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Weight loss and rancid green nappies in 20 week old

(53 Posts)
frekkles Sat 19-Sep-09 14:14:46

help help ladies, give me some sense of perspective, i've got myself in a tizz, i'm all confused and I don't know what to think any more.

my 20 week ds has lost weight this month, dropped from 25 centile to the 9th. He's also had green stinky watery frothy nappies for the last week. He's not feeding very well, just nibbling and not doing those long sucks, then fussing alot or falling asleep within minutes.

I've taken him to the doctors and they've taken a sample to see if he has a tummy bug. I'll find out next thursday.

I phoned up the LLL today for advice, and the lady on the phone asked about how often he fed. When I told her that for the last few weeks he was feeding only once over night she said I should be feeding him atleast every three hours if not more, and ideally sleep with him. I could cry after spending the last three weeks trying to encourage him to stop feeding all night! feel like i've made him ill be being selfish and needing to sleep. He's fed on demand throughout the day and feed generally every 1 1/2 halfs to 2 hours.

So I'm really worried about it now, feel like he isn't getting enough milk. Maybe my milk supply has decreased because of him sleeping? and maybe he's not getting enough milk so is having green nappies through hunger?

I also went back to work for a day and a half last week, leaving him for 3 hours at a time without a feed and leaving him ebm. The LLL lady said that would also decrease my supply. Then she asked if he used a pacifier, and when I told her that he'd recently enthusiastically discovered his thumb she said that if he was thumbsucking it was a sign he needed to nurse more, and that when i saw him thumbsucking I should feed him

I feel terrible now for enjoying getting a bit more sleep and going back to work. I was even excited that he'd found his thumb, and he's been crying less. But I feel like a bad mother now, because he's losing weight and having these nasty green nappies.

I've spent the last two days in bed having skin to skin with him feeding him every hour in an attempt to up my milk supply if it is waning and give him more milk and comfort him if he's ill. His nappies are still rancid and he's still feeding not very well.

I'm worried as I'm due to be working 2 and a half days this week, and so far have only managed to express enough milk for a day of it so was going to supplement the ebm with aptimal for the first time. but now feel that this isn't a good idea?? and should i be waking him to feed him again over night?

or should i just stop worrying. on the plus side he is still active and smiley and alert. so confused. what to do?

llareggub Sat 19-Sep-09 14:21:54

Is he teething? My DC have both those sorts of nappies when teething. DS2 is the same age as yours and feeds just once at night. He also sleeps in the bed with me.

I've never heard thumb-sucking being a sign of needing to nurse more. That sounds a bit hmm to me.

Did he actually lose weight or just move from the 25th to the 9th centile? I saw the HV this week and my DS has moved from the 50th to the 25th centile and she said it was normal around now for bf babies to move down on the centile. She said she'd send me one of the new charts to compare it. No idea if that is true, by the way.

I bet it is a bug or teething. But see what the GP comes back with.

tiktok Sat 19-Sep-09 14:23:06

Aw, frekkles, it's horrible to feel like that ...you clearly adore him and want the best for him, so no 'bad mother' feelings necessary

Green frothy nappies coupled with weight loss are certainly a concern. He could have a tummy bug, which could cause both things. On the other hand, alongside this, or instead of this, he could be jogging along sort-of-ok but not getting enough to eat....and the sort of things you're saying makes me think this might be the case. This does not mean he has been in any state of distress or actual hunger....but reducing his feeds at night, and reducing the frequency he feeds ('cos of your work) will reduce your milk supply, and possibly limit his intake as a result. Not good, but pretty easily reversed by doing exactly what you are doing: feeding him more often.

It also makes sense to stay in touch with the doc to see if he has a bug.

Hope this helps.

tiktok Sat 19-Sep-09 14:25:35

BTW, a baby who is sucking his thumb could be doing this because he needs to suck more. In any case, it's standard when a baby has a dummy or often sucks his thumb and there's a weight/supply issue to suggest feeding instead of letting the baby suck without getting milk, IYSWIM.

