's a terrible story

Is it too late to make an official complaint about this awful HV?