Hand holding required

[Tomkat79]

Evening all

My beautiful DD will be 3 weeks old on Friday and is not gaining weight. She's gained the odd 10g and then loses 20g.

She was born by cat 3 section 14 days late after failed induction due to cervical scarring meaning I was unable to dilate...despite 3 days of contracting. She was 8lb 5.

We did skin on skin straight away and started feeding in recovery. As expected she lost a bit of weight post birth and is now down to 7lb 9.

I thought feeding was going really well but each time she's weighed she's lost. We feed 2hrly day and night and the MW wants me to pump and top up every feed. Safe to say I feel like a full time milking machine. Tongue tie has been ruled out and we are getting loads of wet and dirty nappies, all mustard colour, not green.

She's generally well and appears content, however the scales say otherwise and it's really undermining my confidence. Generally she falls asleep on the breast after 20-30 minutes and milk nearly always drips from her mouth.

On Sunday just gone I had a secondary post partum heammorhage and lost approx 500mls, on top of 650 lost in theatre. My hb was 9.7 but that's now up to 11.6. They gave me antibiotics but said unsure if infection. CRP levels in my blood results was 2 so this seems unlikely. Plus blood isn't offensive. So I haven't taken them as don't want to upset her tummy. (Metronidazole is pure evil!)

The MW thinks I'm 'compromised' and has asked my GP to prescribe domperidone to see if that helps. I didn't get the omg my millks in feeling this time. They feel slightly full but not like they did when I fed DS 7 years ago.

If the drugs don't work they're on about testing her for
Metabolic disorders.

I feel awful. Like I'm letting her down and I feel foolish because I thought it was all going well.

You are doing your absolute best. Listen to your GP and listen to your instincts.

Good luck.

Are you switch feeding and doing breast compressions?

Who ruled out tongue tie?

You are not foolish at all - how are you supposed to know, without experience or specialist knowledge, if your baby is feeding well?

You are doing the right thing - staying in touch with doctors and following their advice on tests etc.

It is a big deal to be losing weight - hope they sort it out soon.

Hope you feel better soon, too. PPH can affect breastmilk production....and how can that be anything within your control?

Yep fleder doing both those things. Can often be found top less on sofa doing skin to skin too!

Thanks tiktok. Haven't seen GP as still under mw care. He prescribed domperidone on her advice so just hope it works. They are v keen for me not to top up with formula just yet but I just want to make sure she's ok. Atm she's lost 7% of body weight.

Tomkat, I think you need discuss with your doc the chance to get a paediatrician's opinion soon....it's really not good for a baby to 12 oz below birthweight at 3 weeks, and to be losing weight.

i don't.have any.ideas, but just wanted to Say That i hope she starts gaining weight soon, i can imagine it must be very worrying for you, sure she is next to you all the time, ds was a bit prem (if you can be a bit?! 36+2) and i read having skin to skin helps weight gain, i think because they expend less energy regulating their own temperature. do you have a sling? moby or other type of stretchy wrap might be nice?

You're doing a fantastic job - your baby's weight loss may need looking into and you'll obviously need to listen to advice from the professionals, but it's not your fault! You are doing the very best you can for your baby and please don't forget that. I hope baby's weight picks up soon and things become a bit easier for you.

Agree with tiktok that I'd want to see a doctor/paediatrician. Sounds like you are doing everything you can.

Just looking at my notes...she's gone from 3795g birth weight to 3570g so 7.9oz lost. Not quite as bad as thought but agree still a lot. She's only gained 50g since day 5.

Yep red we have a moby...she loves it x

Hi tomkat thanks for your reply on my thread. I thought I'd be so chilled BF DC3, in fact was laughing at myself when I found the notebook where I'd religiously documented DS1's every feed and wet nappy, but here I am recording volumes and obsessing about it. MW has just phoned and suggested I just pump and bottle feed for 24 hrs but I'm reluctant, I'm already worried about introducing bottles of EBM so early. It would be the last straw if she forgot how to latch! I am pumping 45-50ml 8 times a day (after she has fed) and her requirement is 450 ml, surely to goodness she gets the extra 100ml from 8 what appear to me to be good BFs?? I am starting to worry that there is something really wrong
Next weigh in tomorrow, we will see what that brings....
When is the next appointment for you?

