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Tiktok et al, I desperately need your help re slow (actually no) weight gain.

(62 Posts)
suwoo Sun 23-Aug-09 11:22:51

Have posted quite a few threads now. Well DS2 had his weigh in today and had stayed the same. He is 23 days old now and is 400g less than his birth weight (roughly 11oz?)

The subject of topping up has reared its ugly head and I actually cried to the midwife who was very understanding.

My plan (for the very short term) is this:

Wear my breast shells and use any milk caught with the minimal supply in the freezer to give one 4oz? bottle at night. I will top up with formula to make the 4oz. While DH is giving the bottle, I will express from both breasts to mimic normal feeding and not affect supply.

Does this sound feasible?

Midwife has suggested not waking him after 2 hours, but letting him go for 3 so he may be more hungry and feed more effectively whilst also letting my milk replenish.

Am speaking to the lactation consultant who is looking after us, tomorrow.

Very grateful for any help/advice.

charleymouse Sun 23-Aug-09 11:40:58

Hopefully someone with more knowledge will advise Suwoo. You are doing well though as I know you thought you would have difficulties. Is the loss since birth or is it just the last week. How long ago since his last weigh in.

If he is pooing and weeing plenty then I wouldn't be too worried. How about a baby mooning session, get plenty of drinks/snacks and curl up in bed with him giving him loads of access to the breast. Chance for DH to take the other DCs out or something and let you have a bit of peace and quiet.

Good luck and you are doing well you know.
<<>pats suwoo on the back>

suwoo Sun 23-Aug-09 11:50:47

Thanks Charleymouse. It was 6 days since his last weigh in. He is doing plenty of poos and wees and is not dehydrated at all.

I'm not sure the babymoon is the answer to this one as I haven't got a problem with him taking the breast, he would be happy to use me as a human dummy all day. Its getting him to suck effectively that is the issue, I am going to try stripping him off and wiping him down with a babywipe this next feed.

prettybird Sun 23-Aug-09 17:11:35

At only 23 days old, I know my breast feeding counsellor midwives were recommending that I wake my ds to feed him and not let him sleep through as he wanted. Their initial recommendation was every 2 hours, before gradually increasing it to to 3 then 4 beofre stopping waking him.

The risk is that if they are not thriving, then thery can become sleepy.

I did also use to try to express between feeds as well to build up my supply (initially with an electric pump borrowed from the hospital, later with an Avent manual pump, which I actualy preferred as it was more gently, and for me at least, just as effective). This was especially effective in the mornings as that is when your prolcatin levels are the highest.

Increasing the time gaps will not help you buld your supplies and "replenish your milk" - it will have the opposite effect.

Initially I supplemented every feed with the EBM I had expressed in between times. Foir a while, I also gave him every second feed as en epxressed feed (expressing immediately afterwards to ensure I jkpet my supply up) - but I now realsie that that was more for my benefot, to give the confidence that I could see he was getting plenty.

A lot of this depends on how well you express. I was fortunate and I was able to express a lot - but some bodies just don't express much - but that is not an inidcation of how much milk your baby is getting.

FWIW - ds was a non "failure to thrive" baby who just happened not to follow the growth charts.

suwoo Sun 23-Aug-09 21:22:23

Quick bump from my iPhone in bed. I got 4oz today just in my breastshells with no pumping. Will be speaking to lactation consultant tomorrow.

Will giving him a bottle be the beginning of the end? Should I try a cup or syringe instead?

sad

mathanxiety Sun 23-Aug-09 21:29:07

I too was told to wake my DD every two hours to prevent excessive sleepiness, which can be a problem. She tended to sleep a lot and fell asleep constantly while feeding. I was so devastated when advised to supplement because I thought I had failed terribly in some way, but really, no-one is judging you at all smile. It's really about the baby and how healthy or otherwise he is. The supplementing actually helped (I supplemented after each feeding, ended up throwing out lots of formula.) After about a fortnight DD was exclusively bfing again, much more awake and hungry. Don't be discouraged if you express and not much comes out. It doesn't reflect your supply situation, maybe try a different pump. Milk is usually more forthcoming in the morning. Don't try it in late afternoon or evening because that's when you have least. Don't feel bad. Sometimes you have to compromise to get baby on track, and it doesn't have to be forever.

notforconsumptionbythemail Sun 23-Aug-09 21:36:41

Best of luck. 4oz is fantastic I am in awe. Not an expert (so feel free to ignore) but giving it to him in a bottle should not be 'beginning of the end' - my ds had about 1-1.5oz expressed milk in a bottle 3 times a day from about 4 weeks until he inexplicably refused bottle at 5 months Breast feeding was still fine. You may find a syringe easier though - I would try that first to be honest.

suwoo Sun 23-Aug-09 21:40:52

Aww thanks, that is really reassuring.

<<weak smile>>

PacificDogwood Sun 23-Aug-09 21:44:20

Suwoo, 4oz in breast shells, that's amazing! Do give it to him, I never found bottles to be a problem as long as they were infrequent. I personally found cups etc too fiddly; 2 left thumbs me!

For "ineffective" feeders ie spends lots of time on breast but does not actually drink a lot, I found this invaluable. There is a video with demonstration on how to do it as well. Dr Jack Newman is my hero blush!

I would also second MORE frequent feeding, not less.

HTH a bit and you and your DS get there.
smile

suwoo Sun 23-Aug-09 21:48:51

Have watched the videos before and DS is the good sucker who turns to a nibbler at the end of his feed but I have been adressing that.

