Baby not gaining weight

[Catspersonalbanker]

My DD is 5 weeks old and has been exclusively breast fed. She was 8lbs 8oz at birth and went down to 7lbs 7oz in the first 10 days. The weight has not started to pile on at all. The second week she was weighed there was no weight gain, third week 4 oz but this week again no weight gain at all.
She is bright and alert, though is having a dozy day today. Plenty of wet nappies and a couple of pooey nappies a day but sometime not which I understand is ok for BF babies.If left I am sure she would not wake for a feed as she has sometimes gone 6 hours between them (when the alarm didn't go off.

She is definitely getting longer and I am feeding on demand and having to wake her every 3-4 hours in the night to feed her. Last week I started expressing to up my supply by the suggestion of the La Leche Advisor. ( They were a god send). Today I've managed an extra 5oz for her from 3 sittings so far, though after 10 minutes there didn't appear to be any more to pump.

The Health Visitor contacted a Breast Feeding speciaist who suggested expresssing 6 times per day plus feeding on demand until I get DD to the Baby Clinic on Thursday.

She is latching on properly and takes an expressed bottle with gusto.Not really sure what else I can do.

Any suggestions with regards to diet, spaces between feeding etc?

My Mum tried to bf my sister but had to give up as she couldn't meet the demand- could this be the same for mer?

sounds like you are doing as much as possible. keep going with the advice you have been given. you are more than likely to be fully able to breastfeed happily. first weeks always a nightmare for one reason or another.

feed her as often as she will take it.
go to bed with her and feed her constantly (if not sore) for 48 hours.
(they are other suggestions but really just keep going )

even if there is nothing else to pump, the stimulation will make your breasts make more milk, likewise if she feeds of a seemingly empty breast, it won't be, and your boobs and brain will make more. v clever.

Thanks for the swift response. Will persevere with the "empty" pumping as the HV didn't explain that this would also work, I thought it would only work if you were producing. Will let you know how I get on.

Am really keen to keep bf ing and am not anti formula but want to try all things before needing a top up.

Cat, glad you are getting some help with this. I think you were let down in the first 10 days - this was a lot of weight to lose and it should have been flagged up as an issue long before then, with a weight taken after about 5 days and someone who knows what to look for checking all was well. It is probably the case you have been playing catch up since then. The lack of weight gain subsequently is a serious thing and you should have had decent help long before now :(

Yes, expressing is important because it does sound like your baby is not yet able to breastfeeding efficiently and effectively enough to ensure she stimulates a good supply. Feeding on demand is not often enough, I would say - she does not demand sufficiently frequently enough.

Yes, at least 6 expressions a day, both sides, and as many breastfeeds as possible day and night, using at least both breasts each time, topping up with your expressed breastmilk....all that's good. Space between feeds should be as little as you can make it - frequent, effective feeding drives supply, and 3-4 hourly is nowhere near enough day or night.

Your diet can be whatever you want - makes very little difference.

It's good she is bright and alert most of the time, and it's good you are expressing a lot. Rescuing things will be hard work in the short term, but it can be done :)

Thanks for the advice. I have been feeding some days almost not stop for ten hours straight (stop to go for wee and eating lunch one handed) so just wondered if there was something I was missing. .

In fairness I have had a lot of help from the hospital midwives and nursery nurses for Bf ing for the few days I was in. Had a 4th degree tear but thats another story.
Everyone wanted to make sure that the latching on was working and that she was producing enough nappies. The Health Trust is very pro breastfeeding as were the community miwives who all checked the positioning. The local BF group is run by a HV and everyone has been very supportive . They have given me some room to ensure that just because she isn't average that I wasn't scared into giving her formula or made to feel like I wasn't Bf correctly. However, she has now gone from the 75 percentile to the 50 percentile which I understand is ok but from todays visit she is now on the bottom end of the 25 percentile and given that I have tried everything else, I may be happy to add formula to ensure that the development is not hindered. She does look quite slim around the neck, wrists and tummy areas [sad} and its hard to see her not improving.

Just wanted to make sure that there wasn't something else.

Will keep you updated and thanks again

If she's feeding for hours and is still losing weight, that really suggests her latch isn't as great as it could be. A deep latch and good positioning is needed for efficient feeding. I had to see an infant feeding specialist to get this sorted with DD as everyone else said my latch was fine.

It is extremely rare to not be able to produce enough milk, especially if you haven't had surgery and don't have hypoplastic tubular breasts (a condition when the breast tissue doesn't develop well in puberty, possibly due to ill health or eating disorders). But if your LO isn't stimulating the breasts enough, your supply won't adjust appropriately.

Pumping 6x a day sounds about right to up supply and provide top-ups. Pump until nothing comes out and then continue for a minute or two.

Just wanted to quickly say congratulations at sticking to the breastfeeding. Stupidly I got overly concerned that my baby hadn't put back on her birth weight by week 2 so followed the midwives suggestion of topping up with formula. My mum also said that as a baby i wouldn't put on weight either so she had to move to formula - I really really wish I had just stuck solely at the breastfeeding. I'm now trying to fight my way back to a good bf supply and reduce the formula as it is such a slippery slope so i think you're a star for continuing and good luck with all the suggestions (i will try a few myself as well ).

hey, just wanted to say that I've kind of been where you are. At 2 weeks old we've already had a bout of evil mastitis and a few days in SCBU where she was so lethargic that breastfeeding wasn't an option.

There is a way back if supplementing feels like your only option but I have to tell you it's hard work for us right now. Breastfeeding 10-12 times a day, pumping 4-6 and still having the hassle of formula feeding for top ups (reducing, thank god). It's coming down though and her weight is finally climbing.

It is tough expressing and feeding constantly and I just want to offer my support.

Just for an update for those who took an interest.
From last Tuesday to last Thursday she put in 2 oz!!! Then the bloody HV said, maybe she was born a bit to big anyway so thats why shes taking her time to get back up to speed!!

We did try the formula but she spat it out so I feel vindicated for holding out so long. However, I am now having the 6 weeks growth spurt and have fed for about 6 hrs constantly this afternoon.
Glad DH is home to give her the expressed bottle so I can have a little bit of space

Thanks to everyone for thei support, it means a lot! :)