9w bf baby not putting on weight

(50 Posts)
milktraylady Sat 22-Jun-13 23:51:40

Hi can you please advise me if there is anything else I can do to increase my milk supply?

DD is 9wks old (10w tomorrow) 5oz formula at midnight each night, sleeps til 5am ish most nights.

Other than that she's bf.

But here's the problem- she's been 4kg for 4 weeks at her weigh ins. She's gone down the centile chart from 50th to 2nd. She is 91st for length.
(I was a skinny baby too)

All HVs say she is too light & we need to top up more formula in the day.

But I don't want to - I didn't want to ff at all, (only doing midnight feed for my sanity as I can't survive on less than 4 hrs sleep) plus my milk should be enough right?

I spoke to la leche league lady who reckoned I wasn't feeding often enough. So for the last week I upped the feeds to every 2 hours. Still no weight gain hmm

I am eating ok, drinking lots of water. Taking vitamin tablets. Started fenugreek yesterday (found this on Kelly mom website) in case this works to increase my supply.

So my question is- is there anything else I can do to increase my milk supply?
Or do I have to top up?

(Not sure if its relevant but I have been getting lots of blocked ducts, taking lecithin & more water & this is working)

I am really upset that my body can't make enough milk, is it a myth that everyone can bf? If there is ANYTHING else I can do- I will!

Thanks

DonkeysDontRideBicycles Sun 23-Jun-13 02:18:54

Someone with more recent experience than me will be along to advise. Please don't lose heart.

I assume as you are keen to bf your technique is fine but do you switch from one breast before the creamy hindmilk has had a chance to get going? The foremilk is more watery so less calorific. Maybe let her finish at one breast until she stops before switching.

Can you tell us when do you put DD down to sleep? She needs more feeding to activate your supply. (You will end up with more dirty nappies as she'll poo more but that's a sign she is taking on board what she needs and gaining weight).

If you settle her around 10pm she could sleep through to at least 2 am, then have a feed, then go back down until at least 5 am and have more milk. she get at least 9 feeds in 24 hours plus a good spell of sleep either side of midnight. etween

DonkeysDontRideBicycles Sun 23-Jun-13 02:22:11

Oops sorry for random final word - on phone very cack-handed at editing blush

milktraylady Sun 23-Jun-13 05:30:36

Thanks if I feed at 10 she wakes at 12 then again at 4.
The last 3 days I've fed her nearly every hour to increase the supply, but she still seems to be hungry.

Yes I finish one side then swap to the other so she's getting plenty of hind milk.

I have her formula yesterday afternoon as well as all the bf 7oz.
There's no way I have that much spare in me!

Gutted that I can't make enough milk.

sarahbanshee Sun 23-Jun-13 05:42:31

The more you feed her, the more milk you will have - the best way to up your supply is to feed as that signals your body to make more milk. I'm afraid though that if you are not breastfeeding at all in the night then that will be decreasing your supply a lot, as in the early days going as long as 6-8 hours without feeding is a long time and a signal to your body to make less milk.

Can you try a 'babymoon' - stay in bed for 24-48 hours with your baby, feeding every time she will take it, no formula, and sleeping in between? That will likely make a big difference to your supply. Fenugreek is good, as are oats, and keeping well hydrated and well nourished will certainly make you feel better, but in the end the most reliable way to up supply is to feed more often.

milktraylady Sun 23-Jun-13 06:41:08

Yup did the baby moon thing for 2 days.
We have never got 6-8 hours sleep! 4 max. If I get less than this I can't function.

No one told me bf might not work. This is shit.

MigGril Sun 23-Jun-13 07:09:42

Sorry just to clarify a few things. You've been giving a bottle at 12pm and baby is sleeping until 5am? Are you expressing at 12pm?

Many mums can introduce a bottle and still breastfeed but night feeds are important for supply. So not doing these feeds can often have a big impact.
The hindmilk thing is a bit of a distraction really. As Long as baby comes of each side of there own accord then that's fine. As well as feeding more often you could try switch feeding. Offer both sides each feed then offer the first side again keep switching sides until baby has had enough. This is a great way of upping supply. Remember breats are never empty most milk is made during a feed and the more milk removed from the breast the more you'll make.

