Newborn has lost more than 10% of birth weight - we have til Monday

[FingonTheValiant]

I've posted a few times about 5 day old DS who is really not feeding well. He was weighed today and he's lost 380g since Sunday. The midwife said she wasn't going to "rush me through a&e to the paediatricians just yet", but said she'll come back on Monday pm to reweigh him, and if he hasn't gained enough he'll be hospitalised, and that the paeds will then insist he has formula top ups :(

I'm desperate to avoid this, but I'm now stressed beyond rational thought.

Also, he's refusing one breast completely (screams, flails, kicks etc) and I'm in agony on the other side. I know that that means he's latching badly, but he is drinking, and with a weight gain ultimatum I don't want to interrupt the feeding he's actually doing.

They've told me to wake him and feed him every two hours. But he spends the first 30-40 mins of that fussing/screaming and not feeding, and by the time I've calmed him and got him on and fed I only have 40 mins before we're meant to start again.

They also said I have to top him up with a cup after each feed, so I've bought an electric pump to help with that. But he wont cup feed properly - he doesn't stick out his tongue, he just gulps at it and hits the cup, and half of it is wasted.

How do I fix this mess? I just want to curl up with my baby and cry forever :(

Fingon- it sounds like you have a good plan for the next couple of days.

I really don't know about the bottles - but from what I've read on here many babies will switch happily between breast and bottle. A supplemental nursing system would be ideal but obviously you won't be able to get one in the next couple of days.

Now get thee to bed and snuggle up with ds.

My milk came in the evening of day 2, I think it's just that his latch was non-existent for a few days.

We'll try an occasional bottle then

Thanks all.

Good luck to you.

My DS lost 10 ounces in his first week & midwife had a wobbly - but it was different as he was born 2 weeks late & fat so was probably reverting to a "normal" weight for him.

Hi,
I really feel for you. Our DD lost A LOT of weight in the first few days and we did end up at the hospital but it was on the whole a very positive experience. The staff were very supportive and though we did have to use some formula top ups to begin this was phased out very quickly. The staff were fully behind my breast feeding and giving up was never mentioned as an option. We really didn't have much idea what we were doing and really benefitted from all the advice and support we were given. We fed DD every four hours (or on demand) and then expressed for ten minutes. To begin my milk seemed to disappear (I think that was with the stress) but it soon came back in. Formula top ups were quickly replaced by top ups from my previously expressed milk. Our DD was fed first with a tube but then with a syringe which she was very happy to drink from. I haven't tried cup feeding but I would think a syringe would be much easier and you wouldn't waste any of your precious milk. We then returned to exclusive breast feeding. I know this is a very anxious time but I'm sure you will soon be back on track. Talking to a breast feeding counsellor really helped me. As to milk supply, when I managed to calm down and relax a little my milk came back in a matter of hours. I'll be thinking of you.

sorry but your midwife sound likeastupidcow ill advised. it is normal for newborns to lose weight. giving you timing deadlines for feeding totally counterproductive.

you've had excellent advice on here. get into bed. stay there. make your mother wait on you if she wants to help and explain to her how important it is for you and your ds to have this time together. screaming/kicking/frustration really normal during the breastfeeding relationship but deeply distressing for you.

i feel for you SO much and i know it's not helpful but am angry that an already stressful situation has been made so much worse by your midwife's attitude and your mothers well intended but misguided attempt to help you.

DEFINITELY co-sleep, the only way to get through this, if you're worried send dh to another bed just for a few days til you two work this out and you will you really will.

and do consider forking out for a lactation consultant visit, if you can possibly afford it. where are you based? what you need is a really good supportive person like a doula to help you through this...i know several excellent ones.

If cup feeding isn't working very well, syringe feeding might be much easier - I never managed to cup feed, ended up everywhere! Once you have got the hang of the syringe you can just squirt a mouthful at a time onto their tongue and very little gets spilt.

Giving him formula after every feed at home for a few days may feel awful and unnatural but you will be in far more control and have a far better chance of getting back on track than if you get taken into hospital (where he will be given formula anyway). It sounds as though you would find that really stressful which is probably the last thing you need. If you stay calm, in bed, eating plenty your milk supply will have a chance to really get going. You may only have to top up with formula for a few days - by the second week I was expressing more milk than I could use, seemed incredible after the blood-from-a-stone hand expressing into a teaspoon of the first few days!

Stay strong - you can do it! It feels like a massive uphill struggle in the first few days but it does get easier.

Re: your question about bottle feeding, I couldn't get ds to latch on at all so he had EBM in a bottle for the first two weeks, but I did get him on eventually and bfed pretty much exclusively after that. I know there is a school of thought that it interferes with bf but I would like to venture that it is a lot less hassle than trying to cup feed, and might give your sore side a chance to heal.

I too had a health visitor who cast doom and gloom because ds had lost a fraction over 10% of his birthweight; I felt so guilty. But when you look at how tiny the amount of colostrum they receive before your milk comes in is, it seems inconceivable that they wouldn't lose that amount. It makes me wonder if the 10% figure isn't bolstered by including ff babies in the statistics.

