Not gaining weight without supplement? 2 weeks old baby

[Thaleia]

Hello,

tiktok & other mums - I wonder if you have some advise for me!

At the 2nd weight check out DS did not gain / nor lose any weight. The MW at the baby clinic told me to express and to formula feed him to get him up to speed. They gave us 2.5 days (Sunday pm to Tuesday pm), during this time, I managed to express 3 times only (I just could not make the time for it as with feeding, settling him, me eating, sleeping or going to the bathroom it was already to close to the next feed) and gave him I think 4 x formula. I only did this on Sunday and Monday as by Tuesday I felt I'm not doing the baby any good as he stopped pooing.

We have quite a big baby, birth weight was 3990gr, down to 3760gr on day 4 and now at 3840gr. Obviously there is the concern now that I don't have enough or good enough milk. He is otherwise a healthy, very strong (can hold his head already) and alert little baby. Before I left too long breaks in-between the feeds as he would sleep for 5-6hrs, which is nice in the night/ morning. The next weight check is on Sunday and ideally he should be back at 4000gr.

DS is feeding and sleeping will during the day but nights are difficult and I'm not sure anymore if I can meet his needs. He is feeding/ sucking for 5-6hrs at night and cries his heart out if I take him off. When he falls asleep during feeding it only lasts for about 1min before he's back on again. I am aware of cluster feeding but this length seems to be excessive, especially as he's not getting a good sleep either.

Are these signs that he's not getting enough and it would be better to top him up before Sunday? I don't want him to starve or loose weight ...

Thanks!

What you are describing sounds normal and I don't think you need to supplement. Larger babies sometimes take longer to get back to birth weight, my ds3 was 9lb 6oz and took 3 weeks, my MW was starting to get concerned by that point but was happy with his output (nappies) and we just left him to it. He settled on to the 50th pc and stayed there. He's 7m now and ebf apart from some solids started in the last couple of weeks.

How old is your baby? This is what happened with our baby in terms of how she fed ... She wasn't weighed until the third week - and shed regained her birth weight at that point. She was on 49rg centime at birth and at for month is on 80tg - and ebf.

Your health visitor sounds pushy ... I would leave it a little longer aa you are to see if the baby gains weight.

He is now 16 days old and 60cm long, so a bit much over average. My main concern is that he's not getting good and enough milk from me. I had him on the breast for 5.5hrs tonight before I dumped him on DH who than co-slept with him till I just woke him for his early b'fast feed. Am I not having enough because it takes all night and not even than he's falling asleep on the boob?

Is he having plenty of wet diapers? If so the milk is getting in

It's common for newborns to have night and day mixed up and want to feed for most of the night. This calmed down for us around 6 weeks. Prior to that the best thing to do is prioritize your sleep over everything but the baby, so you catch up as much as you can when baby is napping or sleeping.

I was worried about supply so took fenugreek, it seemed to help after around 5 days although I cant be sure it wasn't coincidence.

yes, lots and lots. For that reason I wish the HV would back off.

I guess because he wasn't putting on weight and only might have done so after top ups, I doubt myself over the supply plus that so often he's not settling for hours, always with his little hands in his mouth and ready to suck.

not settling for hours is normal at this very early stage - he is ordering up the milk, and his constant sucking is stimulating your body to make more milk.

Keep offering the breast - I know its exhausting but it is necessary to make sure your supply is established. If you can co-sleep and feed lying down, all the better (I must admit, I couldn't feed lying down to start with, so I sympathise if you find it difficult)

you could have his latch checked by a lactation consultant (LaLecheLeague or similar) in case a different position would help him suck more productively, but he is really so very tiny, it is just what they do at this age.

good luck!

two of my babies have only wanted to sleep latched on in the early days. I have no idea re weights, but can reassure you that constant sucking overnight can be normal. can you co sleep by lying on your side so your ds can suck whilst asleep, and you can sleep too? I think the sucking when they are this small is about comfort in a new and overwhelming world. plus I understand that night feeding is the best in terms of increasing your supply if that is needed.

I've tried feeding lying down & just get DD fussing at the breast & not latching on properly - just can't get the angle right.

I agree that trying to fit in pumping can be so hard when you are feeding all the time & in the brief gaps running to the loo/grabbing lunch/changing baby. I don't have the will power to go downstairs and pump at 6.30 in the morning frankly when I could be cuddled up in bed with DD & having a quick nap (as she does sometimes go back to sleep after the 5.30am feed).

oh well ... we are now supplementing every feed with between 100 - 120ml of formula. He is still sucking at the breast, so I guess he'll get what, 40 to 80ml out of it? Not sure how much a almost 3 weeks old baby takes.

