Slow weight Gain

[pixiekid]

My ds is 8 weeks old (born at 36 weeks) and has been slow at gaining weight. He originally lost 6% of birth weight & took 3 weeks to re-gain. He has been averaging only half an ounce per day at the most since. Im EBF but worried about his slow growth. The MW/HV & Breastfeeding support worker all think his latch is okay. He's charting the 9th centile based on his due date age. The HV is not overly concerned at the moment but I'm feeling down about how small he still is (his last weigh in measuring 6.4lbs). I don't want to start mix feeding but wonder if I should (family members and dp are starting to suggest it). Any advice?

pixiekid, it is fine for babies to be on the 9th centile.

If you think there is a concern about his weight and milk intake, and that he needs more calories, then the easiest thing would be to bf him more often - mixed feeding would not give him more calories than simply bf more often.

Can you think of ways to do this? You could give him more 'sides' each time; you could fit in more opportunities to feed; you could keep him close to you so he might 'ask' to feed more often; you could try breast compression (google it). All these things will ensure your baby gets more breastmilk, if this is what he needs.

What do you think?

I'm assuming he is basically healthy and happy, and has been checked for anything preventing effective feeding like tongue tie.

Hope this helps :)

Thanks Tiktok. Things aren't progressing well. He was weighed today and only put on 5oz in 2 weeks.

Im demand feeding, skin to skin, offering both sides, giving 4oz expressed milk (for the past 5 days) etc but it seems to no avail. Hes now on 0.4 centile & Im feeling distraught to think he isnt thriving and feel very inadequate. HV coming to my house tomorrow to go through options.

I struggle to express more than 4oz per day (I can only get 2oz per time) in between feeds so more top ups will be tricky. The HV wonders if he could have an intolerance & says shell go through this with me tomorrow/refer to a pediatrician if necessary (due to the frequency/consistency of dirty nappies). Ive also raised the question of tongue tie & will also ask my gp.

Im worried that its now becoming a health issue & don't want to be stubborn but feel passionately about bf. Should I just be agreeing to formula top ups at this stage? Have an appointment with a la leche on Friday but not sure if I can wait as feeling desperately sad and unsure of what to do.

What does the HV feel he may have an intolerance to? What are the frequency and consistency of nappies she's worried about?

It's ok to be passionate about BFing, and confused about whether you're doing the right thing in sticking with exclusive BFing. If an intervention is required, then that's ok, maybe think of it as a medicine and then once the underlying problem is resolved you can move back to exclusive BFing. This may not be necessary and of course we all know that sometimes formula top ups can be suggested without working out what (if anything) is going on. The judgement is working out whether, if you get advice to top up, it is because they can't think of anything else/it's their normal port of call, or whether it really is indicated. Your LLL leader may help with this - and MN might be able to (possibly).

Do you have any indications of tongue tie? Here's a useful list of symptoms: www.ann-dobson.co.uk/tongue-tie_symptoms.html although many of these can also be an indication of nothing wrong at all.... it's more a combination of a lot of them.

Thanks Organiccarrotcake - Nappies are very thin, watery & explosive normally 8-10 a day. Majority yellow in colour but normally one green per day. He gets very bad nappy rash even with very frequent changes. She wondered if hes intolerant to something in my diet & said shell go through this with me tomorrow...

I'll be accepting if i feel its really justified & not just a quick fix without looking at potential problems such as tt or my diet. Re tt, a lot of the symptoms on the list you link pretty much describe him so i'll push to get it looked at.

In terms of top ups, how easy is it to revert back to ebf once weight gain is back on track? I'm worried about reducing supply.

There's no clear answer on how hard it is to go back to EBF as it depends on when the top ups are introduced, and how much is given. But let's cross that bridge when you come to it :)

How about we see what the HV says tomorrow and go from there :) You are looking at top ups from a sensible perspective - ie accepting them if indicated but not as a sticking plaster to treat symptoms from causes that should be treated in other ways.

I think it's important to get your baby checked out, too, pixie - the nappies sound unusual and the continued slow growth with an already small baby means a thorough 'look' is worth it. Yes, supplementing with formula may well be justified if he is finding it hard to really get your milk supply going, for whatever reason....hope things work out.