PLEASE HELP - bf baby weight gain, 3 weeks

[helenp01uk]

Can anyone give me some advice please?! My baby boy is 3 weeks old tomorrow & we're still under midwife care due to his slow weight gain. He lost well within the 10% at 72 hours, on day 5 he was weighed again & had put on 2oz (in the two days), at next weigh in he'd lost half an oz, then put on 1oz at the following weight check. Midwife gave me until tomorrow to see some decent weight gain otherwise they want us to start giving formula as well as breast milk...we've just tried to weigh him at home & while we think he's put on a bit of weight it's somewhere between 1-3oz in the past week (obviously our scales aren't as good as the midwives!), which I don't think will satisfy the midwives. I have been to a bf support group & they seem happy with his latch & the bf specialists weren't concerned by the slow weight gain. Other than the weight he's a perfectly happy & healthy boy, plenty of dirty & very wet nappies, good muscle tone, alert bright eyes when he's awake, settles well between feeds etc. Has anyone had this problem?! Any advice gratefully received!!

Have you been in touch with La Leche League? They might be able to help.

It's good that he's giving you plently of nappy changing to do - and the fact that he is putting on weight, albeit slowly, is encouraging. Is there any chance that you could feed him more often for a while (even waking him up to feed)? Also, what centile is he on at present?

Hi, it's god you've been to get some support re feeding and that nappies etc are good
Are the same scales being used each time?
You could try having a quiet few days of skin to skin and feeding, always good! Also, there are many stages between here and formula - for example giving him top ups of your expressed milk if mw feels he needs more milk?

Is he following his curve in his little book?
He sounds smashing

Thanks for replying so quickly!

I haven't contacted La Leche, will try to do that this afternoon.

I've been trying to express to top him up, but I've not been overly successful with expressing - I only get between 5-10ml on average (manual pump, but it seems not to catch it all as there is always milk in the "shell" & often on my top underneath the breast) - have been told that low expressed volume can be quite common. I'm sure he is getting far more than this from me as I hear him gulping/swallowing & he usually has a milky mouth when he detaches himself. Midwife told me not to wake him as he doesn't tend to go more than 3 hours between feeds, but will happily try it if it'll help!

Believe it's different scales each time...which wouldn't help I guess! They've not plotted him at all...I've just tried to figure out the centiles but have got a bit confused!

He is likely to be getting more from you than you can express. One option for top-ups might be to rent an electric pump for a week - NCT groups and breastfeeding consultants often loan them out - and you might have better luck.

What was his weight at last measuring?

Ah ok, that's great, thank you. Would be useful to try an electric pump before buying one, will look in to that too.

He was 8lb 6.5oz at birth, down to 7lb 10oz at 72 hours, and last weight was 7lb 13oz at 2 weeks.

At that weight he's not doing too badly. I think he's between the 25th and 50th centile (probably about 35th if there were such a thing), which is still a decent weight for a newborn. His gain is a bit slow for the midwives though - they do like them to recover the initial weight loss quickly!

However - given he appears healthy and contented I wouldn't give him formula if you are uncomfortable with that, but I do suggest upping his number of feeds (make sure you yourself eat enough calories to cope with it - I ate cake constantly in the first few months) and trying with a new pump for expressing. Maybe every two hours instead of three - then he can still sleep but you'll get extra calories in.

One thing you may find is that he may find it easier to take milk from a bottle this early on (so may be stopping BF when content rather than stuffed because he gets tired) - my DD was like this at the start (we had to mixed feed until I could get the expressing going and until she got up the energy to BF longer) so it's worth a thought. If you can get the expressing going it will also help increase your supply further, and may help your flow (mine got a lot better - it was like the boobs needed a bit of practice!).

What you need to keep in mind with the midwives is this however : "he's a perfectly happy & healthy boy, plenty of dirty & very wet nappies, good muscle tone, alert bright eyes when he's awake, settles well between feeds". He is a happy baby and seems to be getting enough for his needs - and as he is gaining weight, you have time to work on the BF.

helen, I agree you might be helped by seeing and talking to someone else, though it's good you have seen bf specialists who are presumably happy your ds is healthy (though the slow weight gain is concerning...you need another up to date weight to give you more info).