It's feeding hell: got up at 3am, woke him up, changed nappies to keep him awake and because there were overfull, started breastfeeding for 45mins, had a break of 15 mins, pumped for 30mins, cleaned bottles, had some toast and it's not 5.20am. In the meantime, DH gave him a bottle and settled him, otherwise it would be 6am now.

When you give the bottle, do you give it in one go or do you stop to let your baby burp? It takes forever to with breaks but at least it's not coming all out again 10mins after feeding. And it takes at least 40mins to settle him. Before the supplements, he fell asleep on my boob (for exhaustion) and I have no idea how to settle him apart from shoving more food into him, out of a bottle.

I'm scared when DH has to go back to work on Monday and I'm on my own and alone again.

This sounds like the worst of both worlds :( is this the right way to go? By supplementing this highly early on you're not giving your body the chance to catch up to your baby's needs.

I hope you're ok, it sounds very hard for you right now.

Have you managed to speak to an actual BFC love? I think you might need some specialist help. Your LO lost very little weight post birth, which is brilliant in itself, and so long as there are plenty of wet/dirty nappies, they are generally fine.

Please call one of the helplines babe and get some proper advice. The sooner you can get off the formula, the faster your supply will recover. IMVHO there's far too much emphasis on weight and not. Enough on the wellbeing of the baby and mother.

Thaleia, I agree that you need to speak to someone qualified and knowledgable. This is not a situation where a talkboard can really help - and though it's a good place for support and encouragement, no one here should be telling you what to do and what not to do, but we can suggest questions to raise with your HCPs.

• it sounds as though you had poor care early on - it doesn't sound as if anyone observed you feed or really discussed ways with you to ensure your baby fed often and effectively your milk quality will be fine - this does not vary between women - but it sounds like he is not getting enough of it. If you had early periods with great long gaps, then your body was not getting the right message to make more - that can be fixed with very* frequent feeding on both breasts, using each breast at least once per session
• if your baby needs formula temporarily, then you need to discuss quantity with an HCP who knows about protecting breastfeeding. The amount you re giving at each feed now is very large - huge, actually. There is just no room for him to have much breastmilk on top of that :(
• the person who helps you needs to observe a feed, listen to what you are saying about feeding frequency, support you in feeding more often and more effectively, and help you work out reducing the supplements to give bf a chance

You are in such a pickle, and wondering all the time what to do, your confidence has plummeted :( Your breastfeeding helper should help you fix that, so you have a plan which you follow.

You can call any of the breastfeeding helplines or there may be a specialist breastfeeding midwife/HCP you can see too, or bf clinic. Don't leave it too long - if you can't see someone today, then see someone tomorrow or Tuesday.

Hope this helps.

Thanks for your help and kind words.

tiktok makes totally sense. I'm trying to go to the bfeeding clinic nearest to me on Wednesday, the other ones on Monday and Tuesday are too far away and I'm too scared to venture to far in case my baby goes off like a siren.

I went for the weight check today and he gained the 200gr needed and is not a bit over birth weight at 4060gr (birth weight was 3990gr) and they released me saying he's a big boy now and I won't have problems with feeding any more as he's now better in sucking. I didn't know that this little weight gain makes all the difference ... ridiculous.

I asked them about the supplementing and she said on top of breastfeeding, I should offer 80-90ml as he's a big boy. At the weekend, I managed to pump on a regular basis as DH is at home and got out a bit more, from 20ml to 40ml. I hope I don't jinx it by writing it down here, so managed to keep the formula down at 60ml.

Do you think I should breastfeed longer? I'm doing it for about 1hrs ... would 90mins make all the difference or just exhaust him again? I don't mind because with all the bottle feeding and stuff, it just takes the same time and it would be less washing up.

She also said that some babies don't settle after a feed and that's normal, too. Some babies are just more alert and awake than others and we have scored one of those. Which is lovely during the day but exhausting at night.

It's great the weight issue is less of a worry; it can be true that a baby gains the energy to suckle better when he is closer to the weight he should be, but it still does not sound to me that the HCPs you are talking to know sufficient about how to protect your breastfeeding. An 80-90 ml supplement at each feed is still loads and very few women would be able to produce this by expressing, unless they expressed more often than they were actually feeding....and who really can sustain this sort of intensity? The shortfall has to made up by formula, and 60 mls is a lot.

