ebf 4 week old not gaining weight

[hawthers]

My ds was weighed by the mw yesterday and has apparently only gained 20g in the last 10 days. At his previous weigh in he had gained 250g in 5 days.

He has been ebf since birth but we were admitted to intensive care on day 8 as he had viral meningitis. He was fed expressed milk via ng tube before going back onto ebf. We were lucky and made it home very quickly.

The large weight gain occurred between 2 days after discharge and 5 days later.

I don't think I've done anything differently si don't know why there is such a difference in the gains. Is it down to the ng feeding in hospital?

Forgot today that my instinct is telling me that it is the mw scaled that are iffy. He's hasn't been weighed on the same set yet. We've thrown money at the problem and have ordered our own scales that are arriving tomorrow.

With ebf you have to take into account not only weight gain (taken at the same time in the same conditions, i.e. nappy on/off, before/after feed etc). Hourly there should be normal bf pattern - proper swallowing motions, regular feeding; daily - appropriate for age number of wet and dirty nappies; weekly then monthly - steady weight gain. Saying that you are in the best position to know how your baby is doing so if you are worried check with HV or GP. We bought scales early on as my son was born underweight so was weighted all the time. You will have to develop good willpower though to stop yourself from overdoing it and getting yourself from tailspin over the figures.

hawthers, sorry you are feeling worried like this :(

Frequent weighing is not helpful - using your own scales will give you useless and misleading information. Of course if babies are weighed, it needs to be done accurately and on precision scales - but once at birthweight, babies should not be weighed too often and current guidance is that anything more often than fortnightly with a healthy baby is neither necessary nor helpful (this is all in your parent-held child record book :) ).

Babies don't gain weight in a regular fashion. Sometimes they gain a whole bunch, and other times they slow right down. This is normal. Your baby has gained 270 g in 15 days - fantastic, especially after that difficult start and the time in hospital. It would be virtually impossible for him to continue gaining at the same rate - he would have had to gain 750 g in 15 days. A few babies might gain that amount , but this would be very rare.

If your baby is healthy, thriving, and feeding effectively, individual weights do not matter a bit...especially if you have no confidence in the scales.

Your midwife should be explaining all this to you - it's mainstream stuff she should be able to convey :(

Thanks tik tok I meant to day he is having lots of wet and dirty nappies and settles well and is alert when awake.

Mw has automatically talked about topping up but I just don't understand why there is a difference. Will not weigh too often but just need some consistency between scales and each measurement.

Shame your midwife seems unable to support you, hawthers. Someone 'automatically' talking about topping up with a baby who appears healthy and thriving is a bit limited...

You say you don't understand why there is a difference (in your baby's recorded weight gain, I think you mean). Here are some reasons:

• the 2 weights are accurate, and just show a perfectly normal physiological difference in growth rate, such as all babies may experience at any time
• the 2 weights are accurate, and show that your baby gained a lot over the 5 days after his illness because his body 'knew' he needed to catch up after this setback...and the following week he slowed down because his body 'knew' there was no further need for this
• the 2 weights are inaccurate, because one scale or both weighed 'too heavy' or 'too light'
• the 2 weights are inaccurate, because either or both of the people who weighed your baby failed to weigh properly (baby not fully naked; scales not on flat hard surface; reading of the scales done badly; translation to/from metric/imperial done wrongly)

As you can see, none of those reasons mean there is anything wrong with you, your baby or your milk supply. But if you do think you want to give your baby more opportunity to grow, then of course you can just bf him more often using at least 2 breasts per feed :) Topping up with formula seems unnecessary from what you say here. Can you discuss this option with the midwife?

Before I get into this I just want to be clear that I have nothing against ff and do not judge anyone who does. I just have baggage galore relating to this issue.

So ds has gained only 100g av per week for the last 4 weeks. This means that he is now under the 2nd centile down from 25 at birth. He is not gaining enough to follow the line let alone catching back up to the 25 centile.

I've git a private bf adviser and I'm doing everything she has told me to but nothing seems to make a difference. We are feeding at left every 2 the in the day and 3 overnight, expressing, breast compression, fenugreek, domperidone, switch feeding. Why the hell is he not gaining weight?

Feel like I'm being stupid by wanting to continue to bf when it clearly isn't working for f. I would have just liked ^one^ thing to work out/have choice in in this whole pg/birth/newborn stage.

He seems fine but the numbers just don't reflect this. Now we are too close to disappearing off the bottom of the charts to continue to stand my ground. Just can't understand why nothing is working. He sleeps well, is pretty settled, has wet and dirty nappies and seems fine. Have lost all my confidence in being a mum as a result if all this. Feel like a failure.

Hawthers has your baby been checked for tongue tie?

hawthers, your baby's weight gain is within normal limits. Healthy babies can gain in exactly the way you describe - it does not have to mean anything worrisome.

Is there concern about his health?

Just to check - he is gaining weight, yes?

Just at one point you ask why he is not....

Tongue tie def ruled out.

He is gaining weight but not at the rate needed to keep up with the charts. He's gone from 25th percentile to the 0.4th percentile and if he continues he'll drop off the bottom.

He had viral meningitis at 8 days old but there is general concern that he is not growing properly.

hawthers, it's just not possible to say if your baby needs to gain weight more quickly than he's doing or not. Most babies who fall down centiles like you describe are actually fine - it's just the way they are. I can see there would be concern for your baby because of his previous illness, and because his weight is slowing at the lighter end of the spectrum, but even so....there's still no reason to assume there is anything wrong with the feeding in terms of your supply or his intake.

If you think he needs more to eat, then he prob needs to feed more often - some babies really do need to feed more often than the 10 times in 24 hours or so your baby is feeding, but check this with the people advising you in real life.

hawthers, I'm in a similar situation due to my baby's severe reflux. It took five weeks of full-on BFing to get him back to his birth weight. Now he is seven weeks and, thanks to meds, is finally putting on weight.

He was on the 75th centile at birth and is now on the 9th. His growth chart, a feeble slope next to all those lovely curves swooshing upwards, is depressing to look at! For the past couple of weeks he has put on weight at a rate of 100g a week, just like your baby.

However... the HV & the other professionals currently involved in his care are happy with this rate of weight gain. 100g per week is ok - it could be more but it's going in the right direction, the baby is clearly healthy and the 100g is a darned sight better than the 20g per week he was managing before! What is your HV saying these days? If your baby is healthy and is putting on at a rate of 100g per week, are they happy for you to continue doing what you are doing?

As for FF: please don't beat yourself up about it. I, like you, was/am fiercely opposed to the idea, but before we turned a corner and he started gaining at an ok rate again, had U-turned reconciled myself to the possibility. Ultimately, I felt that I would roll with the punches and do whatever it took to get him gaining again - be that BF, FF, whatever!