Still not gaining enough weight despite top-ups, 2 hourly feeds, expressing... help?

[aamia]

So - gained 20g in 4 days :(. We're always offering more than he takes, and feeding every two hours. If not gained much by Wed going to have tests done etc - which is good because he needs to be doing better, but I'm still worried. What could it be? What can I try in the meantime? Would hungry milk be better? He only takes about 45ml (sometimes up to 60ml if we're lucky) at a time. Would the hungry milk get more calories into him? I don't even know what they'll test for tbh. Poor baby.

Very stressful! How old is he? From what I understood of hungry baby milk, it has more protein in it which slows digestion and makes them feel full for longer. If he's needs to gain weight faster, you want him to be hungry to take more milk. 60mls is about right for the stomach size of a 10 day old.

They'll want to rule out a medical problem stopping him from using the calories he's getting. It may be that he's just a slow gainer. It took my dd 6wks to regain her birth weight and both she and ds gained about 30gs a week. The HV's fortunately recognised that this was just their pattern and that they were otherwise healthy happy babies. Hopefully they will put your mind at rest soon.

I'm not an expert, but I think hungry baby milk has the same number of calories as normal formula, but just takes longer to digest - in which case it's the opposite of what you want. I think I've read on here of people being prescribed higher calories milks, so might be worth talking to your dr about. Hope you get some answers soon.

for now, you need to feed as often as you can - even if it's continuously.

does he fall asleep while eating? if so, you'll need to keep him awake - rub his hands, or his legs, or jiggle his feet.

are the 2-hourly feeds breast with top-ups after?
make sure you don't give top-up until you know he's had enough.
also ask them to check for tongue-tie.

if it's formula, then you need to just keep going until your appointment.

is he pooing/wweing?
throwing up?

Thank you! Not an option then. He's 16 days old today and still hasn't regained his birth weight :(. Is growing like a weed (won't be long till the Moses basket is too small), doesn't look thin, and is bright and alert in every other way. Just threw up an entire feed's worth of milk - joy. Did this last time we came back from hospital visit too so hoping it's just that.

What could it be? Any ideas? Is it worth trying soy formula to see if it's the lactose or something like that? Feel so powerless to help him - however much we feed him it seems to make no difference ;(.

Ooh actually missed the expressing part of your title - you're mix feeding? In that case try and up the breast feeding as much as possible, this is so quickly digested that you'll be able to get calories in more often than with formula which is very slow in the digestive tract. You need to make sure that you're making milk, that milk is getting into your baby and that he is able to use it to grow. The making milk bit is encouraged by putting your baby to the breast as much as possible. Getting it into him is covered by checking your latch, checking for problems such as tongue tie and high palette. The milk processing bit will be checked by the dr's. Wet and dirty nappies are a good indicator of how much milk is going through.

Try looking for a breastfeeding support group in your area or ringing one of the feeding helplines. Dr's are very quick to jump to more formula as its easier for them to control, but some problems can easily be fixed with a bit of time with someone trained in breastfeeding.

To add to the above - breast feed on one boob, wake him up, top up with what came off the other one, then add formula as required 'till he's full. He takes about 15 mins worth of breast, then 30ml expressed + 10ml or so formula. Then the next feed is formula (takes about 45ml) then repeat the cycle. His poos have been more yellowy and solid since adding the formula in, and we are now getting the odd wet nappy + the usual peeing on us when changing. Before was brown water basically and every 10 min or so a bit more. I've been saying it feels like everything goes through him but no one has listened. He is tongue tied also, being cut on Wed.

If he's growing in length - that's were his calories are going! Get them to measure him as well as weighing they can't do it all :)

Sound's like he's taking masses of milk the 30ml ebm + 10ml formula is enough on its own without the 15mins on the breast too. Glad you're getting the tie cut, some mums have to fight tooth and nail to get that done. Get them to check for a lip tie as well to make sure he can turn his lips out fully on the breast. Brown water in the nappy every 10mins doesn't sound right, is it possible he could've had a bug?

Some mums find that their babies react to things in their diet so it might be worth researching that.

I'm paying to get the tie cut or it'd be a 6 week wait! He looks like he has lip tie but it looks quite loose so doubt it's an issue. He drinks fine from a bottle so shouldn't be losing weight from lack of milk :(. The brown water was there even when he was in hospital and he was on iv antibiotics then with temp checked every 6 hours (early jaundice so they grew a culture and did the iv thingy just in case). I've kept an eye on his temp and it's been fine - below 37 degrees every time.

Regarding my diet, I'm coeliac anyway, then you cut out anything with xanthan/guar gum (not recommended to bf and eat those) and I'm not left with an awful lot! Seeing as he's better on formula thought prob not cow's milk protein issues either. I think if it IS my diet, I'll just have to give up and ff him. Right now wouldn't care tbh, just want him to gain weight healthily and be ok!

yes, it sounds like the length is taking over the weight!

I can't understand why they would force you to wait 6 weeks for a tt cut.

you might fidn it better to feed him one breast, then the other, then the other, etc, rather than topping up with the bottle after one side - there's every chance he's finding it hard to pull the milk out and not taking in as much as he could be, because he knows the bottle is coming (which is easier to take milk out of)

you can eat lots of potato :)

aamia, have I mentioned the tongue tie support group on facebook?

There are loads of mums and babies on there with gut issues and food sensitivities, you might find some useful info.

When are you getting the tt done?