5wk old bf baby losing weight - don't want to suppliment with formula

[entropy]

reposted from other thread (sorry)
My 5 week old dd lost weight this week. I am exclusively breast feeding now, but my HV has given us a week to try and sort things out before she thinks I should supplement with formula,
My dd was born weighing 7lb 9oz. I did introduce an evening bottle at 2 weeks as her weight was falling (7lb 3oz) and I wasn?t coping very well but she started to suffer terribly with colic so I went back to exclusive bf (she still gripes a little but is lots better in the evenings without the bottle) her weight which had crept up 7lb 15oz has now fallen by 2oz this week. We were feeding roughly every 3h during the day with a 5-6h gap at night. I was demand feeding and this is the schedule she settled into. Her poos had a green tinge when on formula, went yellow again when we swapped back to total bf but over the last couple of days are looking a browner shade of yellow. She also went a whole day without pooing. (Could have been due to running out of colief the day before) The poo was still soft when it finally came though. There have always been plenty of wet nappies.
Since I found out yesterday that her weight was not increasing I have tried to bring her feeds closer together and offer both breasts at each feed (wasn?t doing this before) I?ve only been trying this for 24h but it is really unsettling her to feed more often and she is no longer having what I consider to be good feeds. She falls asleep very quickly as if she isn?t really hungry. I keep waking her but she latches off a lot and the constant on and offing is making me very sore. It also makes the feeds take ages (up to an hour) which isn?t leaving her that long to digest the milk before I try again (and her tummy pains were back last night.)
I could really use some advice as to whether or not I should be trying to force her to feed, and how long I should hold out against the bottle if her weight doesn?t pick up. I know I caved in too easily the first time and don?t want to go to the other extreme this time but I hate to see her in pain and the formulas seems to be the main cause of the colic.

entropy,

There are some situation where close monitoring of weight is necessary due to severe health problems. Most of the time though seems to be more a source of stress than anything else!
If you forget the weight thing, how is your baby? Does she seem healthy? alert when I awake. Does she stop feeding on her own accord? If so, I would say try not to worry and follow her lead.
Someone else will come along and give you really expert advice, but I am pretty sure that as long as your offering on demand and she is allowed to stay as long as she want, she is getting the nutrition she needs.
Besides two ounces is really the differnece between before and after pooping sometimes! Keep on going offer loads, and see where you are in a week or so.

Good luck

p,s,: My DD was quite large when born and just kept loosing weigh and falling off centile curves. She is a 3 years now, bright as a button but tiny. I believe she has the genes to be tiny, and was over inflated at birth by getting direct nutrition from me, IYSWIM...

I am not an expert but I would ask you this - if you hadn't had your dd weighed, would you be at all concerned with her general wellbeing, nappies etc?

Sometimes the weekly weighing can just be a source of stress imo

From what I remember, both mine took an hour or so to feed, then had a little sleep, filled their nappy and then back on to feed again, seemed like CONSTANT feeding

I don't think you will have to top up with formula but Tiktok or someone will be along soon, fret not.

xx

I was just going to post that 2 oz could be down to clothes, nappy and whether she's just been fed.

I think you should go back to what you were doing before and see what happens. sometimes by trying to feed more you end up feeding less because they get less hind milk. like fot says, if she's alert, weeing regularly etc she's almost definately OK. a day without poo at 5 weeks is normal.

I'm quite glad now I don't have an hv and have never weighed any baby weekly!

was it the same set of scales? Was the baby naked both times? If not weight measurement is worthless. Also, it could be the difference between a big poo! Why supplement with formula if you have milk in your breasts? I'd definitely offer both breasts, but not try to force her to feed. It might be worth getting your latch checked at a breastfeeding clinic to make sure she is feeding effectively.

Hi, entropy. Here are some Qs:

• was the weight done on digital scales with your baby naked?
• can you increase the frequency you are feeding? You didn't get off to a good start - that early weight loss over 2 weeks shows that bf may not have been that great even then, and the bottle will not have helped supply...plus the one breast only per feed.....it all means that the current 'demand feeding' may not be enough to build up and maintain a supply, and this is the reason why your baby has had a weight loss (albeit small) rather than the weight gain you would expect in a baby of this age.

Most babies feed more often the 7 times you're describing, and most mothers will need more than this to get a good milk supply - esp after a tricky start.

You can try breast compression (search web or archives) and you can feed 2m 3 or 4 sides per feed, as well as feeding whenever you can in the day (and yes, waking at night if you can bear to!). Placid babies don't always 'demand' the feeds they need, and this is where you come in, doing the 'demanding' for her

Your HV should have given you other options than a deadline, BTW....

When I said 2m, I meant 2, not 2 minutes!

