3 week old not gaining enough weight - advise please

[splatt]

My 3 week old breast feed baby isn't gaining enough weight :-( The health visitor is otherwise very happy with her. Have to take her to be weighed again next week, and got the impression that if she's still not gaining enough there would be a "discussion" about introducing formula. I really don't want to do this.

So am after any and all advise as to what I can do to increase my supply and ensure she has good gain this week. (She was 7lb 11 at birth, 7lb 6 at 13 days and 7lb 9 today at 3 weeks).

She latches well and this has been checked. Feeds 2-3 hourly in the day with some cluster feeds, then max of 4 hourly at night (I set an alarm, she once went 6 hours and was a very unhappy baby all of the next day). Feeds about 15 mins on one side then falls asleep. I then tend to change nappy and feeds 10 mins on the other side. (obviously all the above vary!!!)

Is she generally alert? Is she doing plenty of wet/ dirty nappies? Do you feel generally happy with her?

My DD took 6 weeks to regain birth weight. But I could answer yes to all the above so there were no great concerns. At 5 weeks we had to see the GP to check there was no sign of underlying problems, but this really just involved answering the questions above.

At 6 weeks she was on the 40th percentile (from the 90th at birth) and has followed this exactly ever since.

Nobody ever suggested formula and at 20 weeks we still haven't used it.

splatt have you seen a breastfeeding counsellor? preferably face to face?

it might just be that she is slow to gain and will get there eventually, but it would be worth seeing someone to see if there is some reason that she isn't transferring milk effectively

how are the feeds for you? any pain?

Barbeasty - that makes me feel a bit better!
She is very alert, lots of wet and pooy nappys etc etc.

Seen 2 different breast feeding counsellors (1 before hospital discharge, 1 at BF support group yesterday). Both can see no problem.

Tis all a bit frustrating

splatt - I think there is some justification for concern as this pattern of weight gain is unusual, though not serious. She sounds as if she lost a lot of weight after the birth, which will inevitably mean a longer time to regain birthweight.

She is not feeding hugely often though - by my reckoning maybe 8 times in 24 hours? Or 9? More frequent feeds, using two or three or four breasts so you actually invite the clustering :) is the easiest and most obvious way of increasing her intake.

I agree that I cannot see the problem as long as DD is chirpy and the nappies are plentiful the it is fine.

All of mine lost over 10 percent and took a while to get it back except no. 4 who started off big, didn't lose too much but at 10 weeks weighs ony 10lb 8oz when he started at 9lb 1oz - all are fine and well

I am a peer supporter and we were taught that unless the baby is out of sorts or the weight loss is extreme then no worries

tiktok - she is so variable.

This afternoon / evening she's been feeding on and off since 3 o'clock. falls asleep and falls off the breast but as soon as I try to move her wakes up and wants to go back on

splatt- that's just normal newborn instinct to want to be close to you .....in days gone by, babies had to stay with their mums otherwise they got eaten by tigers.

Hope you get things sorted soon.

If you are advised that your DD isn't gaining enough weight then you know that breastfeeding alone isn't giving her enough nutrition. Don't let the 'breast is best' message cloud your judgment. Formula isn't going to harm your baby. Inadequate nutrition will.

scarabeetle - if a baby needs more nutrition, what would be wrong with addressing this very issue by breastfeeding more often? Why would this be a sign of clouded judgement?

Nothing would be wrong with breastfeeding the child more often tiktok, provided the baby gains weight adequately.

Failing that, how long do you propose the OP should keep chanting the EBF mantra? How far down the growth charts should the baby be allowed to drop?

The 'breast-brigade' shouldn't scare women into believing that formula is harmful. It provides valuable sustenance for millions upon millions of newborns and infants world-wide.

Anyone telling a new mother to disregard medical advice and persevere with EBF instead of supplementing with formula is irresponsible. It's not high minded, it's reckless.

Keep your comments about 'breast brigade' off the thread, please, scarabeetle, thanks :)

Of course babies who are unable to be fully fed on breastmilk alone, and whose weight and well-being are concerning despite more breastfeeding need supplementing - they might have expressed breastmilk, donated breastmilk, or indeed formula (or with older babies, more calorie-dense solids).

I don't think this is a precise point on the chart - for some babies, 'their' point at which they need something else will be different from other babies.

I agree that no one should be told to disregard medical advice on a talkboard - risky and foolish.

But no one has told the OP to ignore professional advice - she has not even been given the advice to give formula anyway, just alerted to the liklihood of a discussion. In response, people have shared some insights and their own experience, and given the OP some info, and the possibility of discussing other options with her HCPs.

