5 week old EBF... Only gaining 4oz per week. Should I top up?

[Thepursuitofhappiness]

My DS had a rocky start, lost 16% of his birth weight so dropping from 40th to 9th centile on day3. We were then in hospital on and off to combat dehydration. He's had a barium scan showing he has reflux as I think the reason for his weight loss was probably excessive vomiting. He's been prescribed gaviscon and ranitidine but still has a vomit, o various sizes, on 2 out of 3 feeds.

For the last 2 weeks he's put in 4oz a week, so dropped from 9th centile to circa 5th centile. I EBF but also worried about my supply, I can only express 2 oz from both breasts, is this enough? Sometimes he doesn't seem satisfied after hours cluster feeding.

I've started compression when he is on the Breast but not pausing. Also expressing after feed to make sure breat is emptied. However I'm scared he's so little, I really may need to top up for the time being to save dropping any further down the growth charts. I don't want to lose my supply even more though. Hv says 4oz ok despite dropping to 5th centile.

What should I do??

My husband is 6'2 so guessing he's not genetically a tiny baby.

Who guidelines state 4oz to be part of the average weight gain to be seen in ebf babies. My dd is averaging just over that and is also ebf - don't worry. You don't need to top up based on the info in this post. If your hv is happy, you can relax a little.

Expressing is no indication of supply. Some women just don't respond to a pump, and babies drain a breast far better.

Also, my DH is 6'3, but skinny as a rake. Both my dc take after him - maybe your DS will be a long and lean baby?

Cluster feeding is natures way of upping your supply - he won't seem satisfied, but he is increasingy your milk, and it doesn't last for long. Just feed on demand and consign yourself to the sofa until he passes this growth spurt - there's one at around 6 weeks.

Thanks bunty.

Yes, I'll try not to worry unduly. He just gets himself so stressed and unhappy after some feeds (often early evening ones, as in the one just got). I feel bad that I can't satisfy him, and he refuses to go back on the breast when he's not getting milk out. I tried expressing an massaging afterwards and only got a negligible amount out so I think he's pretty much emptying it.

Ill keep persevering!
X

I think you should hang in there for now, sounds like he is working hard on your supply!

4oz gain is still a gain and is within a normal range.

And I agree that expressing is no indication of supply.
Does he still fuss if you put him to the other side? Just keep swapping until he's done!

Good luck

happiness, has he been checked for tongue tie