Ineedsomesleep Sat 19-Sep-09 14:29:48

Can't answer all of your problems sorry, but DS has something similar with the nappies and crying. The crying was like colic in the evenings and at night. Once I stopped having anything with caffeine, his nappies went the right colour and he stopped crying. It could have been a co-incidence though.

I think you need to see a bfing counsellor, not talk to one over the phone. Have you got a Baby Cafe near to you?

I gave mine formula while I was at work, but I did start work when they were a little older so it was less worrying. I never did get on with expressing.

They've both survived and had the benefit of breast milk the rest of the time. If you have to top up while you are at work don't beat yourself up about it.

Make sure you read up on expressing though. One of my friends tried expressing and going back to work and it didn't work out. Now she bitterly regrets that she didn't know enough at the time.

Try here or here

And lastly, when you say he's gone down on the centiles, is he being measured on the new WHO charts?

tiktok Sat 19-Sep-09 14:38:20

Using the newer charts will make no difference in a baby of this age - a drop from the 25th to 9th centile will show up just the same. It's not until later that the differences show up in the chart.

Having said that, the issue is not a drop to a lower centile - that's within normal. It's the actual loss of weight, which always merits concern.

frekkles Sat 19-Sep-09 14:59:21

thanks all. big thanks. I do adore him, I'd hate to hurt him.

but i also do need to sleep. he was feeding six times a night a few weeks ago, and increasing and I was hallucinating and fainting through tiredness. I also need to work. Big debts, need the money. Although I'm only leaving him without a feed for 3 hours at a time, and no more than 4 times a week.

I go and weigh him every fortnight, and a fortnight ago he gained but only a little so fell out of the 25 th centile and this week he'd lost weight and is now at the bottom of the 9th. as titkok says, it's the same on both charts. As I said he's alright in himself, chatting away, giggling , constantly wriggling. But is pale looking and skinny, can clearly see his ribs.

He could be teething, he's drooly and when his thumbs not in his mouth his entire hand or some portion of my hand or his dad's hand is. But he's been like that for months, it's not particularly different.

I do drink plenty tea.... hmmmmm.... maybe switch to decaffinated. I was wondering about an allergy too as I've noticed he has dry skin on his arms and legs recently. But the more reading I do the more it seems like it could be so many things! aaagh, brain soup

I am worried about my supply. It's never been abundant although he's been OK and followed the 25th centile happily till recently. But I've never had enough milk to express, can get about 3oz a day tops if i express after every feed (took me about two weeks to get enough milk for him while I was at work last week, and apparently he wolfed it down in minutes each time he had a bottle . 3 in total) . I never leak, my boobs never feel hard, i don't feel any kind of let down and he seems to have to work fairly hard, always been quite fussy on the boob. I also have Polycystic Ovaries which I've read can have an effect on supply. My periods came back at six weeks post partum. He always seems more fussy whenI'm on my period, and this month I've had two as I had to take the morning after pill last week blush ....

So confused!!!! I'll just keep feeding him lots this weekend then. I hope it helps. I'm feeding him every hour, from both sides and then expressing for ten minutes afterwards too. He looks like all his christmases have come at once. Although he's still trying to put his thumb in his mouth even when my nipple is there, and filling a nappy every time i feed him.

frekkles Tue 22-Sep-09 16:09:54

hello, me again. weighed him again today and he's exactly the same weight as last week, and nappies are still green. not heard back from the doctors yet re infection and still feeding him every hour.

got to go to work tommorow and only have expressed enough milk for 3 feeds :-( so worried . his dad'll need to give him aptimal if he needs more than that but i'm upset about this. should i be? hopefully he won't need more as i'm only away from him 9-noon and 130pm till 4pm. but the way he's feeding just now i expect him to be wanting to suck every hour

tiktok Tue 22-Sep-09 16:11:52

It's good he has stopped losing weight, frekkles.

You are doing a great job - feeding often is the way to go.