From the last comments, it appears my milk is plentiful, so WHY is he not gaining?

suwoo Sun 23-Aug-09 21:53:59

Oh and of course, thanks smile

PacificDogwood Sun 23-Aug-09 21:57:47

???

You sound well clued in and I certainly have no more to offer.
You do need TIKTOK <<waving frantically>>.
My DS3 was a bit like what you are describing, and at 4-5 weeks just very suddenly turned the corner. I am not aware that we did anything differently, it just suddenly seemed to click hmm.

Hope you get some more competent advisors than me wink.

prettybird Sun 23-Aug-09 22:13:08

If he is not gaining weight, yet appears happy, healthy and alert, with wet and dry nappies, then it might just be becasue he is following his own growth curve. The growth charts are averages - not everyone follows the nice smooth curve.

He could also be an example of "catch down" growth, ie born higher than his "natural" position (due to the fantastic nurturing you provided him in the womb! wink) and is now adjusting to his "correct" position.

That was defnitiely the case for ds - born on the 91st, big initial fall, then extremely slow weight gain (although never actually losing weight) until he dropped out of the cahrts, before starting to follow the charts just underneath. At 4 months or so, he started to gradually creep back up until he started to follwo the 50th - can't tell you exactly when, as I had stopped getting him weighed by then.

He is now nearly 9 and a happy, active boy who is somwehrre about the 50th for both wieght and height. Again, can't tell you for sure as it really isn't that important - but can tell by looking at him and at his friends (and do occasionally try to find whate ver the current chart is to check apporximately).

Congratulations on the "overflow" milk. SOunds like you should be able to collect plenty to supplement him and to reassure yourself.

Would re-itireate again: don't drop to 3 hour feeds until you are sure of your supply. It will only decrease your supply and have the opposite effect to "replenishing" your boobs.

I'll also add that ds was fine with his bottles of EBM and never refused the breast. He was just a very lazy feeder! grin

I did manage to exclusively breast feed him for 13 months in the end. I got very bloody minded about continuing to feed him - espcially once I knew that all the extra EBM he was getting made no difference to his weight gain.

suwoo Sun 23-Aug-09 22:23:15

My other two dropped down the charts as all were born at a 'good' weight. No-one stressed over them losing though as they were being bottle fed. They are now just below the 25th and on the 9th centile for weight. Mine and DH's family's are all on the slim side so yes, he is just finding his own level. Am trying the compression in the meantime until I speak to the LC.

JetLi Sun 23-Aug-09 22:24:17

Hi Suwoo - we use a Breastflow bottle for DD which sort of mimics the action on the breast. It was recommended by another MNer and they're brill. Some branches of Mothercare stock them.

suwoo Sun 23-Aug-09 22:34:48

I've got those bottles grin just loathe to use them (or any). Can anyone tell me about using a syringe?

Meglet Mon 24-Aug-09 09:37:57

Bumping for you. I hope the apt with the lactation consultant helps too.

prettybird Mon 24-Aug-09 11:00:18

Although ds never had any problems with bottles v breasts, the one thing I would recommend is keeping him the small hole teats, so that feeding with a bottle never becomes too easy! grin

AvrilH Mon 24-Aug-09 13:15:06

In contradiction of prettybird - I also had to top up, and found my newborn DD took hardly anything from the small hole teats. My excellent community midwife (who we saw for ages until paed signed DD off), said she wished they never sold the things and that for top up feeds you always want to go for the later stage teats.... so get advice!

Best of luck

prettybird Mon 24-Aug-09 14:34:01

Can't really argue with AvrilH - it was only be chance that I stayed with the samll hole teats, as I never knew any better! Because I wasn't bottlefeeding per se (although he did end up getting EBM for 12 months as I went back to work full time at 4 months) I never realised that there were "other" teats blush

It was only with hindsight that I reckoned that the reason I never had nipple/teat confusion was because bottles were never "easier" than the boob.

One other bit of personal experience - ds was alwyas a very "soft" and very slow feeder and I cuold never really tell when he was finished. I alwys used to offer both boobs and then, if I could unlatch him without actively having to "break the seal", I reckoned he was just comofrt feeding at that point.

AvrilH Tue 25-Aug-09 06:35:20

I guess it is something of a trade-off, maximising calorie intake vs nipple confusion (though we also avoided the latter).

Rhian82 Tue 25-Aug-09 07:23:32

When DS wouldn't latch at all when he was born, we used to feed him EBM from a bottle lid (used as a cup) until he got the hang of it. It was a faff but worked pretty well.

suwoo Tue 25-Aug-09 08:38:10

Thank you so much for all your advice on this.

I spoke to the lactation consultant yesterday and she advised to top him up after feeds 3 times a day of about 1.5 oz. I am using my own milk that I have collected in the shells. She suggested pumping in the morning, but I only got 1 oz this morning.

I am using the breastflow bottles, which do really seem to mimic the same sucking action on the breast. Hopefully this will give him the calories he needs to grow a bit and become more alert, therefore improving his feeding from the breast.

As soon as that happens- I stop supplementing grin

AvrilH Tue 25-Aug-09 10:04:23

When my DD's weight gain improved, we started to gradually reduce the top ups - after a couple of weeks we were able to cut them out completely.

Best of luck!

notforconsumptionbythemail Tue 25-Aug-09 13:01:50

Hi Suwoo - just wanted you to know I am thinking of you and hoping it is all still going well. Do be aware that expressing does make you very tired, especially trying to fit it in between 3hr feeds - try and rest as much as possible and drink lots of water!

best wishes

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