Very slow weight gain for 3 weeks on bf baby, should I introduce a mid day bottle??

[Rosie87]

Hi I exclusively bf my 10 week old with the exception of one formula bottle last thing at night. For the past three week she has put on very little weight, only 1.5 oz this week. I had issue with my first baby solely bf so am conscious that history may be repeating itself. I am considering giving her a formula feed at midday to try and up her weight gain slightly and help with day time naps, which she is terrible at. Any suggestions??

Stop weighing her! There is no need for a baby to be weighed as often as weekly.

As long as she is alert when expected, meeting any expected milestones and is producing wet and dirty nappies as expected, then she's fine!

The HV said to keep having her weighed. She's 10w3d now and only 9.11, her birth weight was 7.7 and she's dropped off her line now. She does have lots of wet nappies, her dirty ones have slowed in the last few weeks. She is very alert but doesn't nap at all really during the day but sleeps well after her formula feed at night!!

How often does she feed, how long for, do you offer 1 or 2 breasts at each feed? Are you getting enough food and rest? Do you feed on demand or try to stick to a routine?

It's a giant leap of faith to breast feed, but it does work. You cannot see what is going into your baby, so the appeal of a bottle of formula is sometimes clear - but if you're already giving her one bottle per 24 hours, introducing more formula might jeopardise your breastfeeding altogether.

If she is producing half a dozen wet nappies a day, is alert, and fairly regular stools, I wouldn't worry. Sometimes babies grow in length, but don't put on weight for a week or two, so don't panic if you have a couple of weeks of a plateau, but do make sure you are offering her feeds frequently enough.

a normal healthy baby really only needs weighing once a month... it should advise that in the red book and this is one of the reasons why!
some weeks your baby may not gain as much as usual, then the next week gain more.
sometimes they gain less if they've been ill, or if they have suddenly grown in length...

formula strives to be as much like breastmilk as possible. it isn't really very much like it, but the calories are going to be roughly the same.
so why swap a breastmilk for formula? it won't make her gain weight, it has the same amount of calories...

as long as you are feeding on cue and she is gaining weight and having plenty of wet/dirty nappies then I honestly think you have nothing to worry about :)

Hi, Legoballoon thanks. I feed her on demand and usually offer her both breasts, she goes anywhere between 15mins to 45mins, it's quite erratic sometimes. I would rather avoid giving her the extra bottle but I'm not going to let it get to the point where it is detrimental to her by not giving another top up. She is a very long, thin baby so perhaps that is what is happening. I think I will give it another week of how we are at the moment the see what happens. That will then be a full 4 weeks to gage her actual weight gain. Hopefully she will improve then I will only get her weighed fortnightly. Thanks so much for your help, I think I may well have given in tomorrow otherwise!!!

Thanks thisisyesterday it is really hard which is why I came to mums net, there's nothing like the advice of other mums and I feel much better now. I thought it would be easier the second time round but I think my experiences with my first have made me over paranoid about it all. 4 weeks sounds a long time to go without weighing, would fortnightly be beneficial do you think, just to keep an eye on things?

if you think it needs keeping an eye on then go with fortnightly, but i'd say monthly would really be fine.

if you're concerned though it might be worth seeking out a local breastfeeding group? that way someone qualified could check how baby is latching on and watch a feed and maybe reassure you that everything is going ok?
I say this not because I think you need things checking out, but because I think it might help put your mind at rest.
Like legoballoon says, it can be a big leap of faith to breastfeed and to trust your body to produce what it needs to and to trust your baby to take what she needs... but it pretty much always works and there is nothing in your posts to suggest that anything is going wrong

Thank you, I did go to one bf group but will go along to next one to make sure I am still doing things right!!

Just to give another point of view I gave my DS a bottle of formula once a day from about 4-5 weeks (can't remember exactly, a long time ago ), he was also very slow at putting on weight and had health problems so seemed to thrive better when he had one formula bottle a day, also made it easier for DH to share feeding etc

Ahh thanks. I did mix feed with my first, he had top ups after every feed and I managed to bf for 9months, so I have no issues with topping up if that's ultimately what I need to do to help her gain weight. I'm going to see how it goes this week and make the decision next week!!

If you want to give a bottle at lunch time, then that is of course, absolutely fine.

I personally found that in the early days weighing helped build my confidence, but that was obviously because DD went up the centiles then followed the line exactly. Had her weight gain have happened differently, then I might have felt very differently about it. Now (and she is much older, 8 1/2 months) I don't get her weighed and haven't done for ages, but I know she is fine by her nappy output, but most of all, just looking at her. It's obviously much easier to be relaxed with an older baby, especially once they are on solids.

I think one thing to keep in mind is that the red books suggest weighing monthly for a reason. If your DD was weighed once this month and hadn't gained much weight, you might find that the next month she had gained loads. One weigh in of not much gain wouldn't worry you I expect, whereas weekly weighing means that in that month you'll have more weigh ins of not much gain and so it will worry you more, naturally. (I hope that makes sense)

Also, HV's just don't have much experience of BF babies, because not many babies are BF for very long, so it's natural they'd feel less comfortable with BF babies, because they really are very different.

