Breast feeding baby not getting back to birth weight

[krisskross]

I've previously posted re my difficulties breast feeding..... pain / latch etc.

However, DS aged 12 days seems content once on, but im still in pain and actually its been getting worse.

I saw the midwife yesterday and she told me he has lost a bit more weight..taking him to 10.1 % of birth weight lost.

I want to perservere with EBF, so her suggestion is that i express 3 to 5 times each day and top him up with this milk in a bottle .

I was so upset with this.....i dont want to introduce a bottle at this point in case it causes confusion.But also i have two older Dc and most feeds take over an hour currently, So the idea of expressing and bottle on top, as well as offering both boobs at each feed and never going more than three hours from start to start is pretty horrendous.

He is doing wees and poos.

I've been to two breastfeeding groups who both thought his latch was ok...just needs practice. Though one was 50/50 re tongue tie.

Ive booked to see a private lactation consultant on friday but in the meantime im not sure what to do...obviously i dont want him to lose more weight.

Couple more things that might be relevant....i have quite flat nipples (though not after he has finished!) . He was also big at birth....over 4 kilos.

Thanks for reading and any advice you have. The sad thing is, though I'd been finding it really tough the one thing i felt confident in was him getting enough milk ...now that's totally gone!

[ifyouthinkiwillsleepyoudream]

First of all, Congratulations!

DS also had weight loss and latch issues at first and we were also advised to introduce bottle early. I was worried a lot back then but turns out it was a very helpful decision! The top ups helped him sleep and gain weight so much better and slowly I relaxed too. We never had nipple confusion issues and he takes both breast and bottle very happily to this day (he is now a happy 6 month old). The only issue was the faff of having to wash the washing the bottles etc tbh

Good luck!

[FluffyTowers]

I haven't experienced DC losing birth weight but with DC1 after a horrendous birth and hospital stay I expressed enough for DH to do a feed a night to help me get some 'rest' & recover. This started at less than a week old and he never had nipple/teat confusion (and had tongue tie).

I gave up expressing a few weeks later which I regretted as he then became a bottle refuser when I tried to wean him.

With the right pump and timings expressing shouldn't take too long so don't get stressed over that. Good luck and congratulations 😊

[Newbiecat]

I could have written your story myself. My DC3 is now 7 months but we had a rocky start where he was latching well but took an hour to feed. He was too sleep to effectively feed and he lost about 9% weight. We topped up each feed with a syringe of expressed milk and set my alarm 3 hourly at night. How disappointing when a week later his weight remained the same! After that I continued with the above plan expressing 3x a day at least but 2 of syringes a day after feeds were formula. This was purely to support my breastfeeding until my milk was better established and of better quality. The following week things started to improve. At 3 weeks I stopped syringe topups and introduced a bottle once a day of either EBM or formula (depending how i got on expressing with 2 other kids to look after!) From 6 weeks things picked up lovely and he was exclusively breastfed and heading back to 50th centiile.
I have breastfed all 3 of my kids and had a range of deliveries- emergency section, VBAC and elective section and all 3 growth charts and stories look similar! I have come to the conclusion that my milk is there but not of great quality for the first few weeks. I know how much self doubt I had about my supply do I really do empathise.
Don't worry too much about nipple teat confusion - none of my 3 ever had it and we introduced 1 bottle a day from 2-3 weeks with all of them.
Make sure you get support from your HV too and BF group. Be careful with the lactstion consultant - have the come recommended? They always seem to diagnose tongue tie and in my experience these can often be anatomical but not functional and have nothing to do with feeding issues. It's a bit topical currently.
Best of luck

[krisskross]

Thanks all for taking the time to respond.

Can anyone advise me re when to express and for how long? Do i do both sidws each time.

Tbh im feeling so crap. My other two lovely kids arent really getting a look in from me and im so scared we just won't get back to the way we used to be. Sorry to seen melodramatic...ive been up all night.

[ifyouthinkiwillsleepyoudream]

It will get better! I know from experience, it is hard to keep a positive outlook when sleep deprived and exhausted. But it WILL get better.

I express at night or first thing in the morning as that is when I have the most milk. Takes me about 20mins to get about 3-6oz (varies depending on the day). I think ppl can get more or less, depending on each body.