What's wrong with any of that?

You're doing it right here, you're doing the softly-softly 'formula as last resort only' thing which scares the hell out of new mothers and makes them feel it's not a real option.

It's there in the subtext - much better to get donated breast milk than crack open a can of SMA. Nonsense.
Fact is babies thrive on formula too.

Breast brigade breast brigade breast brigade.

I don't want to scare people. I do want them to have grown up information.

Donated breastmilk is more suitable nutrition for a young baby than formula. There are many reasons why. It is ignorant to dismiss this as 'nonsense'. Of course donated breastmilk is only available (if then) to sick and vulnerable babies but the principle remains.

Formula is a necessary product, because not all babies are bf, and not all bf babies are fully bf....of course they need formula.

I do hope no one is scared by any of that

I take it you withdraw your suggestion that anyone was telling the OP to disregard her HCPs?

That you just made that bit up?

92 per cent UK babies get formula at some point.

I would be astonished if any mother did not regard formula as a 'real option'.

What planet would she be from, I wonder?

If you want to be taken seriously as an openminded advisor I would drop the donated breast-milk line.

Don't worry, scarabeetle - I am not really bothered about whether or not you take me seriously!

But in the spirit of sharing tips about self-presentation, you could drop the 'breastfeeding brigade' line...it sounds really, really, really stupid.

Scarab, do shut up, will you? You're really not doing any favours, to the OP, or to your "cause". Donated breastmilk is better than cracking open a can of SMA No point getting arsey about the facts.

OP: I know its very frightening, but first give yourself a pat on the back for doing so well! And you can avoid giving formula if you want to do so, as you have said. Have you tried expressing after feeding? If they do suggest top ups, you are just as able to do that with EBM as with formula.

Can you see another breastfeeding councellor, and maybe attend a couple of groups in the time before the next weigh in?

I was in the same boat as you with my DD. It was suggested I introduce a bottle of formula a day. I almost did until I realised there wasn't any need. DD was alert, still gaining (even though it wasn't much to begin with) and there was good nappy output.

I just knew deep down we'd be just fine once my milk supply became established.

Just feed feed feed!

You people are sad. You would rather see a child go hungry than get over your monumental arrogance about your magical breastfeeding abilities. SirBoobalot - the name says it all.

The OP says she really doesn't want to give formula. People are trying to help her get what she wants.

OP: have you tried breast compression? (Google it, Jack Newman is the expert) That can squeeze a bit more milk into a sleepy baby ... worth a go, anyway?

Oh, and YY to what tiktok says, offer more breast, skin to skin, to encourage more feeding, and switch breasts as often as you can.

scarabeetle - you are reading things very oddly.

• there is no suggestion the OP's baby is 'hungry' or that her well-being is suffering in any way
• her HCPs have not advised anything - just alerted her to a possible discussion
• so there is nothing for people here to tell her to disregard
• she asked for advice on how to increase her supply

Asking again, 'cos you did not answer, how would a mother not know formula was 'an option' in any feeding situation?

Ooppss, didn't mean to start such a harsh debate.

In answer to any questions no one has as yet suggested I do anything other than continue what I'm doing, and to think about trying to express some. No one has told me to give formula and I just want to try to not reach the point where they do. Obviously if my daughter was suffering and I was advised to then I would do what was best for her. I have friends who were advised to formula top up I have other friends who exclusivley breast feed and others who went straight to formula. I am open to all possibilities but if possible would prefer EBF.

However, she is bright and alert (the health visitor in fact seemed surprised at how alert she is) and is weeing and pooing plenty, no signs of dehydration.

Infact she seemed to understand the HV and feed almost constantly from 3 til midnight yesterday, utterly exhausting but obviously demanding I make more milk, and boobs actually did feel fuller this morning.

Just a bit worried that I was so exhausted last night I fell asleep twice with her in bed feeding and woke up a good hour or so later.

I was going to try to go the hospital drop in BF session this morning but after yesterday's marathon am too worn out to get there in time.

"If you want to be taken seriously as an openminded advisor I would drop the donated breast-milk line."

Um, I think you'll find that tiktok is taken very very seriously as an openminded advisor by pretty much everyone who reads this board. There are many many people who have gained valuable information from her (myself included) from reading her excellent, informative and very very helpful posts. She gives up an awful lot of her time to help people looking for information and reassurance.

OP sounds like you had a great (although tiring!) night for getting the supply sorted, well done. I'm ashamed to say I fall asleep feeding ds (9wks) a lot as well.