A drop that much is quit concerning, has your HV referred you to a pedatriation? They should have and if not ask for a referral. As this may not be a milk issues but a health issue. Is your baby happy and meeting milestones regardless of the weight issue?

milktraylady Sun 23-Jun-13 07:38:12

Thanks Mig- I am feeding her bf at 10pm to 11. Then she is asleep & when she wakes next my husband gives her 5ish oz.
before we started doing that I was of course feeding her but she never slept more than 2 hrs in a row. And after 5am doesn't really sleep again.

I have tried expressing but never get more than 1/4 oz.

milktraylady Sun 23-Jun-13 07:40:51

The switching thing yes I've been doing that & always letting her finish the feed.

Paed referral- HV coming tomorrow to check in detail what I am doing wrong with bf. yes she is meeting all development milestones, growing longer. I was a skinny baby too.

DeathMetalMum Sun 23-Jun-13 07:51:41

I think at 9weeks shes is unlikley to be feeding every 'x' number of hours both of mine certainly were not they would be feeding lots whenever they made any sign of being hungry/not happy. They could feed for 90 minutes have a little sleep feed for another 90 minutes then a slightly bigger sleep and so on throughout the day. Both went for quite long periods overnight quite early.

I would be putting baby to the breast at any grumble as this will stimulate your supply, try and ignore the 'clock' if she seems hungry feed, she will drop into a more predictable feeding schedule eventually.

Tweak32 Sun 23-Jun-13 07:54:56

I had exactly the same situation, it was really upsetting as felt like no matter what i did my ds kept dropping down the centiles.
We gave one bottle of formula a day, he would also have a feed from me straight after if he could but i dont think it was a case of him actually wanting more milk, just a comfort suck so he could fall asleep. I did find that switch feeding helped a bit although it was quite hard going as it meant feeds went on for ages! To be honest though we just perservered and it slowly worked out ok.
I know its hard when there isnt one specific answer but 9 weeks is still so young and you are both figuring it all out. Give it time, maybe try feeding around 3am so you get an extra feed in during the night but still around 4 hours rest after the 10pm one (get dp/dh to do bottle at midnight). Is she smiling and alert otherwise as thats a good sign of health. Easier said than done but worrying is not good for your supply either so if an extra bottle means you can keep bf'ing the rest of the time, at least til she starts gaining weight, and you are both happier then maybe its not such a bad option. Good luck, I know how shit it can feel but it does get better!

milktraylady Sun 23-Jun-13 08:34:06

Thanks tweak you have given me hope!

milktraylady Sun 23-Jun-13 08:35:03

Thanks too dmm, I think I was trying to get a routine way too early.
Any squeak and she's bf now!

FannyFifer Sun 23-Jun-13 08:37:29

So she is not losing weight at the moment?

DD often stayed the same weight for a few weeks, I went with the as long as she is peeing, pooing and happy then she's fine. grin

She was and still is just a petite wee thing, although she was quite heavy when born (8lb8oz) and up in top centiles she then dropped and sat around 2nd centile till she was about 2.

My health visitor wasn't worried about this as she wasn't losing weight just gained slowly.

milktraylady Sun 23-Jun-13 08:40:07

And yes yes yes to smiling & alert!
She has been alert since she was born & lifted her head when she was put in my tummy & looked at me!
Started bobbing her head & latched on!

Every single person who meets her says how alert she is. Lots of smiles, found her hands, very interactive, loves the bath.

So I'm not worried about her development, it's just she's too skinny & hasn't actually put on any weight in weeks.

Extra ff in the day is bound to put weight on. I just don't want to give up bf completely. Hopefully we can find a middle way

milktraylady Sun 23-Jun-13 08:42:38

Xpost with fannyf
Yes she's not losing weight, but not putting it on. Is getting longer though.

2nd centile weight 91 for height.
So even if she stays on 2nd for weight I would be happy, as long as she's gaining weight.

SpanielFace Sun 23-Jun-13 08:50:09

DS was born on the 50th centile and dropped to the 0.4th centile (and, eventually, below it). His problem turned out to be a tongue tie. I fed on demand, roughly every 2-3 hours, including overnight, he cluster fed in the evenings, and yet he still failed to gain weight. But I had no pain, none of the classic tongue tie signs. Has anyone checked for this? It might be worth seeing a lactation consultant, it can be easily missed. It's so demoralising isn't it?

DonkeysDontRideBicycles Sun 23-Jun-13 09:01:10

See what HV says. It is a shame you are feeling disappointed but you're certainly not letting DD down.

