Newborn breast feeding advice - baby not gaining weight :(

[McDreamy]

My SIL had a beautiful baby girl just over a week ago and she's so keen to breastfeed. So far she's doing brilliantly but the midwife came today and found the baby weighs more than a pound less than when she was born. (She was only 6lb 14oz at birth).

The midwife is coming back out later in the week to re weigh and if no gain she will be back in hospital.

The baby is a quick feeder, she's usually done in 8-10 minutes and then will go 2-3 hours between feeds.

My children were big feeders so weight loss was never an issue for me. I'm finding it a bit difficult to offer any decent advice.

Can you help?

she needs to see a breastfeeding counsellor, ideally face to face so they can see her feed and make sure latch etc is ok. is she in any discomfort herself?

it's possible that she isn't latching well, or that she is sleepy and just not transferring milk well and that's why she has lost so much.

in the meantime I would suggest LOTS of skin to skin, really... as much as she can. just stay in bed/on the sofa and feed baby every time she stirs.

ideally she wants to be feeding at least every 2 hours, which will boost both her supply and the baby#s weight.

what area is she in?

She is in Swindon.

And no discomfort, she did have in the first couple of days but it's all settled down now.

McDreamy - lovely you are there for your SIL.

This is a very serious situation - I think it is terrible the midwife has just left her like this. Has she not told her anything?

A pound weight loss is very serious - here are some ideas:

• poor/inaccurate weighing - weigh the baby again on good quality digital scales, with baby naked. Check metric/imperial translation
• baby not feeding often enough - 2-3 hourly gaps between feeds means feeding is not really often. Baby should be skin to skin 24/7 and should feed twice as often as this
• baby not feeding both sides - baby should feed both breasts at least at every feeding sesh, and possibly switch feed , so swapping from side to side for as long as the baby is interested
• breast compression - google it

Baby should be weighed again in a couple of days.

is the baby pooing plenty of soft yellow poo? If so, then my guess is the weight is not accurate. If not, it's part of the picture of not sufficient milk going in.

This can be turned round but things need to start turning now.

Hope this helps.

Ladies thank you, some fab advice.

After the meconium she had the expected yellow poo but over the weekend it went a bit bright green and foamy for about 24 hours. She contacted her midwife and was told it was probably something she ate affecting her milk. Anyway that has now settled and I am almost positive we are back to yellow poo but will double check.

She is worried they are going to insist on formula.

I have just asked her for the weight in metric as the same happened to DD, luckily my HV was on the ball and noticed the mistake before anyone panicked!

yes yes, v good point about inaccurate weighing. that needs to be double checked,

is there another weigh-in place she can go to in the meantime?

Some midwives still weigh with spring balance scales. Not really accurate enough for clinical decisions.

If weight is going to be done, it needs to bf done properly.

Ask how it was done, McDreamy.

The first and easiest thing she can do is offer the other boob when her DD comes off - is she falling asleep or awake but just seems to have had enough?

It is really appalling that she's been offered no support - I actually had a really similar scenario with DS though. Top ups of formula etc were threatened but no-one offered any support or advice.

She needs to see a BFC face to face so that latch can be checked.

Scales were digital.

Used on the non-carpetted floor? baby naked? Metric converted accurately? 5 lbs 14 oz is 2665g and a big loss in a week :(

she should also consider putting in a complaint about the midwife if she feels up to it.

a pound is a huge amount when the baby was only 6lb 14 at birth. so to say "i'll come back later in the week" is actually really quite shocking

It's a 14 per cent loss.

Not good.

I have spoken to my brother and SIL and given them all your advice which she is going to follow She is also going to try and contact a counseller to come over.

They are a bit upset and worried at the moment (my brother more than my SIL I think). It's such a worrying time with your first baby isn't it

I've just run through the conversion with my brother from birth, all seems to be correct. Could it be something more serious?

i think it's impossible to say McDreamy. I guess there could be other issues, but it's more likely to be either an error with the weighing or just not getting enough milk into the baby for whatever reason.

