Slow weight gain / Green poo in BF baby, Help?

[IWantToBeADragon]

My 8 week old (on monday) baby, has slow weight gain, still not regained birth weight

3.940kg at birth
dropped to 3.560
then slowly gained about 2oz-80/100g a week since, shes now 3.90

I have been on fenugreek since day 5, and domperidone for a week now

Nothing seems to be helping her gain quicker top ups (of EBM) have been offered since day 3 but she still refuses bottles for most of them, and makes her self sick from crying forcing the bottle away.

This week her poo is becoming more and more green
could this be too much foremilk? The domperidone? She has a cold, could it be down too that?

Saw a pead (two weeks ago) who signed her off as she IS gaining, so apparently its not a worry, but she said that green poo is a sign of starvation, so of course im now driving myself crazy worrying about that as well as the slow gaining, and if i can help any other way

Starvation?!! Bad choice of words by the doc there I think, as he/she wouldn't have signed her off if she was anywhere near starvation.

Sorry don't know anything about domperidone (though it sounds like dom perignon, was that a typo?! Sorry, just being a dick.)

But my kids had green poo and it turned out to be food allergies. As you are bf you could rule this out by having allergen free diet for a couple of weeks and see if things improve. Most common allergens in babies are cows milk, eggs, wheat/gluten. So if you could bear a diet of meat, spuds and veg, and substitute cows milk with coconut milk, butter with sunflower spread etc for a fortnight or so you never know your luck, might solve the problem without having to try any medicine or get any referrals etc. just make sure you get enough calories and calcium. Just an idea.

How often is she feeding? Are you switch feeding, doing breast compressions etc?

Starvation is ridiculous! What a stupid thing for the paed to say if they are signing you off.

My 6 week old DS has green poo fairly often. He's put on nearly 3lb since birth so it's definitely not due to starvation.

This sounds like my dd. it turned out to be an allergy to milk. Took ages to figure out.

Green poo is often a sign of wind.

My dd had a lot of green poo. No allergy to milk. She was a bad feeder with a bad latch. This is such a difficult problem to solve as symptoms overlap so much. Don't feel bad. Your baby won't starve and you'll get the right advice soon. You're doing the best you can.

on my phone so sorry for not using names!

I express for 10 minutes each breast every 4 hours so that she gets more of the higher calorie milk, and then allow her to completely empty one breast to her satisfaction, then offer the second side. Yes to breast compressions both when feeding & expressing

allergys haven't even been mentioned to me by anyone, not hv or doctors, would I just cut everything and re-introduce one thing at once?

she doesnt seem more windy than before, would trying her with gripe water/colife/infacol be a good idea to rule this out?

feeding every 2 hours through out the day and every 4 at night, my DD is content, alert and smiley/happy, hitting milestones, and comes away from the breast looking "milk drunk" seemingly satisfied, HV and breastfeeding person at clinic all said how good latch is . I want some lol

It sounds like there is nothing wrong. She might be gaining weight slowly, but she is gaining. If everything else is ok, and you're in contact with health professionals regularly for weight monitoring then try not to worry. Easier said than done, especially when people feel free to wave the terms 'failure to thrive' and 'starvation' about. You're a good mum and your little baby sounds a happy little thing

Good grief, what rot saying "starvation"! Green poo can mean lots of things, and it can be normal too. It could be not getting enough of the higher calorie hindmilk, wind, intolerances, maternal medication, baby is unwell (has a cold, just had jabs etc.). Is the poo usually green?

We have a slow weight gainer here too, and his poo varies between yellow and green. If you try feeding from one boob only for two or so feedings it may go back to yellow (if it is normally yellow) and if it is too much foremilk...that's what we find.

I also found a useful poo chart (we all love a good poo guide!) similac.com/feeding-nutrition/diaper-decoder

I don't know what to suggest regarding weight gain, but we have been assured that a gain is a gain and they don't tend to worry unless they cross two centile lines. We'd just love a magic solution to get our LO to chub up, as we're fed up of people's shock when we tell them he's 13 weeks :-( and "what a tiny baby".

Not regaining birth weight after 8 weeks is concerning and would usually mean baby has crossed two centile lines since birth. Is that the case, op?

I would suggest getting to an NCT bf counsellor, or a La Leche League meeting, to see if there's anything else they can suggest. There are even slightly different techniques for breast compressions and deep latching, and something might make a difference to your lo.