I'd suggest giving the doc's surgery a ring and asking for those results.

frekkles Tue 22-Sep-09 16:33:58

thank you tiktok! appreciate you saying that. he's dropped further down the centiles though as he's stayed the same weight

just phoned the doctors and they won't be ready til friday , as it's 5 working days and monday was a public holiday here.

will taking aptimal tommorrow be a terrible thing tiktok? i'm worried really. i've been expressing every feed but just don't have enough milk not to worry. would mixing my ebm with aptimal be a good thing to do to stretch the ebm further tommorow? does mixing them together make it more digestible?

and also could teething cause these kind of symptoms? because the last couple of days he's been very bitey, red checked and screamy. still not feeding well either.

tiktok Tue 22-Sep-09 16:46:18

OK, frekkles, here some info:

* no, of course formula is not a terrible thing...doesn't have to be aptamil, you know! Can be any brand. My main concern is that you would not normally give something new to a baby who may be fighting a tummy bug.

* not a good thing to mix ebm with formula, no. It makes no difference to the digestibility of the formula, and risks you giving formula when ebm on its own would be sufficient.

* if you want to avoid formula and lets say ds is cross and looking for a feed and your dh knows you will be 10 mins only....then cooled boiled water on a spoon is worth trying instead.

* teething can cause bitiness and red cheeks from extra salivation...but not an upset tum.

So it's a judgement call for you...sorry.

frekkles Tue 22-Sep-09 16:56:48

thank you tiktok ( you know, i keep mearly typing titkok! grinblush ). I'll just need to see how it goes x

tiktok Tue 22-Sep-09 16:59:27

Good luck....and thanks for avoiding that 'new' user name for me

manyhatson Tue 22-Sep-09 21:35:30

Frekkles, you sound like a wonderful mum. Try not to worry too much; everything will be OK xx

frekkles Thu 24-Sep-09 09:52:07

thank you, that's a nice thing to read.

So we both survived my having to work yesterday, and the little boy had two bottles of EBM and 4oz of formula. I felt so sad about it all yesterday as I didn't have the test results back yet, but I couldn't do anything else. I've cancelled today's work so I can feed him lots today. I'm working again on saturday 12-4, so hopefully I'll be able to express two bottles of EBM for him by then.

Heard back from the doctors and the tests were negative. His poo is still liquid and green though. I'm not sure what to do now. I don't know if I can feed him much more than I am, it's been pretty much every hour of the day for the last week, and twice or three times over night (goes to bed at 8, and wakes sometimes between 1-2am and then always at 4am and then 6am).

Even yesterday when I was at work I fed him at 6am , 7am, 8am, left for work at 830am, he got 6oz of EBM at 10am and then his dad brought him to me for lunchtime. I fed him at 12 noon and 1pm. And then his dad gave him another 6oz of EBM at 2, I got home at 4pm and he was still napping, so I fed him at 430 and 530 and then had to go back to work and his dad gave him 4oz of formula at 730pm before bed. He woke up at 10pm too when I was home so I fed him for an hour . He then slept through till 4am this morning!

So even though I was working yesterday I fed him 8 times. I'm not sure how I do more.

My breast dn't seem to have responded to this regular feeding either. Still don't feel very hard or full, no leaking etc. Still woefull when expressing.

I've got an appointment with HV tommorow to measure his height to see how much he's grown in weight. I think I may talk to her about weaning and start thinking about it in the next month. Any advice ?

The little boy still seems well in himself though, smiley, happy and very active, nearly sitting up unassisted and rolling about all over the place. He's alot more active than other babies I've met, so maybe he does need extra calories?

frekkles Thu 24-Sep-09 19:35:06

leeetle bump x

boredwithfoodprob Thu 24-Sep-09 21:00:23

Just wanted to say you really shouldn't feel upset about having to give your DS formula. I was the same as you - when DS was first born we had to feed him EBM at first as we had latching on problems and then when he was only a week old I was just so tired and stressed about the whole feeding lark that I just couldn't express a single drop and DS was starving! Hubbie had to run out to Tesco's and buy the dreaded formula which DS then wolfed down while I sat crying my eyes out feeling like a complete let down sad But at the end of the day this was the absolute best I could do for him, I could not have done any more. I carried on bfing for 6.5 months as well as giving some formula too along side and this worked well. What i'm trying to say is don't feel guilty about giving him formula, it's what you had to do and when I look at my DS now (13 months) all tall and chubby and happy I realise I shouldn't have been so upset. I hope your DS is better soon, i'm sure he will be - mine had a tummy bug for about a month when he was about the same age as yours and we never did find out exactly what it was but I know how worrying it can be - he'll be fine. Good luck smile

