10 day old not gaining enough weight

[niceandsimple]

I had a baby boy 10 days ago, he was 4.47kg. when the midwife checked him on day 5 he was 3.99kg - 10.7% weight loss, so the midwife has been coming every other day to weigh him. He put on some weight, but now he has lost a bit again. He is now 4.13kg. He is also jaundiced and had tongue tie - fixed now.
Can anyone advise me on what I can do to help him as best I can? I do not want to have to bottle feed, but the midwife keeps on suggesting that this will be my only option if he doesn't put on weight.
If absolutely necessary I will, but I don't want to. The last thing I want is for my baby to be ill.
Just to add, I can express, but as feeding is still being established I don't want to confuse him and make the feeding harder.

[OverTheRainbow88]

I’ve never met a baby which has ‘nipple confusion’ or whatever they call it from breast and bottle feeding.

I would suggest breastfeeding as much as you can/want to and then topping up with formula after most feeds. My sister did this for 2 weeks and then didn’t need to again.

[turnthebiglightoff]

My baby wouldn't not take a bottle until 7 months. I know lots of other babies the same. Bear that in mind OP. How often is baby feeding?

[niceandsimple]

Thanks @OverTheRainbow88
That is helpful. All of my friends/family have not had this issue. Also, they have either formula fed, or breastfed, not combined.

[niceandsimple]

baby is feeding around every 2 hours, and for half an hour or more each time. He is a bit sleepy when feeding, but is getting plenty as I am changing his nappy before every feed!!

[Aroundtheworldin80moves]

I had similar with DD. She lost loads of weight, and wasn't feeding enough. The midwives had me feeding her, then she would get a top up while I expressed. She was then offered the expressed milk after her next feed, and so the cycle went. After a few days she didn't need the top ups anymore. I breastfed her for 17 months... Until my milk dried up during pregnancy.

She's 9.5years now, and still very skinny... Maybe part of her weight loss was to get her natural centile!

[niceandsimple]

@Aroundtheworldin80moves
"Maybe part of her weight loss was to get her natural centile!"
That makes sense. My older 2 are tall and thin, so maybe this will be how he turns out too. I will express for him and see how it goes.

How did you know when to stop the top ups?

[crazychemist]

Do you really think you need to top up? Your baby is fairly heavy - lots of the initial weight loss is because babies often carry extra fluid and loose this in the first two days, might your baby have just had more fluid than average? You say the tongue tie is fixed and you are getting plenty of wet/dirty napPies so it doesn’t sound like feeding is an issue. Can you monitor weight for another couple of days? If you’re getting wet/dirty napPies then it doesn’t sound like the decision needs to be made straight away.

Currently combination feeding my twins - they were premature and not able to suckle effectively, so I’ve had to do supplementary bottles. Would you consider expressing milk? That way giving bottles wouldn’t affect your supply. To avoid nipple confusion, i was advised to always offer the breast before and after the bottle and to keep top-ups minimal. A typical newborn takes about 2oz in a feed, so I would breastfeed for 10 mins, give a 1oz bottle and then pop them back on again. I’ve been weaning them off the bottles - now they are a few weeks older they more reliably wake when hungry, so I do about half of feeds without the top up in the middle. Going well so far.

[Harrysmummy246]

He's started putting on weight, I'd be asking for more time if nappy output is ok. And have you been offered a feeding assessment, this should be the first resort not pressure to top up

[Harrysmummy246]

Ps, there are other options in addition to bottle feeding if it is necessary to top up, such as cup feeding and any bottle feeding should be paced feeding

[JohnMcCainsDeathStare]

My DS1 lost weight for 4 weeks and he was smaller than yours when he was born (3.18 kg at birth). He had some jaundice but was feeding well and leaving plenty of wet and dirty nappies. He was also meeting all the milestones you would expect for 4 weeks, like following and proto-smiling as well as not hitting himself in the face.

If your gut feeling is that he's fine then he's fine.

[Irre247]

Congratulations on you new baby! I hope you are recovering steadily and being looked after.

