Weight gain issues, feeling bleak about BFing

[Hopefully]

This is going to be v long, sorry! DD (DC3) is 4 weeks, EBF, fed on demand. She has just been weighed and, exactly like DS1 and 2, is hardly gaining.

For background, DS1 was huge at birth (9lb 9oz) and slid down the percentiles till he weaned at 6 months. HV ascribed this to him finding his natural level, but he crept back up the percentiles again and has stayed at least at 75th for height and weight ever since. He was topped up with one 4oz formula feed a day from 12 weeks. DS2 was smaller at birth (7lb12oz, ELCS due to horrific first delivery) and again slipped down the chart. He was under the 0.2nd when we were referred to a paed and more or less ordered to give formula top ups (have never been able to get more than 0.5oz per side pumping). It was all stressful and hideous and I was all but accused of starving my baby by not eating properly/feeding enough etc etc. Horrible. He was topped up from 12 weeks onwards Both DSs were fed on demand, and I co slept with DS2 for maximum feeding opportunities. I fed both for almost a year each.

Aaaaanyway, DD3 is shaping up much the same - born between the 25th and 50th percentiles (7lb 2oz) and at 4 weeks already down to just below the 2nd (7lb 5oz, only regained her birthweight last week).

I am just feeling utterly shit about not being able to feed my DCs myself. The assumption is that it is a genuine supply issue - feeding has been painless from the start with DS2 and DD, latch has been checked approx 1 million times, tongue tie has been checked for almost as often. I don't ever leak, have never had full breasts or any sensation of milk coming in, can't pump. I know none of those things individually means low supply, but the combination, along with perfectly latched, demand fed babies, seems to point to it. It's just utterly shit and I feel crap about it.

Not actually sure what I'm hoping for by posting this - a sympathetic ear, more ideas to improve weight gain, someone to make me feel better - but I'm feeling pretty blue.

Hopeful, first of all big congratulations on your lovely new Lo

Unfortunately I don't feel able to offer any advice but just wanted you to know someone was thinking about you. Hopefully someone with more knowledge or experience will be along soon.

While you are waiting have a read of How might I increase my baby's weight gain? and I know you've had tongue tie looked at but was it by a Lactation Consultant who specialises in tt? There is some information here.

Might be worth googling images of upper lip tie too

Have you been seen by a lactation consultant? It may be that you could use a supplementary nursing system, or that you could be offered medication to increase your supply. Your GP and HV will not necessarily offer you this.

Well done for trying so hard with 3 children. Be proud of your hard work and willingness to both seek help and take advice.

If you didn't know her weight, how would you think things are going - how often is she feeding, how many sides at each feed, does she seem content/satisfied, how is she sleeping etc?

I know someone who wasn't able to ebf as she had hypoplastic breasts so fewer milk glands and not enough supply to fully support a baby - however she mixed fed successfully. There are some conditions that effect milk supply and are just one of those things, nothing to feel shit about. The most important thing is that the baby is fed, and luckily we have such a good alternative to breastmilk if necessary now.

Can I ask how you've tried expressing? I'm just thinking that maybe the hospital would let you try one of their machines that are more efficient than ones you buy (unless you buy an expensive one). Or, can you hand express at all?
I had twins at 36w and at first I was expressing 1ml of colostrum (how I was supposed to then split it between two of the was beyond me) but hand into a syringe (fiddly but I got the hang of it). From about a week I was using the machine pump and ended up buying one but I still never got a massive amount. You should be able to get something though (I didn't get anything from a handpump).
How does it feel when you feed, can you feel dd sucking?
What's your diet like and are you drinking? I was always told to have a drink of water everytime I fed (although I was rubbish and rarely did).
Overall, if you can bf then that's great but it's not the only thing you can do for your baby. I've never met anyone who bears a great resentment to their mum for not breast feeding. You just need to do what's best for you and baby. Hormones made me feel like a failure for topping up with formula and someone on here said something about me spoiling my dtd's "virgin gut" which is the reason I left mn for about a year. It's bollocks and my normal brain knows this but me emotional hormonal brain did not. I was bottle fed myself and I know my mum's reasons and cannot fault her. My db was breast fed and has far more health issues than I do.
Take care of yourself. Your body is amazing and has grown and given birth to 3 dc. Your body is recovering from a cs and from 9 months of carrying a baby. This is one blip, just enjoy the rest of it. xx

Just thought - the hospital lent my mum (30 years ago) baby weighing scales and before and after each feed she had to weigh me to see how much milk I'd actually got and note it down. After a few days it was clear an hour feed resulted in very little milk so she went to formula. Not sure if they still suggest that?

How much you eat or drink will have very little effect on your Lo although a good diet will help you recover from your pg, section and looking after Lo. Have a read of how does a mother's diet affect her milk?.

Personally I wouldn't be keen on weighing before and after a feed. There are so many variables, like are the scales calibrated, has the baby had a poo or need a wee. You are much better looking at the other signs, is your baby bright and alert at times, what's your nappy count like? There is some info on what is normal in the first few weeks here.

Are you getting any RL support? Is there a BFC or Lactation Consultant near to you?

Know you've got lots of experience, and sorry for all of the links. Just thought you might like this one on demand feeding

How often is fed on demand? My DD would rarely demand so I had to feed her far more often than she asked. If you're worried about weight, I'd aim for a feed every 2 hours.

