Slow weight gain

[massagegirl]

Trying to breast feed 3 week old. Has one formula top up a day. Had gained barely anything. MW won't sign us off. Worried about how much Breast milk she's getting, feel she is often using breast as a dummy. I don't go out just stay in trying to feed feed feed, on demand or waking her. Just been referred to prolonged jaundice clinic. Feeling utterly miserable and like I'm failing. Needed to rant. But if anyone has advice that'd be lovely. MW and HV both said latch is fine and I don't have sore nipples. I just wanted a happy gaining weight baby!

:( :(

The two main reasons why babies don't gain weight as they would be expected to do are

the baby is a naturally slow gainer - what are the details of your baby's weight, massagegirl*?

the baby needs more milk - and for a breastfed baby this means i) feeding frequently day and night, with the baby coming to the breast many times in 24 hours, so day and night ii) breastfeeding on both sides at* least, as much as possible - definitely not only feeding on one side

This might mean dropping or reducing the formula top up - if the formula extends the gap between breastfeeds, it could mean that you are reducing your milk. But you would need to check with mw/hv before dropping it, in case your baby needs it at the moment.

What do you think? Is this any help?

Thanks tiktok. She was 6lb 9oz. Smaller than I was expecting. One week early but I think they may have dates wrong and maybe she was a bit more prem.
She was very very sleepy for the first two weeks, had to wake her to feed, been given so much conflicting advice from mw to top up every feed, to just top up in one big feed.! i was told in the hospital by 4 diff people to feed ger ever 2,3, 4 or 5 hours... i dont know whst to do or who to listen to! She is feeding more through the day but sleeps like a log at night, have to wake her.
I really want to breast feed but feel like I am failing massively.

Massagegirl, you are not failing at all. I found the first three weeks by far the hardest.

There are many people with far more expertise than me and I'll leave actual suggestions to them - but don't think you're failing, it can just take a while to get things sorted. I know three weeks feels like forever, but it really isn't x

I was in your boat. DD dropped 11% BW and took three weeks to return. Then was a bit slow. Had jaudice as well. Feed both sides and take care of yourself. If your not eating and drinking well then that can effect your milk supply. Babies normally have a feeding frenzy at around 3 weeks which is rough. My DD used to take about 30mins on each side per feed every three hours it was exhausting. She was sleepy (jaudice can make babies so), so I had to change her nappy before I feed her to wake her up.

It does get easier. I'd agree with tiktok and drop or reduce the formula.

Hi massagegirl, I agree with what others have said but also my son was jaundiced at birth, kept in for 5days and then wasn't discharged from MW care until he was about 2weeks old,(very sleepy also) we were advised to feed on demand really, definitely no longer than 2-3hours in between feeds and top up with formula with each feed. I expressed in between feeds. They get into a habit of being so sleepy they miss a feed then dont gain weight.
What did she weigh last time she was weighed, and her centiles?
You are not failing! You are seeking help and wanting the best for your daughter

Thank you. We just had a nap together and I've stopped crying! I don't have the figures infront of me but think the 2nd centile for weight. Weighs about 6lb 5 now. I am finding if hard to express during day as at the moment she is not happy to be putt down inbetween feeding, OH is home now so he can cuddle while I express. It can all feel a bit hopeless when you're at home alone really trying to help her gain weight. Think it came to a head as i trued to go out and neet a friend for cofee and baby was just screaming in pram until i picked her up and fed, so i cabcelled coffee, guess its still early days and I need to stay home and let her take the ledwith feedings. Really appreciate the support. X

I don't know if this is relevant, but I read recently that some doctors and health visitors use growth charts for bottle fed babies, who tend to put on weight faster in the first few months than breast fed babies, but catch up in the next few months. Maybe Google some growth charts for breast fed babies? You might find your not that far off the norm.

My cousin exclusively breast fed and the health visitor kept saying she was underweight, but she was very healthy and is now an overactive 5 year old.

My lo arrived at 35 weeks weighing 6lbs 11oz so we had a major battle with weight gain. Try to speak to a lactation consultant who can check latch and feeding technique. Try and rest as much as possible , take plenty of fluids to help with supply. I co slept for the first 16 weeks. It will get better. I fed on both sides at each feed and still do. I am still breastfeeding 7 mths later but I do give 2 formula bottles too...

