12 day old not gaining weight yet

[ApuskiDusky]

Hi, I'm hoping for some advice and/or reassurance, after the midwife didn't turn up today. She was meant to be reweighing ds2, as at 10 days he had lost more weight since discharge.

V quick history: born by emcs, 3.62kgs (8lbs), milk came in day 3, good progress with feeding it seemed. Disgnosed with jaundice, 12 hours of phototherapy brought this back to acceptable range. Discharged on day 4, weighing 3.42kg. Feeding pattern in a day seems to be a few (4 on average) proper feeds where breast is emptied and next is started, then two sessions of small cluster feeds every 30 mins or so for a 3-4 hour block, falling asleep within 5 minutes each time.

He is sleepy, will sleep for 3-5 hour stretches if we let him - we are now waking after 3 hours to try to feed again, but he doesn't take on much with being sleepy.

At 10 days had lost more weight (3.3kg), and jaundice levels showed no improvement to discharge levels.

Wet nappies seem normal in quantity, dirty nappies a bit bizarre, will dirty 10-12 nappies in a day with really small quantities, but normal yellow mustard seed contents.

I guess the jaundice is causing a lot of this with the sleepiness, and the weight loss overall isn't huge, but hasn't picked up yet.

Any thoughts on what else I could do, whether I should be concerned at this stage, and what the midwife might suggest next if he hasn't started to gain whenever she turns up to weigh again?

at midwife not turning up. Did she call to rearrange?

Do you strip him before feeding?

cool cloth on head/neck to help him stay alert/suckling during feeds?

Lots of daylight/indirect sunlight?

No, she just didn't turn up, so we were waiting for her all day. My community midwife is on holiday at the moment, so the rest of the team have been covering but it has been pretty shambolic, I had to chase to get a visit the day after discharge.

He's getting as much daylight as we can, have put his crib into the bay window, and weather permitting he has napped outside. He seems pretty impervious to having his babygrow off for feeding, but we haven't tried cool cloths, so will give that a go. Thank you!

Hope it helps and the midwife team get themselves sorted.

I hope someone more experienced than me pops along soon but was just thinking that 6 feeds a day doesn't sound very much. I know it seems alot to do more (it did me when I started out) but it's possibly worth trying to wake your baby more often and encouraging him/her to feed. My baby wasn't a big feeder and was quite sleepy to start with and I expressed with every feed for a while to get my supply going. She now feeds quite quickly herself and I can't tell any difference in the feeds but she's gaining weight now whereas she wasn't to start with.

Fingers crossed Tiktok's along with better advice soon...

Thanks Happyseven - with the cluster feed sessions it's hard to gauge how many normal feeds it's equivalent to, but he'll have at least 5 or 6 mini feeds in those sessions.

I have wondered about expressing, maybe as a top-up - I think I'm ok in terms of milk supply.

My eldest son took nearly six weeks to regain his birthweight, which was very worrying for me at the time. It seemed impossible to imagine then that he'd ever be anythign other than a little scrap of a baby. He's now a healthy, lively eight year old! - those worrying early days will pass, even though it's hard to imagine it at the moment.

Are the midwoves checking if the jaundice is clearing up? It's probably making him sleepy and may be effecting how much milk he's taking. Expressing milk might help as he'll take it faster out of a bottle and therefore might well take a bit more in the time before he drops off to sleep again.

Also if you wake him for a feed then make sure he is properly awake before feeding him, for example by changing his nappy. If he's still half asleep then snuggling up to you will definitly send him straigth back again!

If the midwife doesn't come tomorrow I would ring them up and ask for advice over the phone. Hopefully you will also get a health visitor soon.

Make sure that you are getting plenty to eat and don't restrict yourself. You'll lose plenty of weigh by breastfeeding so there's no harm and lots of benefit in adding calories. I lost loads of weight in the month after my third child was born inspite of eating more chocolate in that month than I ever have before! And he was the best of the three at gaining weight. And when I was unwell a couple of months later and didn't eat much his feeds lasted twice as long as if he was finding it much less satisfying. So getting plenty to eat definitly seems to improve the milk.

Whatever the midwife advises it is only advice and you do not have to take it. My midwife advised me to top up with formula something I was very unwilling to do. I kept exclusively breastfeeding and when a week later I was seeing a health visitor they agreed with me.

