Small newborn - not gaining weight - please reassure me

[DidoTwiteInnit]

Hi all,

I recently gave birth to my second child. He was born at 37 + 2 and seems tiny to me (6lb 1). My first child was 8lb 9 so the contrast is quite a shock as he feels so fragile and small in comparison. He is also jaundiced quite considerably, only just below needing treatment on a graph the midwife showed me, and so sleeps ALL the time.

At the last two midwife appointments (6 and 10 days) I have been quite upset as he's not gaining weight. He lost weight after birth (about 100g) and has been losing weight slowly ever since. We are trying to wake him for feeds every two hours and he is taking between 1-2.5 ozs but sometimes he is very difficult to wake. He won't breastfeed properly either so I'm just expressing and feeding him that way. I'm keen to keep trying to breastfeed but at least this way I can measure what's going into him iyswim.

We are going back to the midwife at 14 days and they said if he doesn't gain weight by then he will need to see a paediatrician. He just looks so helpless and small and I don't know how else to help him. I feel quite weepy generally.

I think I am looking for reassurance really. Has this happened to anyone else and will things be ok?

My ds was 5-7 born at 35 weeks. Also jaundiced and under a lamp for a week. Left hospital at 4-12 and took ages to gain weight. . I bf and was told not to let him go more than 3 hours between feeds even if had to wake him. Lots of skin to skin really does aid their eagerness to bf! Invest in a big cosy blanket and some day time TV choices and settle on the sofa. .

I just wanted to say I feel your pain. Not quite the same, but my little girl is 9 days old and had lost 10% and isn't gaining - same issue with sleepiness. It's so frustrating.

I think you're doing all you can - sometimes they just will not be woken! Take it easy on yourself and keep trying with breast and topping up with bottle.

If your baby continues to lose weight - give formula milk.

A fed baby is better than a starving baby.

Losing weight after birth is normal.
Taking a while to regain that weight is not unusual in breastfed babies.
Continually losing weight is unhealthy.
It means the baby is being slowly starved.

I make no apologies for being very clear and frank in saying that.

Is he weeing and pooing? How long until he is seen again?

Ime of breastfeeding 2 small slow to gain babies (for a year plus each), a bottle of formula administered at this stage does a very nice job of waking them up enough to feed properly on the boob. Do let him get as much sunlight as possible too, and don't accept the sleepiness, however much it's tempting congratulations op, I know this is worrying but hopefully soon he'll be right on track.

You can buy starter kits of formula on Ocado, although they are a bit pricy. They are ready made with little sterile teats, and I found them perfect for my small babies. I breastfed them and topped them up with a bit of formula to perk them up and feed them up a bit.

Can you see the midwife again sooner? (Not sure what day you're on today). My DD was born at 35+2 weighing 5 lb 11, by contrast with your situation we were kept in hospital with frequent blood sugar tests until her sugars stabilised and she started gaining weight. She had to be fed a mix of formula and EBM via an NG tube at first (and was also very sleepy). It seems so different if you do get discharged quickly at first - pros and cons to both. Like Fate says don't worry if you do need to give formula, as it's your second child (assuming you BF your first) and you're expressing already milk supply should be OK - DD was on 95% formula at 4 days but fully BF from day 14.

Thanks a lot for your replies - they've helped to reassure me a bit.

We're going back to the midwife on Weds (four days later). She said to ring if we thought anything was getting worse - like the jaundice- but she said if went back any sooner any weight gain might not be obvious.

And yes, despite the guilt (I know I shouldn't feel guilty about not breast feeding, but it's hard) we have been topping up with formula. Definitely can see that him being fed enough is the most important thing. We will keep persevering with the two hour feeds (even though it feels a little like force-feeding) and keep our fingers crossed for an increase on Weds.

My DS wasn't quite as small but was jaundiced, lost quite a bit of weight straight after birth and was very sleepy.

The absolutely best thing you can do is feed feed feed. Lots of skin to skin and so whatever you need to do to keep him awake. DS was weak and feeding poorly at first so it was a bit of a vicious circle in that he needed to feed but was too little and sleepy to do it.

I was also expressing but in the end had to stop because it was so exhausting. Feeding DS then expressing then cup feeding and start again. I had no time to sleep. In the end a lovely community midwife advised me just to put him to the breast as much as possible, as much skin to skin as possible and to do whatever it took to keep him awake for feeds - strip him, tickle him, clap at him etc etc.

It will be fine. Good luck!!

If he's jaundiced he will be sleeping lots and struggling to feed. If he's only just below the treatment line, then keep feeding as the liquid helps flush the bilirubin out. Formula is actually better at getting ros of jaundice.

24 hours under the lights, if needed, is not a big issue really. If he does end up going into hospital, they'll get you feeding him lots, so you might as well keep persevering at home.

If you're worried, get him looked at sooner than weds.

My twins were a bit smaller when they were born. They were losing too much weight and were too weak to feed. I was able to stay in hospital for a bit and had support from a bf consultant. She sat with me a whole day and helped me - I fed, pumped, dripped milk into their mouths off a spoon, fed,pumped,spoonfed again -repeated this without a break for a whole day. By the end of the day they were already a bit stronger. Second day I was alone with them -weight had already stabilised an they were stronger. For the jaundice we put the babies next to a window so the light from outside reached faces and hands.

My DD was huge when born, almost 9lb but lost a lot very quickly and struggled to put it back on (she was jaundice) it took ages but there was a noticeable improvement once the jaundice eventually left. Have they done bilirubenemia (sp?) testing? Or are they waiting till 14 days to do that?
DD is now 19 weeks and thriving, gaining weight and growing perfectly, and not a concern now. I only say this to try and offer some comfort, it's terrifying when it goes wrong but hopefully she just needs some time and possibly a day under the lamp. As a pp suggested as much time in the sun as you can manage (I moved the sofa to under the window) it'll help with the jaundice. Most of all congratulations on your new family member

Some very good advice from @Itwastgenandstillis. OP are you able to spend a day with baby doing this? Have you called the MWs today and told then you need some support and how you are feeling? If you wish to BF, have you called one of the Bfing Helplines as well?

There's some advice here on feeding sleepy babies most of which should work however you decide to feed your baby

@tiktok can you offer any advice?

FAT if the baby is taking one or two ounces of ebm, why would switching to formula help? The OP has not said how much percentage of weight her baby has lost and the WHO Guideslines for infant feeding are bf, if that's not possible ebm and ff should be a last resort.

Until we know how much percentage the baby has lost, we are not even sure there is a problem

If you want to refer to my post JiltedJohnsJulie, it properly please.

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