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 :(

Don't want to dwell too much on this, but astonished that someone said that maybe your baby wouldn't have survived! My guess is that before formula, when there were problems with feeding, you would have got someone else to feed him or given him a top up of whatever milk was around, cows, goats anything...

Anyhow, glad you've seen some improvement and hope it continues. Brings back memories of the confusion of having a newborn for the first time and the conflicting advice I was given. Hang in there it will get easier and its still really early days.

BTW, was he early? I had a lot of problems with feeding that (with hindsight) were down to having an early baby.

Agree with you on that one MustHave..- it's a totally insensitive thing to say at a time when a mother is already feeling upset and anxious.

let's hope Fingon has some good news later

Fingon really hope it was good news today.

I really hope it was good news too.

you are doing fantastically well.

I am literally having to sit on my hands and bite my tongue and generally exert immense self control in order to abstain from commenting on the treatment you received in hospital.

I sincerely believe later in this thread when all is well I shall find a place (and time) for letting rip.

you really are a star and you and your lovely ds are just doing brilliantly!

Hi all,

Well the midwife came and he'd put on 50g since Friday - so she phoned the paeds and they said that they're happy with that - thank goodness!! - so no hospitalisation for us! We're not completely off the hook though as she's coming again on Thursday, and obviously he has to have kept gaining for them to be happy.

They've told me to give him two proper bottle feeds of EBM a day, so that they can be sure that he will take a big feed at least twice, but when we do that he sleeps for hours (4-5 easily) which doesn't work with the original advice about waking him. However, the midwife has gone from telling me to wake him every two hours to saying that 3 hourly is fine, and if he wants to sleep for 4 at night I should make the most of it I wish she'd make up her mind.

Thank you all so, so much for all your support over the weekend - I was beside myself with worry and it really helped knowing that you were all interested and cared, so a big thank you :)

I'm still a bit concerned about him though. Every thread I've read along the line of "how much should/does a newborn breastfeed" seems to be full of people saying "constantly" and he's really not interested in it that often. He easily goes 3 hours between feeds and if I wake him he just wont feed before he's good and ready. And he easily goes for 4-5 hours over night.

He's still fighting at the breast, although he's latching on a lot better, but bizarrely he fights the bottle as well. Dh tried to feed him last night and he still flailed, pushed it away and came off and on and screamed. I have no idea why he doesn't like feeding. Eventually he settles and gets going, but he's really reluctant.

Anyway, for the time being at least things are looking up, and I'm hoping that he'll start to like feeding more and more and that in a week or so I'll be on here asking for tips on how to persuade him to go back to 3 hourly feeds and bemoaning my loss of sleep!

Thank you all again :)

Great news about the weight gain Fingon - you must be relieved.

Are you giving him the breast before those two big ebm bottle feeds? Was just thinking about the impact on your supply - especially if he is sleeping for 4-5 hours after that.

It does seem rather like your mw got you in to a panic and has now backed off- especially now they are saying 3 hourly feeding.

Anyway, hopefully things are going in the right direction now and you can relax and enjoy your LO.

Huge relief!

I have been giving him the breast, but not for long. But I've been getting dh to give him to bottle and then pumping both sides to try to keep my supply up. It seems to be working so far, hopefully it's sustainable.

Yes, couldn't believe the volte face of the mw. I think maybe the paeds were less concerned than she was expecting - when she phoned them she told them how often I was trying to wake ds to feed and they said (audible to me and my mum) that it was overkill and he could go longer with no problems.

Things are definitely more relaxed here now :o

Fingon - thats marvellous, well done.

Well done! I wouldn't worry how often he feeds compared to other babies. All babies are different. My first born fed constantly. My other two straight away went three or more hours between feeds, which I found much easier! Make the most of the time he sleeps with lots of rest for you, warm bath, yummy snacks! Well done again - I'm sure he'll keep gaining weight now and hopefully you can get on with enjoying your new baby!

Forgot to say - the two who went at least three hours between feeds stacked the weight on, while the one who fed constantly took 6 weeks to get his birthweight back!

Just persist, thats what I had to do, My baby lost 12.5% of his body weight, but just persisted with breast feeding, i wasnt given any deadlines and because he was abig baby dont think they were too worried.

Wish you well x

Just read this last page, fantastic news :) x

That's great to hear moajab, I'll try to just make the most of it!

Thanks Principle :) Glad to hear it worked out for you too.

Just seen this thread. I'm glad things are better. I was just wondering if you'd considered cranial osteopathy for your DS? My friend's DS fought the breast, screamed, flailed etc as a newborn. He had a couple of sessions with the cranial osteopath and things improved no end.

Fingon that is great news :)

Don't worry about what other newborns are doing, if he is gaining weight then that shows he is getting enough milk. DS didn't feed that often until he was about 2.5 weeks old, and then suddenly he just wanted to be attached to me all the time - so your turn will come I am sure :)

Sounds like you are still getting some really conflicting advice from the midwives, which is a shame but sadly not unusual!

