help/reassurance/advice re: poor weight gain & BF

[flibberdyjibbert]

Hi, am feeling in a complete muddle with DD2 & BF. I fed DD1 without too many problems until she was 14 months, so thought it would be plain-ish sailing with DD2, however she's crossing centile lines like no tomorrow - she was on the 50th at birth & gained 5 ounces in the first week, however was down to the 9th at 9 weeks & yesterday (at 12 weeks) was on the 2nd.

Up until yesterday was pretty much feeding on demand, & feeding every 2-4 hours, but DD was only feeding for about 5-10 minutes, then pulling away. She just doesn't seem to be a hungry baby & when I tried to offer more or change sides she'd just cry & get cross. She seemed to be latching well, was settled between feeds, and was sleeping for up to 6 hours at night. She's having et & dirty nappies & not vomiting/posseting & if it wasn't for the scales I wouldn't have thought there was a problem. She's otherwise developing fine & length-wise is outgrowing her 0-3 month clothes.

The HV solution (fairly predicably) was to offer a bottle, which I really don't want to do. But now I'm wondering if I'm doing the right thing to try to persist with BF, & whether I'm being selfish & I'm now finding feeding stressful, which isn't helping anything.

I'm now offering her a feed at least every 3 hours (4 hours at night), trying to make sure she feeds for at least 15 mins to get the hind milk, changing her nappy & then offering the other side. Overnight wasn't too bad, but during the day today she's sucking well for about 7 mins, then drifting off to sleep but still sucking up to about 15 mins. When I try to offer the other side she just gets cross & cries & pulls away, prefering to suck her thumb. I've cancelled plans for the next couple of days while DD1 is at nursery to get some more rest, & trying to eat & drink well, but through all this I just worry that I'm still not going to get enough calories into her & should stop being stubborn & give her formula .

Sorry for the long ramble, any advice gratefully received.

Sorry you are feeling so stressed about bfing. What weights has she been? Has she lost any weight or has weight gain slowed?

Over the next few days can you take DD2 to bed and do lots of skin to skin whilst DD1 is at nursery?

You don't need to worry about getting her to feed for 15 mins or any other time scale, just offer frequently and swap sides or do breast compressions if she seems to be drifting off/slowing suckling down quickly. Does she do 'suck, suck, suck, pause (swallow)' or similar?

I'm not qualified to comment on whether there is a problem, but it is possible everything is fine. My DD's pattern of weight gain was very like your DD's. She was born on the 50th, lost 9% of her bodyweight, took 4 weeks to get back to her birthweight and was then on 9th centile (length and weight) until 16 weeks when she dropped to the second (length and weight). She was alert, bouncy, feeding frequently on demand (generally every 2 hours) and seemed satisfied after each feed. HV told me she wasn't latched on properly and was only getting foremilk from me which made no sense and trying to get DD to change her latch just resulted in me getting a blocked milk duct. So I opted to ignore the HV and carry on as before. At 26 weeks DD was back up on 9th centile for weight and length. Clearly her natural pattern of growth places her between those two centile bands.

You say if it wasn't for the scales you wouldn't be worried. So maybe the scales are the problem not the baby.

Have you had her length measured since she was born? It is useful to know if she is in proportion.

Also do you belong to a family of smallish people and/or were you or your partner small babies? Maybe being a bit small is quite normal for some members of your family.

I'm not sure making her spend longer at the breast will help. The hindmilk/foremilk distinction is a bit confusing, see here: www.kellymom.com/bf/supply/foremilk-hindmilk.html. If your DD is happier if you switch breasts frequently do that instead. Nothing wrong with you resting and eating and drinking properly, but unless you are seriously malnourished the content of your milk won't be affected by your diet.

Sorry should also have said before deciding to ignore the HV at 16 weeks I sought advice on here and spoke to a local bf-ing counsellor. If you have a local breastfeeding counsellor to talk to (check your local NCT branch - the service is free and completely fab) do that. Or try one of the breastfeeding helplines.

Thanks for the replies! - she's not lost any so far, just been slow to gain. She started out at 7lb, was 9lb 5 at 6 weeks and 10lb 3 at 12 weeks, so things have really tailed off in the last 6 weeks or so.

Have tried skin to skin in bed last night & ended up with nappy leakage & wee all over our duvet, tried again this morning & she was really fractious & only settled when plonked in her cot & sucking her thumb - you know when it feels like everything is going wrong! But will try again tonight & tomorrow. Will give the breast compression a go as well & dig out the breastfeeding support line number (NCT doesn't appear to have anyone in our area). I'm short & DH is tall but skinny, so maybe DD's got the short skinny gene combo...

Thanks again

She's gained 3lb 3oz in 12 weeks though which is 4.25oz a week on average, that's on the lower side of normal but still in the normal range.

Try and keep her close (if she'll let you ) and offer at the slightest hint she might be hungry. With DD3 I tried to make sure she was fed every hour (not on the hour but that she had a feed between 10-11, 11-12, 1-1, etc, etc) during the day (she went from 91st to 2nd%ile following a series of bronchiolitic attacks). It didn't matter if they were big feeds or small feeds, I just tried to keep the milk flowing into her at every opportunity.

Good luck with the next few days and definitely give one of the bfing help lines a call for some specialist advice.

I have exactly the same situation with my DD (20 weeks) Good weight gain at first and then slowed right down at about 10 weeks, went from 91st to 50th percentile. She is very content between feeds, feeds better a night, fussy feeder in the day, pulls off to suck thumb! I feed her whenever she seems interested.

My GP thinks she has silent reflux and put her on Gaviscon, this seems to have helped a little. But I'm not sure it is reflux as she is so content between feeds. However the GP is amazing and really supportive of bf, she says that some babies just have slow gain after an initial burst. I take my daughter into be check by the GP every few weeks and she is fine. Hope some of this helps, I know how you feel!

It's good to know we're not alone! I find BF such an emotive thing - it's hard not to feel like I've messed up somehow. However we're feeding for longer, more wet & dirty nappies than before, am feeling shattered but just had a great chat with a lovely NCT BF counsellor, thanks all

we've been lucky DD is now on 0.4th (just) started on a bit above 25th. No-one has ever mentioned needed a solution and she's clearly fine.

I looked into the usual like reflux. Did switch feeding (continually switching sides until she wouldn't take anymore) and fed her every 2 hours or more to reassure myself I was giving her every oppurtunity.

There are times when I feel, not like I'm failing, but like I'm not doing something quite right. Especially when she hadn't doubled her birth weight at 6 months. I feel slightly afraid as I feel there isn't any room for error IYKWIM.

But she's been walking since 8.5months so figured she's just a very active baby who likes to burn off all her energy.

Maybe we should start a new support thread for little babies