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 :(

No the GP isnt involved, I think I'll call them on Monday and see if they can help at all.

Thanks for reassuring me (again). And yes, now I'm calm it's obvious he must have been eating to have anything inside him to come out.

It is so easy to lose all rational thought when you've got such a young baby, especially in the position you are in where you've got pressure on you.
The carpet weighing never occured to me when DS was little and we were battling for grams - my head was too full of other things and I was in too much of a panic. I've had a whole new surge of rage at my bloody incompetent community midwives after it has been pointed out as bad practice on this thread!

You really are doing so well, in a few weeks this will all seem like a bad dream.

You're so right Alibabaandthe40nappies -sometimes it just seems like you can't see the wood for the trees doesn't it.

You will get there though Fingon - my DS wasn't even on a line on the chart 9 months ago and now he's just over the 25th centile, still short but wonderfully chubby.

omg the carpet! there was a difference of a couple of stone when i weighed myself on carpet!?

God I'm having a major wobble tonight. I'm exhausted and he's spent much less time at the breast today, so now I'm in full on panic mode and starting to wonder if it wouldn't just be easier to start ff to put the bloody weight on him. I'm dreading the thought of every breastfeed as I know it takes ages, and at the end of it I still have no idea how well he's actually fed.

DH just keeps saying "he's fine", but isn't really engaging with how miserable I am about the whole thing. I wish he could just understand how much of a failure I feel and then give me the appropriate number of hugs.

I hate that so far ds's life with us has been so miserable and stress-filled. And I hate HCPs who say there's a problem but don't do a bloody thing about it.

Sorry to vent

Hi
I'm no expert but just wanted to sympathise, it is SO HARD breastfeeding at the beginning, and you are doing so well to keep going. It will get better! Just keep asking for help if you need it, and tell DH you need lots of hugs and for him to do the housework and keep bringing you chocolate and drinks.
Good luck

Oh Fingon, poor you! Are you giving him those 3 bottles of EBM, because if so then he will have spent less time at the breast wouldn't you say? I don't know enough to be able to reassure you or caution you at this stage, but please hang in there.

Sorry, remind me how old your DS is now? I make it 13 days - is that right? The first 2 weeks are the most important for EBF as I understand it, and you've pretty much done that already. If you do feel you need to give formula to put your own mind at rest - and let's face it to give yourself a much needed break - then do it and don't stress about it. There's no way that would be irreversible if things pick up after a few days.

But as long as your DS is still looking healthy and alert I'd try to hold off if you possibly can. Have you spoken to the BFC again?

Fingon bless you, you poor thing (((hugs)))

If your DH is anything like mine, he probably feels completely helpless and is still shellshocked at becoming a Dad! My advice is to give him practical tasks, get him to bring you a drink whenever you sit down to feed, be in charge of nappy changing and/or winding after a feed.

gaelic is right, that if you are giving those 3 bottles of EBM then he won't want to spend as much time at the breast. It is also very possible that as his latch is improving and he is more efficient at removing milk that he is getting full faster and therefore doesn't need to feed for so long.

It is a difficult process, to come to trust that your baby is getting enough milk when they are BFing - all you have to go on is how they are - alert/wet and dirty nappies - and of course weight gain, which for you at the moment is compromised by the medication you are taking. Try and relax and enjoy the cuddles :)

And I totally sympathise with your anger at the HCPs you've been seen by. It is dreadful that they have supported you so badly :(

Well I steeled myself for it and he's been at the breast again, no formula yet.

I wasn't very clear before - he's spent less time at the breast per feed than previously, not just total. But then I think he's had more feeds, so it's been like prolonged cluster feeding this afternoon.

Yes gaelic, he's 13 days. I do think it's getting easier, but it's still so hard, if you see what I mean.

Also, I'm stressed because I dont seem to be able to express as much as before. I only got 10mls the last time, combining both sides, and before I was getting 70-90mls. I hope my supply hasn't dropped.

And I've got a pounding headache.

Thanks for letting me whinge at you all, and for being patient enough to keep replying!

That sounds like a growth spurt to me then, more feeding coming closer together.

Let him feed whenever he wants and your supply will soon rise to match what he needs, and make sure that you drink a glass of water whenever he has a feed to make sure you don't get dehydrated, which could be part of the reason for the headache.

Are you sort of hunching over him when he feeds? I used to do that in my anxiety without realising and it gave me such a headache until I read something on another forum and realised what I was doing.

Try not to worry about the expressing, it really is no indication of how much milk you are producing for the baby - if you haven't got enough to give him EBM in a bottle then just give him a feed directly instead :)

Hang on in there, you can do it!

What Alibaba said.

Also, the more stressed you are about expressing, the harder it is to get a good, or any, letdown. Ease up on yourself and try to go with the flow.

I think two weeks is very rushed for birth weight to have to be put back on. I've just had a check of my babies records and even the baby who gained weight the quickest and was a very chubby baby took 2 1/2 weeks to get his birthweight back. DS1 took nearly 6 weeks and noone suggested hospital.

I'm reluctant to ever suggest that anyone should ignore medical advice, but in this case I would seriously question it. Your baby is feeding, gaining weight, pooing, weeing and alert. So where's the problem? If the midwife still isn't happy then maybe you could take your baby in for a check up to rule out dehydration (which seems very unlikely given your description) but otherwise insist that your baby is continued to be EBF if this is what you want. I get the impression from your comments that you're considering formula just to get them off your back, but please don't just for this reason. How you feed your baby should be about what works for you. If your baby was dehydrated then some formula might be necessary, but if it's just about ticking boxes and meeting a line on the chart then it's definitly not. Point out to them that given how much weight he initally lost then it was always very unlikely he would regain his birthweight in 2 weeks.