The length of time you breastfeed for each session is not as important as the frequency. Feeds lasting an hour are normal for a baby of 2 weeks - by the time you have switched sides, maybe more than once, the baby has had a doze or two, you have stopped and started a bit, changed the nappy, an hour can go by easily. There is no point in deliberately prolonging these sessions but if your baby shows he is happy to take more, think of it as another feed. If your baby is unsettled after a feed , he prob just needs to be put n the breast again :)

Frequency is most certainly our downfall but I don't know how to fix it.

DS woke up at 5.30pm, breastfeed for 1hrs, little break where he slept for a few minutes, woke up, got 50ml expressed milk, little break to see if he's satisfied, got 60ml of formula, would not settle, got another 60ml of formula and it took another 30mins for him to fall asleep. He now slept for 30mins and is awake screaming, either because of nappies which DH is changing at the min or because he's got a stomach cramp because he ate so much.

Is it possible to overfeed such a small baby already or would all come out before this happens? We just don't know how to settle him and he seems always hungry.

Thaleia, it is not possible to overfeed a breastfed baby, because they regulate their intake more efficiently than a formula fed baby. The concern about bottle feeding is that babies do take more than they need, and this might be a worry in your case, because your baby is having a lot of formula (something you do need to discuss with your HCPs - this amount of formula is undermining your choice to breastfeed). Babies who have taken in more than they need at any one time usually bring the excess back, even so.

In this situation - the one you are describing now about last night - the hour feeding is normal, and the need for more feeding afterwards is normal - you can discuss with your HCPs the need for 120 mls of formula, after the expressed milk....it might be fine for you to have put him to the breast again, on each of those three occasions, and again when he started to cry at the nappy change, perhaps using expressed and minimal formula if needed. But check things out, with someone you trust and who can observe you.

Formula is best kept to a minimum, consistent with the need for your baby to grow, while you work on improving breastfeeding.

At the moment, it sounds so stressful. You are breastfeeding, topping up with expressed, then topping up (a lot) with formula, then worrying about whether he will settle and then worrying if he doesn't settle for long enough, and then worrying whether he should be fed again when he wakes and then trying to find time to express.....exhausting :( :( and not sustainable. I hope you get some good real life help!!

Yesterday day time was a good day, I had the neighbours round who held DS twice whilst I expressed. Unfortunately, the evening did not go so well. I struggle to keep up with the feeding, pumping and calming. I try to stick with a feed every 3hrs, so started at 3am, 6am, 9am, 12.30, 3.30pm,7.30pm, 10.30pm, midnight ... I than lost it as the midnight session took me too long, I had to clean some bottles and was just so slow so only finished at 2.45am. DS already slept from 2am or so and I could not get up at 3.30am again, so got up at 5am, had an awful, very painful breast feed and could not express a single drop of milk. Again, could not get up at 7am, felt too shattered, so decided to feed him at 8am. He's still not asleep and I dropped him at the neighbours whilst I express milk - at least hopefully.

During the day, I am able to express 40-60ml, but closer to 45ml, after the 3.30pm feed (= 4.30pm), I only got 20ml, than again a bit more with the evening feed and as I said 0 (maybe 10ml) after 5am (=6am). He needs a top up between 40-60ml every time. He might take more than 60ml but I feel he's got enough as he's not throwing it all up and not choking (much) on the bottle.

Also, I have to wake him every time for a feed - Is that a good/ bad sign? Not sure if he gets enough sleep although more than I do. It's exhausting but I could not sleep at 3am but was freezing in bed, despite having eating a bit and a heating blanket. Same this morning, I was already awake at 7.15 but did not get up for 30mins because I needed some "me" time.

I can't ask my husband for help with the 3am feed, he's under so much pressure at work. I gave DSl to him at 6am this morning which was ok as he only lost 1hrs.

Am I trying to hard now? From one extreme to the other? But how do other people feed their DC every 3hrs if not that way? If I could at least lose the bottles during day time but this morning, with me not able to express something with the last feed, he took 50ml.

I said to DH I'll give it till DS is 4 weeks old next Tuesday and if it's not better, something has to give, either I stop bfeading all together or maybe just express and top-up and save the 40-50min? So, so sad as I really enjoy(ed) doing it :-(.

