2 week old not gaining (breastfed)

[PrivetDancer]

Hello, my DD is 14 days old today and is not gaining weight. She was a decent weight to start with (9lb 2oz) and only lost about 5% by day 5, but then lost a bit more by day 10 and is only now just starting to gain minute amounts. She has not been discharged by midwives yet and they are weighing every two days.

exact weights have been:

birth 4140g
day 5 3940g
day 10 3820g
day 12 3860g
day 14 3880g

(these are all from different scales / on different surfaces but you get the drift)

on day 10 the midwife observed a feed and had a few tips on making sure it was a deep latch and showed me how to encourage her on to other side once she'd finished on the first side, but overall said positioning etc looked ok.

I am feeding on demand, which is roughly every 2-3 hours in the day, every 4-5 hrs in the night. she's weeing plenty, pooing only every couple of days but they are quite big when they happen and yellowy etc. My milk came in quite early, on the afternon of Day 2.
she is very alert and seems very happy in general - as the midwife said this morning, if we didn't keep weighing her, there'd be nothing to worry about!

I had similar problems with my older DD but they didn't start til about week 7 when she suddenly plateaued and didnt really gain much til she was weaned just after 5 months. ended up on domperidone and doing nightly formula dream feeds with her, none of which seemed to have any effect. So I was determined not to get obsessed with weight this time around but don't really have any choice with it happening so early on as I obviously want to see her back at birth weight and upwards.

I've now been advised to top up with expressed milk after feeds, which i will do, although worried about nipple confusion. If this works though will I end up having to do this forever? are there any implications of her not regaining her birth weight for a couple of weeks (which at current rate is how long it would take)
Why are my boobs not just working like they should?? :(
I'm fairly sure supply not an issue as they feel full and then softer after a feed and she is sleeping well between feeds. And I've pumped 3oz while typing this, after having just fed her.

I know what you eat / drink should not affect the milk, but are there any things you can suggest I might be able to do to improve things? I had a PPH so on iron tablets as am a bit anaemic - one of the midwives did say that anecdotally she has noticed this does seem to affect weight gain in the babies, even though it shouldn't make any difference.

Apologies for the length of this.

[hmmSleep]

Hi Privet, no advice I'm afraid but thought I'd bump this for you in the hope someone more useful comes along! Fingers crossed.

[hmmSleep]

Oh, somebody already has!

[RubyBuckleberry]

What StarlightMcKenzie said. Everything sounds fine. Even the midwife has said that if you weren't weighing her, you wouldn't suspect anything was wrong. Offer her more feeds if she will take them. Like snacks, as SM says. And offer multiple sides. Go back to the first breast and back etc...

I would say not to top up. She might be gathering pace in the weight gain department as you both settle into it.

[PrivetDancer]

Thanks guys. It was the midwife who weighed her this morning who said about the top ups, I think they feel like they have to suggest something each time, but I must admit I don't really want to go down that road just yet. Will pop the expressed stuff in the freezer for now and see how she gets on, at least for the next couple of days.

Will definitely try the multi-sided feeds then, not just 2 sides. I guess that's essentially the same effect as a bottle top up really, isn't it, just a way of trying to squeeze more calories into her.

[sedgiebaby]

I've been in a similar situation, I don't have time to say all I'd like to but you can cup feed, or try the medela calma teet.

Also has she been checked for tongue tie, sometimes even a really slight tongue tie

[PrivetDancer]

Thanks sedgie, did you get the tongue tie snipped then?
I'll have a look but goodness knows when she'll get chance to cry, she has a boob in her mouth as soon as she opens her eyes at the moment :)
She does stick her tongue out of her mouth a little bit though, so if she does have one it must be pretty mild.

Is the reason for not topping up (with expressed milk) purely nipple confusion then? Or are there other issues too?

[MoonUnitAlpha]

Partly nipple confusion (and that the baby might prefer the "ease" of a bottle) and partly because you'd end up exhausted! Feeding every 2 hours, expressing, bottle feeding, washing and sterilising bottles - it sounds like a lot of extra stress if not strictly necessary.

[hellymelly]

My DD had a slight tongue tie,and she lost weight at the beginning.I saw a lactation consultant who said she thought she would be three weeks old before she was back at her birth weight,and gave me lots of help and a plan to show the docs/midwives stating that she should be back at her birth weight by 3 weeks,she was,bang on three weeks in,back at her birthweight and was fine after that.She's always been slender actually but stayed on her centile ever since.(50th at birth,under 25th shortly after,just under 25th ever since,she is six soon).

[PrivetDancer]

How did you find the consultant hellymelly?

[Groovymoves]

She is probably just going to be a slow gainer.

You say she is weeing and pooing ok and is our alert, this to me would suggest your boobs are doing the job they need to be doing.

Do you have to have her weighed so frequently? If she's just had a poo or wee just before weighing that could count for a good few grams of weight.

I really don't see how offering an expressed feed aswell will help. As someone above suggested offer boob as often as you can and try both boobs and repeat every time.
Also, lots of skin to skin to help the lovely hormones.