If nappy output is good, nod, smile and ignore them. You can stand your ground, you don’t have to top up with formula unless baby is becoming unwell/dehydrated.

I didn’t with my first and ended up combination feeding which worked ok, but I didn’t continue to bf at all much after I went back to work (6 months)

Second time around I just ignored them, did my own thing and am still bfing 14 months later, I went back to work at 11 months.

If there are no clinical issues, they will just want him to follow a centile and some babies just aren’t meant to! My second was born huge (9lb 6!) and just needed to find her centile, she is quite petite now and in 9-12 month clothes.

[niceandsimple]

I don't think I need to top up - the midwife does. I am worried because the midwife keeps on coming back, which I know is not usual at the moment.

[niceandsimple]

Thank you for all the replies.
I am usually confident in my choices, until someone questions them, and then I start to question myself.
I should know that it will be ok, as my other two stopped growing at 6 months for a few months each, and my GP, who is also a family friend told me not to worry as long as they were meeting developmental milestones. they are both healthy, tall and thin for their ages.
I guess it's because he's still so young that I got scared!
Thank you again for the advice.

[TheWashingMachine]

My DC1 was 2.6kg at birth and dropped to 2.2kg in the first week as we both struggled with breastfeeding. He was always tiny, but if it is not working out get help. Breastfeeding doesn't always come naturally, he ended up be mainly formula fed and is fine. Although I had as much guilt at the time and I rembeber seeing a 3.6kg baby and bursting into tears because he looked like a curried shrimp next to it. (He also had jaundice so was dozy)

[twinklespells]

When was the tongue tie cut? My DD lost too much but after the TT was cut her weight gain began to pick up.

[InTheLongGrass]

I agree with twinkle, how long since the tie was divided? DS1 didnt hit birthweight again until a week after his tie was divided (so nearly a month before he got back to 7lb3, but he never dropped the magic 10%)

[niceandsimple]

@twinklespells the tongue tie was cut on day 4. His feeding is much better and he is getting plenty. He's just not putting on weight.

I have just tried to top up with expressed milk and he gagged! (that was scary to see) I am going to try again later, but if he responds the same way, I think I'm just going to wait and see how much he weighs on Thursday before I make any changes.

[PlantDoctor]

We had this issue, and a similar weight loss. I had a different midwife at every appointment, all of whom suggested different things, but the one who seemed to have the most sensible advice that actually worked told us to top up with 10ml formula per kg of bodyweight after each feed. That helped very quickly. Check with your midwife of course, but I'd do that again if I had the same issue next time. We dropped the top ups by 6 weeks I think. She's been a fine weight ever since and still bf now at 1yo so didn't mess up her feeding.

[GrumpyHoonMain]

It take a month for a tongue tie fix to result in weight gain - most mw don’t have experience of that in the UK as they rarely stay with a healthy baby that long after the birth. She probably wants you bottlefeeding to release you to a HV like mine did.

Suggest you get a second opinion or call your health visiting service. Explain you aren’t being supported to breastfeed by mw and would like someone in their team to take over weigh ins. In many areas they will do this straight away - in some the HV will come in tandem with the MW.

[taskmasterfan]

Are you looking after yourself and eating and drinking properly?

Are you doing nice long feeds so baby gets foremilk and the hindmilk just incase one is fattier than the other? I had a similar
Problem and was also advised to just different positions to drain breasts fully and get all the good stuff out.

Also someone recommended me oats. I started with porridge for breakfast and then lots of flapjacks as snacks and my DD soon fattened up nicely.

[Biscuitsneeded]

Are you getting enough calories yourself, OP? This isn't scientific but all the people I knew who struggled to get their babies to put on weight were pretty slim types themselves. If you can up your own milk or cream intake you might see a difference. I developed a weird craving for milkshakes and ice cream etc during my first pregnancy (having never really liked milk previously) and it carried on into new motherhood - and surprise surprise I didn't get back in shape very quickly but I did make lots of milk and DS grew and gained weight pretty well. It's difficult with older children to entertain but if you can make time to sit still and keep eating full fat stuff yourself it might really help.