Also depending on the pump. I had a medela electric one and not much was happening. Switched to a Philips manual and it made a world of difference. Most ppl I know have a medela though, so I think it is just me!

[TheElephantofSurprise]

Hello. Just short of thirty-five years ago, I was in your position. Please don't panic about topping up if you have to. My dd had soya milk (the trendy thing at the time) top-ups from four to eight weeks. After that she was ebf until she started reaching for food from my plate, and she was breastfed until four years three months. More recently, she gave top-ups when needed to her own dd, then exclusively bf, then continued feeding until my dgd was four years six months old.

I was encouraged to express, and did, but I did it by hand not with a pump. The first time I got a couple of drops. Within a couple of days, I could get a couple of ounces at a time. I used it for top ups, of course, but the main benefit of expressing was the extra stimulation to produce milk.

Certainly don't worry about 'each side' - breastfeed/express as is comfortable and convenient. Unrestricted suckling is key.

[BertrandRussell]

Is he losing weight or just not putting it on very fast? I ask because I had a very big baby and he gained weight incredibly slowly. Because he was my second, I could see that he was content and happy, peeing and pooing and not showing any signs of dehydration so I was able to hold my nerve . He actually moved down the %ies until he hit the 60th, and just stayed there and is probably still there now.

A couple of years later I found out (on here) about something called "catch down growth"- which essentiallly means that a baby finds it's own level after being born bigger that they should have been, for whatever reason. It's certainly worth googling, if everything else is looking going except weight gain.

[LookAtAllTheBullshit]

When you say flat nipples, do you mean when your breasts are choc full of milk right before a feed?
Mine used to fill like that. The breast was solid and the nipple quite flat-I was advised to just hand express a small amount from near the nipple to slightly empty that area. It softened the breast and nipple so the nipple protruded more and baby latched better.
Before it was like trying to get him to latch on a football.
I only had to do it the first few weeks until my supply fully regulated.

[tiktok]

Please dont worry about confusion.....continue with the breastfeeding and your baby will manage both 'methods' just fine.

I can well understand the concern - your baby really does need to stop losing weight and to start gaining.

It's a big task to express and feed and feed from the bottle. But it's important to tackle this now. Also read up on breast compression and switch nursing.

It's good you are getting help with this - it's early days, you can turn this round :)

[krisskross]

Thanks everyone.

I am going to start expressing twice a day, topping up temporarily and taking fenugreek. Ill also perservere with advice re latch.

The catch down growth is fascinating....my three have all been 9 pounders and my first two struggled to regain biryg weight (had forgotten) IIRC both went to around 50th centile and stayed there. We are not otherwise a big family

Somehow i need to get the balance between feeding him what he needs...even uf thats extra, knowing whats right fpr him and looking for signs he well fed / not well fed. Not easy as you all know, especially when they are so tiny and im so tired and nervous.

Sorry to ask agsin ...but presumably i express immediately after a feed? I can give him the previously expressed milk just before?

Thanks again.

[krisskross]

Sorry for all the typos.

[NameChange30]

Ideally you need to get him properly assessed for tongue tie before Friday if you can. Are there any breastfeeding clinics / drop-ins near you? Some of them might have a lactation consultant who can do a tongue tie assessment. If there are no clinics or drop-ins and the private LC you've found isn't available before Friday, could you find another one who is?
www.lcgb.org/find-an-ibclc/

We were lucky to get DS's tongue tie diagnosed by a breastfeeding counsellor at a drop-in. We then found a registered tongue tie practioner to divide it straight away (paid privately as I didn't want to wait longer and travel a long way to get it done on NHS).

[NameChange30]

Oh and my suggestion for expressing is to get a Haakaa pump, you can use it to express from one boob while feeding from the other, so it's not an extra thing you have to find time for, IYSWIM?

Before DS's tongue tie was divided and he was feeding constantly, the last thing I wanted to do when he wasn't feeding was attach myself to a breast pump! But after it was sorted, he has been feeding less and I've had time to express with an electric pump. I'm using the Ardo Calypso which I'm happy with, it's quiet and efficient.