You mention blocked ducts, I wonder if your baby is latching on fully. Have you consulted a La Leche advisor face to face?

milktraylady Sun 23-Jun-13 09:05:01

I've got a HV coming tomorrow to check the bf situation.
I will definitely ask about tongue tie- thanks!

And I'm going to la leche league meeting on Thursday so will ask them too.

I did ask in hospital for her to be checked- after reading a lot of people having tt problems on mumsnet.
Was told no she's fine.

My DS was born on the 50th for weight and 75th for height. He did the same as your DD - over the first four months he didn't have steady gains and fell to 2nd percentile. He's now 11 and on the 2nd for weight and 97th for height.

With hindsight, and other DSs under my belt, it was a combination of two things. He was moving to his genetic build -tall and very thin. He is also an endomorph body type. He immediately burns energy so gets hungry very suddenly and needs a huge amount of food to put on weight. He now eats twice the amount I do but still can't put on weight.

I'm really sorry you're experiencing this too. It's a tough gig, especially as bfing benefits are universally discussed and it seems to be so easy to do until you get there. You are doing great though.

Get tongue tied checked out. Try a craniopath. Have the meeting with the HV. All i'm saying is that your baby is alert and you should trust your instinct rather than go on the HVs concerns.

Make the right decision for you - giving more formula if you want but carry on EBFing if that's what you want.

I EBF and introduced some solids at 15 weeks but I'm an old gimmer and that was what was recommended then.

crikeybadger Sun 23-Jun-13 09:17:26

Is there anyone else who knows about breastfeeding that you can talk to? Someone at a bf ing group or on one of the helplines?

Any HV who only suggests giving more formula without doing a proper breast feeding assessment is clearly lacking.

Tongue tie and poor attachment are definitely worth investigating regarding the blocked ducts.

Hope you get some helpsmile

crikeybadger Sun 23-Jun-13 09:18:51

Duh, just seen you are going to Lll group- they usually v knowledgeable.

crikeybadger Sun 23-Jun-13 09:21:04

Oh and one more thing.... You don't need to overdo the water....just drink to thirst. Sometimes drinking gallons of water can negatively affect supply.

I'll be quiet now smile

tumbletumble Sun 23-Jun-13 09:27:36

My DS1 was born on 75th percentile and gradually fell to the 25th percentile (while staying at 91st for height). I agree that he was settling into the body shape that was right for him. My DH is tall and skinny. I persevered with bf and did not introduce formula. He's now a healthy 7 year old - still tall and skinny!

Try not to stress about it - I know that's easier said than done! I have 3 DC and the other two followed a similar pattern, but I was much more relaxed about it by then.

milktraylady Sun 23-Jun-13 09:40:47

Thanks you have all made me feel more confident.
My mum says I was like this but didn't get freaked out as I was her 3rd & knew what she was doing.
Plus one of my sisters was a dentist (fribro now unfortunately) so I am facetiming her today to see if she can see a tongue tie.

Can the HV force you to top up with formula?

StuntNun Sun 23-Jun-13 09:44:15

I would offer the breast as often as you can, you could express milk after feeds to stimulate your supply and give that instead of the formula. If you want to increase your supply then feeding (or expressing) between 2 and 5 a.m. would help due to the breastfeeding hormones being at their highest then. One of the women on my birth club had her DH giving a night bottle so that she could sleep and her milk supply dropped disastrously. Also dropping percentiles can be normal, sometimes a baby has to find their own percentile. My DS1 dropped from the 50th to the 2nd but then he stayed on the 2nd consistently from then on.

ChunkyPickle Sun 23-Jun-13 09:48:15

Lastly, don't stress about how much you can express - it's no indicator of anything, it would take me 3 days to express enough for a bottle, but DS was EBF until 6 months, and kept it up until he was 2.5.

Some of us just aren't made to express it seems.

chocoluvva Sun 23-Jun-13 09:52:04

Your post brings back so many memories milktraylady

Please try not to worry or feel bad - so much easier said than done I know - I'm another one who had a good-sized baby who slipped down the centiles and is now a tall, very skinny, energetic teenager.

You're probably at the most difficult time now - sleep-deprived for many weeks now - it will start to get easier before too much longer. Try to take things one day/morning/couple of hours at a time and keep giving yourself a pat on the back for getting through another day. Many mums do find this stage extremely difficult - it's 'normal' I'm afraid. Get as much help as you can and go for the convenience option whenever you can too.

milktraylady Sun 23-Jun-13 10:09:10

Blimey cocoluvva- normal??
I had no idea this bf malarkey would be so bloody difficult.