It is very hard when it's your first baby and it's sometimes hard to believe that the baby is yours and that yours are the decisions that count. But please question their advice. If they recomend formula ask why its necessary. Ask what would happen to your baby if he didn't get formula. Ask if it would really be a problem if it took him three weeks to get his birthweight back. I can't help thinking that they just want your baby to regain his birthweight so they can tick you off the list. But if there is a good reason for top ups they should tell you. Is is possible for your cousin or anyone else to be there when the midwife next comes? It might well help you to have the confidence to ask the questions.

I'm sorry you're having such a worrying time. I remember so well the struggles feeding my DS1, coming back from the HV in tears because he'd only gained 1 oz in a week. But I've never regretted my decision to EBF. So hang in there - get your baby checked for any dehydration, listen to the medical advice but go with your instincts as to what is best for your baby. In a few weeks or maybe even sooner you'll get that first smile and everything will seem worthwhile.

fingon, a good expressing tip:

get an electric pump...the medela swing is very good.

and very importantly, pump one breast whilst you feed from the other: it's awkward (can dh help?) but SO worth it...

when i try and pump 'blind' as it were, i don't get hardly anything, when i pump when ds is on the breast, I acheive let down in both breasts and can pump 100 ml in less than 10 mins!! the difference is astonishing...pumping without him suckling is really like getting blood out of a stone whereas when I pump when he is sucking, it's so easy.

you are doing fantastically well, and really need to find the courage to question and stick to your guns...he sounds like he is doing really well.

Hope you have a relaxing day today- just ret and rest, feed and nurture yourself.

Agree with moajab about questioning the use of formula. If HCPs are asking you to do something different than you are doing already- then they need to be able to justify this. Remember, formula hs no more calories than breast milk.

Good luck with today.

sophable that is so true about expressing - but a bit of a juggle if you only have a manual pump. I love my Medela Swing, I wouldn't have managed to BF DS without it I am sure.

Hi all,

Thanks for the recommendations, but a medela swing is what I'm using - glad to hear people think it's good though!

I'm convinced that DS has got diarrhoea today though. His frequency has been increasing for the last few days, but today he's pooed at least once an hour. So we can kiss goodbye to weight gain this weekend.

I took my last anti-B today, so I'm wondering what to do. Should I keep on with bf, which is what's giving him the diarrhoea, or should I give him formula for the next 24 hrs whilst pumping and discarding, in the hope that something stays in?

He's still alert and doesn't seem dehydrated, he's still peeing, but I'm a bit worried now.

I'd call NHS direct, but I know that I probably wouldn't get bf friendly advice.

Is there an out of hours GP? Call them.

My gp doesn't have out of hours, so called nhs direct who have passed on my details to their out of hours gp who will call back. The nurse said she didn't know if anti bs transfer to breast milk so she said to keep giving it to him. And in the meantime she's told me to give him cooled boiled water. But they didnt say how much or how often, and I only realised after I got off the phone

He's asleep at the moment so I'm going to get pumping.

Fingon, you might be right and tbh your instinct is by far the best guide...BUT ds (12 weeks now) spent the first four weeks of his life once my milk had come in pooing CONSTANTLY. Every single nappy had poo in it more than 20 a day...it's calmed down now.

I wouldn't necessarily assume that it is definitely diarroheah (just can't ever spell that word) as it may be that now that your milk is well and truly in it is well and truly in him too...and poo needs to come out!

just a thought.

Not sure if water is a good idea for such a little baby - can you call the hospital and speak to a midwife?

I agree with sophable too, we went through 12-14 nappies a day with ds for the first 4 weeks all of them liquid poo.

More than 20 a day they told me 10 max. Even 12-14 sounds like loads! Oh dear, I'm going o be doing a lot of laundry if it lasts for 4 weeks.

Ok, in that case I may have panicked unnecessarily.

MoonUnit I'm not convinced by the water either. I think I'll just try to fill him full of breast milk and hope that works.

Thanks for replying :)

He's 11 weeks now and only pooing 2-3 times a day so there's hope - though he only stopped pooing at night a couple of weeks ago. I only have 15 nappies so it did feel like constant laundry for the first couple of months.

I think you're doing the right thing - I would continue feeding him too and just keep an eye on him.

if your baby has an upset tummy formula is the last thing he needs! breastmilk is full of good stuff to help your baby's gut recover faster. also cooled boiled water is not what he needs either. your breastmilk is mostly water so he can have that. it is unlikely to be the antib's in the milk causing a dodgy tummy afaik (you need to check that) tbh without seeing him, it is impossible to give the right advice - you need to be seen by a RL person.

breastmilk poo is runny so difficult to tell if diarrhea - does it look like water literally or just runny, as runny poo is normal. does it have a foul odour, or is that the same as before?

ia he ok in himself or is he looking weak? if he is weeing lots, he won't be dehydrated.

you won't neccesarily have to kiss godbye to weightgain - he may just be using the milk and pooing out what he doesn't need, particularly if he is getting alot.

seriously, he does not need formula is he is sick, he needs your milk.

check out kellymom for reassurance:

half way down is the vomiting and diarrhea bit