I hope some of this is helpful and that your son has gained some weight when next weighed. I'm sure in a few months time you'll have a chubby, smiling baby and you'll be wondering why you ever worried! In the mean time try to enjoy these precious early days. Good luck xxx

Hiya

just also wanted to add my DD did not regain her birth weight til 4 weeks and this was very stressful so I can sympathise- mainly stressful because of our midwife who kept 'advising' formula top ups. I didn't give any formula top ups and at 12 weeks she is doing just great, not the heaviest baby- on the 25th percentile but has always gained steadily. To get through these early weeks I fed on demand (tough if he is sleepy) so try to do what you can to wake him up but above all try not to worry too much.

hugs x x

I know maternal diet is unpoven as to how it improves quality of breastmilk, but mothers do need to consume extra calories while breastfeeding and I was advised to snack regularly by a midwife in the early days - admittedly she advised far healthier snacks - chocolate was simply my own personal idea! Not as healthy as the midwife's suggestion but far easier to prepare! At any rate, for the OP to make sure she eats plenty herself is not going to do any harm and in the early days it's easy to forget abou yourself when concentrating on your baby. With my first baby, the one who did not gain weight, I regularly didn't eat lunch as I thought I would have something when the baby settled (which he never did!) and I suspect that helped our downward spiral.

Our 12 day old ds is currently struggling to regain weight, (he was 8lb 9oz at birth and is 7lb 11oz now) He was in SCBU for the first 8 days, and although he has been demand b'fed for the last week, he lost a lot of weight at the beginning when he was on a drip, and couldn't be fed at all.

The MW recommended the following:

Wake him for a feed if he hasn't woken within 3/4 hrs

when he falls asleep mid feed let him sleep for a few minutes then change nappy/strip him off/use cold flannels on hands and face

Feed from same breast, and repeat this every time he falls asleep (ds can fall asleep several time through feed) - to ensure he is getting all the fatty milk and thirst quenching milk.

Look after yourself, and, ok this bit maybe a myth, but it makes me feel better! - eat lots of full fat dairy.

He has just turned the corner, and has gained an oz each time at the last weigh ins (every 2 days), so I am keeping my fingers crossed it works.

Will be keeping my eyes on this thread for any more tips.

Good Luck.

Apuskidusky (apuskidoo!), I expressed and then fed it straight to dd after a feed. It was quite a faff but she wasn't strong enough to take much off me herself and this way I was still being stimulated. I only had to do it for a week or so and now she's fully on the breast. I found expressing while feeding was the quickest way as you benefit from the let-down. If your baby doesn't want it then he/she may not need it but in my case I think it's what kept me breastfeeding. She was only 5lb 10 at birth and went down to 5lb but at 11 weeks she was 10lb.

Apuski - I can understand the concern and it's bad the midwife did not turn up. You'd be fully justified in phoning the maternity unit (or whatever no. you have been given to contact midwives) and asking for someone to come today.

Four feeds a day + two cluster feeds is not really enough for most mothers and babies to build up and maintain a good milk supply in these important early days. Three hourly feeds are not normally sufficient. Seems to me that the reason for poor weight gain is plain and simple - not enough milk going in.

That's good, in fact, because this is easy to address - the baby needs to be close to you 24/7 with as much skin to skin as poss, so you can respond to every little tweak and twitch with the offer of the breast. Use both breasts often, 'switch nursing' to maximise intake and stimulation, and google 'breast compression' for instructions on how to keep him sucking if he tends to drop off to sleep.

In your case, OP, it might be worth while expressing as well, but not at the expense of direct feeding, and to offer the ebm if you feel he will not take more at the breast.

The other thing is that I'm assuming weights are accurate - baby weighed naked on electronic scales. If they are, then this continued loss of weight is something that needs to be tackled - he lost 120g between day 4 and day 10 and this certainly indicates the need to turn things round. Staying the same would have been less worrying - babies should not be actively losing weight after day 4-5, and it's bad your midwife has not ensured continued monitoring

Thanks everyone - the midwife did eventually come out yesterday, and he had gained a little weight, so that is something of a relief, but there's still a way to go before he's back to birth weight. I think we've turned a corner with the feeding though, he's having regular at least two hourly proper feeds where I can feel 'empty' on one side and usually a good spell on the other as well. I think it's a combination of the jaundice improving and my determination that he needs more milk! Thankfully my supply seems to be keeping up.

They are going to reweigh and retest the jaundice on Tuesday when my lovely community midwife is finally back from holiday, so am hoping it will have continued to improve by then. I was probably taking advantage of the extended early days sleepiness to recover from the emcs without realising how much the jaundice was affecting him and therefore his weight.

Thanks again!

Well done, it sounds like you've really turned it around! Hope it continues to go well!

Good news

Our babby is 10 days old he was born 35 weeks old and he was weighing 2.4kg now we didnt check how many kgs but w're worried coz he is loosing weight too much we can't look on his legs coz they're too thin,even his stomach u can see the ribs.We went to the hospital and they say the baby is fine but w're very very very worried,Please Your help is welcome and appreciated please please......we use public hospital we cant afford the doctors here in south africa.thank u.