HELP PLEASE. TIK TOK??? 1 week old baby losing weight. MW adviced top ups.

[princessProudmel]

Hi
I am posting for my friend.

Her ds2 is just over 1 week old (maybe 11 days, I'm not exactly sure) and he has lost 1 lb 20z since he was born.

His mother is rightly very worried and upset and is looking for advice.

She has been told by her MW to top up with 1oz of formula after every bf.
Also she's been told to eat a lot more high fat/rich foods in her diet. Eat every 2 hours. MW said her milk is like semi skimmed as apposed to full fat. :(
MW said that her ds2 cannot lose any more body fat and that he MUST put on weight by friday.

She said that he doesn't have enough energy to suck strongly enough to make my friend produce 'better' milk.

Advice please. This is going to be forwarded to her.

Thank you :)

Right, am no expert but that eat high fat/rich foods stuff is nonsense. She needs to eat and drink to her own appetite. The food she eats is not what determines the quality of milk at all.

Can you provide more info too. What percentage of body weight is that? How is the baby otherwise? Weeing? Pooing? Periods of alertness? Tongue tie checked?

The absolute best thing she can do is see a proper, qualified breastfeeding counsellor. Are you in the same area? Do you know of the local ones or do you need the numbers?

And when/how was the baby weighed? Is it always the same scales with a naked baby?

Hi he's gone from 8lb 10 oz to 7lb 8 oz in 10 days.

His poos are yellow, todays one was quite small tbh but it's the only one I've seen.
Tongue tie been ruled out.
Sleepy most of the time.
Slept 10-6 last night. Thats was first time for that.

Agree with above, any mw that talks about diet influencing the quality/quantity of breastmilk is clearly showing their lack of knowledge in the breast feeding department.

The weight loss does sound large though but it depends on the percentage.

Is the baby latching on well and can you see strong sucking action (movement at the jaw/ear area)?

Get your friend to ring a bf counsellor as soon as you can.

Hi, princessproudmel. Sorry about your friend's difficulties :(

Unless your friend's baby was extremely big, then this situation is concerning - can you work out exactly what percentage of weight he has lost? It's probably easier in metric :)

The midwife may well be right that the baby needs topping up at the moment and your friend really should listen to this - but she is WRONG that eating more high fat/rich foods will make a blind bit of difference :( :(

If babies have lots a lot of weight (and this should have been spotted by the midwives days ago, seriously - a baby should not get to this age before poor feeding is discovered) then they can get to a point where they don't suck effectively, and they conserve energy by staying asleep a lot.

Formula can be necessary, for a short time.

However, at the same time, if she is keen to bf, she needs to preserve her supply by expressing in whatever effective way she can - hand or pump. This should be done many times in 24 hours - if the baby is not bf direct very well, she will need to express at least 8 x in 24 hours, inc at night.

She can have the baby close to her, skin to skin, so she can respond quickly to any slight feeding cue. This is hard, at the same time as expressing frequently, I know :(

She can eat and drink to hunger and thirst - no need for anything special or frequent. This is for her own comfort. Will make no diff. to the bf.

Has your friend contacted any of the bf helplines for real life support and info?

second what showofbloodystumps says. It sounds like the midwife doesn't know much about breastfeeding. The diet stuff is crap, and what's this nonsense about semi-skimmed milk??!

I think urgent real-life, qualified help is needed to establish if there is a problem, and if the weight loss is as it appears, then likely there is. I don't think that waiting till friday is a sensible option.

Try one of these helpline numbers who can point your friend in the right direction:

0300 330 0771 (NCT breastfeeding helpline)
08444 122 949 (association of breastfeeding mothers helpline)
0845 120 2918 (la leche league)

Hi, he lost 10% in first week and then was weighed today and had lost half a lb. Sorry can't do percentages :(

I could see his cheek moving as he sucked but she says she doesn't always feel him sucking, as if his suck is weak.

soory am holding ds2 will be back.

X posts.

This is quite a concerning situation, princess - the long sleep, and the frequent sleepiness, is not good.

The weight loss is large - 13 per cent.

Lack of poo is significant.

This is clearly a baby who is not feeding well, and may be at risk of dehydration. If she is not getting the formula into the baby, and he is still sleepy, then she prob needs to get another midwifery opinion. If he gets worse, she needs to see a doctor...this is not to panic, but to make sure the baby gets the right sort of help to prevent him becoming poorly.

