Baby not gaining weight- worried

[LauraSmurf]

I have a 14 day old beautiful baby girl. She has already given us plenty to worry about as we spent the first week of here life I the NICU and special care baby unit due to breathing and swallowing gunk during labour ( not meconium)

She came home at 7 days old and has been EBF from day 5 (nil by mouth til then). We are having to use nipple shields as my nipples are quite short and she had lots of dummy usage during hosp procedures so she got used to rubbery feel and seems to prefer it.

However was weighed today and she has lost 10g since leaving hospital a week ago. MW says to pump at same time as feed and then top up with that at end of feed. Anyone else had success with this? It seems like such a faff. Trying to pump while feeding not easy and then the bottle bit at the end. Then mass sterilising before next feed in 3hrs time.

I can't go anywhere and am going to be chained to my breast pump for days it seems like.

Any thoughts or helpful stories. I am worried she will not gain and end up sick again. I can't take seeing her like that again. Please help.

Are you feeding to a routine? You mentioned feeding 'in 3 hours time' made me wonder about this. The easiest way to get a baby to put on more weight is to get more milk in to them- so ...
-frequent (more like 2 hourly) feeds
-offering both breasts and lots of feeding at night too.

Nipple shields can impact on supply, although some women use them successfully for the duration of their bfing. I wonder if you could wean her off them? Maybe others would have some tips about how to achieve this.

Obviously your mw has suggested that you express and top up. As you say this is time consuming and your baby will in fact be better at removing milk than the pump. But, your call of course.

btw- re. the weigh in- was your baby weighed in the same way as in the hospital? ie. naked, on digital scales?

oh and congrats of course!! Sounds like you've all had a tough start.

I'm not massively experienced but wanted to post as I was in a similar position to you as my baby lost a lot of weight after he was born and we almost ended up back in hospital.

All I can say is feed, feed, feed. If your baby falls asleep whilst feeding open their babygrow and let them get a bit of air to wake them up, or tickle their feet slightly.

My baby is now huge (99th centile for weight) so don't stress you will get there, just keep feeding :)

Thank you for responding.

I have been worried about the nipple shields getting in the way but when I take them away she doesn't latch. so I am still using them.

I have been feeding more regularly since lunchtime yesterday and adding the expressed milk for the other breast as a top up. She is just so sleepy when she feeds and skin to skin sometimes helps but she can sleep through anything!!

She slept like a dream last night after 2 nights of really broken sleep. It seems that she was hungry. I feel like a bad mother, not providing enough food for my baby and not noticing.

She is much more awake today, hopefully that is a good sign that she is getting enough food now.

Any more thoughts?

Keep her with you all the time while you establish BF. DD doesn't ask for feeds until starving if someone else is holding her. If I hold her she'll do her tiny tongue sticking out thing and I'll stick her on (she's 13 days).

You say she slept like a dream?....

Laura what a difficult start.
Hope you are still seeing the midwife daily or thereabouts.

Your baby needs to feed a lot day and night, from both breasts, as often as possible. Shields have their uses but they can make milk transfer slow and less effective, so even more close attention has to be paid to see the baby is doing ok.

Your pumping and topping up routine with the ebm is only a temp measure while things get sorted - you don't normally need to sterilise the pump between each feed so do check with the midwife on that. 3 hourly is usually nor often enough at this stage - though you could probably just do the pumping at that frequency, as long as she is feeding direct more often than that as well.

Hope you have a better day.

A further way of checking she is transferring milk is to check nappies - she needs to have several wet nappies and at least 2-3 good size poos each day. If you see those, it's reassuring.

I'm no expert but maybe google breast compression on kellymom? I think it's great, just as baby dozing off you squeeze your breasts AS they do a little suck, the extra milk gets them going again. And it's the hind milk too.

Been feeding + expressing every 2 / 3 hours all day and then giving expressed as a top up. She has been feeding well and for slightly longer than usual. I am getting about 35ml from each breast when I express which I know isn't great but it is only having 2 hrs to recharge each time. MW coming in morning to weigh. Fingers crossed she has put on weight.

Good luck for the weigh in tomorrow Laura

...and don't worry about breasts having to 'recharge' (they're not batteries y'know ).

plus 35mls is a lot of milk for 14 days so a very good sign.

It's not a bad sign to not be able to express any milk though (some women just can't pump for love nor money!) just that if you are removing lots of milk you are obviously making it!

The more milk that gets removed the more you make and speeds up production too.

Hope you get good RL support from the MW tomorrow. Perhaps you could ask for help in weaning off nipple shields?

Well it's not good news. She has just been weighed and lost 20g in 2 days. We have 2 more days to get her to gain weight or she will end up back in hospital. We are feeding every 2 hours and topping up with formula as well as expressed milk now.

MW called paediatrician who said she needs topping up with 40mls after a feed. We feed at 10 and she took 50 mls or formula and 10 of expressed milk after a 30 min feed. It seems like she is feeding ok. Health visitor says she is latching ok and definitely feeding in some way as you can hear swallowing and see jaw movement. But is it possible she isn't getting much?

I am so scared that she will be taken back into hospital. They took my baby away 5 hours after birth and didn't give her back for a week. Now they might do it again. Why am I not a good enough mum to do it properly, why do they want to take my baby away?

Oh Laura . Please don't say that- of course you're a good Mum. What happened to your baby from birth was not in your control and now you are doing everything you can to change things around.