I really feel for you as we've had the same with our LO who has now been referred to a paediatric dietician and is on high calorie formula as a top up. We're still BF, mixed feeding, but I felt exactly how you feel. I remember just bawling my eyes out one day as I felt like such a failure. But...you aren't a failure, you're concerned, you care, and you want what is best for your baby.

I would definitely ask to see a lactation consultant, and get referred if you are concerned to a paed, who may be able to investigate further. It could be that they are just "finding their natural curve" but there could be something underlying as well, such as an allergy or whatnots, and it would put your mind at rest.

You have two other babies who have flourished after slow gains, so it is likely this will happen again, and is more proof that you can do a jolly good job!

You're right that the signs you indicate don't necessarily mean low supply, but another poster gave a link to some useful information about supply. Eating oats and taking fenugreek is quite anecdotal, but many swear by it, and I did find that regular expressing after each feed increased my supply, but it was bloody knackering and I spent my whole life with either a baby or machine on my nipples. Also breast compressions seemed to help marginally when I was feeding, in that LO's gain increased for a while, but he hated it as he has a crap latch and just kept pulling off when I was interfering with his drinking by squishing my boobs! Might work better if your LO has a good latch though.

Best of luck, and many hugs x

Thank you for all the kind words, I was genuinely expecting more along the lines of 'try harder and stop being such a drip'.

I honestly don't think I could cope with a SNS on top of the rest of my day (I have school runs for DS1 and DS2 to look after as well during the day), but not sure how much of a faff it is really?

Re pumping, I have tried hand expressing (most successful method, but also most time consuming), electric pump and hand pump (least successful).

I am planning to chat to BFing lady at clinic tomorrow (my understanding is that she is a qualified ILBLC counsellor, but not certain) and try to find out more about demanding domperidone, as that seems my best/only shot for continuing EBF.

TBH she does look v slim, and DS2 did look slim/skinny as well, and although there are a reasonable number of wet nappies, she has only done two poos in a fortnight, so not much reassurance from that end either. She is not unhappy, but that's largely because she is fed every time she squeaks/gives any sort of feeding cue!

She does demand plenty - am feeding at least every 2 hrs during the day and every 2-2.5 at night (midnight-7am), but TBH the day is more like one giant cluster feed from about 10am-11pm, very hard to differentiate the beginning and ends of feeds as she is feeding so much. Today I did not leave the sofa apart from loo trips from midday until 7pm, then from 8:30 until now (midnight). She dozes for a few mins, then feeds again. I was prepared to put up with that if she was gaining properly, but it feels like a shitload of punishment for very little gain at the moment . I have been doing breast compressions/switch feeding from v early on.

I think if i were in your position I would mix feed and probably enjoy the breastfeeding more if the pressure of weight gain was taken off. The benefits of EBF vs. mix feeding are pretty minimal and not enough to feel so stressed about.

I know you've had tongue tie checked but your lo's feeding does sound exactly like my DS. It turned. Out he had upper lip tie and tongue tie.

Poor you OP. I had the same with DD1 - she just dropped through the centiles and I was ordered to mix feed at 4 months. DD2 has also been slow to gain weight, partly because she had a tongue tie. Although I feed on demand, co-sleep etc and think things are generally OK now there are still times I put her to the breast and there's nothing there for her. It's just so rubbish when you feel like you've been trying so hard and then take them to be weighed and they've barely gained, isn't it? Have you tried taking fenugreek? I found it really helped.

fuzzy exactly that - I feel like I am working do bloody hard and she still isn't gaining enough.

Saw BF counsellor this morning (who confirmed no tongue tie again, and agreed I am doing all I physically can) and bought fenugreek capsules on the way home to try.

Was so struck at the BFing group how all the other babies had a feed, then stopped for a little while, then fed again (or not), whereas I fed constantly while I was there.

Really feel for you. Did you have a chat with the BFC? Did she have any suggestions? How did she check for tt? If she just looked into her mouth she could have easily missed posterior tongue tie.

Had a good chat with BFC. I think she put a finger in DD's mouth to check as well as looking, but had a phone call from MIL (who was looking after DS2) just as she was checking and wasn't paying full attention . She also went through the usual list - switch feeding, compressions, co sleeping etc (all of which I do), which made me feel she actually had some idea what she was talking about. She was openly surprised that I seem to have a genuine low supply issue, she said 95% of the feeding problems she sees are milk transfer issues - latch/TT/nipple confusion/holding off feeds with a dummy etc, rather than a true supply issue. But as she said, someone has to be that tiny percentage who don't make enough milk. Yay for me and my freak boobs

Well if it does turn out that you are that very small percentage, you can't say you didn't give bfing every single chance.

So where do you go from here? Are you going to try the fenugreek? Do you think talking all of this through with a BFC might help you decide and deal with your feelings? Have you got the helpline numbers?

Am taking great big doses of fenugreek as of today, DD is being weighed next weds (she will be 5 weeks), and we'll play it by ear for there. Will probably phone LLL helpline to talk through whatever plan the local BFC suggests at that stage, just to get a second opinion.

from there.

And thank you for being supportive jilted and everyone else , it makes a huge difference to helping me limp on with it!

I think that's part of it travel - it feels like a cop out, somehow, so say I have low supply, when it's so rarely the really problem. I always feel the need to explain my entire BFing history if I am ever asked about it