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!!!)

Thanks, Cosmosis, that's kind of you :)

I don't want to argue with people, honest I don't, but I don't like to see rubbish go unchallenged!

splatt - it all sounds pretty good today!

Splatt, sounds exhausting but great! Could you maybe co-sleep for a bit?

Splatt My dd2 was 7lb15 at birth then dropped to 7lb1. It took her almost 5 weeks to get to 8lb. My MW suggested top-ups of EBM. I was adamantly against introducing formula as I knew I could make the milk myself. I expressed twice a day to help get my milk supply up and had a couple of baby days where we just lounged in bed having skin-to-skin.
If you don't want to give formula then be prepared for extra weighing and extra feeding. At one point I was feeding constantly from 6pm till 1am then having 2 night feeds. My answer to falling asleep in bed was to co-sleep but I know that is not to everyone's taste.
Up until she turned 18 months she was slow to gain weight but was very happy, alert and did lots of wet and pooey nappies. In the end I am still feeding her at 26 months and her baby sister.

Take it a day at a time and let her feed whenever she wants and she will be fine.

splatt- you didn't start a 'harsh debate'- scarabeetle did that

Have to say I just sat there fuming- luckily Tiktok was around to come up with the apt retorts.

Hope you have a good day today

Scarabeetle: my ds was 8lb 15oz at birth, lost over a pund initially and took 7 weeks to regain birthweight and thereafter gained weight very slowly. He dropped from the 91st centile to eventually following the growth curves from just underneath the centiles.

He was happy, healthy and alert throughout. If I hadn't been weighing him, I wouldn't even have realised.

Fortunately, I had qualified HCPs (the breastfeeding counsellor midwives at the maternity hospital) to support me who never once suggested formula. What they did suggest was supplementing with EBM, initially after each feed and then, for a short time, every alternate feed. Interestingly - although I was fortunate enough to be able to express loads (not everyone can - which is not a relfection on how much milk they are producing) - so that I could see that he was getting loads of milk - it made sweet FA difference to his growth curve which stayed on exactly the same trajectory.

By your logic, I should have given him formula so that he could have stayed on his centile

I was referred to the consultant paediatrician, just for a double-check. he was more interested in what my father was doing (who used to be a radiologist at the same children's hospital) than in the manifestly happy, healthy and alert baby in front of him (7 weeks by this point, under the growth curves). He told me to "stop the faff of expressing, go on doing what I was doing, enjoy the baby and that eventually he would move back up the chart - that he was taking time to find 'his' curve". And guess what, he did.

I later learnt that ds was a claissic case of "catch down" growth: born "above" his natural weight (thnaks to my efficient placenta/good health and possible even borderline Gestational Diabetes) and therefore "needed" that period of flat/minimal growth until he could get onto "his " centile. Ultimately he crpet back up to the 50th and I successfully fed himfor 13 months. :)

splatt: what my BFC midwives did recommend in the early days, when he was a bit too keen to sleep through was to wake him 2 hourly (( have to admit I did 3 ), then 3 hourly (= 4 in reality) and at 4 hourly (= 5)

Co sleeping - not so keen TBH.
Worry about bad habits forming for the future and bout squashing her. Tried getting her to latch with me lieing on my side but couldn't manage it, big boobs!!

Have had pump out of box and will try later. Only have a manual one (tomee tepee). Any top tips for successful expressing?

Forgot to mention that my dh always told me not to worry as my dad, who was/is a reired paediatric radiologist who was checking ds out every time we see him (at least once a week) and if he had though that anything where amiss with his PFBGS (Precious First Born Grand Son), then nothing would have stopped him immideately contacitng one of his formwer collegues at the children's hospital.

He gets really annoyed by how people today (and he includes HCPs in this) look at computers and statistics before looking at the "patient"

Fair enough :) Its not for everyone, and that's fine - just wanted to suggest it in case you hadn't thought of it. Remember how tiring it is.

Here is a link about hand expressing.

I've always been taught that you should massage your breast for a few minutes before you start, and use breast compressions (putting temporary pressure of parts of your breast, moving your hand regularly) to help stimulate your milk as much as possible.

For expressing: alternate boobs - it is not like feeding. Do 5 minutes on one boob, then swap over to the other, then 4 minutes on each, then 3, 2 and 1. (Adjust timing according to how much time you've got, how much milk you are pumping). I wouldn't have known this unless I hadn't been readmitted to the maternity hoptial at 2.5 week post partum with an unrelated infection and had to use the "expressing" room.

Also, the first time you make up the breast pump, you will think that you'll never get the hang of it. Soon, you'll be able to do it in your sleep. :) (I had an Avent one, which I actually preferred to the hospitla electic ones, both the ones in the expressing room and the one they lent me).

If you don't want to co-sleep then a good chair in your bedroom is a must. It needs to be comfy enough to sit for 30 mins or so but not too comfy that you fall asleep in it.

With pumping if you can hold the pump to the left side as you feed with the right side you will catch all the let down and be able to get a couple of oz's. If you're not able to do that hold a bottle or storage cup over your breast and you will still catch some. If baby sleeps after feeding from one side then you can pump that side until she wakes up.
You will soon find a way that works best for you.

Splatt, I did the falling asleep then waking up an hour later thing all the time Took me a couple of weeks to get the hang of feeding lying down, but once I did I didn't have the fear of dropping ds. I kind of semi-cosleep now in that I try to put him back in his cot after a nightfeed, but if I fall asleep it's still safe. I've never rolled on him, and don't think there's a problem with habits as he goes to bed without me and does end up back in his cot after feeds most of the time.