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Infant feeding

Get advice and support with infant feeding from other users here.

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Original poster

breastfeeding and baby not gaining enough weight

19 replies

missporto · 20/10/2010 16:59

Hi, my baby is 9 weeks old and has only gained 300g in the last month. This is either because I'm not producing enough milk or baby is lazy when it comes to sucking. I think it's more likely to be the second reason but my doctor says she'll have to have a bottle to supplement each feed so that she gains more weight. I don't want to give her formula and it was suggested that I could supplement with my own expressed milk. Has anyone else been in the same situation? This is really getting me down and I'm worried that even if I supplement with my own milk she'll start to prefer the bottle to the breast. Any advice greatly appreciated. Thanks.

OP posts:

tiktok · 20/10/2010 17:24

???

300g in a month is not necessarily a problem.

Why do they think it is?

What is your baby's overall growth on the centile lines? A fall of up to 2 lines is within normal limits, and even then, the majority of babies who drop this and more are fine.

If the concern is your baby needs more calories, the simplest and most effective 'remedy' is to breastfeed more often, day and night, using two, three or more breasts at each feed. This will increase the volume of milk made and drunk.

If your feeds have been less than needed, or you have given one side only at a time, then it may be your baby has not had sufficient intake. This can usually be resolved without formula supplements, or ebm supplements.

What do you think?

togarama · 20/10/2010 17:40

If you haven't already done so, download the WHO infant development weight charts and plot your daughter's weight so that you can see the pattern yourself.

If you see no cause for concern, ask your doctor to justify what they're saying or get a second opinion from another doctor. If there is any sign of a problem, you'll see the line falling across several centile curves rather than following them. However, there may not be a need to jump straight to formula even in this case. As the PP said, you can also breastfeed more frequently or adjust your technique.

A number of people (nursery staff, other parents etc.. ) used to comment negatively on DD's weight and imply that I wasn't feeding her properly, should give formula etc.. However, on the WHO charts she has always been around 9th centile and is just a small girl. Some people seem to think that kids are capons to be fed up to the maximum normal weight.

tiktok · 20/10/2010 17:45

If the OP is in the UK, her baby's chart will be the correct and current one - these are indeed based on the WHO data.

The chart will be in your parent-held child health record, OP, usually 'the red book'.

MrsGangly · 20/10/2010 18:11

"using two, three or more breasts at each feed"

Grinning at the idea of having three or more breasts, but have to say that doing this has made a huge difference to my DS. BFing was slow to get going because of jaundice and tongue tie but doing this (after reading it on MN) has made a huge difference to his intake and weight.

tiktok · 20/10/2010 18:14

Annoying thing is, MrsGangly, that mothers are sometimes told by people whose job it is to support their breastfeeding that they must only ever use one breast per feed......:(

MumNWLondon · 20/10/2010 18:40

missporto - how often are you feeding your baby, how many feeds in a day/during the night? when do you change from one side to the other?

i wouldn't supplement unless there really was no weight gain instead for the next month try and feed for as long and as often as possible.

Original poster

missporto · 20/10/2010 19:27

Thanks for all of your advice. I've been to two doctors who both say the same thing. She's a bit skinny and hasn't put on enough weight (especially this month). I live in Portugal so I'm not sure if doctors here seem more obsessed with the issue of putting on weight than in the UK. She's supposed to gain between 150 and 200g per week as well as 1 cm in length (which she has done). She often seems to have feeding frenzies when she seems to want to feed constantly (2, 3 or 4 breasts) but at other times she can go for 3 hours without showing any interest in feeding. The nurse I saw today said she seems to be using my breast as a dummy which explains why my nipples are sore but how can I avoid this and make sure she's really feeding?

OP posts:

tiktok · 20/10/2010 19:33

As you're in Portugal, then you won't have the UK charts, but you will have something similar, yes?

I think you would find help speaking to a breastfeeding counsellor - LLL are in Portugal:
www.llli.org/Portugal.html and I see there are English speaking contacts.

It is normal for babies to suck for comfort - the attitude that this is 'using the breast as a dummy' is daft. The other way round is right - the dummy is used as a breast!

Sore nipples sometimes means the baby's position on the breast can be amended to relieve soreness and to improve bf effectiveness.

Feeding frenzies are normal, too.

