2 week old still not back to birth weight- sleepy baby

[Needsomewine]

I'm feeling a bit sad tonight. Dd is 2 weeks old and is still not quite back to birthweight of 6lb 3oz. She is very sleepy and only feeds every 4 hours. Please don't tell me I need to feed her more often as some of her 4 hourly feeds are very hard work in terms of keeping her awake. I often have to take her off the breast as she has fallen into a deep sleep. She feeds naked and I wake her up up to 8 times during a feed. However, she can feed really well, I hear her glugging milk down and she has very wet nappies throughout the day. She only poos once every 5 days so god knows what weight she'd be if she poo'd more often. I topped her up for the first week or so as she was tongue tied but she then started settling between feeds just on my milk so I stopped top-ups. When she has a good feed, she will posset so I don't think she would tolerate top-ups anyway. I keep her on each boob for at least half an hour (in total), longer if I feel there is still milk there. What am I doing wrong. She only lost about 5oz as I topped up in the first week so why isn't she gaining well? Any thoughts would be really appreciated:).

[AKMD]

DS was a very sleepy baby and it was a nightmare trying to get him to stay awake long enough to feed him properly. I ended up expressing and feeding him with a bottle for a few weeks just to make sure he was getting something. So you have my sympathies!

Has your MW or HV expressed concern about your DD's weight? If so, they should be offering advice. If not, try not to worry too much; it sounds from the number of wet nappies like your DD is getting enough and she will catch up soon.

[thisisyesterday]

tbh, and i know you've said not to say it... but the only way to get more calories into her is to feed her more often.

I would recommend seeing a breastfeeding counsellor in person. they may be able to give you more advice on feeding a bit more frequently and getitng her to feed longer without going to sleep and general stuff like that. they can also check positioning and latch to ensure she is transferring milk efficiently..

[twinklegreen]

Sorry to hear you are having such a tough time

have you tried it can help get more of the high fat milk into you baby.

I would also recommend getting lots of skin to skin contact with your baby, have you tried having DD in a sling next to your skin all the time.

[RitaMorgan]

I had a very sleepy/jaundiced baby too and it was a nightmare getting him to feed at first - I woke him to feed every 2 hours day and night, and each feed took an hour, so I do understand how tough it is. Unfortunately I don't think 4 hourly feeds will be enough for her to gain weight or to maintain your milk supply.

Have you tried switching breasts every time she nods off? Might rouse her interest a bit.

[Needsomewine]

The midwife and HV have checked her latch and are happy with it. I shouls also add that she stays awake and alert after a couple of her feeds for quite a while, i obviusly offer her the breast during this time but she is not hungry, just awake and is very contented. The m/w advised me not to switch feed so that dd gets more of the hind milk. I have no doubt she is getting milk because of her nappies. I don't think there's any problem with my milk supply, plenty there. I guess she is not getting enough hind milk because my breasts are always pretty full when she feeds. I am already doing breast compressions as well as generally tweaking her when she gets sleepy. Dd1 was also pretty sleepy to start with but I think she started gaining about 7oz a week by this stage. I just don't know how I can get her to feed more often :(. I feel pretty confident I'm doing everything I can but just feel so down tonight, probably tiredness:(.

[RitaMorgan]

I would try and see someone qualified in breastfeeding - midwives and HVs may not have had any particular training.

[Needsomewine]

I know what you're saying Rita but I am confident that dd2 knows how to feed as have seen a bf counsellor in the past with dc1. This is how i know about breast compression and tweaking her to keep her awake which works to an extent. It's how to keep dd awake for longer during feeds that is the issue. It would be nice to see her put on some weight but maybe I'm stressing too much. HV doesn't seem worried.

[RufflesKerfluffles]

Are there any local breastfeeding counsellors you could speak to? Or a support group? If not, could you try one of the helplines? I'm not an expert, so please seek further advice on this, but I thought switch nursing (switching from side to side multiple times during a feed) actually was recommended for getting sleepy babies to feed more, and improving weight gain.