Morning tins....how strange we should both find ourselves in exactly the same position! We also have another dreaded weigh in tomorrow.

You're doing well with the pumping...I can't even get 25ml off a 'fullish' boob. My body is just not sending the milk signal.

Do you think DD would forget how to latch? Lolly took 2oz even via a tommee tippee bottle last week and she was fine bf afterwards. It's such a horrible feeling though I know.

I also chuckled to myself when I thought how I used to write r side 30 mins etc with DS 7 years ago and was so relaxed and almost cocky about how easy bf would be again for us. I don't think I need to write it down atm tho as it's pretty constant feeding from both sides!

I really hope your LO has a gain tomorrow and there is nothing wrong other than she's taking a while to pick up. All this worry tins getting pregnant, staying pregnant and now feeding x

I know! Didn't really ever worry about this bit - too focussed on making it through pregnancy. You'd think fate would give us a bit of a break now!

What are you pumping with? I've hired a hospital grade double electric pump which is saving me a lot of time and increased the volumes I'm getting. It is £45 for a fortnight then £45 a month if you decide to keep it longer term, but I used one whilst we were in hospital and it was so much better than my hand one that I decided it was worth the money.

I don't know how likely bottle/nipple confusion is, I never gave my boys bottles early on and they were both reluctant to drink from one later. The hospital said most babies have no problem swapping, but I wasn't that convinced by their BF friendly credentials.....

I think me and fate are gonna fall out!

I was very lucky...the same afternoon I looked and panicked at the price of a medela swing my MW team leant me a double lasinoh electric pump. It's ok, it's just so deflating to only see half an oz after 10 mins! I started on domperidone today so fingers crossed it will work.

If not it's the dreaded f word for us. Thing is, it's not that bad. Found out today that friends have just lost their little boy at 38 weeks. Kinda puts things into more perspective for me. Yes it's crap that had to have section and then a pph and low milk but have a gorgeous little baby and she'll thrive whatever.

Really hope your dd has turned a corner last 24 hrs and she gains tomoro. Have these girls no idea what the last 9 months has been like

I just wanted to pop on and say that you're (both posters) doing a great job in bloody challenging circs. My DD was a bit early, v low birth weight (growth restricted so only 2lb 10oz at 35+1, I had pre-e and emergency c sec. Getting my milk going was so hard- DD was too wee and sleepy to feed from me until 3 weeks so I had to pump enough milk to be ahead of feeds by about 3 feeds before going home from SCBU each night.

Pointers:
Pumping yield isn't necessarily indicative of actual supply- the 'art' of expressing is tricky. Try massage techniques on your breasts, try to pump with your baby near and see if you can get someone to massage your shoulders while pumping too.

Eat foods which promote breast milk production (google galactagogues). These include oatmeal and apricots

Research shows that coconut oil can boost proteins (I can't recall exact name) in breast milk

Try Polish milk tea also

Are you starting feeds on the breast that you last fed from then switching over a few minutes in? I hope I've remembered this correctly but this can mean that the baby gets straight to the hind milk if that breast wasn't completely emptied at the last feed. I may be wrong though- all of this was a while back for me.

With weight gain, this was also an issue with DD. They eventually took a urine sample and found her to have low sodium levels which was inhibiting weight gain.

Bottles/teats: we used medala calma teats and DD didn't have any nipple confusion. These teats mustn't be used for formula top ups though as the formula clogs the valve as we discovered

Good luck both of you and try not to worry, hard as it seems at the time

Thank you sage. Wow...sounds like you did a grand job getting your milk going.

What I find funny is that every professional you talk to says something different. Apparently there is no such thing as hind milk according to my mw, she says this is latest research and all the milk mixed together. Bf specialist said to stop feeding on one side after 10 mins as baby might be thirsty and need a drink off the other side!

I know, Tomkat, and add the mixed messages to lack of sleep, worry and no time to think and process info and you can become so overwhelmed.

I just know that the oats, Polish tea and massage worked for me.