Kind of working on the real life help, just v difficult if one is housebound :((. I only have 1hrs max in between feeds, apart from nights, when I'm slower and it's even less.

Thaleia, wow, that is hard work and exhausting :(

I don't know what to say - only to repeat you need real life help from someone who really understands how to observe a feed and how to unravel a difficult situation.

The hard work is inevitable when you are breastfeeding, and expressing, and giving ebm, and preparing and giving formula....it's like feeding 3 babies instead of one :( It's not sustainable.

3-hourly breastfeeding is not normally sufficient, especially when you are trying to do catch-up with a supply that never got a good chance to get going.

But to say 'you need to feed more often' sounds crazy when you are doing all the rest of the expressing/feeding ebm/formula prep/formula feeding...which is massively time consuming.

You say 'how do people feed their babies 3 hrly?' and the fact is they probably feed more often than that but they don't have all the other stuff going on as well - they might feed 10-12 or more times in 24 hrs but the feeding is not a palaver with bottles and expressing and washing.

You're going to the bf clinic on Wednesday - I hope there will be someone there who knows how to help you, because continuing the way you are doing is not good :(

hm - do you think it's really worth doing? The MWs I spoke to on the phone said that once he's stronger he's able to suck more effectively from the breast and that when the formula feeds get less. And apparently it is possible to go back to bf exclusively after top ups ... or am I too far gone to achieve that?

It's all speculative anyway, who knows how much catching up he has to do and how little I actually produce.

I still enjoy my baby, if I stop doing that, I'll stop that very second as it's not worth it. It's just a shame that I can't go out now and have fun - even if it's just a trip to the supermarket or a stroll in the park.

I don't think someone speaking to you on the phone is enough. As a breastfeeding counsellor I would want to see you feed and talk with you at length about what was happening and help you work out a plan of reducing the formula and the expressing. It won't happen by itself - your baby is already bigger and stronger and you are still topping up a lot. Yes, exclusive bf is certainly possible even after a lot of topping up, but it needs to be planned for and applied :)

Up to you! If you want it to change, you will need real life informed help and support - that's what I think :)

In my experience it is definitely possible if that's what you want. I weaned the topups by reducing them at each feed, DS bad to spend more time at the boob and he was fussy but after about a week we were down to just boob plus topups of ebm only. We then weaned that too.

It would help for you to have the support of a bf educated hcp to do this though.

Hi Ladies,

wanted to share my "happy end" with you!

After being utterly exhausted by the bfeeding, expressing, topping up and crying (crying before a feed, during a feed and with the baby after a feed), I run dry. There was no milk coming out of my breasts at all any more not did they feel full and I thought, I had lost it completely at 5am. I formula feed him all day and by the next morning my breasts were mahusive and I thought: sod it, I'll try breastfeeding again and forget all the rest, as looking at my baby, he seemed fine and happy with daddy. No happy times for and with me! Anyway, this was on Tuesday ... and I just continued. When he cried I fed him and I woke him every 3hrs to do so. Then the weight check came: not only did he put on weight, he's now on the 75% line and the MW said, I had enough milk to sustain him and I should not worry. I wasn't sure if I should cry or lose it there and then for all what has happened.

I'm not saying that there weren't right but if they had told me to take it easy and top him up to get him going instead of putting the fear of god in me for starving + exhausting my baby, the whole thing might have been different and I wouldn't have lost a week worrying about it all.

So, there I am, back at breastfeeding and what I've learnt meanwhile about my DS is that he's not a 3hrs guy but only wants food every 4hrs, which is awesome, especially at night of course. The only thing we need to work on is the settling but that's a whole different story.

So, all in all a dreadful experience but all in the past now and we're a happy little family with a big appetite now :).

Thanks so much for your help to get through it and for the reassurance it's possible to go back to only breastfeeding. Without it, I would not have the confidence to have done it!

Hey, good to hear you're back bf.
My dd2 only fed on demand, and we did try the every two/three hour thing, and she was just a sleepy head, and still is at 11mo (two naps a day, and sleeps through :) )
I only fed her when she woke from her sleep, rather than wake her, and she gained masses, and is still on the 75th+ centile line. Little chunk!
With dd1 she never gained wait til the two week mark. She seemed happy enough though.

That's good news :)

It's possible, but not likely, your ds will continue feeding 4 hrly - most babies feed more often and less regularly than this, so it's likely to change :)

When he has difficulty settling, how about bf him again? That usually works!