Slow weight gain in BF baby?

[Bellyshelf]

DS is almost three weeks old and is EBF. He seems to feed well, he latches on and stays on until he's finished, then he unlatched himself. I offer the second breast, sometimes he takes it, sometimes he doesn't. He goes approx 1-4 hours between feeds, likes to comfort suck if he's tired, and has the occasional cluster feeding session.

Sometimes though he fusses when feeding, popping on and off and whining. Other times he will finish a feed from both breasts and want another literally five minutes later.

Generally though he's fairly settled between feeds, sleeps frequently during the day and for 2-3hrs at a time at night, he also has periods of alert wakefulness where he'll sit/lie quietly and happily look around.

He was 9lb at birth.
At day five he was 8lb 4oz.
Day 13 he was 8lb 8.5oz.
Today (a week later) he is 8lb 10oz.

The HV wants me to have him weighed again next week because he's concerned he's not gaining as he should. She did say a gain is a gain and that BF babies tend to make small, steady gains rather than big leaps but that they just need to check him next week. If he's feeding tails off or nappies reduce I've got to get in touch.

Its got me really worried and now I can't think how many wet nappies he actually does have. He's done two dirty ones this morning but both were tiny (maybe the size of a 10p piece) and neither nappy looked like it had wee in it.

He's fed loads this morning, 8:30-9 (both sides) then 9:20-9:40 just the left, then 10:30-11 just the right, then 11:30 to a few minutes ago both sides again. Between feeds he's been asleep and is now asleep again.

DH has tried to reassure me that he wouldn't be sleeping if he was hungry, he wouldn't be content when he's awake and he wouldn't be gaining any weight. He repeated that a gain is a gain but I'm still worried. Part of me wants to go up to Tesco right now for some bottles and a box of Cow and Gate :(

Does anyone have any advice or experiences to share?

Don't worry, exclusively breastfed all five of mine, each lost weight within the first couple of weeks and then gradually put it on once they'd 'bumped up' my milk supply. Countless hours of just feeding for the first couple of months. Sounds like you're doing really well.
I'm afraid I didn't get on with my health visitor due to the fact she made me paranoid about my premature dd1's weight, so I only saw her once with my other children, I felt comfortable enough to trust my instincts so this was not a problem.
Good luck and keep with it

Please don't panic, I've bf my 3 and my youngest took forever to gain weight which worried me greatly.

Do you have any bf clinic/groups to get your latched checked and support? There are techniques you can be shown to get the fattier milk to pass to the baby more quickly, breast compressions being one.

Belly, sorry you are worried. Your HV is absolutely right to want to keep an eye on this. It is unusual for a bf baby to be under birthweight at three weeks, and it's important to be proactive in a situation like this.

It may well be your ds is fine and his slow weight gain is physiological - that is, just how he is 'meant' to be.

But it's much too soon to assume that.

His other 'signs' sound normal. It's not fully correct that he wouldn't be sleeping if he was hungry....it's not quite as simple as that. Sometimes babies who could do with more calories sleep a lot to conserve energy. They can be hard to wake up. It doesn't sound as if that is the case with your ds, as he is feeding nice and often.

It could be a case of 'catch down' growth which is not at all unusual in bigger babies.

But the HV is justified in staying involved, and you are doing the right things in ensuring he continues to have every opportunity to feed, offering at least two and possibly three or four sides each time :)

I know it's stupid but its got me worrying he'll waste away between now and next week, I know that's silly but he's so small and skinny with little stick arms and legs and he actually has loose skin on his back. I feel like I'm letting him down.

I can understand why you're worried (apart from anything else, it's the default state of motherhood!) but you are not letting him down. You are breastfeeding him, which is giving him a fantastic start, and while everything isn't yet completely smooth, you're following medical advice in addressing that (ie monitor, but don't panic yet). That cannot possibly be failing him.

I'll echo Gimme in suggesting some real life BF support if there's some available near you. It's nice to have some real life hands to hold as well as the virtual ones on here

Loose skin is normal in newborns.

Get more intense help and hand-holding to keep you going - and pop a cotton wool ball inside the nappy to check he is weeing, as super-absorbent nappies just don't show wee, sometimes.

I am in the same place. I was happily EBF then HV pointed out my baby had dropped almost 2 centiles BUT he was always gaining a good amount of weight. I suddenly felt like a failure and it was all a major downer. Was advised to visit GP who told me to express for a day to see how much I was giving. Tried, failed because pump was bollocks, had meltdown, got really upset/anxious and decided to give my LO a bottle of formula in the evening when I'm feeling dry and on intense growth spurt/cluster days when he seems frantic and upset he can't get enough. On those days I must say I feel like the pressure is off on me, but I've decided that as long as he's gaining weight and happy then I'm going to continue mostly as before.

Forgot to add the next HV who visited me said she was happy with my baby's weight gain and she wouldn't have referred me to the GP. So I went through a shite load of anxiety/expressing and experimenting with formula for nothing.

Expressing 'to see how much you are producing' is TERRIBLE advice....expressing is no reflection at all on how much a baby is getting.

A baby who is not managing to feed well might remove less than the pump.

A baby who is feeding fine might remove more than the pump.

Either way, it is stressful and anxiety-making and produces no useful information at all.

Grrrr.

DS gained weight but very slowly, turned out he had an undiagnosed tongue tie. He could stick out his tongue, but couldn't lift it high enough in his mouth to feed efficiently which is why it wasn't picked up for so long. IME not all HV or GPs are great with tongue tie so it might be worth investing in an appointment with a lactation consultant.