underweight breast feed baby help me please

[theshield]

My Ds is 19 weeks and only weights 5Kg (about 11lbs) .The health visitor has advised more frequent feeding breast feeding or topping up with formula. what is the best way to go about it. He rarely cries for a feed and sleeps all night. Any advice would be greatly welcome. My other 3 children all have been lighter than average but healthy

Look at the other things instead.. does he have a decent period of alertness every day.. plenty of wet/dirty nappies?

There are other signs as gamerchick says to watch out for, as well as weight gain. Once your little one is alert, progressing towards milestones, and having wet and dirty nappies, the basics are more than likely ok. For a variety of reasons, I never had DS weighed after 4 weeks, but at 4.5 months discovered he had dropped to the low end of the weight charts. At that stage he was sitting, rolling and babbling and having plenty of dirty and wet nappies, so it hadn't occurred to me that anything was amiss (and really, it wasn't, iyswim). Turned out he had a tongue tie, one that wasn't immediately obvious, and very like his sister's (hers was picked up the same week his was, when she was 2.5yrs) which was why I didn't know there was anything "off" with his feeding. Would it be worth contacting a lactation consultant to see if you could get any advice?

theshield, this is very light for a baby of this age. Of course some babies are naturally light - that's just the way they are. You don't say what his pattern of weight gain has been since birth - it would be important that he has consistently gained, for example, and quite serious if he was losing weight.

But the fact your HV is concerned indicates that he could do with feeding more, anyway. To increase his intake of milk, you need to breastfeed more often (obv!) - this will mean not waiting until he cries for a feed (which is a late sign of needing it) but offering frequently, and swapping sides often to encourage him to take more (it's called 'switch nursing' and you can google it - it's a useful technique to help babies who need more milk than they 'ask' for). Breast compression is also a good technique.

Depending on how serious the situation is and how much better it is with the above suggestions, he may need to be woken in the night for extra feeds.

Good luck with this. A call to any of the breastfeeding helplines will give you more ideas about boosting his intake.

Some babies sleep all night to preserve energy, I would start by waking him fir a dream feed and by offering the breast as often as possible in the day.

Sometimes when you have a few kids a placid baby will nor demand the milk/attention that they need. They seem content etc and they are ok but could benefit from feeding more.

How often does he feed?

How many wet and dirty nappies and is he alert and meeting milestones?

I would attempt to increase bfeeds first of all.

If it makes you feel any better my 22 week old is just over 10lb. And that's with expressed top ups, as many breast feeds as I can give and wakes every 4 hours in the night. We've had her checked by paed and that's just who she is.

I've no advice but just wanted to let you know I'm in the same position to hand hold.

I had a baby that was failing to put on weight at that age. She was alert and hahad plenty wet nappies but was falling down the weight charts rapidly. It was her reflux that was causing the issues. I was feeding her but most of it was coming back up again. Once we started treatment for reflux and topping her up with a bottle of . formula at bedtime she started putting on weight again. She's now 1 year and definitely not a skinny minny anymore.

Good luck OP

I'd try feeding every couple of hours in the day, offering both sides, and every 4 hours at night.

Feeding in the early hours of the morning is very important for supply so I would try waking for a feeding sometime between 1 and 5 am (ish) as this is when the milk producing hormones are strongest. Mums who don't feed at all at night can run into supply problems. I second the advice to feed every 2 hours in the day, switching sides frequently to boost supply.

Formula milk doesn't contain anything 'extra' that breast milk doesn't have and is no more effective at promoting weight gain so while you need to get more milk in, there is no sense whatsoever in using formula, when you can use breast milk! Also, supplementing with formula very often leads to a drop in your milk supply, so you'll end up with less, not more. You might choose to supplement with formula if you don't feel able to increase your supply or for example, if you need to get Gaviscon into your baby (pretty tricky otherwise without a bottle! Although you could express milk in this situation).

Lots of people think it's desirable to get babies sleeping through the night asap but it really isn't natural and it really isn't good (for BF babies) so don't view waking him as a step backwards or anything like that, your just enabling him to go through the developmental stages he is supposed to pass through, sleeping through will come in time. Sometimes very little babies can get themselves in a bit of a downward spiral, where they don't feed efficiently enough, so they get sleepy and stop asking for feeds even if they need it. How is he in the day? Is he otherwise alert?

This site is really helpful, full of evidence based information and advice:

kellymom.com/health/growth/weight-gain_increase/

kellymom.com/bf/normal/weight-gain/

kellymom.com/bf/got-milk/supply-worries/low-supply/

Of course, determine if there is a weight gain problem first. Some people are small! I had comments from a health visitor and a load of worry at one point but DD is just a small person which isn't all that surprising considering DH and I are both quite little so we were never going to have a big baby.

Thank you for the advice everyone. He is feeds about 7 times a day now . He is very alert and reaching all his delevopmental milestone .
Five mad things you hit the nail on the head. He is a very placid baby and has very scuttle feeding cues. But now that I have Learnt them i can feed him much better.
I have made an appointment to see the gp to check for tongue tie and a general check up . Hopefully it's something simple.

theshield, good that you are feeding him more often. It's likely you will need to feed him more than 7 x to really make an impact.

Hope things go well for you. Usually, when babies are underweight it is something simple, especially when they are healthy and developing normally, as your ds is. The simple thing is mostly that intake is less than it could be and you are adressing this - so all good :)