[RitaMorgan]

I would also try switch nursing - if she needs more calories then getting more milk into her is important.

[crikeybadger]

Agree with Rita and Ruffles about the switch nursing suggestion. Block feeding is usually only recommended for those with oversupply problems. Dare I say it that maybe the mw is a little confused about the foremilk/hindmilk thing?


You say she lost 5oz initially, has she gained since then or remained static?

[tiktok]

I agree about getting further support from someone who understands better about foremilk/hindmilk. The midwife's advice against switching sides for a baby who's gaining weight rather slowly and who is sleepy and feeding infrequently needs questioning - seems to me from what you say that you had a difficult first week and that you are still getting over this.

Four hrly feeding is just not enough for most babies of 2 weeks - not enough to ensure good weight gain and not enough to make sure you are boosting production. Skin to skin, offering the breast at every opportunity, but with less fighting to keep her awake, and deliberately ensuring two, three four or more sides each time....that's the way to make more milk and to get more milk into her :)

Phone any of the breastfeeding helplines, and they will help you with more details about why this is normally the better way to get bf off to a good start.

[Needsomewine]

She lost 140g of birth weight (well that was the day 3 loss). On day 13 she had gained 120g back so was 20g under birth weight. She is definitely going in the right direction and I can tell she is generally improving with feeds but I just hoped she'd be gaining a it more by now. She was jaundiced and Tongue tied though so maybe it will just take a while...

[Needsomewine]

Right ok, I will give switch feeding another go on the next feed. Just gearing up to wake her up now! She feeds much better from one side too so I have been trying to put her on the slower side first. Any thoughts on this. The letdown seems slower in flow and slower to come through on the dud side!

[Needsomewine]

Went ok at 10.30, did the switch feeding but am sat here crying and expressing at 3 as dd is too sleepy to feed at 2.30. Have lost all confidence:( :( and not relaxed enough to feed her so dh is giving her a bottle.so sad

[MigGril]

I think you do need more help as other have said 4 hourly feeding is not enough. And I don't want to alarm you but a baby this young should really be pooing every day so this is an issue dispite what you HV said.

Have you tired lot's of skin to skin, don't put baby down at all if you have an older one to look after do skin to skin with a wrap sling. This should help her demanded more often it's supposed to help with sleepy baby's.

Ring one of the helpline's they are open 7days a week the BfN one is 9am-9.30pm 265days of the year.

Helplines

National Breastfeeding Helpline
0300 100 0212

The Breastfeeding Network Supporterline (BfN)
0300 100 0210

NCT Breastfeeding Helpline
0300 330 0771

La Leche League Helpline
0845 120 2918

Association of Breastfeeding Mothers
08444 122 949

[tiktok]

Needsomewine :( :( It's fine for your dd not to want to feed sometimes and to be sleeping instead....no need to struggle to keep her awake all the time. I think you'll be really supported if you speak to one of the helplines. You can phone anytime, inc at weekends.

Hope the rest of the weekend goes ok.

[Catslikehats]

I sympathise. DC4 dropped almost 20% of her birth weight due to being extremely sleepy. She was not big to start with and having dropped to 5lb she became even more sleepy.

I am sorry to say that you do need to be feeding her more often, 4 hours isn't enough at this stage. The advice I was given, which worked was this:

Feed two hourly in the day and three hourly at night.
Undress the baby and yourself for plenty of skin to skin.
Switch sides every time baby sleeps.
Express after each feed, 6 minutes each side and top up with this.

You can be suprisingly "rough" with a baby to keep it awake, prodding, rubbing, patting. Wet towels can also help.

Prepare yopurself for the fact that it is really hard going - you will have little time to do anything else but it gets much easier very qucikly. After adopting this routine DD was gaining every day and back to birth weight within a week and we were able to revert to a more "normal" patter of feeding..

