4 day old baby losing weight - length of feeds?

[pommesdeterreetfromageblanc]

Hello

My baby was born on Tuesday and I have breast fed her since. I thought things were going fine as she was feeding for quite a long time (20-30min) but today the mw said that she has lost almost 10% of her weight :( - luckily she was quite a big baby to start with.

The mw suggested that I did skin to skin as much as possible to make the milk come. The milk has come but now my baby only feeds for 10 min and then goes to sleep for an hour... I am worried she is not getting enough and will lose more weight.

The mw suggested expressing and maybe even topping up with formula. It seems very early to me to introduce a bottle when I am only just trying to establish breast feeding.

How long do you feed your baby for each time?

Many thanks

Congratulations!

It varies from baby to baby. DS used to take 2 hours to feed, dd never did more than ten minutes. I think ds had an undiagnosed tongue tie though...

Is she your first baby?

ds was a very sleepy baby, that's probably why it took so long to feed him. I used to try lots of different things to keep him awake, gently rubbing his ear lobes, blowing on his face, tickling his toes to keep him alert and feeding. I would also strip him down to a vest and nappy (if I was in a fairly warm room) to try and keep him alert.

There are lots of things you can do before resorting to expressing and topping up with formula. Ds went from 7lbs7 at birth to 6lbs8 and then just stayed there for weeks. I absolutely freaked out, but thanks to the reassurance from people on here and La leche league things did pick up. I think quite often some babies are born bigger than they should be iyswim.

Ds was on the 50th centile at birth and then dropped down to I think the 0.4 centile, he did eventually get up to just below the 25th and he's stayed there ever since. That was probably where he should have been all along. Don't think they have to stay on the centile line they were born on.

You are right, it is very early to think about supplementing and doing so could be detrimental to establishing a good supply.

almost 10% is within normal boundries so I wouldn't be stressing out jsut yet.

There is nothing wrong with 10 mins, some babies feed faster than others. The question to ask is "is my baby feeding effectively?" so is the baby actually getting the milk from the breast well? So when you have your baby latched on what do you notice? Is the baby swallowing? Can you see the ears twitching? (ears should be moving as the baby feeds, this shows a nice latch and shows that the baby is using the whole jaw to suckle). What about nappies? Are there plenty of wet nappies? Is the poo changing from merconium to nice yellow splats? If the answer is yes then the chances are your baby is doing fine. Especially if she is happy and content between feeds and feeding frequently (no more than 4 hours between feeds, some babies do this, most I know do more like 1.5 hours to 3 hours).

Of course plenty of skin to skin and lots of feeding is always a good thing to be doing and will be great for establishing feeding.

I had a very similar thing happen to me when DD was born. She was a big baby (8lbs 13) and in the first few weeks lost alot of weight. The mws were threatening me that if she didn't stop losing weight then she would have to be hospitalised. I felt very worried and nervous about it. I too was bfing and they got me to do top up formula feeds after each feed and also tried to get me to express so they could measure what she was having (but I couldn't).

Re: how long DD fed, tbh I can't actually remember exactly . but 20 - 30 mins doesn't make me so I assume that it's not too unusual.

In DDs case she lost alot of weight initially but it was only as she was finding her place in her natural weight - she was born on I think the 91st centile but dropped to about the 10th or 15th centile and stayed there for many months and as soon as she settled on that centile the hvs seemed really happy with her progression. It's just she was born heavier than she naturally needed to be IYKWIM. Just feed the Lo when she wants it for as long as she wants it.

Sorry, forgot to add, skin to skin is always good regardless of how things are going. With ds I had a baby moon on the advice of a bfc.. basically I went to bed for the weekend with ds. Him in just a nappy, me with only pj bottoms on. I made sure dh was on hand to bring me lots of snacks and drinks and magazines and I just fed him pretty much continuously for the whole weekend. He was two weeks old by then and I realised at no point until then had I had any skin to skin contact with him . He was born by cs and I'd completely forgotten to ask and no one had suggested it until the bfc did two weeks later.

It was absolutely the best thing I did, really got bfing off to a cracking start, I bf'd him for a year after that. If you can manage it, I can't recommend it highly enough. The weather's going to be blooming cold this weekend anyway, so a perfect time to give it a whirl.

Oh and it's pretty normal for newborns to need to feed every hour.. all this four hours between feeds nonsense is just that. Nonsense.