Have you considered other options to help with daytime naps, such as a sling? Even if your DD doesn't nap in it, you'll be able to get more done and be more mobile. If it helps at all, my DD didn't nap in the day unless being held for months. Then suddenly she would nap in her cot for 20 mins and now she'll sleep in there for up to 3 1/2 hours. It does get better, I never did anything differently.

If you are concerned there are things you can do now with BF which could help. Don't just offer two sides per feed but offer 3or4 or as many as she will take, you can also try breast compresion (google for videos) to help her take on more breast milk before you go donw the route of adding in another formula feed.

Going along to the drop in group is a good idea, they should be able to go over all this with you.

Weighing weekly was giving me reassurance that she was gaining sufficient weight and she was for the first 6 weeks!!

Have had a nightmare two nights with her and today was awful, she wouldn't sleep at all and was feeding constantly, so reluctantly I gave in and let her have a small amount of formula, she fell asleep within half and hour and slept for two!! I'm not going to do it as routine though, only if she gets really fussy. She's better this evening so will have to see how things go.

I see what you mean midori, thanks for the advice, I am going to cut down on the frequency we get her weighed and see what happens.

I have tried popping her back on the other side migirl but there doesn't seem to be anything more there when I do so she just gets stroppy. She is normally a very happy baby on the whole so I guess I just need to keep trying.

Correct me if I'm wrong but if you are offering her formula then your breast milk supply will dwindle so when you do go to offer her it there might not be any there- but if she were exclusively bf there would be a constant supply? I guess that every breast feed missed, they slow down production? And it will snowball from there on in...?

My DD was a 1.5oz was a slow weight gainer. With DS I actually don't have him weighed, he was weighed at 2 and 6 weeks and that's been it. He is coming up to 5 months. I just found it too stressful and as I don't have any other concerns I am leaving it.

Did you move to ff with DC1 is that why you are worried about it going the same way? I look at pictures of DD and wince but I also know that she healthy, alert (she was just above 0.4th at 9 months but was already walking so can't have been unhealthy) and the pediatricians never had a single concern nor even mentioned her weight. Didn't stop me worrying though.

They do have their unsettled periods and it is hard not to blame the feeding, but that is babies for you. If you can get to a bf support I would as if there are issues they will be good people to help you out, not a HV (who may alert you a problem but probably not a bf friendly solution)

I'm with bramblina on this one. I think one bottle every 24 hours shouldn't lead to problems with your baby preferring bottle teat to nipple, but if you do introduce more frequent bottle feeds, that is a risk, as the rate they can empty a bottle is quicker and the speed more regular than the more erratic performance of a breast.

Another reason why you might not want to introduce more formula at an early age is outlined in this interesting article.

www.thealphaparent.com/2011/07/virgin-gut-note-for-parents.html

Plus, once you start introducing 2 feeds a day, you tamper with the supply-and-demand balance of your own milk production more significantly, which might compromise your longer terms plans to BF. That said, by around the 3 month mark, your own supply should be well established, and I don't want to put the frighteners on you - you ultimately have to decide what you are happy with, and many mums decide to bottle feed exclusively from day one (for various reasons), so don't beat yourself up too much if that's the route you choose.

If I was you, I'd try to give it another few weeks, keep an eye on nappies and behaviour, and make sure I was well rested, well fed, and offering the breast whenever my LO showed any interest - it is very likely all will come good quickly.

And FWIW, difficulty with daytime naps doesn't necessarily mean she is 'hungry'. My BF DS1 was a shocker - he refused to go down for a nap - I spent hours pounding the streets with the pram trying to get him to sleep .

If you want to increase your supply, offering the 'third side' i.e. going back the first breast (sometimes called 'switch feeding' I believe) can be good, and there are also pages on www.kellymom.com which give info on foodstuffs and herbal remedies that are supposed to increase milk supply.

And I was with you, legoballoon! :)

DS just cries in the buggy

OP although it can help you mentally to be well fed etc. it shouldn't come about due to you being stressed about it, as far as your milk goes it doesn't matter.

I did switch feeding although not actively, we just fell into it after her 6 week growth spurt.

Rosie87 - milk works on a supply and demanded baisise the less you feed her the less you will produce. The fussing could be something other then hungar and the sucking is just comfating her.

Breast are never empty, the softer they feel the higher the fat content of the milk. Not much milk is stored in the breast most is actauly made as baby suckles so the best way to increase supply is to feed, feed, feed some more. Switch feeding is a good way to do this. Baby's can sometimes prefer the faster flow from a bottle and even a full baby will take some milk from a bottle due to the way the milk is delivered.

Giving formula to small baby's can have the effect of making them sleeply it's a bit like stuffing yourself with a sunday roast and falling asleep on the sofa in the afternoon. Doesn't mean she need the additional milk or that you wheren't producing enough.

Hi all, an update... We had a further 4 days of being very unsettled and after speaking to my nan who sat with me for a few hours and watched DD feeding she thought she wasn't getting enough milk from me either (she has worked with mums and babies for 30 yrs plus). So after much thought we have introduced a bottle at lunch time but this is on top of me feeding her as well. I out 4 oz in a bottle and if she is still hungry after that I offer her me again. So far we haven't had any problems and she is much happier and has started gaining weight again.

I will continue to BF mostly but having the extra bottle has made all the difference and I am confident that I made the right decision for my DD. Thanks everyone for your advise.