Thank you all.

MrsGSR, you said, "I don't know if this is relevant, but I read recently that some doctors and health visitors use growth charts for bottle fed babies, who tend to put on weight faster in the first few months than breast fed babies, but catch up in the next few months."

Not correct now - the charts in use since 2009 have been based on data from breastfed babies...and in any case, bottle fed babes don't tend to gain faster than bf babies in the first few months. This happens later - after about 5-6 mths.

It is likely that the OP's baby is smaller than most babies at this age, but this does not mean there is anything seriously wrong....but the long sleeps at night do mean she prob needs to feed more.

OP - why are you expressing? Why not just feed more frequently?

Ahh, thank you, I'll have to remember to check the dates on what I read!

Expressing as been told to by every midwife so far. This worked when having to wake her for Each feed but now she feeds a lot more in the day I don't have the chance to express. Also the thinking was to put as much expressed milk into the formula feed as possible. Just woke her for 3
Feed... She's very sleepy in the night time.

massagegirl - check the expressing advice again for an update. It is appropriate when a baby is not feeding and is sleeping instead, to protect the mother's milk supply. It may not be right to continue doing it now.

Adding breastmilk to formula - in the same bottle - is unusual practice, and not something generally advised.

I had a sleepy baby too, it was hell waking her for feeds and getting her to stay awake during them long enough for a decent feed. I had to strip her off, tickle her, blow on her face and all that palaver. I attempted to feed her (so tried to wake her) every two hours day and night, setting alarms at night. It felt like a full time job and I was so stressed - my DH once let me sleep for 4 hours because I was knackered and I was so annoyed he had let a feed be missed because she wasn't gaining enough weight!

I wouldn't bother with expressing, the constant feeding is work enough. Good luck! My DD got the hang of it at about 3 weeks so I didn't need to set alarms any more and has been gaining weight beautifully since.

Hello, you sound like you're having a really tough time. Please listen to Tiktok, whose sound and generous advice helped me through similar difficulties with my older son. To be frank, it sounds like you're getting some inaccurate and counter-productive advice from the midwives at the moment.

My DS1 was on the 25th centile at birth, jaundiced and sleepy. After a very slow start he dropped down to just below the 2nd centile and stayed there until he reached six months. Then he had a massive (massive) growth spurt and went up above the 92nd centile, where he remains today (at 2.5yo).

For me, the key was accurate advice, co-sleeping to cope with his feeding demands, a decision to give him completely free access to the breast, and a sling (buggy was impossible as he just screamed!). If you have a local La Leche League group, I would highly recommend joining. They really know their stuff.

And listen to Tiktok. She is expert and deserves an OBE!

Thank you. Yes have had conflicting advice from day one and it has really pissed me off. She's feeding happily now, well with me ticking her toes to stay awake. Have to take her to hospital today as also had clicky hips, dreading that but have my breast feeding cover so can just sit and feed while we wait. Tik Tok you really do know your stuff... Thank you. She's just come off the breast and has a nice milky mouth which is always good to see! She is being weighed again Friday and Monday.

Is she having a hip ultrasound? DS2 had one the other week for asymmetric hip creases. He threw up all over the special foam thingy they have to hold them in the right position :). Hope it goes well!

Hi liz. Yeah she's having the ultrasound today. She generally hates being undressed having nappy changed etc so should be fun!

It's very quick, and they're used to being screamed at!

With the feeding on both sides. How do I know when to switch? When the breast feels soft? She tends to do a few little feeds rather than longer ones and sometimes falls asleep, I think she's done and then starts sucking again.

With a small sleepy baby, every time she loses interest and pops off the breast/looks like she's about to fall asleep, I would switch to the other side. Unsurprisingly, it's called switch nursing :) and it helps to both keep the baby interest and build your supply. It worked very well with my jaundiced pair.

That's great. Thank you.

Just wanted to let you know that my nct came over and thinks baby has posterior tongue tie. Am going to breast feeding clinic tomorrow to see what they think.