Indith interesting what you say re: 10% being in normal boundaries - my mws told me if DD dropped by 10% they would be seriously looking at her being hospitalised - just shows one region to another and how they vary!

We had to introduce formula top ups I think in the first week or two (we actually were forced to give DD and formula feed before we left the hospital by an odd nurse who wouldn't let me leave until we had given DD a formula feed but that's another story and I still feel really about it as it made my first day at home with DD almost impossible to bf). We did have problems after introducing the formula top up with DD struggling to latch on and suck from my nipple. It took alot of time and persistence but we did get through it.

I am not sure why your baby was weighed on day 4, in my experience they are usually weighed on day 5 (the day they were born being day 0). But I am only concerned if they lose more than 10% and that is the cut of most hospitals use. It is not unusual for breastfed babies to lose up to that in the first 5 days (especially if they have done some great big meconium bowel movements!)
I would second the advice about skin to skin, and I would aim to feed about 2-3 hourly (but more frequently if baby wants to) if baby is only on for 10 mins. At least 8 times in 24 hrs and at least once at night. No need to top up unless you want to (and it's ok to want to!)

10% is considered the boundry line as it were so if the baby has lost almost that then she is still within the norm and I could understand wanting to make sure she is doing lots of skin to skin and feeding effectively but I am very at top up suggestions at this stage if the baby is healthy in all other respects. Floating down centiles is perfectly normal for babies, some float down to follow a line, others shoot up. All normal.

Yes indith agree, but I was given same advice as OP and pretty much told if I didn't formula top up DD she would be hospitalized

Weight loss after birth is a delicate area - if you had a drip in labour, that can result in a falsely high weight for the baby, for example.

How often is your baby pooing at the moment? Is it still meconium? Do you ever see drips of milk? Are they white or still yellowish?

How do feeds feel? How are your nipples? Are they sore or cracked? Is your baby jaundiced at all?

Skin-to-skin is a good idea. Feeding for 10 minutes and then sleeping for an hour can be fine, if the 10 minutes is a fairly energetic sort of feed. If the ten minutes is just vague weak sucks, not so much.

Do you know how to hand express?

Thanks for all that! My baby was 8lb 14 and did have a drip as I had an epidural. My baby has not pooed a lot today but it is my first day of milk started this afternoon (I leaked quite a lot of milk today so I know I have some), it did look like the milk has come through as it is not the brown meconium anymore.

She is showing signs of feeding (ears moving, looks like she swallowing, had a drip of milk coming out of her mouth earlier etc). My nipples are not cracked but they are burning like hell, and feeding is really REALLY painful today.

Yes, our baby had a bit of jaundice too.

I will do more skin to skin and will spend as much time watching TV and feeding whilst being served snacks.... it has to be done!

Thanks for all the pieces of advice!

Ok, burning nipples sounds like her latch isn't really ideal. Has anyone had a look at it? (If not, have a look at the cross-cradle hold online - that's the best hold for newborns, from what I know.)

Pain during feeds means a) your nipples are getting damaged, and may well end up cracked and b) your baby is getting less milk than she would, if she was latched well.

If she's pooing out milky poo now, then that's a good sign. We expect at least two poos a day, from day 5, and each poo needs to be the size of a two-pound coin. That lets us know the baby is transferring milk ok.

Yes burning nipple sounds like latch is not quite right, You could probabl do with someone having a look in person and actually watching you latch her on, not jsut looking at her while she is on there.

Hello

I had a great mw today who showed me how to put the baby in position and it has made the world of difference! My baby has gone from feeding 10 min at a time, to more than 2 hours this afternoon, virtually pain free.

I am a new woman!
:)

That's so good to hear pommes- what did she show you that was different to what you had been doing [nosy emoticon]?.

I was holding my baby too low and I was not shoving my nipple in her mouth quick enough and far enough so she was only taking the tip of the nipple rather than the aureola bit too. To be honest I read all the pieces of advice out there and nothing compares to having someone showing you what to do. I hope that it was not a fluke. I am learning a bit more with each person I speak to. I will go to a breast feeding 'group' tomorrow to really make sure I am getting it right as I am not prepared to be in pain for weeks, I would rather express.

Brilliant :) Now you really know what it should feel like then keep trying at each feed to get it like that, if it hurts then take him off right away and try again. Onwards and upwards!

Thanks pommes-sounds like you've had some good help there.

yes it did help but she fed for soooo long yesterday, my nipples are super sore today.... breast feeding is really really challenging, i am not out of the woods yet :(