[Zimm]

Agree with all 4 hourly is not enough. I know what you are saying - I had a sleeper and every 3 hours (although had I found mumsnet in time I'd have done it every 2 hours during the day and 3 at night) I'd wake her up by changing her nappy - feed one side and keep dripping cold water onto her head is she started sleeping and then change her nappy again and do the other side with cold water as needed! I also expressed and topped up until she started gaining well. It sucks doesn't it - hang in there, you are going a brilliant job but you do need to wake her more often.

[tiktok]

Just to clarify - there will be times when your baby will not feed and needs to sleep....so no need to fight her all the time :) But she does need to feed more often, for sure.

[Needsomewine]

Thanks all, I spoke to a LLL volunteer this morning. She said that the 4 hourly thing wasn't ideal but was very supportive and reassuring of everything else I was doing:). I find conflicting advice really stressful but I'm not getting at anyone who has replied, I'm very grateful:). The LLL lady didn't advise switch feeding but said the same as the mw-try to keep her on one side so she gets hind milk. Maybe I am going wrong with the length of time my feeds go on for. This is generally 50 mins to 1.5 hrs with lots of waking her- up in between of course so most certaintly not constant sucking!! Maybe I shouldn't try so hard to keep her awake during each feed and she'll be less settled and wake to feed more often?? Has anyone got thoughts on this?

Zimm- maybe I'll try that! I do drip water on her head but maybe I should have a bowl next to me for every feed! Re top-ups I would definitely give her them if she would take them but she already possets up a bit of my milk and either refuses top-ups or takes about 10mls and seems to poseet it all up. I am confident she's getting enough milk but agree with what posters have said on here- it's probably too much of the watery stuff!

[Bert2e]

Has she had her tongue tie snipped? If feeds are lasting that long I'm guessing she's actually falling asleep as she's exhausted by trying to feed as her tongue wont let her get enough milk. You really could do with seeing a bfc face to face.

[Needsomewine]

Yes she had Tongue snipped. Feeds fine when actually awake enough to feed. Glugs it down better than dd1 infact. know she is transfring milk etc etc, has loads of wet nappies. The issue is how often to try to wake and feed her and how long to try and keep her feeding for.

[tiktok]

Totally understand how frustrating it is to cope with conflicting advice :(

However.

The way to increase volume of milk produced and volume of milk taken by the baby is to switch sides - keeping a baby on one side only deliberately time after time reduces both. There is no need to worry about time on the breast equating to 'getting the hindmilk' and I am really, really surprised an LLL person suggested there was.

A young baby who stops feeding after a couple of minutes would stay on the same side when he/she starts feeding again - true. Staying on the same side over and over again and then next time, staying on the other side over and over again is only ok to do when there is no issue with supply and intake.

www.analyticalarmadillo.co.uk/2010/07/foremilkhindmilk-and-lot-of-confusion.html is a good explanation of all this :)

[Needsomewine]

Tiktok- just to clarify, she didn't say to put baby to the same side time after time but when I asked 'should I change sides every time dd falls asleep (this could be only a couple of mins of not proper sucking), she said no- I took this to mean to put dd back on the same side for 2 or 3 times depending on how she is doing.

I have been switching sides a bit more today though. If I was feeding the ideal 10-12 times a day, how long should she be properly feeding for each time? Dd has fed at these times today-
6.30-7.30
10.30- woke her up but she was still sleepy, not a great feed
11.30-12 quite good feed
Was then awake til 1.20 and fed well for 15 mins
3.00- woke her and fed well,on and off for an hr
6.00- woke her and fed ok on and off for 1 hr 10 mins
She's just gone to sleep at 7.30 but only a light sleep so she'll prob be on and off for a while

[tiktok]

I see what she meant now, thanks :)

It's frequency of feeding which is more important than the length of time at each session (within reason).

The feeding you have described as happening today sounds fine.