Honestly, I really think you'll be helped by speaking to someone. It may be your little girl does need more breastmilk.

Original poster

missporto · 20/10/2010 20:25

Thanks tiktok. I've sent an email to LLL and I'll wait and see what they have to say.

OP posts:

becausewecan · 20/10/2010 23:20

My 10 week old dd has only put on 160g in the last 3 weeks but the baby clinic and doctor don't seem overly worried. They have advised not to get her weighed for another month and to try to space out feeds so she is hungry and has a really good feed instead of snacking all day! They think she's just a petit frame as she is bright and alert and is growing in length, head circumference and developing well. Apparently I was a really skinny baby too and I was formula fed..my mum was accused of starving me!

ClimberChick · 20/10/2010 23:45

So if I've got that right, they reckon 5-7oz per week. That's loads. Babies on the 25th or lower do not equate to putting this on a week.
Mine's on the 2nd and put on 3oz or less a week (started from 25th).

I just monitored output and assessed her alertness. Then trusted she was fine and fed on demand, which was typically every 2 hours, but she didn't have cluster sessions.

AS tiktok says, 2 centile fall/rise is normal see what it looks like on a chart.

But do see someone for the soreness, it may just be you've both got complacent with the latch.

ClimberChick · 20/10/2010 23:47

Sorry maybe should be clearer 5-7oz is the average, if you happen to have a smaller than average baby then they will put on weight a bit slower.

tiktok · 21/10/2010 09:14

becausewecan - glad you and your baby are doing well....but boy-oh-boy, very misleading and uninformed advice from the baby clinic.

Spacing out feeds is the opposite of what babies need in order to gain weight as they need to.

Babies need volume of milk - snacking is normal and highly productive both in terms of you making more milk and the baby getting more milk inside.

Anyone who talks about spacing feeds to stop snacking is demonstrating their lack of knowledge.

If you want some references on this to show to your doctor, just ask :)

Please don't space out feeds. Your baby may well be fine and be naturally petite, but you would not want to artificially limit her intake....which is what spacing out feeds could do :(

HappySeven · 21/10/2010 11:06

Tiktok, we're still not using the breastfed charts here (I'm living in the north west). When my baby was below the 0.4th centile at 6 weeks I asked at the clinic about feeding advice and was told "oh she's probably be fine on the new charts". I pointed out they are very similar for the first 3 months and the reply was "oh, I haven't actually seen them".

It drives me crazy as they were saying we should be using them 4 years ago when my son was underweight.

muslimah28 · 21/10/2010 23:11

just to give you some hope, my DS went from the 50th centile to the bottom one (i think it's 0.3rd centile), and only after 3 months did he steadily start tracking that line, and now at 5 months, he's just gone up a centile. OK he did drop quite a few centiles, more than 2- but the key point in growth is to track a line, and now he has been comfortably doing that.

i think your baby's still young, and it's worth persevering with the BFing a little longer before thinking about supplements.

tiktok can you explain a bit more about the not snacking thing being not true? as i had my DS on a routine from 5 weeks to 20 weeks of 3 hourly feeds. this was nothing to do with his weight gain being slow, because he fell into the routine really well. and i only kept him on it as long as it worked for him and me, so for the last month he's been BF on demand as he wants to feed every 1-2 hours now.

tiktok · 22/10/2010 08:52

muslimah - snacking is fine, but it is not compulsory :)

If your baby fell into a routine and he did well on it, no problem.

Some babies only get the volume of milk they need by feeding little and often - 'snacking'. Others space their feeds. Or others like yours space their feeds for a while and then a have a period of more frequent feeding.

Point is, to be responsive to the baby's communicated needs.

Hope that makes sense :)

muslimah28 · 22/10/2010 14:46

it does make sense, and is what we've done!

the thing i'm confused about though is that i understood that with 'snacking' it can mean the baby only ever gets foremilk and not enough hind milk. is that true?

muslimah28 · 22/10/2010 14:47

oh, sorry OP if this is a hijack of your thread, am only asking this question cos the fore milk/ hind milk issue links to weight gain.

tiktok · 22/10/2010 14:56

muslimah, you can get a good explanation of why a baby who 'snacks' does not get foremilk only at www.kellymom.com and click on the links to 'how breastfeeding works' and 'foremilk and hindmilk explained'.

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