Help! 6 week old bf not gaining weight

[Sparklyboots]

... he's dropped from the 75 to 20th centile. Obviously I feel crap about this. HV suggested we not use the dummy, but he's a really sucky baby - it's either a dummy or someone's finger for hours and hours, (or screaming himself sick). Is it the dummy? Thing is, without dummy, we don't sleep and if we don't sleep we are so fraught we can't eat...

We had been having some latching issues - we went through a few days of him crying off the latch mid feed - we went for maybe four or five days last week without him falling off natuarlly. Then we seem rather to have cracked it - I felt v. smug - but I think we've just hit a growth spurt so he's getting a bit fraught because boobs haven't time to fill properly before he wants another feed. This means he gets increasingly wound up in a feed and we end up just trying to calm down, but when boob presented just spirals rapidly into distress again.

I have just started expressing and been using the expressed milk to tank him up for the evening. But during the growth spurt, I have used the expressed milk when he was too frantic to latch and now it seems like he doesn't like breast, he just gets more and more upset.

On top of all this, he gained only 130 grams in 2 weeks. Am I starving my son? Please help, I am totally desparate

Hi Sparklyboots, congratulations on your baby and getting this far! The 6 week growth spurt is really hard.

To be honest, if he's a sucky baby the best place for him to suck is on your nipple rather than a dummy or finger - this will up your supply and get more milk into him. You don't have to wait for boobs to fill up either, milk is made constantly as it is taken from the breast - there is always milk there even if the flow is slower. The problem with offering a bottle during a growth spurt is that it is bypassing the supply-demand thing with milk production, so your breasts didn't get a chance to catch up with his increased demand. The best way to remedy this is to drop the bottles and dummies and just feed him as often as possible - keep him skin to skin with you and let him feed at every opportunity.

Dropping centiles isn't necessarily a problem - my ds was born big on the 75th centile but settled down to his line just below the 25th. He was just born bigger than he was destined to be! But if you're worried about slow weight gain the first thing to try is probably feeding more often, and offering both breasts at each feed. How many times does he feed a day?

Thanks Moon Unit. He has been feeding every 3 hours in the day and 4 or 5 hours at night, but I have been waking him up for that. He's generally good with just one breast but obviously during the growth spurt I've been giving him both. I'm consious to try and get him to drain one boob (for hindmilk) but sometimes offering the other before the scrum starts - the softer my boob, the more frustrated he seems to get (if v hungry).

I see what you mean about the sucking but the problem is he doesn't settle when he's tired and offered the boob, it just winds him up as he sucks, get some milk he doesn't want, pull off, screams, reattaches (repeat until major blowout).

During this growth spurt, I'd be totally happy for him to be attached all day - but he just won't. He gets more and more upset on the breast, we start with a goodish latch then it just gradually becomes a scrum. I burp him, and change him since he seems not to be able to concentrate if he's wet, soothe him, start again, and then the whole cycle repeats. But his tongue is all curly and he's doing dry coughing crying/ shouting - which is (I think) his hunger crying.

I'd try feeding him more frequently in the day, maybe every 2 hours - there might be less frustration if he's feeding before he's starving iyswim?

If he's not gaining much weight then I'd say you need to get more milk into him - don't try to keep him on one breast, offer the second as soon as he comes off the first and then offer the first again after the second, switch back and forth until he doesn't want anymore. If you're trying to keep him on the emptier breast once he's finished with it that might be upsetting him. I really wouldn't worry about the whole foremilk/hindmilk thing, I think it's a bit misleading - just follow his lead as to when he's had enough of the first side.

Sparkly - 3 hourly in the day and 4-5 hourly at night is not very often for a 6 week old with possible weight gain issues. So much, much, more freq. feeding will do a huge amount to turn the situation around.

Please don't worry about 'draining' a breast :( :( Impossible to do, anyway - swap over when your baby seems to indicate he wants to swap or that he has finished active sucking on that side. I wonder if the 'scrum' you are describing happens because you are waiting for the 'draining' or judging in some other way to keep him on one side.