My ds went through a similar thing with slow weight gain, where we went through the mill with a horrible paed we were very unhappy with. If you're not happy with where your paed left things, you can always ask for a referral back or for a second opinion. They can order tests to rule out any underlying reason for the slow weight gain - perhaps you've already had that done, not sure.

Have you tried a variety of different teats when trying to give her ebm? Babies differ enormously in what they'll accept so it might be worth a try. It's best not to persist if she's upset, though - if she's crying until she's sick, then it sounds like it's stressing her out. Offer ebm in small amounts when she's done on the boob, and take it away if she refuses.

Or have you considered giving her ebm via another means, like cup-feeding or an sns? A bf counsellor or LLL leader should be able to help if you ask, but in the meantime there's some info on Kellymom.

Dragon, below birthweight at 8 weeks is something to be very concerned about.

Please get good help from a specialist infant feeding person.

The green poo in your case could be a sign your baby needs more to eat.

Please don't ignore it. You dd is not 'starving' as she is gaining, but it is a worry.

Not ignoring, i am seriously concerned thats why i came on here (again), i just dont know where to turn at all, breastfeeding counselor says latch is perfect, baby is perfect, happy healthy etc... I just cant work out where we are going wrong, everyone has said it isnt the quantity of BM shes getting, we feed/top up enough. But something must be wrong right? As of shopping today when DH gets home i am going dairy/gluten/wheat free

Poo is going back to yellow as of yesterday, its been green for a week'ish with no difference in feeding.

Ive offered avent, cheap botles & tommee tippy i think there called. i havent tried cup or anything else, should i?

Yep two centile lines were crossed mid feb :( thats why the paed, who then said oh, but shes gaining & looks lovely, alert, happy, dont worry & signed her off. She said aslong as her poo is yellow as well even less worry, green poo would be worrying cause that is starvation... less than a week later green poos for a week

Shes had no tests, or real in depth looking at (i dont think shes ever been checked for tounge/lip ties etc but that could be because its ruled out by her latching so well? I dont know enough about it all)

Do i just ring LLL? Or do i need to be a member?

Thank you everyone, and sorry again for lack of names

Dragon, I'd listen closely to tiktok's advice. She's an NCT bf counsellor and the most knowledgable amongst us here.

Ring your HV and ask to be put onto the local infant feeding coordinator, or whoever else up the food chain can take responsibility for your lo's care. Stamp your foot if you have to. From what you've said, it might be that the paed signing her off has led other hcps to relax about her progress, but you don't have to agree to that!

You can still talk to LLL at the same time. You don't need to be a member, just google to find your local branch contact info. Even if there isn't a meeting for a couple of weeks, you may be able to meet with a leader sooner if you say it's urgent. They might even be able to tell you who in the local NHS is best to ask for - some infant feeding coordinators may be better than others if there's a choice of hospitals in your area.

Sorry, not reading names very well on phone, but yes tiktoks advice is always amazing :)

I will try LLL as soon as baby settles, my/our/her HV calls her our anomaly, it seems everything is perfect, but somethings not working! I just need someone to tell me to give up BF i think, i am pretty much done, i cant work all this out i feel really out of my depth

I know you were not ignoring it, Dragon, but there were suggestions on here that it was something you might ignore :(

The thing is, your baby may be fine. She may be an 'outlier' - a baby who is gaining way less than most babies but who is still fine. You need to find the person who can assess her 'in the round' and give you that reassurance, if it is appropriate. This person also needs to know about bf.

I suggest that while the vol orgs can support you, they are not the right people to assess all this, and I certainly wouldn't, if I was involved with this in RL.

Your baby's cold could be a reason for the green poo as you suggest - but with the weight gain you describe, it's not certain.

Your feeding frequency is not great - and I think expressing to make sure she gets the high calorie milk is something you might consider stopping. She needs volume as this is what puts weight on despite far too many people these wittering on about hindmilk and foremilk :( :( Whoever told you to express for this reason is not the person to help you.

Upping your frequency, switch nursing and breast compression are essential....but getting someone to see you and assess you both is just as essential.

The problem is that even though shes been losing from the start and then really slow gain, all the advice i have been given is top ups, i have done that its made no difference, i was waking her every two hours from day 10 till we saw the paed who said try going longer at night to see if she takes more when she is woken.