You don't say how many times you are feeding him - babies of this age, especially the ones playing 'catch up' , might come to the breast many, many times day and night. 3 hourly is nowhere near enough. It would be a good idea to try 'switch nursing' and breast compression (you can google these) and if no one has already suggested any of this before saying you will have to give formula, then they are simply not doing their jobs properly :(

I do think anyone would be keeping an eye on a baby with weight gain like this - it is slow, but it also sounds as if you have not tried everything yet :)

Zia - I don't understand why you are unconcerned about this baby's weight gain....at 2 weeks, he is well under birthweight with a 3 ounce gain only in 12 days :(

Plenty of healthy, happy, thriving babies have a slow weight gain like this, of course...but the point on the centile chart is irrelevant, with a v. young baby.

I'd be very concerned if he was still losing weight, but he is not, and the OP's description of the other things (like nappies) indicated he is not massively dehydrated or anything. I would therefore think that a bit more food more regularly might do the trick. However, I am glad you are here as I know you are an expert (I'm not being sarcastic there - I do mean that but I know text doesn't always come across well).

And I wanted to know the centile as if OP had said he was a tiny baby who had falled off the centile charts I'd be a hell of a lot more worried :)

ZiaMaria - thank you. I've been trying to keep positive with the thought that he's well and happy with normal nappies etc. I would really prefer not to give him formula if I don't have to...obviously I just want him to be healthy so if I have to I have to, but I want to try everything I can before going down that line. I think a lot depends on how I can improve my expressed volume - a friend has just popped round with her electric breast pump for me to try. If I can improve that "top up" volume (& also my production) then we might be in with a chance. I will certainly bear in mind your bottle feeding tips too. It's also reassuring that you managed to mixed feed before bf picked up.

Tiktok - thank you too! I'll google switch feeding, I had heard of compression and have been trying that for the last day or so.

3 hours is really the maximum he goes between feeds. It's often 2 hours or less, & he then is on the breast for around an hour (that is for most feeds, although tends to be longer when he has slept for the 3 hours, only sometimes does he feed for less than 20-30mins) - for example last night he fed at 12, 3 & 6, but each time for an hour, so only slept for 2 between feeds. He will often cluster feed during the day, like this morning when he didn't really come off the breast for any prolonged time from 6-10. He does sometimes fall asleep quickly whilst bf, so I tend to wind him or change him & relatch.

OK, Zia - you are right that the OP's baby may be fine and the description is of a baby who is healthy :) Problem is, this weight gain is something that's worth keeping a close eye on. Charts are not used for babies as young as this - you will see there is no line (except a notional one - I think in most red books it is dotted) for the first 2 weeks, because growth is assessed in a different way in the very early weeks. You'd only be talking about dropping centiles after about 4 weeks. This baby is not even 3 weeks old.

helen everything you say is reassuring and getting more breastmilk into him may well help him turn the corner :)

Glad your friend could help OP. Keep up the positive thinking. One tip also for sleepy feeders is don't wrap them up too warm. Dd fell asleep on the boob loads, but if I took off a layer so she was warm, not snug, she would feed more actively.

Thank you so much for all your advice. I've been up half the night feeding, which can only be a good thing! Happy to report that the electric pump was much more successful, still not huge volume, but at least triple what I got from the manual pump...and that was on first attempt. Just keeping my fingers crossed for the weigh in today.

Good luck Helen

My LO took 3 weeks to regain his birthweight, but we got there! MWs encouraged me to keep bf.

The fact he is already on the way up is fab :)

Quick update - we've been discharged from midwife care, yay!! He's not actually made it back to his birth weight yet, but he put on 4.5oz (130g) so they were happy with that...no advice to mixed feed, just to continue what we're already doing (& the extra tips I've got from you lovely ladies on here). Thank you for your support & advice!

Yippee!!! Well done and keep up the good work. Enjoy your snuggles (I'm feeling broody again). :)

:) Helen :)