Weight gain concerns - should I top up?

[SLVC]

Apologies for what turned into an epic first post...

My beautiful bf 7.5 week old DS hasn't gained weight of any significance for almost two weeks, dropping down the centiles. Despite being a very frequent (if lazy) feeder - sometimes doing one hour on, one hour off during the day. At night he will go 4/5 hours, then feed and sleep for another 2/3 hours.

He has been having 100ml of formula in the evening from DP, I cannot express any significant amount.

He is happy, smily, plenty of wet and dirty nappies and not dehydrated; but the doctor told me to further top him up with formula as he wasn't getting enough calories from me.

I really did not want to do this, but worried about him, gave him a formula top up in the morning two days ago. This resulted in a satisfied, and satiated baby, but one who wouldn't properly feed again for over 3 hours - thus missing feeds from me, causing me pain, and in my mind defeating the point of trying to get calories in him.

My now 4 year old DD did not latch on until she was 5 weeks old. I almost killed myself getting her to bf, but I stuck with it. My supply never really caught up with her though, and she had small formula top ups during the day (she had reflux so I mixed it with her Gaviscon). I fed her for 7 months until I went back t work.

This time I was determined to make bf work. I conceded to my DPs suggestion of an evening bottle after 6 weeks, owing to sheer exhaustion and poor weight gain. But while I am now getting more sleep, it's made no difference to his weight.

I would rather stick with bf for all feeds other than this one, but I do not want to do my son a damage by ignoring his failure to gain weight from me.

My daughter eats tonnes and is very tall, but very slight, so I do have thin children. But surely he should be ganing some weight?

He was 7lb3.5 at birth and was only 9lb at 7 weeks.

I am starting to feel that my milk is just not good enough and I should give up, but I stuck with it for my daughter and feel I want to do the same for my son.

Any advice would be appreciated.

Hi SLVC,

Poor weight gain is potentially a really serious issue so you are absolutely right to work out a strategy - but it's not always a problem at all, either. It's excellent news that he's smiling and happy, and that his nappies are looking good, and not dehydrated, so it sounds like he's doing fine most probably. As you say, it could be "just your children". But, it's impossible (and dangerous) for me to make an actual judgement on that from this.

My concerns on your post come from your comment about your "frequent but lazy" feeder. It may be that for some reason he's finding milk transfer really tough, so running out of energy to work for it. What was his delivery like? Forceps? Anything which could affect his ability to suck because he's got some residual birth trauma?

You are absolutely right that giving him formula will reduce the milk he's getting from you and your milk supply, and that he's still not gaining as rapidly as you'd want him to ont he formula suggests that isn't the solution. You're engorged when he misses a feed so you can see that not only are you making plenty of milk, but he's also taking it because otherwise you'd be engorged more often.

Your GP was most unhelpful saying that he's not getting enough calories from you and suggesting formula rather than working out what (if anything) if going on. If it wasn't for the lack of weight gain would you be concerned? Does he look like he's nice and chubby? How much is he ACTUALLY dropping through the centiles?

He was on the 25th when tiny, then around the 9th (went under, back up and under again).

His birth was completey normal.

By frequent and lazy, I mean that it takes him an hour per feed, often needing to be woken up, as opposed to magic 10 minute guzzlers I hear about. And will often want feeding again after an hour.

OK. And if he wasn't being weighed would you think there's a problem?

No!

Well, in that case, I suggest that you call the NCT breastfeeding line on 0300 330 0771 to talk through things a bit more with someone who, unlike your GP, knows about bfing. You can confirm there's nothing going on that is actually a problem (and it sounds like all is probably fine) and then relax and enjoy him :)

Does that help at all? I have to say that never have mine weighed for just this reason :) My MIL keeps asking me what he weighs and she can't understand why I don't know!

Incidentally a drop from 25th to 9th then tracking around it, is fine and normal and sounds like your daughter.

I agree with organic - the weight gain is within normal, his behaviour and health and development sound normal.

If he needs more calories, then you have them in your breasts :)

He can feed more often, using at least both breasts each time.

Breastmilk varies hardly at all in quality - you don't need to worry that it is not good enough.

Formula will undermine your choice to bf - 2 bottles a day at 7 weeks is a lot, and it appears he is feeding maybe 5-6 x in 24 hours from the breast? For most women this is not sufficient to maintain a milk supply at this stage, so you do need to consider dropping the top ups and bf much more often.

I agree a call to a helpline will be a good idea.

Thanks for your advice occ and tiktok, and for taking the time to help.

We have our 8 week check on Monday, I'm just hoping he will have gained a nice bit of weight to prove all is well and apease the GP!

He's feeding a lot more than 5/6 times 24 hours (rough count just now, I don;t actually count them) and will cluster feed most evenings too. I had not thought that the one bottle could interfere elsewhere. If this is the case, the GPs advice would appear way off the mark!

Incidentally, the GP was not worried about anything other than the weight chart either.

Well on that point, he's your baby, not the GP's, and if the GP is worried I would ask exactly what about as he seems well.

I would get to a BfN clinic or see a BFC and keep getting as much help as you can with latch and positioning. It made a huge difference to the efficiency of DD's feeds - we really struggled with weight gain at first. Hour long feeds with a 7 week old would make me wonder if some improvements could be made.

I also found some of the online videos (e.g. Jack Newman) helpful, but the most help for us was an infant feeding specialist who taught me to use cradle hold properly.

Thought I'd update for those kind enough to offer advice; I stuck with bf and no added top ups and DS put on 5.5oz this past week. Long may it continue (though I think I will not get him weighed every week from now on)..