Weight loss in newborn

[MsElisaDay]

One of my best friends has just been readmitted to hospital with her week-old DS after he lost 13 per cent body weight.
She thought bfing was going well, as he fed virtually all day and night, so was surprised by the big weight loss.

Obviously she's very worried and asked my advice, as I had a similar thing with my DS. I got lots of advice from this board and also from the LLL and NCT helplines, so passed that onto her.
The advice was basically to feed on demand (even if it seems too often), lots of skin to skin, cosleeping etc.

However, in hospital she's now been told to forget all that, and her DS has been put on a strict feeding routine. The gist of it is that if he feeds on demand there's not enough milk "there" for him, so he has to wait for it to "build up" to a full feed, IYSWIM.

This is at odds with everything I was told, and everything I (not very helpfully, it seems) told her.
So what I'm wondering is, is the midwife right? Can a strict routine actually help a newborn who is struggling? and if so, was I actually given the wrong advice myself? My DS has never had a routine but is gaining weight well now.

I'm just confused I guess, as I thought I was doing the right thing by advising her to feed on demand, but the inference is that it was the wrong thing to do.
Thanks in advance.

[LeggyBlondeNE]

iPad just deleted my response!

I had similar experience to your friend first time and never managed to exc,usively BF. This time when problems arose I went to a LLL leader with
IBCLC training and got told to switch nurse frequently, eat insane amounts of oats, tr domperidone, and he's now gaining well on just BM. So my experience supports what you were tod.

My understanding is that weak babies need breaks and top ups. Isyurfruend's baby weak or 'just' losing weight. 13% can be a lot for some babies.

[Samvet]

Tell her to ask them to check for tongue tie. We were in same situation (13% loss) and even when re admitted the TT was missed.

[RedKites]

She could try asking to speak to the hospital's Infant Feeding Coordinator or similar - they often have more training on breastfeeding.

[Twattybollocks]

I would make sure they have checked for tongue tie, the problem at the newborn stage is almost always not lack of milk, but ineffective milk transfer ie the baby can't get at it for some reason. you would be amazed at the number of paediatricians who don't check for tonge tie in these cases, in my experience they almost always insist on huge formula top ups, which whilst I agree that the baby needs milk urgently, seriously hamper breast feeding efforts. If she is really committed to bf, supplemental nursing systems can be very useful and she needs to get hold of a good double pump. The infant feeding coordinator at the hospital may be able to help, or the bf specialist team if there is one in her area. Failing that, sure start centres sometimes have them for rent.