When she was taken away in hospital, were you pumping regularly to maintain your supply?

You can offer one breast, then follow with the other, then keep switching when she seems to lose interest or slow down. This is called switch nursing and is a good way to up your supply and get maximum volume of milk in DD.

Have you given one of the bfing helplines a ring? They may be able to offer you some more support too.

I really hope you can sort things out.

Laura, you've been offered really good advice here from the bfing experts . I would just add my tip: if baby is quite sleepy and not actively feeding try stripping her to her nappy, and stand in front of an open window. This was an excellent way to get my DN who was super sleepy to feed more. I also second crickeybadgers suggestion of switch nursing. Get comfortable in the sofa or in bed and feed feed feed. Best of luck!

Laura, so sorry you are facing this - nothing to do with your qualities as a mother, anyone can 'hear' in your posts you care and you want only the best for your dd.

It sounds from what you say that the situation is serious enough to need dealing with in the way the paed suggests - a baby losing weight is not in the best way to make sure breastfeeding is effective and she needs the extra calories at the moment to build up her energy.

It may be that those early days of separation have meant you got off to a difficult start and unless you were expressing (hand or pump) round the clock during that time, your 'production line' has not been well 'primed' - nipple shields, too, make bf less effective, so you have a lot to contend with.

Priority is to get your baby's weight up so she is good and strong; you absolutely need to pump at least 8 times in 24 hours inc at night and on both breasts and this is very, very time consuming, on top of caring for and feeding your baby, so no one should pretend it's all easy 'cos it isn't :(

But it's not something you will need to do forever.

Hope you have a good day.

Laura, I just wanted to second all the advice to feed and express as often as you possibly can. My DD initially couldn't feed and the hospital put us on a schedule of feeding and topping up with EBM every 3 hours. In hindsight this wasn't enough and my supply suffered, I don't want anyone else to make the same mistake! It sounds like you're doing brilliantly, all that expressing and worrying is really tough and this is absolutely not your fault.

Just realised my last post was a bit gloomy - it does gradually get easier and you won't have to express forever. Keep going, and make sure you find time to enjoy some cuddles with your DD, you're doing a fantastic job.

Have been feeding every 2 hours since yesterday morning and expressing at the same time. My breasts are feeling fuller and leaking coming up to feed time. But she is still not feeding for long or very well I don't think. We have stripped her, change her, cooled her down erc before feeds and she drops off or gives up after 20 minutes. I offer a top up in a bottle and she has been taking at least 30mls each time. Despite being repeatedly offering breast again before the bottle.

I think she just prefers he bottle and isn't an efficient breast feeder. I have managed 4 of the feeds with no nipple shield and still the same result.

I am beginning to think that I will never be able to breat feed if it takes the pump to make my breasts full and she isnt feeding properly. But I think I'm ok with bottle feeding formula if it makes her well. I'm just so scared she won't gain weight.

Laura I had exactly the same thing with my daughter (except she was not in SCBU at birth). She was sleepy, lost 10% weight bfing, MW threatening to readmit her. The only way in the early days I could get her to put on weight was to give her formula and she ended up fully ff.

Retrospectively the mistake I made was to listen too carefully to the purists who claim that for successful bf ebf from the start is the only way. You need to get her strength up before she can suck hard enough. I have since met several people who topped up but managed to ebf in the end.

Of course its up to you in the end but dont rush into abandoning bf completely if that is what you want.

Sounds like you're doing everything you can Laura.

Try not to be despondent- as tiktok said, it won't be like this forever. As she gets stronger, she will get more efficient at feeding and things will get easier.

Great news that you've managed some nipple shield free feeds.

Keep going, you're doing great.

My dd was also losing weight and at 3 weeks old we were told by paed that she had to have formula topups after each feed. I was really upset as I thought that would be the end of breastfeeding for us, but it wasn't! Today she is over 9 weeks old and exclusively breastfed for a few weeks now.

Like many posters have said, the key is that baby puts on weight and your supply is maintained. Sol expressing is taking care of both. Offer the breast at every opportunity but try to not get stressed if its not always going to plan. My dd was not latching properly and often screaming at the breast so I compressed my breast to give her extra milk and keep her interested.

Gradually she was getting less formula or ebm, one day she refused completely and I stopped offering it. It really can happen, make sure you feed her often enough, even if you wake her up every 3 hours also at night, which is the hardest as you need your sleep too.

Concentrate in the here and now and don't worry about tomorrow and next week... Good luck!

Thank you all do much for your supportive messages, you helped keep the craziness at bay.

She was weighed today and has put on 220g!!! And is practically back at her birth weight. Midwife has signed here off and health visitor will weigh again on Tuesday.

As suggested on here we are going to keep BF and formula topping-up and then see what happens. If she starts taking more breast and less bottle then we will work towards EBF. If she keeps taking lots of formula and demanding more of it then we will do FF. we are going to give it 2 weeks and see.
Let's just hope she keeps her weight up.
Love
Laurasmurf

Fantastic news Laurasmurf

Is that 220g in 2 days? Wow!

So pleased that you've turned the corner.

Yup 220g in 2 days. We stuffed her like a Christmas turkey MW said! She has continued to want feeding every 2 hours throughout the day. Trying to tank her up a little now to get at least one 3 hr stint tonight!!! But just so relieved!