Anyway, good luck this weekend and fingers crossed for you both for the next weigh-in.

bedlambeast...i'd have more faith in the OPs midwife if she hadn't left her alone for the weekend having threatened her with hospital! better get it sorted over the weekend love otherwise it's hospital for you...

that is NOT the kind of support a new mother needs at all. stress does not help up a milk supply. nor does it facilitate the relaxation needed for feeding to work.

If the baby has lost 10% and more the baby needs to be seen. You need to get them to check for tongue tie and then to get help with breastfeeding which may or may not include expressing. What the baby needs is to be fed! So if you are expressing, even if you use a bottle (because he can't use the cup), you should use ebm.

I think it sounds like your DS has tongue tie. Do please get them to check and tell them that his inability to breastfeed effectively may well be down to that.

When a baby needs to be fed more formula shouldn't be the default answer.

Hi OP, my DD lost 12% of her birthweight, which I didn't think sounded like much more than the 10% cut-off point. Hospitalization was not mentioned in our case either though I agree that it was a situation that needed monitoring to make sure that she headed back the right way after that.

The latch wasn't right in my case and it took quite a while for it to get really proper, with various advice sessions from bf counsellors, so do get as much help as you can. I found that things would get a bit better each session - i wasn't getting 100% better after one session, because it's hard to absorb what they tell you in one go.

One thing that one mw suggested that worked was to express as often as possible for a few days - five or six times, even if only for fairly short periods of time each go - so as to build up my milk supply. That worked pretty quickly and did definitely help - maybe as the latch wasn't good, my milk supply hadn't built up as much as it should have done. I also was giving the EBM as a top-up. We used syringes at first but she sounded like she was being murdered! So we bought a bottle when she was maybe 3 weeks old and that did work better despite any suggestions of possible confusion.

Who has checked for tongue tie? There are different types, not all obvious, and a MW who's just looking for an obvious heart shaped tongue may not spot one that's more subtle.

Having said that, my DD was like this and she, unlike my DS, doesn't have tongue tie. She grew out of the flailing and kicking but that doesn't help you right now. I would agree that you could possibly give nipple shields a go for a while, or EBM in a bottle - anything to get your DS to feed tbh. You can work on your latch later when things settle down a bit.

I have read that refusal to feed on one side may be to do with an injury sustained during the birth. Did you have a difficult/prolonged labour?

just a thought for you.

the first couple of weeks after dd was born my let down was initially quite slow. it was slower on the right than left side.

dd would "fight the boob" and cry at it unless the milk was already flowing iyswim.

and it was much worse on the slower side. plus the slight engorgement i experienced as the supply was establishing made it harder for her to latch properly and cue more fury from the small one.

i used to take a hot flannel and hold it over the boob and then massage a little until letdown came and the put dd once milkies were flowing.

result was happy baby, happy boobs (was a bit gentler somehow) and happy mummy.

it only lasted a couple of weeks and te
hen we were all "pros" at the boob thing and i could put her straight on with no issues.

you have probably already thought of this in which case sorry but if not then give it a go.

i also during that first week bfing used to pump a little off the boob first if it wa very engorged to get dd an easier latch.

it was all trial and error tbh as a first time mum.

i used to sit with my nhs breastfeeding dvd and handout to check my latch position and so see if dd was feeding correctly even in the middle of the night. must have made a funny sight.

hope you are both getting on better with bfing.

x

hi don't think i can really add much to tips and techniques and stuff but just to say, that i went through this too and my DS was admitted to hospital. they did some blood tests said he was very dehydrated (he had been screaming inconsolably since day 2) and he was eventually put on a drip. but in just a few hours, less than a day, he was off it and we were out. he was much happier the hospital staff were lovely and helped me establish breastfeeding whilst he was actually on the drip which reduced the pressure. it may sound horrific and i'm not trying to make you feel worse at all, just to say, you will get over this stage, honestly, i ended up breastfeeding him without any formula at all for 14 months.
if you do end up in hospital dont' panic (i know i did) you don't need to, it isnt' the end of the world.
btw i wish i had tried our local nct bfc before things got to that point, but in my case i think it was partly that my milk didn't come in until day 5 or 6.
x

I had to top up my DD with ebm because she lost more than 10% of her birth weight and went down to 2100g. I used a bottle about twice a day for a couple of weeks and although I had read that this can lead to problems, it didn't in our case. She is now 12 m and exclusively bf and ironically, I can't get her to take a bottle!
Keep it up!! It will soon start getting easier

Have you tried swaddling to stop the flailing? We swaddle dd2 just under her arms which means you can release them once feeding as they like to pump the breast.

Also opposite to the other poster could you have too fast a let down? Does your little one choke or cough on the breast? Or get very windy? Think I may have this problem on one side which is causing poor latch.