[ifyouthinkiwillsleepyoudream]

Oh yes, @NameChange30 's advice is excellent. Best (and easiest - milk flows much more freely while you feed) is to do it while breastfeeding on the other side if you can. Takes a bit of practice in coordination to start with, but worth it

[NameChange30]

I've just realised I posted on your previous thread, gave you the same advice 10 days ago!!

Why would you wait 10 days when you have a newborn struggling to feed and put on weight?!

[Newbiecat]

name change don't you think you're being a bit harsh here? The op is only asking for advice and I don't think she needs people having a go at her when she's tired, sleep deprived and trying to do the best for her baby.
Op as I mentioned in my previous post please be careful you don't unnecessarily get diagnosed with a tongue tie it may be the case for some babies but it's definitely overdiagnosed as the sole cause for feeding problems and that is not always the case.
La Leche League are really helpful as well as Kellymom for help with problems with breastfeeding I'll try and post a link here.

www.llli.org/faq/faqsubject.html

I had an Ardo Calypso double pump and used to pump twice a day after feeds - double pumping is so much more time efficient when you have other children and I wasn't a great expresser! You top up after a feed so as not to fill their tummies up beforehand and make them reject the breast.
Fenugreek helped me a bit too although I did smell like I'd been eating curry constantly

[NameChange30]

Yes probably a bit harsh but I'm sleep deprived myself and it's a bit frustrating to realise I've just wasted my time repeating the same advice!

Never mind. Hope you can get it sorted soon, OP.

[NameChange30]

And FWIW I think tongue tie is under-diagnosed, not over-diagnosed, but I'm probably biased by my own experience.
Anyway, a lactation consultant should be able to confirm whether it's tongue tie or something else.

[NannyOggsKnickers]

We had a similar problem with DD. With her it turned out that although an almost full tongue tie had been noted in hospital they don't routinely clip them. We had to wait until she was 6 weeks old for an appointment. Until she had it clipped she didn't gain weight but did produce dirty nappies.

I pumped and topped up with one bottle a day. Although I couldn't pump enough to for a feed after she was three weeks old so there was some formula. I used to stay up after one night feed and pump both sides for ten minutes each. It was oddly restful. I'd also do one in the morning between feeds. Apparently this is when milk production is at it's highest.

She never got nipple confusion but we did end up mixed feeding eventually because DH loved spending time feeding her in the morning. And I didn't mind the extra sleep

We never had an issue with nipple confusion.

[krisskross]

Thanks everyone.

Namechange- there has not been a weight issue until he was weighed yesterday . At his first weigh in all was fine, midwife observed him feeding and felt all was ok.
So to be clear i haven't been ten days with a newborn struggling to feed and put on weight.

My first post was about my struggle with feeding, not the baby struggling.

[silkpyjamasallday]

Hello, my DD lost just over 10% of her birth weight because she had jaundice and struggled to stay awake for feeds so I had to hand express and feed with a syringe at 2 hour intervals for the first two weeks. Once the jaundice cleared she got the hang of it and she is now just shy of 8mo and is absolutely enormous, she is heavier than her 13mo friend. She has only had breast milk until weaning no formula top ups. One HV advised I gave formula but it can damage your supply so I persevered without.

Be kind to yourself and remember that you are both learning how to do all of these things, and it will take time, your baby has only just come into the world and it is all so new to them, as long as you have plenty of wet and dirty nappies baby is ok. I pumped for bottles from about 5 weeks and it didn't take long for her to get used to the bottle, but did this more so DP could be involved in feeding and to give her a big feed before bed to help her sleep than for top ups though. I have tommee tippee hand and electric pumps and I have found I get more milk using the hand held one, I tend to pump in the morning and early evening when my supply is highest, it does help to do it while baby is on the other boob it just requires good positioning.

Do investigate tongue tie, but as a pp said it isn't always the reason for poor latching. DD wasn't diagnosed with it although her latch was painful at first, but she broke the frenulum under her tongue herself with a spoon when we started weaning and breastfeeding after this seemed to need less suction on her part so perhaps it was missed.

[tiktok]

Catch down growth- babies, especially new babies, do not lose weight. It's not possible to diagnose catch down growth at 16 days. This baby needs to start gaining :)