Trying to increase milk intake to improve weight gain... when to swap sides?

[heatherwil]

DD is 12 weeks old and ebf. She was 8lb 5oz at birth (75th centile), dropped to 7lb 8 (50th) and took 4 weeks to regain the loss. She's now 10lb 9 and has been on the 9th centile for the last few weeks. Average weight gain = 3oz per week.

HV is pretty much useless... has only suggested increasing my own food/drink and putting pressure on to add formula top-ups, which I don't want to do. I asked if there was a tongue tie specialist who could check her over but she was v.dismissive of this possibility, saying "if she can stick her tongue out, she's not tongue tied"

I feed as often as I can during the day (every 1.5-2 hours + cluster feeding 7-ish to 9.30ish) as she only wakes for a feed once in the night. I always give both sides. This last week I've been expressing after feeds 2-3 times a day and DH has been giving her a bottle of ebm (only 2-3oz) before bedtime.

The trouble seems to be that she feeds for a long time (30-40 mins per side) and after the first 5-10 mins seems to be sucking without swallowing. Often she falls asleep, still latched on. The midwife at my local (NHS) bf support group says this is fine as she is getting the fatty milk at this time but I'm not convinced. From what I've read on Kellymom/Jack Newman it would be better to switch sides? To me it seems like a waste of time when she could be getting a larger volume of milk by switch nursing.

Any advice would be most welcome...

I should also add... we do seem to have enough wet/dirty nappies and DD is alert, active and is mostly a happy wee thing :-)

I was advised by my HV to feed for 20 minutes one side, then switch to the other side. I would change nappies inbetween to try to wake my DS up as he would tend to just fall asleep as soon as I started feeding him. This was a few years ago now, so I'm not sure if the advice is now to switch sides more often. Good luck with it all.

'Switch feeding' isn't really done by the clock, and it's not really done 'every time the baby pauses' - the first is irrelevant, and the second would be incredibly hard work :)

It means watching for when the baby slows down her sucking and stops transferring milk (not momentarily, as in a pause). Then you switch.

The weight gain history you describe is unusual - and does deserve concern. Your baby may well be fine and getting what she needs, but it's hard to tell, with HCPs who clearly don't understand well about how bf works (I mean your HV and the midwife at the bf support group)....would be good if you could get a view from someone in RL who could help.

Thanks for the replies. Will do switch feeding and look into other sources of advice.