cleanandclothed Thu 24-Sep-09 21:11:58

Don't worry about how your breasts are feeling. You are feeding so often I think it is completely normal for them not to feel hard, and it doesn't mean lack of milk, nor does the amount you can express mean anything about your supply. With regards food - discuss with you HV and see what others say on here but I would say a) breast milk has more calories than most stuff and b) weaning is a real faff, takes ages, and you still give all the breast feeds you normally give for at least the first few weeks, plus spending ages covered in food and doing extra washing.

WobblyPig Thu 24-Sep-09 21:17:41

Have you considered the possibility of milk protein allergy?

AuldAlliance Fri 25-Sep-09 12:36:03

Frekkles,
Any news?
Just a thought (from a sleep-deprived brain...) I don't know what the general wisdom is, but you said you were expressing after a feed, I think.

I can express a fair amount, but not if I do it after a feed, when my breasts have just been emptied. I try to express kind of half way between feeds, or leave a good long gap on working days and then express loads.
Worth trying to play around with when you express?

frekkles Sun 27-Sep-09 12:26:12

thanks for the support ladies, sorry not to be around , i broke my bloody laptop so don't have internet access much now.

Just to say I am a little relieved because when I took the wee boy to the HV on Friday to have his weight checked again and he's put on weigt and is now what he was a month ago. His poo is a bit more encouraging too, still mainly green, but not as watery and occasionally brown too. So I'm hoping that something's changed.

I am however confused still as the HV told me I was feeding him too regularly and should only be feeding him every 3-4 hours during the day, and never at night or else I'll turn him into a snacker using the breast for comfort. and not too wean till 6 months. and if i'm worried about my milk supply to take fenugreek and brewers yeast supplements. AAAAgh. Too many dogmatic opinions everywhere.I can't really cope with.

So I've decided that I'm happy that aslongs as he's gaining a little weight each week and looking well. I'm going to ignore the centile charts as long as he's not losing weight. I'm going to ignore the nappies as I know now he's not got an infection. I'm going to continue feeding on demand, and not let him go past two hours in the day. And I'll feed him the two times he akes at night, but not let him fall asleep on the breast. I'm going to continue to express as much as I can, but not stress about it and use formula to allow me to work if i need to. I'm going to take a supplement in the form of the more milk supplement from breastfeeding heaven. And try not to worry.

Alibabaandthe40nappies Sun 27-Sep-09 13:01:08

Frekkles you sound so much more positive

I think you are sensible to ignore the HV and to keep feeding on demand. If you are struggling with supply how can it possibly be a good thing to limit feeds and time at the breast?

tiktok Sun 27-Sep-09 14:47:15

frekkles - good news things seem much improved.

Have to say, this is extraordinary advice from the HV, and if you can be bothered, you might want to ask her to justify it on these grounds:
* how does limiting feeds help where there is a history of concern about weight gain and some recent actual weight loss?
* is she not aware that feeding in the night is normal for a baby of this age?

DubyahDawtHoochieMomma Sun 27-Sep-09 14:57:25

Message withdrawn

frekkles Wed 30-Sep-09 11:26:24

Hi there!

Have now been taking fenugreek, goats rue, fennel and blessed thistle supplement for a coupl of days. It makes me want to throw up, but i do seem to have more milk. For instance when he breaks off mid feed i can see milk in his mouth and coming out of my nipple. Never seen that before. He seems more settled at the breast too. Hopefully this'll tranlate into a weight gain. He does look in better health, ribs not so visible and colour in his cheeks. He's not demanding food constantly now either, i'm stilll feeding him every two hours though

His nappies have changed too, he's now not had a poo for 3 days! dear oh dear. He went 9 days once before the last month happened.

Last night he spontaneously slept through for the first time. Half seven till six this morning. wow! He fed for an hour then and is very happy today.

so hopefully things are on the up

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