I dont understand how to stop expressing and still up the volume of milk i am giving her tiktok? Sorry might be being dumb.

Who do you think i should get to assess? I spoke to LLL on the phone, and she agreed its really worrying, and even more so, she was concerned that DD hasnt ever had urine or blood tests to see if theres a reason that can be easily found from her, since i Seem to have enough milk

Will up my frequency again, how often would you suggest? Back to every 2 hours?

Thank you

dragon:( what a struggle.

What I meant about stopping expressing is that you are spending time with the pump you could be spending bf. 'Engineering' your milk so it is higher in fat (think that's the rationale) is not necessary. Babies gain weight with volume of milk and it's fine that they get what's available.

Two hourly feeds - yes but more accurately just whenever you think it will be accepted :)

Is there an infant feeding specialist in your area.

Dragon, if you can manage it tomorrow or the next day, take your dd to bed for a babymoon. Forget housework, baby groups, etc. and just set yourself up with snacks, water, magazines, phone, etc. and just feed feed feed. Keep her in her nappy for skin to skin if you can, and get comfortable. If she squawks, put her on the boob. If she's awake, offer the boob. It doesn't matter if she's feeding every 20 or 90 mins... Just go with the flow. Let her sleep latched on as she might dreamfeed while she's there.

I suggest it because not only will it increase your supply and get lots of milk into baby, but because you sound stressed and could use a bonding day with your dd without the faff of expressing. And you can still make all your phone calls from bed.

Hang in there. [hugs]

rang up paed and stomped feet a bit like you all said, DD went down there for a weigh in, she's 4060g now, paed said carry on doing what I am up the feeds if possible, they made another appointment with her for the 14th if she gains as she did this week, they won't test her for anything, if she has more slow gains, they will do some tests.
tiktok, would you have any idea how I could find someone in my area to check the feeding properly?

I would love a babymoon, think it will have to be Saturday, lots of baby appointments, injections etc this week

thanks for the help

So she's gained 160g in how long? That's a week? Ok, still not real 'catching up' yet but it's a greater gain than before. What's she doing on the charts?

Most maternity units have an infant feeding specialist. Some places have one or more who work in the community.

Not all of them are brilliant, but many are pretty good.

Your HV should know who to contact (the paed should have referred you to someone like this, and your HV too....). I'm assuming you are in the UK, BTW.

yep that's exactly a week, best gain she's had ever so hopefully its a little breakthrough, she's still hanging around on the topend of the 2nd, chart wise she dropped to the 2nd two weeks ago and stayed at the top end of it. paed seems nice but based on what I have read from you all, and from LLL not really doing what needs to be done, she won't refer me to anyone, or do tests till the 14th & not then if baby has gained a decent amount again.
I was hoping to get someone private in, sooner because of that, but I don't really know where to start looking. DDs poo is back to bright yellow fully now as well, so was put down to her cold

I think it's fair enough not to do tests (though I am not a doctor....just so's you know :) ). The vast majority of 'slow gainers' don't have a metabolic disorder, or an allergy, or some underlying disease preventing them from growing well. With an otherwise healthy baby, it's a good idea to i) check the feeding is sufficient ie the mother is not doing something mad like restricting the feeds or saying she is feeding often but not actually doing so, and lets assume neither applies to you :) ii) check the feeding is effective ie the baby is removing milk adequately....that has not been done as far as i can tell from what you say here and maybe the paed does not know of an infant feeding specialist who could do it

The worry might be that a very slow to gain baby may appear ok, but actually lacks the energy to feed better and more often....it doesn't sound as if this is the case here, but that's where you need real life help and assessment.

'Treatment' - if the baby isn't lacking in energy to feed - would be to make sure the mum knows how to make breastfeeding more effective and to increase the volume of breastmilk taken in by the baby....you have found out yourself how to do this. Then you'd give this a chance to work, and to show up on the scales, before discussing supplementing.

Some babies are 'outliers'. They are off the charts, but are still fine.

I attended a Dr Jack Newman seminar on Monday and he touched on this and he mainly recommends a SNS for top ups if needed as it means bb can still get mothers milk but also top up and it means bb won't miss any let downs. He is very against bottles so maybe this would work especially as bb is refusing bottles.

I'd also say above advice of baby moon and lots of skin to skin with proper attachment and feeding when hunger signs ate shown will help with weight gain.