9 week old dd not gaining weight

[Eskarina]

I'm hoping someone can give me some ideas for helping dd put some weight on as the only advice I get from the health visitors is "feed more often" (currently they're saying "at least 10 a day) and the GP says to introduce formula.

DD is 9 weeks old and exclusively breast fed. She was born at 42 weeks weighing 8lb 3oz. At 9.5 weeks she now weighs 9lb13oz, and for the last weeks she hasn't put any weight on, so has dropped from above 75th %ile to below the 9th.
She has infant gaviscon twice a day as the dr thought she has silent reflux. I wasn't convinced but she definitely seems happier and screams a lot less now she's on it.

I'm trying to feed every 2 hours during the day, doing breast compressions as hv says this will push the hindmilk forward for her. If dd seems hungry I might feed at less than 2 hours, but its really starting to interfere with life functioning normally (or at all) if we go too far down that road - feeds last at least 30 mins. Whilst feeding I express from the other breast and over the day I get approx 6oz which dd has in a bottle as her evening feed. she will glug as much as i can give her in that feed.
DD is NOT a fan of daytime naps so is often tired and a bit cranky...it takes ages to get her to fall asleep, then of course it's time to feed again...so do I wake her and feed her chronic over-tiredness, or do i let her get some sleep and risk her not eating enough??

On the positive side I have a happy smiley baby who is very active, plenty of wet nappies, a dirty one every day... Plus she sleeps well at night!

Thanks

Hi Eskarina,
Sorry you are concerned.

I was just wondering over what time scale she has lost the weight?

From your post, the only thing that I'm not sure you are doing is something called switch nursing. Feeding on one side and then swapping over to the other and then back again (repeat as required). This is a good way to get more calories in to a baby and possibly better than expressing as the baby will be more efficient in getting the milk out.

Has the HV given you any more suggestions? Latch OK?

Thanks Badger
DD hasn't lost any weight, just climbed slowly to current weight (about 4 oz/week) then stayed there for 2 weeks.

I'd read about switch feeding but keep being advised to keep her on one breast per feed. I do the expressing as I want her to be able to take a bottle (and was advised to give one daily if I want it to last) and also to get my supply up. There's a bf clinic at our children's centre and the HV's there seem happy with her latch.

It's all rather exasperating!

OK I see.

Do you have any idea why you were advised to just feed from one breast at a time?

I'm no expert so not sure I can add anything but just wanted to add some support. My DS is now 20 weeks and is still gaining weight really slowly so I totally understand how you feel.

I second crikeybadgers suggestion of switch nursing. My DS will often switch 4 or 5 times a feed it seems to keep him interested. Whenever he comes off I just swap sides until he really doesn't want anymore!

Keeping to 1 breast per feed was to make sure it was emptied fully as dd would only get foremilk if she kept snacking from each side at one feed...

Thanks both, it can't hurt to give it a try

Most babies who gain slowly like this are fine - they're just unusual :)

Having said that, one sided feeding reduces both supply of milk and intake of the baby, and it is at least questionable why you have been advised to do this. If the answer is 'so she can be sure to get the hindmilk' you can blow a raspberry and be safe in the knowledge that they don't understand about bf.

One easy thing to try - given your baby is healthy and happy and active, so no need for urgent panic :) - would be to offer at least both breasts each session, switch nursing when it's convenient to do so. If the bottle of ebm means she is going several hours without actually being at the breast, you could make the bottle a small one and just do the rest 'direct'.

Hope things work out.

Agree switch nursing is a good idea.

How many feeds is she having in 24 hours? In terms of squeezing some more feeds in, have you tried dream feeding her (either during naps, or night sleep)?

I have a happy smiley baby who is very active, plenty of wet nappies, a dirty one every day... Plus she sleeps well at night!

This is what matters, nothing else. Has she gained nothing at all or less than expected? For how long?

My DD was the same, born on the 75th and dropped to the 9th before she was 12 weeks. Cue the GP sending us to a pead who told me to top up with formula, which I was NOT prepared to do. DD was happy, having plenty of wet and dirty nappies and was settled. She also had silent reflux. I carried on the way I was and did not top up, refused to attend any more pead appointments and stuck to a HV who simply said that the placenta which was her main source of nutrition caused her to be born at the weight she was but she was not destined to be a big baby. She is now 3 and weighs 2 stone. It's just the way she is.

I also used to feed on both sides, 30 min per side and often constantly from 5-6pm until 11pm at that age.

Sorry, x-posted with TikTok.

It sounds to me like you're doing all the right things. I'd echo what's been said about dream feeding, and offering both breasts. The way I did it was when my baby de-latched of her own accord I'd offer the other one. Sometimes she latched, sometimes she didn't.

Why don't you try having free unrestricted (ie no clothing in the way) access to your breasts in the evening? It would be a big boost to your supply as well as being a nice bonding thing for your both. For the same reason, I'd swap the time your give her ebm to during the day- it'll help boost your supply.