You absolutely don;t need to 'keep him on for the hindmilk' - foremilk and hindmilk look after themselves, no need to 'engineer' the process :)

I think it might help for someone who knows about bf to observe you feed - hard to tell exactly what's going on here.

Thanks all, I hear the more feed message, but how, if he won't latch and presnting boob leads to spiralng meltdown? We did seem to be oing well earlier this week and end of last with 3 hurs feeds, but had a visior at wknd which got us all out of sorts and had hd some poor days lst week (latch poor I thoght cos of lack of sleep). We got sleeping again Sunday nd latch improved but fell apart as growth spurt kicked in and he wanted some 2 hourly feeds - no real naps. Except in poor phases, he rarely wakes yp to feed - I was waking him at 3 hours most of the time. He rarely cries for food til the feed has started and we're having latch problems. Btw, he finished feeding round midnight last night and didn't wake til 5 ... shuld I be setting an alarm to feed him int middle of night?

I would say one 5 hour stretch is ok if he's feeding every couple of hours the rest of the time. Maybe you could just spend a couple of days in bed with him doing nothing but feeding and sleeping - have him skin to skin lying on you or next to your breast so he can root and feed without any pressure?

Try googling biological nurturing too - it's positions where the baby can self-attach and can get a better, stress free latch.

Tiktok has given you some good advice - things I found that helped were to keep switching sides, when he gets fussy on the 1st, go to the 2nd. Keep switching. You could also try swapping positions - try in the 'rugby ball' hold under your arm - this seemed to persuade mine to have a bit more milk. Or take a break, do something for 20 mins and then put him back on. Lots of skin to skin, feed in bed, take him into the bath with you.

I did used to set alarms for ds1 as he would happily sleep 8-10 hours as a newborn, but was starving, and weight was plummeting, so I set an alarm for 3-4 hours after his bedtime feed, and I also didn't put him to bed until midnight or so, so would feed him as much as I could in the evening, put him to bed at 12, set the alarm for 3.30, feed/change him again.

His problem was he was falling asleep during feeds, so I had to keep waking him up, to make him feed properly, rather than just nibbling.

How are his nappies?

I agree with Moon - take a couple of days just to chill and relax with him. Everything sounds very difficult - a visitor at the weekend shouldn't affect your baby's feeding, really, and that sort of shows things are tense and you could both do with some time out :)

Go with his flow. Dont try to do anything else except snuggling and feeding him (yes, with the biological nurturing Moon suggests).

See if things are better .

The visitor affected his sleeping, primarily, too exciting/ interesting to sleep, then too frazzled to sleep, then too tired to latch properly.

Nappies - generally regularly quite wet (we're on cloth) and quite pooey but during growth spurt wet is up and poo is down (this is normal, no?).

We've done a bit better this morning, but it took more than an hour of quite fussy feeding and I'm not convinced he's full... - he just ran out of patience and cries became tired rather than hungry. His latch is still a bit rubbish, it's hard to convince him to open wide, but it was better, and he didnt do much crying but quite a lot of fussing. He's asleep now, will wake him at 11 to feed (he fed between 8 and half 9 ish).

God, that weigh in has knocked me for six... we had really started to do well, and the visitor thing didn't really bother me as I thought, ah, well he's just tired and overexcited, and when she's gone we'll be back on track... which we were until growth spurt started!!! But it seems my earilier confidence was misplaced. But really, he was happy, sleeping well, usually alright to latch, gorgeously sociable after a feed and just a bit grumbly when tired. How are you supposed to know he's not eating enough in such circumstances?

Sparkly - normally it's fine to leave it to the baby to decide how much to have and when...no need to worry how you know they are not getting enough to eat feed-by-feed.

I really, really think a couple of days in bed /on the sofa will help; it will boost your confidence and help you avoid the pitfals of 'micro-management' of each feed (is he full? is he tired? is he grumpy? is he excited? should I stop? should I let him sleep? should I keep him awake? has he had enough?....all confusing and stressful).

Over to you :)