Slow weight gain - is 8hrs sleep too long?

[NauseousKitty]

My DD is 21 weeks and was born at 8lbs 3oz. She as had really slow weight gain and is only 12lbs 9oz (only 5oz in last three weeks) but has never lost. I have spoken to a few people - both professionals and other mums - who have said she could just be petite but my HV is concerned.

A friend spoke to a lactation consultant who said that her sleeping 8pm to 4am is too long and I should wake her every two hours to feed. I am confused - I thought her sleeping through was a sign of contentment?!

All advice appreciated. Thanks

Forgot to say, she is EBF.

You're right that it can be a sign of contentment, but some babies will sleep for long periods of time when they haven't had enough calories and need to conserve their energy.

You say DD hasn't lost weight- is she following roughly the same centile line on her growth chart?

How are you feeding her? By that I mean, how often? do you offer one side only or both sides? Does she have a dummy that could be lengthening out the time between feeds?

How do you feel she is in herself- does she look OK? Is she generally content and does she come off the breast spontaneously when she has had enough?

Sorry, I seem to have just fired questions at you, but without knowing a bit more, it's hard to know what suggestions to make.

HTH

Did she put on weight well in the first few months but it has recently slowed?

Crikey - she was born on 75th but is now on 9th and has been for th past six weeks or so. I had GD and hae wondered heather she was larger than she should be because of this. During the day we feed every couple of hours or so, but there is no pattern. She often falls asleep when feeding but is still sucking and she comes off spontaneously. She does tend to stay on one side because of this but has a shorter gap between feeds when she does. There is no dummy and she won't take a bottle - it's mummy or nothing for the little madam, although we have started introducing some banana for her to squish in her fingers as a pre-curser to weaning.

Thoughts - she has been 'below average' for weight gain since the second week. Weirdly though she didn't lose in the first week and actually put on half an ounce! Downhill since then.

Thanks

What have her nappies been like? Suggest you try a nappy change after she has finished feeding and then offering the other breast for no other reason than to get more milk into her.

Would not wake her every 2 hours though

kd73 - I used to do this, esp at night, but she got grumpy and/or refused to go back to sleep at all. However, I may reinstate this plan to feed more. Thank you!

Sorry, also meant to say plenty of wet nappies and poo every other day... and lots then!

is the poo yellow or green and has she following the 9th Centile line for the last 6 weeks?

Still would not wake every 2 hours

Yellow poo and yes following the 9th for last six weeks or so. She has dipped slightly under it now, which is why I am starting to worry again.

Her length and head measurement are just above the 9th but dropping so many weight centiles has made me nervous that I am doing something wrong.

You could be right that her birth weight was inflated because of your GD.
You said your HV is concerned, has she given you any suggestions or support about this?
You could always seek out a breastfeeding counsellor or feeding specialist if you have a group near you and chat things through with them.
I agree with KD though, I wouldn't be waking every 2 hours at night unless the situation was looking really desperate- maybe just try and squeeze another feed in the day?

I have spoken to our local breastfeeding guru lots. DD had a tongue tie which she diagnosed and fixed at 5 wks. She has said that DD looks fine (she's sitting up, grabbing food, generally cheeky and good skin colour) and that she is thinking of starting a clinic where people look at babies rather than weigh them!

I am just feeling insecure as DD is so slow to gain and is still in most of her 3month clothes. Also other mums keep commenting on how small she is, like I am starving her and something must be wrong.

I have EBF 3 DC all were born on 50th centile, all had regained birth weight by day 5, DS had actually put on weight, but they have all slowly made their way down the centile lines, DS who is now 7 months is only just above the 2nd.

I weaned them all before 6 months, by DC3 all the HVs agreed this is what my DC needed, to be weaned before 6 months, the fall down the lines happened from about 1month to 4 months, when I weaned them, and then they all tracked the line they were at.

Can I ask OP are you petite, I am and all the HV have said 'your children are not going to be huge are they!'.

All my DC have slept 11-12 hours at night from between 7-12 weeks, no-one ever suggested I should wake them to feed in the night even when they were dropping down the centiles.

A 21 weeks, I'd be looking at weaning, plenty of people will now say 'but milk has more calories than food etc etc' however I have found found with my DC that they have not seemed to take less milk to start with, just the additional solids. DS now has loads of bf in the day, but also has 3 pretty good meals at 7 months

Sounds like she is doing fine, both of you would benefit from offering both breasts at each feed. The nappy change between feeds as it can wake her up and encourage further feeding, but she is following her centile (albeit the 9th).

A newborn often feeds every 2 hours but generally at 21 wks she should be able to go longer, have you tried dream feeding as you go to bed (just pick her up and pop some milk onto her nose / top lip and she may automatically open her mouth and start feeding)

If she continues to drop centiles get a breastfeeding expert to check she is latching on and feeding effectively.

Any weight gain should be celebrated so be pleased with the progress you are both making

Just read your last post, my DS is small too, he weighed 15lb 5oz last week, he's 33 weeks, but he is like your DD very alert, healthy looking, clear skin etc. the HV are not at all concerned abut his weight gain, but appreciate he is how he is.

Thank you. Just off to bed now so will try dream feeding tip. She is a nosy little so and so though so I am expecting full wake up and scream session! I may be back...

It's good that you're getting some breastfeeding support face to face and that this person has seen your dd and thinks things are fine.

Maybe she's just going to be a slow gainer, perhaps that's just how she is.

You mentioned tongue tie, and one other thought I had was that the tt had regrown which could account for the slow gain in the last few weeks?

Hadn't thought about regrowth. I will ask councillor to check for that. Getting her weighed again tomorrow, so wish me luck! she had two night feeds (dream feed at 11 and 2am) before we got up at 5am but she hasn't fed well today :(

Thanks again for your help. Any other thoughts are appreciated.

Well done Nauseous Kitty, seems you are doing everything you can

Just an update. Little monkey got weighed today and put on 10oz in six days!

Ha ha! Wow, that's an amazing gain - I think your little one just wants to keep you on your toes!

Fantastic news, delighted for you both