(Love the name btw wink)

tumbletumble Sun 23-Jun-13 10:11:10

The HV can't force you to give formula. It's your choice entirely.

milktraylady Sun 23-Jun-13 10:48:03

Just facetimed with my dentist sister- her tongue is on a wonk!(dd not sister!)
Definitely not right.
Will see gp tomorrow and ask for a referral.

Does anyone know the nhs process after that?

Tea THANKYOU for suggesting tongue tue!
I knew mumsnet would have the answer!

gringringrin

chocoluvva Sun 23-Jun-13 11:37:40

Tongue-tie is extremely easy to fix. My DN got an appointment with a nurse who sorted his tongue. (Actually, I wonder if my skinny DS has a slight tongue-tie). I'm not sure, but I think it's usually done in hospital just in case of excessive bleeding. Apparently DN had almost no bleeding and barely cried. The nurse snipped the membrane, slung the scissors in a bin and pronounced it was, "All done".

But really, stories of healthy babies gaining weight slowly are quite common even wihout a tongue-tie.

That's very encouraging for you. If your DD has a tongue-tie then presumably your supply will gradually have been getting less from the prolonged effect of getting less stimulation from your baby.

chocoluvva Sun 23-Jun-13 11:40:13

Many mums have major problems with BF, but manage to BF for more than a year. I think the health professionals don't want to scare new mums. It was a huge shock for me certainly. It took a lot of obstinacy determination to persevere and caused a lot of anguish.

SpanielFace Sun 23-Jun-13 11:42:51

Tongue tie is surprisingly common. About 1 in 10, apparently. I suspect most people with a tongue tied baby give up and switch to formula without ever having it picked up on, which is why you don't hear about it more often (apart from on forums!).

DS had his snipped at 8 weeks old, his was quite a major tie that was spotted at birth, but we were told in hospital that it won't cause him any problems, despite the fact that he couldn't actually stick his tongue out hmm. Unfortunately it partially reattached, but we made the decision not to have it done a second time. I managed to EBF until 5.5 months, and he maintained on the 0.4 centile until then. At 5.5 months, his weight suddenly dropped off the bottom of the charts, and the HV started talking about failure to thrive, at which point I decided enough was enough and introduced top-ups. He's now 10 months and on the 91st centile for both height & weight - he just grew so much after I introduced formula (a pound a week at one point!), so it's clear that he really wasn't getting enough calories from me. sad All because of the tongue tie.

Some HV are of the opinion that if you have no pain, it can't be a tongue tie - this isn't true. The kellymom website has loads of good info, as does milkmatters - http://milkmatters.org.uk/2011/04/15/hidden-cause-of-feeding-problems-however-you-feed-your-baby/

Good luck!

milktraylady Sun 23-Jun-13 11:51:22

Thanks for the tt info.
Hopefully gp will refer us to the specialist for treatment quickly.

This might explain the 'lipstick' shaped nipples that just don't look right to me.

Wish me luck for a fast nhs referral!
How likely is that I wonder??

Tryharder Sun 23-Jun-13 11:52:40

If you ring your local LLL consultant, she will probably come out and see you at home before Thursday. Or ring up the hospital where you gave birth and ask to see the bf consultant straight away.

milktraylady Sun 23-Jun-13 12:09:32

Try I will call LLL that's a great idea.
I looked up the milk matters website- we have many of the problems listed under tt symptoms.

She was checked at birth for tt- I asked specifically for her to be checked. (Again mumsnet educated!) And told no.
Is it possible for a tt to manifest itself in the weeks following birth, as she grew?

I shall call my hospital right away!
Woman on mission!

SpanielFace Sun 23-Jun-13 12:19:14

I don't think they can grow, but they can certainly be missed. It sounds like it needs ruling out, at least.

ChunkyChicken Sun 23-Jun-13 12:29:05

Just jumping in on the TT issue.

I was told that 1 in 7 babies have it when DS had his cut. I think HCP just don't recognise it due to the rise in ff. They missed DS's even though his tongue had a tell-tale heart shape. Sometimes the baby's mouth is just too small to see clearly in the v early weeks, but obvious by 6+wks iyswim.

DonkeysDontRideBicycles Sun 23-Jun-13 12:46:05

Can the HV force you to top up with formula?