Good luck, you can get through this :)

Just wanted to add my sympathy, it is horrible to feel this stressed about feeding especially when the advice everyone gives (and it is good advice) is to just relax and let your DS feed as much as possible.

My DD lost 9% and took 3 weeks to regain her birthweight, the MWs we saw were monumentally unhelpful and kept saying things like 'well we'll give you another three days...' without actually offering any help. A local breastfeeding counsellor did help loads so I'm glad you've had contact with LLL.

Once she regained her birthweight DD was on the 9th centile and has pretty much stayed there (she is 22 weeks now) and she was born on the 50th. She is perfectly in proportion just naturally small. Looking back I don't think there were any significant problems with latch or with my supply. I think we can over-complicate matters by trying to seek explanations for our babies behaviour. But really 10% weightloss is only one end of the normal range, fussy feeding and very long feeds are normal. You obviously want to make sure the latch is fine, but beyond that don't over-analyse what is going on or fret about how much milk is going in (or how much is coming out the other end - DD didn't poo for for 8 days which made us frantic!). You are able to do this, your body is producing milk, your DS wants to feed, if you give it time and allow other people to nurture you whilst you get the relationship established it will all be OK.

Also do cry if you need to. It can be very cathartic.

My DC3 didn't regain his birthweight till nearly 3 weeks old.

Everytime the MW brought it up I just told her he was feeding well, had plenty of wet nappies and was alert and happy when awake - I was happy he was fine. After I said that the MW would just agree with me and say let's give it a few more days then...

No panic, no deadline...

Is this your first DC?

I agree, just feed baby, eat and drink yourself and rest. Do not attempt to do anything else in the next few days. Oh and my top tip is to eat lots of cake Makes lovely milk

I though the 10 percent was an indicator that there might be problems such as dehydration rather than being a problem in itself.

So that's why it needs assessing by health professional- if there are plenty of wet/poo nappies and an alert baby then there probably not an immediate issue.

That why some people's babies were left alone and others admitted or monitored. Yes there is a range - my two younger DC didn't lose any weight they put on 1b and 5 lb in five days being exclusively bf but more than 10 percent is a red flag though not automatically a problem.

If there has been a latch problem for a few days its probably an issue of getting supply up and getting help figuring out why there has been feeding issues in the first place.

I do think MW has been unhelpful - but I hope things improve for you OP very soon.

Hi

Two tips:

Look up videos of breastfeeding latching on on YouTube. Picture worth a thousand words and all that.

Also swaddle your baby while feeding if flailing too much to feed. Skin to skin can come before and after.

Good luck. But don't forget a few top ups really won't end your breastfeeding, if breastfeeding is what you want to do.

If I were you I'd really try to see someone with proper breastfeeding training in real life - the midwives are unlikely to have much knowledge, and the maternity support worker they sent out to see you is even less likely.

Fingon

Sorry to hear about this. I posted on your other thread.
he's fighting and flailing on the other side
Keep feeding from the side he will take. If don't spend too much time on it as he'll be tiring himself expending too much energy on it.

Could you express off the unpopular side to soften the breast? How about doing that before feeding on the good side, then let him feed for a bit, wind him then switch him onto the 'bad' side mid feed. Keep pumping as much as you can.

If the cup is getting spilt why not try syringe feeding, do you have one? A pharmasist will be able to give you one as they have them there to give out for the children's medicines.

If you have the financial resources I'd pay for a breastfeeding specialist to come and be with you, for a period of hours to watch several feeds/latching on.

I really feel for you. My cousin's baby lost weight and didn't gain again and was being weighed daily by MW, it was all very stressful for all.

My SIL had her baby 4.5 weeks early due to pre-eclampsia and was only allowed to BF her every second feed (initiall) as the breastfeeds were using up too much of the baby's energy and tiring her. Every other feed was either formula or EBM and feeds had bto be every three hours even through the night. By the time the baby was at 37 weeks he was able to start phasing out the bottle feeds and she has achieved ful BF by the tie she was full term. I say this to encourage you that giving bottles now does not mean you won't be able to fully BF, you certainly can.

It is a balancing of priorities right now because the calories going in is just so iportant for the baby's development. Could you give every other feed in a bottle for now?

They shouldn't weigh BF babies this early. This is what my friend was told when they accidentally weighed her BF baby.

Not correct, hystericalmum - it's very good practice to weigh babies at this stage, as early problems can be 'caught' and dealt with.

I agree with the posts saying this is cause for concern - a weight loss of 10 per or more at this stage for any baby, bf or ff, is likely to be a strong sign that feeding needs to be improved. This is based on research done with many thousands of babies. Of course, individual babies might be fine, and also, feeding and babies can get better any way. But this baby is not happy, he's fighting and struggling - and it's good the OP is getting help with all of this.

I get v. uncomfortable when I read posts which try to reassure mothers in this situation or even tell her the midwife is wrong to be concerned, or that it's normal for her baby to be like this. It isn't. It needs fixing.