4 week old with static weight

[JamieCat]

Hi

I have a 4 week old whose weight has been fairly static over the last few weeks and I was wondering if anyone has any advice or reassurance as I am becoming quite anxious!

He is exclusively breast fed and we want to continue with this if possible. He is doing well health wise and the health visitor is not concerned about him as such, more the lack of weight gain as he has not yet regained his birth weight. He has lots of wet and dirty nappies. He wants to feed almost constantly, which I let him do as I understand this will help increase supply, but he only gained 1oz last week.

When he was littler he had issues latching on, which he now does well, I do get some flattening of my nipples but midwives, hv and breastfeeding councellor have observed latch/feed and say it looks good.

Last week I was advised to hire a pump by hv and pump one breast while feeding from the other then offer expressed milk. He would take this then still feed for about another half hour before dozing off but did seem more contented. Now she has advised feeding both breasts until finished then wait an hour then pump with the idea to offer pumped milk after next feed, but he will doze or 15-20mins tops in between feeds so not able to pump really.

It feels like he is not getting enough milk/calories, especially as he wants to feed constantly (and always really has been like this - not a baby that sleeps much!) and I know that if he carries on like this we will be advised to add in FF but I would like to avoid this if possible.

Sorry this is so long but i would really appreciate any advice you have!
Thanks

[tiktok]

JamieCat - I am on my way out and cannot answer at length but this is a situation which you are right to be concerned about.

Have you tried to contact any breastfeeding counsellor/s or helplines?

A baby not at birthweight at 4 weeks is quite a serious thing - maybe nothing to worry about, but it should be checked out.

Will post later :)

[twinklegreen]

Can I ask what colour his nappies are? :)

[Pippinintherain]

How does he suck while feeding?

A usual feed will start with rapid sucking and swallowing, this will then slow down to deeper, longer sucks with some pauses. The last part of the feed - and this is important- should be fluttery sucks. This is were baby gets the highly calorific milk, they suck in little flutters as this milk is fattier and harder to get out, think trying to suck butter through a straw!

Alot of mums see this flutter sucking and think baby has finished then take them off. Try and leave baby to come off themselves. If they fall asleep try tickling their feet, blowing on them or a damp flannel to wake them.

I would be feeding on one breast until he comes off then offering the next, once off the 2nd offer the first again.

Can you go back to bed and do lots of skin to skin and feed as much as you can?

Can you get to a support group?

You can get this sorted without the need for formula.

[JamieCat]

Thanks for replying

His dirty nappies are the normal mustard yellow colour. Health visitor does think it may be a case of not getting enough hindmilk - she has got me to start doing breast compressions to try encourage him to get more hindmilk.

I have seen a nct breastfeeding counsellor, she thought it was sounding like a latch problem and gave advice on trying to improve the latch, but agreed that it looked ok, but obviously isn't perfect as I get changed nipple shape afterwards.

[JamieCat]

He does suck as you describe Pippinintherain - will get to the fluttery sucks then fall asleep on the boob (not for long though and if I gently remove him he usually wakes up and starts feeding again!).
He does get very fidgety when feeding, usually after he has been feeding for a while, pulling and twisting. Sometimes he pulls himself off like this - I wind him and offer him the other breast. There is still milk there, dont know if he gets frustrated?

I did wonder if he was getting overtired as he doesn't sleep a great deal - he will sleep in his sling (nowhere else!), but he would also happily feed for this time so I feel he should probably feed because of his weight ? Don't really know what to do for the best for him with this.

I've been going to a breastfeeding group which is great for support - frustrating to see smaller babies doing better than him though!
I really want to avoid formula if I can (but obviously if his health suffers I'll do as advised)

[twinklegreen]

If he is getting lots of yellow coloured nappies everyday it is unlikely ( but not impossible) that he is not getting the hind milk.

Definitely try breast compression, getting the latch right and plenty of skin to skin ( sling, co-sleeping etc)

In terms of expressing, you could try double pumping, saves on time and better at increasing supply.

IME if there doesn't seem to be anything obviously wrong breastfeeding-wise yet he is STILL not gaining weight very well, then it is worth getting him checked over by an expert in child development (ie paediatrician) just to make sure there are no underlying issues that are causing him not to gain weight, this may put your mind at rest. You will probably find that everything is fine, but it is worth getting everything checked. And even if there is something wrong it is still very beneficial to him to be ebf.

Hope everything goes well, sorry you are going through such a worrying time.

