6 week-old very long feeds, slow weight gain, what's up?

[OhGood]

My nearly 6wo has been slow to gain weight. Over the last few days he has started having very long feeds - wanting to eat for 2+ hours, and apparently coming off still hungry.

My feeling is that he is getting most of his milk in the first 5-7 minutes of feeding (I have strong let-down) when I can see him swallowing lots, and pretty much emptying out my breast. After that, while he sucks and sucks and sucks, he doesn't seem to swallow that often.

Midwives say he is latching well. What's going on? Any ideas? Am a bit at end of tether.

The midwives view on the latch isn't very useful. How does it feel? Are your nipples sore at all?

Such long feeds can be a sign of poor latch. Do you switch boobs often? If you can do it without annoying him, I would switch often.

Breast compression might help as well?

Has he been checked for tongue tie (by an expert or lactation consultant, rather than a quick peek from a mw)?

You are both right, and I am going to get a recommendation for a lactation consultant and just try and work through all of this with an expert. Getting different advice from HVs and MWs is doing my head right in.Thought this would be easier second time round. NOT.

Definitely get the latch checked - the hospital and my midwive said my latch was good but when my dd had slow weight gain and lack of bowel movements I went to a breastfeeding support group and the person running the season said the latch was really poor!

Hello there, I could have written your post! My nine week old DS has been having similar issues with slow weight gain, and similarly sucks strongly only at the very beginning of feeds. He took six weeks to regain his birth weight and has only been growing very slowing since then (dropping from about the 90th to about the 2nd centile on weight).

I had lots of general advice from friends, which I've summarised below. I'm not a doctor and you should definitely seek medical advice for your little one, but I hope this helps a bit:

1. there's a supplement called Fenugreek you can take that can increase supply, you can get it from Holland and Barrett;

2. as others have said, get checked out for tongue tie. Get a referral sooner rather than later if you can; we were referred to the Royal Free and had to wait 6 weeks for an appointment. Alternatively you could go privately which I believe costs about £100.

3. take a look at the Kellymom website for advice on breastfeeding;

4. has your baby been checked for jaundice? I've heard that can make them sleepy and slow to gain weight;

5. middle-of-the-night feeds can, apparently, up your supply, you are probably doing those anyway though;

6. you can buy tea that is supposed to increase your supply (e.g. 'mother's milk' or 'milkmaid');

7. there are drugs your GP can prescribe to increase supply (e.g. domperidone) but some GPs are reluctant to do so, it could be worth asking about though;

8. phone La Leche League for direct advice on breastfeeding, it's 24 hours 0845 120 2918;

9. pumping regularly can help build your supply;

10. I've heard Geraldine Miskin (www.breastfeedingexperience.com) is amazing - she comes highly recommended by a friend, apparently she does skype consultations or face to face;

11. make sure your diet is good, it will effect the content of your breastmilk;

12. I've heard oatmeal is good for increasing milk supply;

13. you could try breast compressions during the feed, take a look at: www.nbci.ca/index.php?option=com_content&view=article&id=8%3Abreast-compression&catid=5information&Itemid=17

In the end DS and I were referred by the HV back to the hospital (an excellent central London teaching hospital with a dedicated feeding clinic) and they have been absolutely brilliant. They have run lots of tests on DS to ensure there aren't any underlying problems causing the lack of weight gain (e.g. a urinary infection). They have also analysed my diet to ensure I am eating properly, as this directly impacts the content of my breast milk.

In my case I was instructed by the consultant to start mix feeding, which has been very successful, we only started a few days ago and DS has already increased significantly in weight (I cried when I saw the scales!). Of course they approach babies on a case-by-case basis so this may or may not be the right thing for you and your little one. They have also suggested I discuss with my GP taking domperidone in the hope that this will increase my supply and that I may then be able to provide DS with more milk from the breast.

Please, please do not rely on what I've written above and do get your baby properly checked out by a doctor - the problem may not lie with your milk supply and if he/she has, for example, a urinary infection, it would be good to pick this up early.

Very good luck!

Thanks Seasalt for taking the time to write. I am seeing doc for 6-week check on Monday and will push for tongue-tie referral, and am waiting for recommendations for a local BF consultant.

I think my supply is OK - am expressing once a day to boost, in case. And at last weigh-in DS was still on his curve, on the 9th centile (tho a few grams less and he would have dropped off.)

So gload your LO is doing better, well done you, you have obvs done brilliantly.

Anyway, back to the coalface, waking him to feed him.