And when I pumped when both boobs were really full, the first 20 ml or so was thin, grey/blue milk and then the creamy stuff came.

Who knows, though! Keep on trucking. You ARE doing your best!

Been trying to think what helped with expressing for me (twas a few years ago- 5ish) and what I found helped was expressing on one boob at the same time as feeding on the other worked best. It was a juggling act but with lots of pillows it worked as I used to get a few ounces with only a hand pump. I think my DD was a little older than yours but it might help to try. Good luck both of you.

Tomkat your midwife is half right, but not expressing herself (ha!) very well.

Of course there is 'such a thing' as hindmilk....but there is no sudden change from foremilk to hindmilk. All the milk your body makes is the same - but the proportion of fat/water in the milk differs as it comes to the baby, depending on the volume of milk in the breasts.

For a clearer explanation, see here:

thefunnyshapedwoman.blogspot.co.uk/2011/05/foremilk-and-hindmilk-in-quest-of.html

Sage, please check your info about coconut milk....never heard of this :)

There would normally be no need to increase the protein content of breastmilk. Or any way of doing so, sorry :)

Tiktok- coconut oil (I haven't a clue what coconut milk might do) contains/boosts lauric acid levels in breast milk (not protein as I said earlier- my bad, I was testiculating ... ) Lauric acid has huge anti-microbial properties apparently.

Sorry - oil not milk :)

Why do you need more lauric acid in your milk than nature already provides? How does it get into the milk? It really goes from the mother's stomach, into her bloodstream, and then into the milk producing system in the breasts and comes out into the milk?

I'm challenging, sorry, but with a good heart :) There are too many myths and folklore around about breastfeeding, and if women start worrying that they don't have sufficient antimicrobial elements in their milk, it just adds to their woes. Breastmilk has masses and masses of immune-protective substances in it. I doubt it needs any more....and in any case, the OP's concern was weight gain.

Tiktok- when I had a difficult time feeding and then DD wasn't gaining weight I had virtually no advice and support. I would have done anything to even feel that I was making a difference. I'm sorry I even mentioned coconut oil. I don't profess to being an expert, I was just trying to offer some support based on my own experiences and added the bit about bloody coconut oil as I'd been reading up on it the other day. It doesn't mean I am right nor does it mean I'm trying to make a situation worse by implying that the previous posters will feel even worse if they think there's another thing to worry about. If people feel shouted down on here for trying to give peer support rather than expert support then they might no longer feel able to post. I was merely trying to help. I'm sorry, but this has rather hit a raw nerve.

Sorry original poster- I didn't meant this thread to become bothersome. Good luck!

And eating coconut oil and anything that can boost immune systems could help TomKat too given that she's quite poorly and possibly has an infection.

I'm sorry you felt shouted down, Sage - my posts were reasonably polite and friendly, and I explained why I was challenging. I didn't mean to hit a raw nerve! I absolutely did not 'shout you down'.

One difficulty with a talkboard is that content stays around forever. People use this folder on Mumsnet (and others here) as research for their own situations. It's not like chatting to someone in real life.

There is a ton of stuff out there that does not help with bf, and which only serves to make mothers more worried and under-informed.

Peer support is important on mumsnet, but not if it perpetuates stuff that is just not helpful. Think about it. Remember when you were worried and struggling in the early days and weeks - reading a comment about 'research shows coconut oil can boost proteins' is not 'peer support' for someone struggling, and it risks adding to their woes...it even sounds 'expert' despite your caveat that you were not sure. I was right to challenge that - what should I have done? Just left it?

Now I probably sound like a pedantic cow. You meant to help and you are clearly supportive and lovely! Don't let me put you off! But you accused me of 'shouting you down' and you gave me a good telling off for striking a nerve....so I am explaining, and defending myself somewhat. Again, re-read my posts. They were not critical of you in any way.

Sorry to derail thread a bit, OP :(

How did you get on today, tomkat? Relieved to report that DD has gained 100g despite doing a massive wee/poo/vomit before being weighed. We have agreed that I sustain the current 3 hourly feed/express/top up routine for another week, hoping she will achieve the dizzy heights of 6lb then they'll sign us off. Then I will have to work out how to get to a regime I can live with longer term...