[twinklegreen]

Oh and you are absolutely right to be feeding him as often as possible :)

[posterofagirl]

I am in the same boat. My lo just doesn't want to gain weight at a normal rate but while she is gaining some weight the hv is happy just to keep an eye on her as there are no other concerns.

Can't offer any advice but just wanted to let you know that you aren't alone

[JamieCat]

Thanks, the plan is to get checked out by doctor if not gaining by this friday so I expect that is the next step.
Good to know I'm not the only one posterofagirl, it is stressful though and is causing me to worry more than is probably necessary. Hope your lo keeps on gaining.

What do you mean by double pumping? Does that mean pumping both sides at the same time?

Off to bed to get lots of skin to skin!

[twinklegreen]

this is what I mean by double pumping, pumping from both breasts at the same time.
It is no doubt very stressful for you, but there are many babies that don't gain weight for no apparent reason, then just suddenly everything changes and they start to gain well. Hope this is the case with you and your ds. :)

[TabithaTwitchet]

Wow, I didn't know that about the fluttery suck thing - I do sometimes take DD off when she does that (and we have also had some very similar weight gain issues, although things are possibly improving now - you are definitely not alone JamieCat). Will make sure I always wait for her to come off herself in future.
Hope things start getting better for you and DS soon Jamiecat!

[BreastmilkDoesAFabLatte]

DD also took over a month to regain her birthweight, and now DS (almost six weeks) has gained almost nothing in the past three weeks.

With DD, I tried everything you've been advised... and nothing made any difference, so in the end I just went back to EBF without expressing. DD then had a dramatic growth spurt between 12 and 16 weeks, and has gained fine ever since. Really, I think all that was 'wrong' was that she was finding her own size and growth pattern, and is simply destined to be miniscule.

How big are you and your DH and your families? I'm not huge and DH and his parents and siblings are all utterly tiny exceptionally slim and diminuitive.

So whereas I wouldn't advocate you ignoring your DS' lack of weight gain or any of the advice you've been given or are seeking... you may not necessarily have a problem.

[JamieCat]

Well he was weighed today and has gained 3oz in the last 3 days and finally reached his birthweight! Feeling a bit happier now but hopes he keeps it up.

I'm from quite a small family whereas DH's family is tall and slim, so I'm not sure which side he w ill take after. He seems to be growing lengthwise so maybe thats where his energy is going?

Thanks for all your advice and support - its really good to know he's not the only slow to gain baby out there.

[twinklegreen]

Great news Jamiecat hope the good weight gain continues :)

[TheRealMBJ]

Just a quick statement/query.

I have never heard of flutter sucking being important interms of accessing hind milk (at least not from reputable breastfeeding information sources). Pippin would you be so kind as to point me in the direction of your source regarding the flutter sucking?

[Pippinintherain]

I did breastfeeding peer support course (OCN accredited) and we were taught this.
We were shown the sucking pattern of a feed and how it progresses.

I help out at ante-natal classes about breast feeding and both the Peer Support co-ordinator (fully trained) and the Infant Feeding co-ordinator (again a trained in breastfeeding midwife and highly regarded in her field) teach this to the Mums.

I am away from home at the moment but will gladly link to the chart from my coursework when I return.

I am not in the habit of spouting made up information to people and wouldn't offer support to someone with a problem if I didn't have a clue what I was talking about.

[Pippinintherain]

Oh and great news Jamiecat!

[TheRealMBJ]

Sorry, Pippin I didn't mean to offend you I really honestly have never heard of this as a true indication of accessing the full-fat 'hind' milk, and would truly like to know the source.

Sorry again.

[Pippinintherain]

TheRealMBJ, apologies if I came off a bit arsey. A combination of staying at MIL's and 2 grumpy kidsup at 6am made me read it the wrong way.

Will hunt down the chart when I return home to relative sanity

[helens82]

Hi,
I don't normally post, but I read this and it is as if you were in my house a month ago!

My DS took til he was 5 weeks to regain his birth weight and was static for around three weeks before putting any weight on. As with you, he was breastfed on demand and fed nearly constantly, had wet and dirty nappies and apparently a good latch when seen by midwife and breastfeeding counsellor.

We got advice from NCT breastfeeding counsellor who suggested 'switch nursing' where you switch breasts mid-feed as sson as his sucking becomes slower and less efficient. The idea is to switch 3-4 times during a feed so he still gets that hindmilk but I found that switching breasts helped him stay awake durng feeds and there is a further let-down each time you switch, making it easier for him to feed.

DS is now putting on weight steadily, but he is not going to be a big baby judging by the size of me and DH.

I'm really pleased that he is now gaining weight but thought I would post in case it helps.

Good luck :)