In your position I would try to increase the time he spends at the breast gradually over a few days, because a baby sucking does send better signals to your body than a pump. I would especially recommend him taking as much of the feed as possible directly from you during nightime feeds, because your prolactin levels are higher then and it is those hormones that boost your supply.
There is a lot of good information about ensuring and increasing supply on kellymom

You are doing brilliantly, you should be really proud of yourself :)

Just wanted to add that you could have been me 13 months ago - I was on here regularly in tears about my DS who was born at 36 weeks and took forever to gain weight. He had jaundice, didn't want to feed, and I didn't know enough to make him. He lost over 10% and we had hideous advice from midwives, health visitors and doctors. It really helped me to see an NCT breastfeeding counsellor who gave me the confidence to carry on, though that wasn't until he was five weeks old. Up until then it was a nightmare in spite of the support here (though that helped too!).

I ended up BFing for half his feeds, then two-thirds, then all but one, and at nine weeks he was back to just BF. You can go mad with all the expressing and feeding and it seems very unfair that you can't just latch him on and go, as everyone else seems to - but it takes time to get it right. I took the view (once I'd calmed down) that nothing else in my life was as important as feeding him so I would take a good long while to latch him on, fed him for as long as he liked as often as he liked, and although I really suffered from other people's comments about his size as he was very small for months (off the charts), he suddenly shot up the centiles at five months. Now he is a proper chubster, loves food, full of beans and utterly gorgeous, so please don't feel you won't get there. You will!

You ARE doing brilliantly, and I hope you are able to give yourself a pat on the back for top mothering.

Fingon - well done you! Great news.

I know people who have used a cranial osteopath and seen a real improvement. Also it could be reflux - the screaming and flailing can be symptoms of this - again cranial osteopathy can help with this, so I understand.

My DD never used to demand to be fed very frequently either, and would refuse it if I offered, but she was putting on weight really well so there was no real concern. If your DS continues gaining well hopefully you can just enjoy it while it lasts!

fantastic news fingon...really really pleased that you are feeling a bit more relaxed...

Thanks for all your messages. Unfortunately it's looking bad again :( The midwife came to weigh DS again today and he's only put on 25g since Monday, so a total of 75g in a week, which is apparently not enough.

So she called the paeds again, who said that as he's peeing, pooing, pink, active and alert they're still not too worried yet, but that if he isn't at birth weight by Monday then we'll have to come in.

So basically he has to gain 295g by Monday to avoid hospital.

I'm so pissed off because that will never happen, so they might as well just have told us to come in today and done with. In the meantime, they now want me to give him 3 full feeds a day of EBM from a bottle (so now I'm really worried about preserving bf and his latch).

I'm trying not to get stressed and upset by it again, but it's so bloody depressing to be honest. He looks so healthy and content, but he's not doing well. :(

GAAAAAARRRRRRGGGGGGHHHHH

Sorry, just needed to vent!

Oh Fingon, I'm so sorry to hear this. I'm very confused about this requirement to keep giving EBM in a bottle. If the issue is supply then the best way to address that is direct feeding. If the issue is the latch, then the best way to address that is practice and direct feeding. It kind of sounds to me like the people who are advising you (who are "they" exactly?) don't have confidence in the natural flow of breastfeeding - that age old thing that you can't see how much they're getting.

Have you spoken to that LLL lady again? Does she agree with the advice you're getting?

:(
I avoided posting because I had similar issues and the way it was resolved probably isn't to everyones liking.
At 10 days old my DS was weighed and found to have lost 15% of his birthweight. The midwife called the paeds and although he was alert, pink etc... Because he hadn't pooed for 5 days and we hadn't got many wet nappies (and the ones we had left slightly powdery stains in the nappy) we were whipped straight in. DS had blood tests and they decided he was dehydrated and we were admitted to SCBU. To cut a long story short, I continued to breastfeed, but after every breastfeed I was told to top up with 40-60ml of formula, I also had to wake him every 3 hours for feeding.
He picked up in no time at all and when he was 6 weeks old I was back to exclusively breastfeeding... He now refuses point blank to take bottles at 6 months!

oh fingon, i'm so sorry :(

keep hanging in there and make it a priority to get RL properly trained support?? phone all the helplines etc?

guacamole, poor you but what a great outcome in the end...

the average weight gain of a breastfed baby 0-4 months is between 5-8oz or 155-241 grams per week. this does mean your DS is not gaining alot. whether it is enough is for someone who can see him to decide. i would definitely see someone with experience, breastfeeding specific. a breastfeeding specialist? if he is pooing, pink, active alert, just keep giving him that breastmilk . i can totally see why once he has had a full feed, he would sleep it off and use it to grow and get stronger. sleep (as long as it not the not-enough-energy-to-function sleep is very good for them, and he will probably wake up over time. just keep feeding him so he can practice and get stronger at the breastfeeding, and your body can respond to his suckling, and give him the expressed milk too. formula supplementation will short circuit the whole process at this stage and if you can keep it up a bit longer, it might well sort itself out! keep going keep going, you have come so far! get rest, lie down with him, just let him feed and feed.

please do get breastfeeding specialist advice though!

in response to what gaelicsheep said about the EBM, i should think you need to give ebm in a bottle if he is unable to transfer good amounts of milk from your breast. the larger volume of breastmilk from a bottle, he can then use to grow and get stronger, and then get better at direct breastfeeding, in which case you can phase out the supplementing with EBM. Supplementing with formula or EBM is the same, so if the hospital staff want you to supplement his feeding, you can insist they allow you to provide it by expressing. If you can express it for him, you won't need to give him formula. Let him breastfeed as much as you both can to encourage milk production and enable him to practice. It is also really good and comforting for them to suckle. He will love being next to mum and it will produce lots of nice endorphins in his brain too .