Losing weight on breastfeeding alone

[evets51]

Bit of a long first post but we're getting desperate for advice ....

DS is now 2 months old. He was 3.51 kilos when born. Difficult delivery (forceps), and he wouldn't feed at all for 24 hours after birth. We tried everything, letting him find the breast himself, showing him the way .. nothing worked. After 24 hours the hospital didn't seem too concerned but he was obviously very distressed so we bought some formula and gave it to him from a sippy cup, which he took instantly.

48 hours after birth he still wasn't feeding properly, hospital wanted to keep him in but weren't offering any help or advice and wife was exhausted so we took her home and arranged an appointment with a private lactation consultant. She diagnosed partial tongue tie and showed us many useful tips. We had the tongue tie operation (again privately) the next day, and 48 hours later DS was starting to feed properly. All this time we had been giving him formula top ups. We now started feeding him on demand, which he pretty much wanted to do around the clock - very lazy feeder, would fall asleep mid-feed. We continued with formula top-ups just so that I could take him for a few hours and let my wife sleep.

After 3 weeks he started getting very bad tummy problems, reflux etc - Gaviscon helped some but not enough, and we had the lactation consultant around again. She suggested that he might be allergic to cow's milk and that we should cut out the formula completely. It was tough, but we did and he was exclusively breastfed from that time on. All the time, he wanted to be fed constantly - would maybe sleep for 3 hours at night, but the rest of the time he had to be feeding (although would very often just suck for a bit then fall asleep for 5 minutes, and repeat). He is also constipated and only poos once every 7 days or so. The GP at first said this was normal, then after much badgering gave us some glycerin suppositories. Every 5-6 days his tummy obviously starts bothering him, we give him a suppository and he goes - but never goes of his own accord.

Somone suggested a cranial osteopath and we took him there, who also suggested cutting cow's milk out of my wife's diet. She did that, and DS has been to the osteopath 4 times since. He still is not a settled baby though - we really can't put him down for more than 5 minutes at a time, other than his one 3 hour sleep at night. I have to take him from 5 in the morning for few hours so my wife can get some more sleep and have a shower before I go to work, because if she tries during the day he just cries as soon as she puts him down.

At 6 weeks we weighed him and he was 4.16kg, which was a big drop in the percentile charts compared to birth. We then weighed again at 7 weeks and he was 4.06kg, at which point we were alarmed. We took him to the GP who didn't seem concerned. At 8 weeks we took him to the HV drop-in for a weigh, and he was 3.96kg. We were very worried by this point - the HV didn't seem concerned, said try some small formula top-ups if we really wanted.

So we started on 50ml of formula twice a day - and immediately his tummy problems came back, in lots of pain. In despair we took him to the out of hours GP on a Saturday who prescribed Nutramigen AA and recommened an emergency referal to a paediatrician, saying "this baby is clearly undernourished" - which was obviously very upsetting. We are seeing our own GP today hoping to get this referral (and will go privately if necessary).

The thing is, since we've had the Nutramigen he sleeps. We can give him 60-90ml as a top up, he gulps it down then contentedly goes to sleep for several hours. We've tried everything with BF - pumping, massage, feeding on demand for weeks on end, but it would appear that poor DS has just been hungry all along. We'd love to continue, and will wait to see what the paediatrician says, but at the end of the day have to do what is right for DS - and it appears that BF just isn't working for him. Everyone seems to say "trust your body" but it can't be right that he's losing weight like this and constantly wanting to feed. Anyone else had any kind of experience similar to this? Thanks in advance for any advice!

Poor you , it sounds like you have all had a horrible time. I haven't had these problems but just wanted to offer a bit of support. I would strongly recommend that you get help from a breastfeeding councillor. Check out LLL, ABM and NCT websites for phone numbers. I sounds like baby is not managing to latch on for a good feed. I did have some probs. with my fourth baby feeding but nothing as bad as this. She couldn't latch on very well. Turned out my nipples were too big for her. My problem was solved by using nipple shields for a few weeks until she grew bigger. You should get advice on this from a councillor though because it is not generally recommended. Has your partner tried expressing milk for the baby to take from a bottle? This could help in the short term if she wants to continue breastfeeding.

Your getting some good profesional help there and there isn't much more to suggest but. Could it be something else in your wife's diet? how long is it since she cut our dairy offten it take's upto 4week's to clear your system. she would have to cut out all dairy to not just cows milk, it's offten hidden in a lot of processed food's so can be a PIA to do but well worth it.

I'd also seconed specking to a BF counciler, it would be very unseal indeed if it was BM that was causeing the problem much more lickly to be something else.

Ah yes forgot to say we did see an NCT breastfeeding councillor before we saw the lactation consultant, she was lovely but couldn't offer much help - said the latch etc looked fine.

Dairy was cut out 4 weeks ago now, and its all dairy not milk - we cook most things fresh and check the labels on everything processed. Wife has tried expressing but can never get more than 20-30 ml (with an Ameda double electric pump) - no matter what she's tried that's the maximum we can get. I know they say expressing is no indication of how much milk you have, but coupled with a constantly hungry baby it has made us worry more that there's just not enough there ...

evets - sorry to hear all this.

