The bf saga continues - slow weight gain?

[PurpleBucket]

I've posted a couple of times recently with bf queries. DS is 11 weeks and breastfeeding has been a real struggle for us. I had to pump for weeks to keep up supply and bottle feed until DS was big enough to latch onto my giant nipples.

We started slowly re-introducing DS to the breast almost three weeks ago and for the past week I've been exclusively bf with just a bottle of about 100ml before bed.

I was feeling so confident and happy that things were finally going well. DS is happy and content and has started sleeping up to 9 hours at night (a surprise to me too!). He has lots of wet nappies and usually one huge dirty nappy a day (and if he has a day without a dirty nappy then he does two the next day). I've noticed no changes in his behaviour or nappies since transitioning from bottle to breast. I feed completely on demand which is normally every 2 hours during day and every hour in evening.

So the "problem": I weighed DS three days ago and he'd put on 60g or 70g less than I am told is the norm (ie 20 to 25g a day) since we started re-introducing the breast . I was a little concerned but carried on bf and weighed him 3 days later. He'd put on no weight in 3 days. I was completely thrown by this.

Paediatrician came this morning and is completely happy with baby: says he is following 90th centile for height (he grew 4cm in the past month which she said is a lot) and head size and following the 75th centile for weight. but she said because of the rintroduction to the breast, we should weigh him again in a week just to see (although she said it's better to look at the picture over a month).

But.....after all the struggle with the bf, I just have this nagging feeling that DS' weight gain was all from the period that he was bottle fed and that he's put on no weight since I started bf and will have put on no weight when I weigh him in a week. This all may sound silly but after everything I've been through with the bf, every little thing matters to me and I've got myself into a bit of a state.

Not entirely sure why I'm posting. I think just to talk to some mothers who know what I'm going through and to get some reassurance that everything is ok as I'm an emotional wreck. I pumped all night (while baby was asleep) and was too upset and lost confidence to bf today so been pumping again which I hate.

Sorry for the long post and thanks for reading.

Babies often take more from a bottle than they do from the breast (whether ebm or formula) so it may be that his weight gain was a little artificially inflated while bottlefed - how much was he taking a day? Or maybe he just needs more milk from the breast - can you feed more often, offering 2+ sides each feed?

:( :(

You sound as if you are doing really great, and you have made a major breakthrough in getting your baby back to the breast.

You have stayed in touch with the HCPs and the paed has explained to you that all is well....not sure if you are in the UK, but good practice now is not to weigh babies more often than once a month once they are deemed to be healthy and thriving. With your baby's history, it's prob fine to weigh a tad more often than that (and the paed seems to be following this accepted good practice) - but you absolutely don't need to be weighing daily or every 3 days, and babies beyond the newborn really don't 'have' to gain a certain amount a day. Weight gain is not even or predictable, and frequent weighing is very misleading.

I think it sounds like you have a confidence problem, not a feeding problem, honestly. If you think your baby does need more calories, then just offer him the breast more often, maybe three or four breasts each session, but he may well not really want any more :)

oh poor you. Its really hard work doing all that pumping and looking after a baby. Well done on getting back to bf!

Weight gain goes in little stops and starts so three days is really too often, even every week is too frequent to really see the larger picture. And normal for your baby may be slower weight gain - someone has to be on those lines at the bottom of the chart or else they wouldn't exist!

We put a lot of emphasis on weight gain but its a tool to help spot babies who have problems. And if the paed is happy, I think you can tell yourself to relax.

Do you have a bf support you can go to (search here) so you can talk it through it reallife. Meeting others who have had problems and now have lovely healthy babies may help you visualise yourself getting through this.

Thank you so much for replying. I definitely have a confidence problem (which I was just starting to get over before this weight issue came up ).

I am offering both breasts at a feed but have also tried to make sure he "finished" one breast so as get more hindmilk before switching. As a result of all my expressing, I had way too much milk for DS and had to wait for my supply to go down a bit and adjust to his needs.

Do you think it's possible that he's not demanding to go to the breast enough? I put him on the breast though at the slightest chance he might be hungry.

Do you think I should also express at night given that DS is sleeping for up to 9 hours? I wasn't before as really had way too much milk (could express over a litre in 24 hours and think DS was drinking about 700ml) but I don't want my supply to drop too low because of the long gap at night.

No I'm not in the UK and afraid I don't know the UK equivalents for the weights etc that I've mentioned.

Yep, a confidence problem for certain :)

• you don't need to worry for a second about 'hindmilk' - just switch when he seems to 'need' switching
• just be responsive to his needs, and accept that there is no reason on earth why he would not take the breast when offered it in order not to 'demand' too much. Healthy, thriving babies like yours just do not do this :)
• no need to express at night, I wouldn't think - you have had a problem with oversupply so why would you try to create another one? If you wanted to deal with worries about a drop in supply, then offer him a feed in the night - in any case, babies grow not on the milk you make but on the milk they take! But I think you are anticipating something that may not happen.

And most of all, forget the idea that babies of your baby's age should be gaining Xg a day.....way, way out of date.

I agree that meeting other bf mothers might help you feel more confident.

I think I'd offer every couple of hours if he hasn't asked before then - but if he's sleeping 9 hours a night he must be getting plenty in the day!

Try and trust him to take what he wants / needs. There is no harm offering more than he is actively asking but don't let yourself get dejected if he sometimes refuses. Offering the first breast again after the second is a good tip.

Have you tried biological nurturing - get both your tops off and just plop him on top of your chest, tummy to tummy, so he can go to sleep, feed, sleep, stare at you, feed etc. Short frequent feeding helps to keep up your supply so don't worry if you have some longer gaps too. I wouldn't pump overnight personally if you've had problems with oversupply previously.

(btw La Leche is international see here)

Yes everything you are all saying all makes sense and I am already starting to feel better

TikTok - by "demanding" I meant that perhaps DS is not letting me know he's hungry and he is therefore going to the breast less than he should. But if he wants to feed every couple of hours plus hourly I'm evening then I guess he is telling me!

Our feeds usually around 30 mins I think but I've been trying to extend them to get him to take in more milk. I'll try offering both breasts more than once then.

The biological nurturing sounds a good idea. Think I read about it on kelly mom or the jack newman site.

Hang in there. The paed is right in that you really should be looking at the weight over a month. And their weight would need to drop two centile spaces before it's considered a real issue.

Keep seeing what helpers you can re bfing - I think of it as a skill you can contantly be improving. And different things work best for different babies.

30 minute feeds at 3 months are not short so if you really feel you need to get more milk in (and you'll need to see his weight gain over a month before you know), then think about offering more often and improving positioning to get an even deeper latch (which helps them get the fattier milk out).

Sounds you are doing amazingly well

It's so easy to get in a emotional mess with BF, we had nursing strikes, low weight gain and fussiness and would get in a right panic. Lukcily MN was here to come and slap me round the face a few times and tell me to calm down.

Weight gain is not linear, babies rarely follow one centile line but you know all this.

I agree with everyone else, it really doesn?t sound like there is a problem, honestly. Also you say he has grown longer ? well that growth may have been what he has been concentrating on, rather than growing heavier ? as others have said, growth isn?t even, that?s why we don?t weigh every week like we used to.

Thank you all for being so lovely.

Really got myself into a state but now just trying to relax and breastfeed today. He's been snacking a lot and keeps falling asleep but putting him on the breast whenever I can. Think the last 24 hours of solid bottle feeding has made us go a step back so hopefully we'll get into the swing of things again