Trying to persevere with BF with premmie not gaining weight quickly

[Saritabean]

Looking for some reassurance/advice...!

My DD was born at 29+4 due to Pre-eclampsia. We have been really lucky in many ways as she has not had significant health problems apart from her bowel being v slow to get going due to her immaturity and as a result poor weight gain. She is EBF only taking a small amount of EBM in a bottle with her vits/iron etc (gulps it with no probs!) once a day.

She is 16 weeks actual, 5.5 weeks corrected and is well below the 0.4th centile. She was 2lb 5oz at birth (betw 2nd / 9th) and weighs 5lb today (yey!), but it is v slow going and she's not following even her curve (1-1.5oz per week).

We had tried giving her some nutriprem 2 wks ago, but she refused it or threw it back!!! Gave that up after 4 days. Milk supply was great, she was BF really really well, but last few days seems to have lost the plot... Not going for long, pulling off, windy/retching. I posted this in prem section last wk, and wrote 'BF well' but since then things seem to have deteriorated :(

In the last 2 -3 weeks she is pooing a lot less- once (or 4 in a row!) every 2-3 days and it is browny/yellow and quite liquid (it was yellow mushy milk poo on the unit once she was on full NG feeds before she could BF). when she hasn't pooed for a while she is v windy/unsettled and possets lots and has the occasional large vomit if been crying lots.... Large wet nappies still...

We saw consultant y'day who has suggested trying reflux meds, so we'll give that a go, and I'm going to go to BF clinic tomorrow. Suddenly feel though that persevering BF may not be the right thing, especially as it suddenly seems to have become a battle with her :( I can't quite understand why it suddenly seems to have gone wrong when was doing so well... Can it really just be down to me being more worried about her weight?!

Sorry for the long winded post. Any advice/reassurance most welcome!!

Sarita - well done on everything you have achieved. I would second what JJJ said about hindmilk/foremilk. DT2 was small at birth and fed for short times, very frequently. I was worried about what he was getting but he grew fine and I concluded that was his feeding pattern (at 14months he is still a grazer rather than 3 meals a day). However I was expressing and with hindsight may have had some oversupply issues. As you have said, things should settle down when your body adjusts to her demand. I also worried about 'emptying' breasts and there being none left - then I found out it just keeps coming if they keep feeding!

Hope things work out for you - you have done amazingly well.

My premature DD spent nine weeks going along the growth chart in a horizontal line at the bottom some time after discharge. We mix fed with BF and Nutriprem and expressed milk for a few weeks, but at the same time I tried to strictly feed her every two hours, so, one or both of those things worked, she started putting on weight, and then after a bit, we phased out and dropped the Nutriprem.
Actually, DD started totally refusing bottles, so there wasn't much of a choice for us!

Just to give a positive story about a baby who stopped growing for a bit and then started again, I've been in a similar place to you, it's very stressful I know!

Great to hear kKcC - weigh in again tomorrow but BF really well over w/e and refusing bottles full stop now... We will keep offering at every feed anyway. Unfortunately after first feeding session, most of the time she won't go back on again, whichever side I offer! Sometimes it seems like she's still hungry but too windy/retching/ burpy etc, and v rarely is she 'milk drunk' and seeming completely content anymore.... Just occasionally. I'm hoping she'll just grow out of this and, like you say, just suddenly take off.

I'll keep you posted tomorrow after the weigh in!

how did the weigh in go sarita? fingers crossed for you at periwinkle :o

Hi minipopsmum,

Yey- a little weight gain... 75g in 6 days (2.5oz) so now up to 5lb 3oz... Still v slow but I'm happy cos it's still gain :)

Still refusing bottles so trying to make the most of feeding, feeding feeding!

Hope all ok with minipop x

That's such good news Sarita, well done with all that feeding .

Thank you too JJJ all your support when I was starting to despair and considering giving up BF :)

Fingers crossed things continue to pick up and periwinkle here makes a miraculous leap on the centile chart !!!

sarita - you and baby are doing so well. Don't forget though that all children/babies/adults are different sizes and there will always be someone at the bottom of the chart (and still be healthy).

I have female friends/relations who range in height from 4' 10" to 6' 2" - they are all healthy even though they vastly different heights.

Babies can be the same with weight - you may just have a slight baby who is genetically destined to be a slight adult and there is nothing wrong with that. Though it can be worrying (a lot worrying) when they aren't over the 50th%ile some times you have to take the long view that they will be the size they will be and take the food they need to be that size.

It's funny that size 6 is the 'ideal' adult female dress size but the 75th%ile seems to be the ideal baby size

Thanks truthsweet, I know you're right and I'm relaxing more about it again (was really chilled for first 4 weeks home from the unit), it was just because she was so far below the 0.4th centile and although putting on a little weight, was not even nearly keeping to her curve.

But to me she seems very well, developing normally so far and I'm sticking trying to keep confident in my own belief that she's fine!! (following the example of these very much appreciated MN posts!)

That is so true Truth . I'm 5 foot and my bestmate is 5'10" and we are both normal, well as far as height and weight goes anyway .

Glad you feel more relaxed. :)
You really are doing well!

Yey! DD periwinkle has finally started gaining some weight: 80g (just short of 3oz) in 3 days, and managed to avoid the threatened admission to hospital at the eleventh hour. Woo hoo :o
Now weighs 5lb8.5oz - a little pudding!!!

Still BF although my DH has managed to dupe her with 30 mls of formula twice in 2 days...!!

Feel like we're maybe starting to turn the corner :)

Little update...!: DD periwinkle is now 6lb 3oz- gained 5oz this week- woo hoo! Following her curve finally (albeit the very low 0.0000001th centile!!!) and re-admission to hospital been avoided! Still refusing bottles mainly, but seems to be BF well, although still retchy/fussy quite a lot of the time.

All in all, I'm finally feeling a bit more positive and able to trust my instincts and confidence in BFing :o

Thank you for your support and words of reassurance - definitely all helped to keep me sane when I was being tested!!

Yay! well done periwinkle (and mum!) :)

Minipop is 6lb4oz this week