I agree with your concern - and it's beyond what an NCT breastfeeding counsellor (I am one) can 'fix' really, though she would support you in tackling the situation.

It's very worrying indeed that your baby is losing weight, but the good news is that it seems to be a simple matter of not enough milk going in (rather than any difficult metabolic cause or illness). I think you have had some pretty poor care, to be honest - the HV and GP seem to have been spectacularly useless in not flagging up this issue long before now, and as for the HV at 8 weeks doing nothing but suggest top ups, she needs some urgent in-service training, if what you say is all correct.

It seems to me that the difficulties go back to the early days. You (for good reasons) gave formula, and breastfeeding was never really fully underway because it was not 'protected' fully during the formula-giving crisis. Not your fault. Crappy maternity care, probably. Anyway.....it would be perfectly understandable that your DW's milk supply is way down, but it can be retrieved.

You do need a plan to ensure adequate weight gain - formula needs to be as much as he needs to ensure he grows properly and takes in calories that give him energy and enthusiasm for feeding. Alongside that, frequent expressing (at least 8 x in 24 hours inc at night) with a decent pump, at least both breasts each time - you can give this as part of the measured intake of milk which the paed should work out for you. 'Direct' breastfeeding ad lib, to keep him comforted and so he maintains his liking for the breast....how does all that sound? It's hard work though.

I do think you need a proper programme and possibly a new HV and GP.

Hope this helps.

Bumping so the OP comes back :)

I will add that if you go down the route of Tiktok's excellent advice, that the NCT hire out extremely good hospital-grade pumps which will make the expressing as easy as it can. They're not cheap to hire (but cheaper than formula!!). Contact your local branch for info.

op obviously in this case there is a problem with the baby's intake of milk but for future reference it is normal for an exclusively bf baby to not poo for some time (i think a fortnight is the longest i've heard off). Now clearly your baby has lost weight and had formula so it's a different matter, but hopefully you'll get back to ebf (if that is what your dw wants) and then this info will be usefull.

You have clearly had a horrid time and i really hope things improve for you. Well done for supporting your wife through this. Good luck.

If you have a local support group, clinic or drop in then it's worth contacting them. My local one has hospital grade pumps to loan for free. Your story is my story and I remember it well. It was torture but we got there by pretty much doing what Tik Tok said. She was put to the breast at least every 3 hours then topped up with breast milk and formula then when she slept after that I pumped. It took about 3 weeks to get to exclusive breast feeding and so many times I was close to breaking, nearly giving up. In that time I was prescribed a galactagogue ( your wife may not need this). Anyway we got there and it was totally worth it, especially when she looks up at me with her mouth full and grins. Good luck.

OP's not coming back, is he?

Why does this happen?

OP, I hope you come back - you describe a worrying situation :(

Sorry, I'd read the replies on a phone but been too busy and tired to be able to reply yesterday!

Anyway thanks very much all for the advice and sympathy. Part of the advice we had received from the lactation consultant right from the very start had been very frequent pumping - we had hired a hospital-grade double pump for the first month and pumped many times a day, then bought our own double electric pump and kept this up. By the end of last week we were only getting 2.5ml per expressing session though.

Anyway, we had made the decision that our little boy needed food and needed it now, so had made the decision to give him as much Nutramigen as he needed. Amazingly when we went to our GP on Monday evening for the paed referal, he'd put on 220 g and was back up to 4.18kg, in 72 hours is quite incredible! Unbelievably the GP wouldn't refer to a paed because he'd gained some weight back , however was more than happy to make the referral on BUPA so we are still going.

We're continuing to breastfeed and express many times a day, and maybe its the removal of the instant stress over his health but supplies seem to be rising. We are seeing the lactation consultant again for any more help and hopefully the paed will be able to really tie down any allergies. Our boy is chubbing up in the cheeks by the day though, and he's sooo much happier - quite happy to be put down on his playmat with some toys after a feed, and then he just falls asleep half an hour later. Its pretty galling to think we've been starving him for weeks on end, if we can get back to exclusive BF then that's great but we're not going to push for it and make him happy again, will keep giving as much Nutramigen as he needs to be healthy.

So - thanks all for the advice and tips!

Glad things seem to be better, OP.

You best protect the breastmilk supply by frequent expressing and this means in your case 8, even 10, times in 24 hours inc at night, on both sides at least one per session. In my experience people find this very difficult to do, and when they say they are expressing 'several' times they count it up and it's more like 4 or 5.....not enough. It's hugely demanding.

Once a supply is re-established the frequency can be relaxed.

Good luck with the paed.

Wow what wonderful parents you are to go through all this and still persevere! Hats off; particularly to your wife. My son was also forceps and we had similar feeding problems. He lost a lot of weight and I panicked and started him on formula. Four weeks later he nearly died of a chest infection. Maybe there was no link between the two, but suffice to say I really admire your commitment to your son's health. Sounds like he's thriving now