Hope she gets it sorted soon though

The simplest explanations are almost always the most likely - and the simplest explanation is that this baby just needs to eat more :)

It may be his attachment could be improved, but even that is slightly more complicated than 'this baby needs more milk' :)

So - loads and loads and loads of feeding, skin to skin, sleeping on mum (on dad to give her bathroom breaks :) ) and feeding through the night. You know the score, OP :)

Weighing again in a couple of days.

The baby is clearly well ie not dehydrated or too sleepy to ask for feeds (or you would have said), so there is a great opportunity to turn this round by getting more breastmilk in, in the way we've described. It would not hurt to look at the attachment, though, and she could fix up a time for someone to do this now. It's not as pressing as simply feeding more often and on 'more' sides, though.

No need for panic - the midwife has seen the baby, and while she was a bit useless at not suggesting anything, she would have recognised a baby who was sick.

Yes me to. She just needs to go for it!

Thank you so much!

Afaik the baby should get checked by a doctor. When my DD lost another 5% birth weight by day 10 (on top of 10% lost before - she was in scbu) we got rushed down to the GPs.

Positioning is crucial and was part of our problem, added to a sleepy baby who didn't know how to feed. Green foamy poo can be a sign of the baby not getting enough fattier milk, which in our case was partly due to positioning.

Your Sil could express and do ebm top-ups after feeds to avoid formula. We did ebm and formula top-ups, then just ebm top ups then ebf. What worked for us was feeding as well as we could, then eith dh or me giving a top-up, preferably of ebm pumped earlir, then I pumped. And setting alarms t make sure feeds were often enough.

Scuse typos - typing 1 handed whilst feeding!

8-10 mins doesn't sound like long enough for a 1 week old baby - with my 4 feeding took more like 30 mins. Baby could be satisfying her thirst with the fore milk and then not getting enough calories (but just enough to top her off iykwim?)

japhrimel - loss of weight in itself is not a reason to assume the baby is in need of medical attention - the midwife has seen the baby and if the baby is weighed again in 2 days after a regime of feed-feed-feed then they can reassess. It's too soon, IMO, to start messing about with expressing and ebm top ups - give the feed-feed-feed thing a chance to work. But yes, if things are not seen to be improving that would be a next option.

Obv if the baby becomes sleepy, floppy, hard to rouse, unresponsive and not very keen to feed, then it's time to get medical advice.

doggy - it's really hard to guage anything from the length of a feed. For a newborn, a concentrated, business-like 8-10 mins may be fine. Most newborns take longer, I agree, but they are doing a lot of stop starting and that's why it can take a lot longer.

Hard to say what's happening with this little one.

If it was my baby, I'd want a re-weigh on Weds, and to see that no more weight had been lost - that's more crucial than gaining a whole load, though some gain would be welcome. If there was no gain, just a plateau, then re-assess. If further loss, see doc.

Bad news - at the first weigh in a few days ago DN had stayed the same weight but today she has unfortunately lost a bit more and so has been admitted to hospital

DB and SIL are waiting for blood results to come back now. Just feel so sorry for them, becoming parents is not supposed to start like this

That's a shame, McDreamy.

When the weight was the same at the weigh-in a few days ago, were they told to do anything?

A loss of 14 per cent and then static weight is bad news - if they were just told 'carry on and I'll come back and weigh again', this is poor care, IMO.

Was the mum managing to feed more often and more effectively?

If so, then there may be something else going on and hopefully the hospital will find out what it is.

I'm certainly not a breastfeeding expert but was in a similar situation about a month or so ago.

Going into hospital was really tough at the time, but looking back it was good to have our baby checked out for anything serious underlying. Do hope that it works out ok for your DB and SIL.

Our baby started gaining once we got back from hospital. It's difficult to know for sure, but I think the main things that helped were doing lots of skin to skin and getting the latch improved. I'd assumed the latch was ok because it didn't hurt and goodness knows how many people had observed me feed by that point, but there was in fact room for it to be better.

I too am surprised that they left it a week - we were down a smaller percentage at 5 days than that and they checked with the hospital and we had a reweigh two days later. Even after he got back from hospital, he was being reweighed every few days until he was gaining steadily.