No - DD is your baby, the HV can offer advice but the choices are yours to make, this really isn't uncommon but like sicky babies or cranky infants this doesn't get a lot of airtime - people prefer to accentuate the positive!

Anyway sounds like you may have the solution, chase this up and don't be embarrassed at challenging assumptions or "making a fuss". An inexperienced mother doesn't have to be taken less seriously than anyone else.

milktraylady Sun 23-Jun-13 16:49:11

Right, looking at DD mouth after her yelling a bit when I changed her & comparing to the milk matters tt examples- it's a really obvious tongue tie! shock

I will aim to get it done ASAP this week. Really hope I can report back with happier bf story soon smile

In the meantime ff top ups so she's not hungry & hopefully my milk supply will increase when shes feeding properly so we don't need top ups/ or keep them & she puts on weight faster smile

Feeling sooo much better about this whole bf thang.
I knew there had to be a real reason behind the weight/ fussiness/ not sleeping/lipstick nips etc.
Feel like (a sleep deprived) Sherlock Holmes. gringrin

Again- thanks everyone

ChunkyChicken Sun 23-Jun-13 18:21:30

It's a relief to realise there might be a relatively straight forward solution. The lipstick nips to suggest the latch isn't right even without the TT... The trouble is, very few HVs are knowledgeable enough on bfing so will suggest the "easy" option of f top-ups. Which often impacts on supply, leading to more f etc etc.

I hope you get the issue resolved soon & have the bfing situation you want.

milktraylady Mon 24-Jun-13 14:26:08

Just to update-gp says she does have a tongue tie. Nhs is a 3week wait. Too long, so going to go private.

Plus the HV was great! (UNICEF bf trained) she fixed our positioning & latch.
It no longer hurts & I'm sure she is getting more milk. And all the blockages are gone!

Phew!
I think it's brilliant that mumsnet diagnosed our tongue tie gringringrin

chocoluvva Mon 24-Jun-13 15:14:40

Fantastic news.

Really delighted for you smile

DonkeysDontRideBicycles Mon 24-Jun-13 15:25:46

smile Well done OP.

Hurrah. And remember that children come in all sizes - enjoy feeding grin

<looks across at one DS who is on 2nd percentile and one DS who is on 97th>

crikeybadger Mon 24-Jun-13 19:08:06

Yay....but it still amazes me how many tongue ties get diagnosed on an Internet forum. It really shouldn't have to be like that.

Fantastic that you've got some good help tho', here's to you having a pain free and enjoyable breastfeeding relationship. winesmile

IdreamofFairies Mon 24-Jun-13 19:26:10

both my girls were very slow gainers happily dropped to the 2nd centile and stayed there.

my hv was lovely and i was never pressured to do anything differently. i ebf.

As far as she was concerned they were both always alert (very alert they were never still) happy smiley girls. my youngest weighed 17lb at a year old. she was under a pead totally unrelated to her weight and they had no concerns what so ever.

one size does not fit all and this works for growth charts.

if your little one seems happy and healthy to you plenty wet dirty nappies alert smiling. then i would take any advice about topping up with a pinch of salt.

MigGril Wed 26-Jun-13 06:29:43

Well done and what a fab HV, how everything goes well from now on.

Really can't understand why TT are checked for at the new born check. Especially as they are so commune. Some Babies with TT can feed effectively, but it can be worth cutting it for other reasons.

dancinglife Wed 26-Jun-13 13:05:27

Hope things are getting sorted for you.
I breastfed all of mine but had to feed lying down at night as too tired to sit up and its safer to be lying down in case you fall asleep while feeding. If you fall asleep when feeding lying down (never drink/take sleeping tabs, or have a heavy duvet on your bed - had kicked dh out of ours for a few months btw) babies are quite safe as they just fall asleep next to you and sometimes stay latched on - then you have the opposite problem of too much milk.

You could try this during the day too, if not happy with the idea of sleeping with her at night. The rest would do you so much good and you can't genuinely relax and rest away from them at this age anyway.

You do get much more sleep though and its impossible for you to accidentally 'smother' your baby - you are far too aware and switched onto to her even in the depths of sleep. I used to find that i'd rolled over with my baby and changed sides without really waking up.

Maybe this is a different thread - sleeping with a newborn. It is the reason they don't have their own little heating systems though until older - they would get too hot next to their mother's bodyheat - so babies are 'designed' for staying physically close.

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