Low weight gain and worried

[Orenishii]

My son is 11 days old, we've had some issues breastfeeding but it's getting slightly better and we're in the process of being referred for his tongue tie.

I've managed to exclusively breastfeed for the last 4 days or so - averaging around 10/11 feeds a day for about 25 minutes each time. Sometimes he rolls off the nipple with milk dribbling out of his mouth, other times I suspect he's just suckling.

At his 5 day weigh in, he had lost 6% of his birth weight - so within the 10% margin. Today was his second weigh in, 6 days later, and he has only gained 20g. I feel terrible, absolutely terrible - not least because the HV must have said 20 times, "I'm not discharging you yet!"

I am going to be topping him up with expressed milk, and going back to the BFing clinic tomorrow to discuss the referral and how he might not be actually feeding. I know with BFing it's hard to figure out how much he's getting - but clearly it's not enough and I feel terrible. Could someone please put this 20g weight gain into perspective for me - is it really, really low? I have no frame of reference, this is my first child, I don't really know what I am doing. I think he prefers one nipple to the other and that when he goes on the less preferred nipples, he just suckles. It's always the other one that has milk coming out of his mouth when he's finished. So if I am swapping breasts each time, he's only really been getting half the feeds I think he has.

Well, it's a gain at least, if a small one.

Tbh, if he has a tongue tie, then this will explain the small gain.

Do you know when you can get it snipped?

Don't feel bad, I think it can be normal to take a couple of weeks to get back to their birthweight, especially with a tongue tie. I had similar with DD2; she'd lost about 5% after a week or so, and a few days later hadn't gained anything. MWs just told me to feed her lots, about every 2 hours during the day (waking her if necessary), and by the following week she was back above her birthweight. She's 5 weeks now and is definitely thriving.

Just keep feeding as much as you can, get BFing advice if you think he's struggling with one side, and as long as he seems happy and healthy I think it's too early to worry.

Thanks both.... forgot to say he has regular wet and yellowy poo nappies, has clear urine and is alert when awake.

We're going back to the clinic tomorrow to discuss the weight gain and get the referral started for the tongue tie.

There is an excellent tongue tie support group on Facebook. Look for tongue tie babies support group and ask to join. There are many experts on there. Sadly, many hcps are not, even the ones who do the revisions.

If you possibly can, you might want to think about going private to one of the dentists who trained with Dr Kotlow He is a leading expert on tongue and lip ties and the dentists who he trained will do a good job. Not all tongue tie divisions are equal....

One is in Huddersfield and the other is in London.

Oreniishi - all sounds very unconcerning....I take it the only thing that is worrying the HCPs is his weight, and everything else (health, feeding frequency) is normal? It sounds as if the TT referral is worth it but the way you describe the way he feeds sounds as if it could be normal , and you prob do need someone to observe to see what's happening and to look in his mouth.

He is clearly getting milk otherwise he would have started to lose weight by now and show other signs that he was dehydrated/ill.

There are several questions you could ponder:

• accuracy of weights, scales and operator each time
• consistency of weights, scales and operator each time
• whether this weight, if accurate, could just be normal (it could well be!) and not a sign of anything wrong

Well my DD took 3 weeks to get back to her birth weight. She had a PTT but still was latching and feeding loads, loads of wet and dirty nappies. I think I am lucky in that I had a non-panicker of a health nurse (HV), who said that some babies do just take a bit longer to get back to birth weight.
What can I tell you? Health nurse looked at her colour (pink), tone, nappies, and the fact that she was strong and alert. Didn't fuss overly with charts. I worried, of course, but DP kept saying 'look at her -she's fine!'

What's your gut feeling when you look at your DS?

Cursty - that he's fine - he gives me cues when he's hungry, I don't just stick to a rigid two hour schedule, he's alert when he's awake, his nappies are giving healthy signs, he's responsive. Granted we have to wake him for feeds that was when the feed went over the two hours.

My gut response is he's OK but the tongue tie is making it harder for him to get milk, that all these 25 minute feeds aren't actually feeding for 25 minutes.

I just have no confidence. Two different BFing specialists took one look at him and said he's tongue tied but we had so many other problems intially breastfeeding, it's just been a relief to have relative pain free regular feeding. But the MW's have been really scare-mongering about the feeding and it makes me anxious.

Tiktok it's a really interesting point you make about checking everything else - she did concede he's a good colour, responsive, alert etc. He has loads of wet nappies and has clear urine - I've had enough of it sprayed on me to know!

Thank you for your reassurance - I know not every baby is a standard template, I just wish my MW's were a bit more non-panic inducing.

This doesn't sound very worrisome. The thing is, we don't know what happened over the last six days. Odds are he lost a bit more weight, and then started to gain. Maybe he's gained much more than 20g, iyswim.

A possibility, for sure , NQC :)

OP - your baby may have a TT. But nothing you say indicates it is causing a problem. Babies often feed for 25 mins but are not actually transferring milk all that time - nothing wrong with that.

Do ask the midwives why they are concerned and explore the questions about scales and weight. Strikes me it would be useful to keep an eye on things, but not with an air of OMG-panic.....:)