[Groovymoves]

Sorry, meant to add, she is gaining which is a good thing albeit slowly.

Try not to worry.

[cluelessnchaos]

Hi privet, congratulations.

My ds has been struggling to gain weight too. He was 8 lb 15 at birth, 8 lb 11 at one week, 8 lb 6 at two weeks. About that time I noticed a difference in how deep his latch was how many dirty nappies and how settled he was. I have been feeding nonstop since he arrived. He was weighed at 3 weeks and he had gained and was 8 lb 11, today he is 4 weeks and is 9 lb 7. I didn't give ebm just fed through it and kept an eye on wet and dirty nappies,

[PrivetDancer]

Well no I would rather she wasn't being weighed so often, but as she's still under the midwives it seems to be their default time gap, I guess because they want to make sure she doesn't suddenly go downhill or something. I'll suggest leaving it a bit longer if they want to reweigh again after Wednesday.

I've found a lactation consultant from //www.lcbg.org who is actually in my village, so have emailed to see if she can come round this week.

[sedgiebaby]

Hello, yes I had the tongue tie released, there has been an improvement, but I have to top up because it was picked up so late being so slight my supply was affected, despite best efforts inc prescription domperidone I have to combi feed. I'm gutted about it but at least she gets about half from me. My baby's palette is high (hospital feeding expert advised) I think she also has a small tongue and still struggles to latch deeply and it takes real effort for her. Baby dropped from 75th centile to 9th at one point it has all being very stressful, shes starting to go up but its been a nightmare. Hope you can resolve things soon and find something that works well for you and little one.

[narmada]

Sorry to crash the thread, but just to say Sedgie, all the things you're describing affected my DS and me too - tiny tongue, tongue tie, bubble palate etc etc. etc. You did really well to keep going those challenges. We didn't manage to keep BF going because DS had reflux and I developed PND quite badly and had to share the feeding of DS with DH. So anyway, just wanted to say well done for keeping going!

To the OP, second the comments about Lactation Consultants. They can be excellent sources of practical help.

[hellymelly]

You can do a search for "lactation consultants" plus your area. I think that is how we found mine,she was really brilliant but she sadly died last year so I can't pass on her details.You can get a home visit which would be best.It wasn't horribly expensive,but nor was it cheap (I think a home visit is around £75 depending on area) but it was the best money we spent on our dds,as I've been breastfeeding for six years this week (first one baby and then the next with only a two week gap)!

[HappyAsASandboy]

Hi, I haven't read all the replies, but wanted to add that my 8 week old twins were slow to regain their birth weight. They lost about 11% and 13% in the first 5 days, the took until three weeks old to regain it.

Like yours, my midwife said it was not a cause for great concern while the babies looked happy and healthy, were producing nappies etc, but she was obviously a bit worried, which made me worried. My midwife suggested formula top ups, but like you, I couldn't see why as I had plenty of milk and the babies fed whenever they could.

No advice other than keep feeding really, except to try not to worry, and enjoy your baby. As long as everything else is ok, maybe they're just slow gainers?

[sedgiebaby]

narmada - thank you, you cant know what that means, it has been such a struggle. I hope all is now well.

[narmada]

Sedgie (and sorry again for diverting the thread - I don't know how to do messaging thing) things are on the up for me I think in terms of my PND - got really good early intervention - but I still have to reconcile myself to not breastfeeding. That's very hard. Have done relactation before with first DD, but I don't think that's an option this time due to me having a busy toddler too.

You are brilliant for keeping going, seriously. One thought - the prescription domperidone you are on, is it 3 tabs 3 times per day? That is the recommended dose on Dr Jack Newman's website IIRC, but docs only tend to prescribe 1 tablet 3 times per day. I am not medically trained, though, so maybe you shouldn't listen to me.

[PrivetDancer]

Thanks clueless and sandboy for the similar stories, would be nice to think it might just sort itself out.

Sedgie, totally agree with Narmada re the domperidone, when I was on it with DD1 I needed heaps before it had effect, at least 8/day, and then the effect is pretty instant. I actually ended up buying it from chemist (it's motillium) before I managed to get enough prescribed. It's v expensive to buy though.

Unfortunately it seems I did too good a job of feeding her up yesterday, and she ended up sleeping from 8pm til 4am. I didn't expect that so hadn't set an alarm or anything. Will do tonight! Anybody else would just be happy with the sleep but I've been feeling guilty all day.

[cluelessnchaos]

Don't feel guilty, she is going to be a cracking sleeper for you.

[narmada]

don't feel guilty! if she were hungry she would surely wake. i know night time feeding are important for supply but once isnt going to scupper things and ...wow! she can sleep for 8 hours. that is fab!

[PrivetDancer]

She has gained 150g (5oz) since Monday :o

Such a relief. They are going to reweigh on Saturday just to make sure it's an ongoing trend.

Thank you very much for all the advice and stories, I'm very glad I resisted the top ups, as would have thought the gain was down to them if I'd tried it.