The breastfeeding can continue once the crisis is fixed.

X posts again.

The continued weight loss into the second week is not good - any call to any of the breastfeeding lines would urge her to take this situation seriously, I think.

she will be doing the top ups

The 'semi-skimmed' milk is not as daft as it sounds. The baby is not removing milk effectively. So he does not get fattier milk.

I was taught that initially babes get semiskimmed, then after a while of sucking, they get full cream, then finally they get gold top.

If this is still the thinking on richness of breastmilk (ie foremilk is low fat, hind milk is super fatty)??

then maybe if she tries expressing first - take off a couple of fl oz (should be easy if baby is yowling in background) so that he gets gold top from the start.

Worth a try?

just texted her. she's feeding atm. I am sending this to her. I hope I haven't scared her. :( she knew I was doing this though.

shongololo - no, not a good idea. The baby needs a good volume of milk...he needs to suck effectively, so he gets all the milk he needs without falling asleep, worn out.

But the issue is that he hasn't been sucking effectively. This has not been spotted :( :( (in fact, I wouldn't be surprised if the mother has been told all is well, persevere, nothing's wrong, blah blah blah). So his energy levels have dropped and he becomes less able to suck effectively.

tiktok, I bow to your superior (and more current) knowledge. Its been a long time since I BF.

Protocol in my area is to admit to hospital a baby with more than 10% weight loss.May be going up to 12% .It is usual for babies to lose this much...HOWEVER,the sleepiness is a concern and it then becomes a cycle that is hard to break.In hosp they would probably insert an NGT and put EBM down this.This can also be done whilst baby on breast.Thus,the sleepiness may gradually resolve as energy is not expended.Then EBM top ups gradually reduced according to how baby is doing.The prob is a Children's ward is not the best place...if the hospital has a Transitional and Homecare team[based on Neonatal Dept]they can come down to the ward to assist.

tikok, that exact thing happened to me. I was told to keep going despite weight loss, and in the end I did use formula top ups for all of our benefit.

The happy ending is that I'm still feeding at 14 months so top ups don't mean the end of BF.

Good luck to your friend OP :)

oncemore - it's a sad story when a mother is concerned, and is told her baby is doing ok, through HCP's lack of knowledge :(

It's fine to encourage and support breastfeeding, but this has to go hand in hand with an understanding of how to spot and fix problems before they become worse.

Great you overcame that difficult start. A lot of mothers get such a shock to their confidence, they stop breastfeeding....and who can blame them?

To add to what the others said - friend needs to see lactation consultant who can help to improve latch, check that baby is transferring milk effectively etc.

Plus top ups could presumably be of expressed milk rather than formula? Pumping would also help increase/preserve her supply.

I have posted on this before, am v impressed with my SIL who is EBF at 6 weeks - same thing happened at 10 days baby admitted to hospital as she had lost 16% weight, tube fed and saline drip, when discharged SIL feeding via nipples shields (no one in hospital could get baby latched on without aas she would not open mouth wide enough) they hired hospital grade pump and offered 1oz bottle top up after every feed, until evidence of good weight gain (around that point baby started refusing top ups anyway), then as baby got bigger and would open mouth more she ditched the nipple shields.

Agree 100% with tiktok. Can this mum pump every 2 - 2.5 hours to give her baby breast milk and keep up her supply. she can also top up with formula if needs be. This definitely needs to be dealt with properly.

I would second a lactation consultant asap.
good luck

I'd like to add a good news story to this if I may. I posted on here when DS was 3 weeks old.

He had gone from 7lb 6.5 at birth to 6lb 8 and scrawny by 20 days old. He was too sleepy/tired to suck effectively too.

With guidance from here and my HV I gave tops ups for a short time (5 weeks in all, formula initially then EBM) and we got back to fully BF at 8 weeks. The extra calories from the top ups perked him up tremendously and he started to suck well. I pumped frequently too, both to supply EBM and to help supply.

It was hard work but we got there. He is 22months and still feeding. I thought topups meant we would definately end up bottle feeding but it isn't always the case. Hope your friend gets some good RL support.

princess - can we have an update about your friend?

Tik tok, I'd love an update too. :( I haven't spoken to her since I started the thread. I've text her and left a voicemail.
Her mum is there today .

I will let you know when I know. Thankyou :)

Difficult, isn't it?

You want to be supportive, and not pushy, or upsetting....

I think I've upset her :(