I was trying to get over the idea of feeding more than two breasts per feed.

thanks to everyone for your replies,

Tiktok - yes it was the same digital scales and dd was naked both times. I am upping the number of feeds. Today I have managed every 2 hours apart from the time I first looked on MN when it it 2 1/2h before I realised

bf didn't start well as the latch was poor but my MW helped me sort that out eventually. It has also been checked by NCT counsellor last week as I was worried about her bobbing on and off so much. Also I wasn't eating well, (or at all in the first week) as I had no appetite and she had some other problems which completely took my mind off looking after me. My mum thinks this is why my dd isn?t gaining weight but I am getting myself together with feeding me now.

as for offering more than 2 breasts per feed, I am very sore already but I will give it a go.... I havent heard of breast compression before but I will look it up!

Oliveoil - thats how my day has been, feeding for an hour, a nappy change then either a short sleep or a little playing followed by crying/sleep and then its time to feed again! I have been depressed and have been trying to get out of the house a little more to help me sort it out but I dont see how thats possible when its like this. but I feel I have let my little one down in so many ways already so I really want to make the breast feeding work for her so I will do whatever I can

thanks again to you all for your help

Aw, enteropy, you have not let your baby down. You are a responsive, careful and good mother who is having a hard time.

Tell your mum that mother's diet has nothing to do with the quality of breastmilk produced - nothing, zero, zilch. All the research into this confirms this. For 99.99 per cent of human existance, food intake for mothers has been precarious. Nature evolved breastmilk not to depend on maternal diet, and it is made in quality and quantity that matches the baby's needs, no matter what/how much the mum eats.

Soreness - could me your positioning needs further tweaking.

Good luck

Sounds to me as though you're doing a really good job Entropy. This bit is so intense and feels as though you'll never feel relaxed again...... you will

Poo sounds completely normal (I'm still obssessed with my lo's poo and he's 8 months old!)

Eating well yourself will help to make you feel better as will sleep (do it whenever you can) and getting out as you said. And go easy on yourself, I can hear you're not feeling good.
Keep going Entropy, you're doing really well.

Honestly, I sometimes think that HV's should be shot for their lack of tact and diplomacy and their reliance on those bloody charts. My DD1 was born huge, 8.11, so on 75th centile for a girl. I exclusively Bfed as she would not take a bottle even of expressed milk. She was fine on the charts for a few weeks then slowly dropped down the centiles until she hit the 25th, at which point the HV referred me to the paediatrician at the hospital. I was nearly hysterical by this point, actually (and I cannot believe this now) had her weighed twice a DAY, and nearly fainted when she lost 9oz one week, then rushed her to the doc's emergency surgery and he refused to see me as he clearly thought I was hysterical, which I was. When we finally saw the paediatrician at 6 months he looked at her charts, asked if she was active (she was- sat up at 4 months, crawled at 6 then walked at 10!)looked at her and said "well what do you think is wrong with this baby? My answer was " well the Hv suggested Coeliac's disease, etc etc" and he said (bless him)- stop getting her weighed every two seconds, stop stressing as you're feeding her, let her get back into her rhythm (I too was feeding all the time which is counterproductive as they only get the foremilk not the creamy hindmilk) and relax. She is never going to be big, she was born overcooked!! (I'm only 5 ft 1)
With her sister I had exactly the same...she was born big and I just knew we'd go down the same route.. she is now 2 and has been weighed twice.. at birth and at her 7 month check when lo and behold she had dropped from 60th to 5th cntile, but was totally fine. She is incredibly healthy, eats well, is developmentally far ahead of expectations etc etc.
The weight charts are based on American bottle fed babies. The NCT have a bfed one they can give you.. bfed babies do not store fat like bottle fed ones so cannot possibly follow those ridiculous upward slopes.
My advice therefore is DO NOT WORRY, STOP WEIGHING HER and go back to your routine which she liked.
Obviously, if she is listless and unwell then you must get her checked out, but if not, don't worry and keep at it!!

Hang on in there and if your dd is alert when awake and not showing signs of dehydration (which judging from the wet nappies, she's not) don't worry - she's fine! I had a v similar experience - baby dropped from 75th to 25th percentile by 10 days and we got sent to hospital for an overnight stay. After a bloody difficult start to bfing, not helped by an evil sadistic midwife telling me off for having "too hard breasts and too flat nipples" and a baby with undiagnosed reflux, I had just built up a little confidence and had my first successful day of bfing. Well, the hospital stay put paid to that - people yanking at my boobs every 2 hours, dd screaming with hunger and refusing to feed because I was so distraught. Then at 3 in the morning, I got locked in the loo for 45 minutes and they had to get a security guard to kick the door down. And that was the last time I managed to bf, thanks to NHS health professionals. I still feel crap that I had to give up.

entropy - feeling down is very normal in the first few weeks (or months in my case!) - does not automatically mean PND, just that you are overwhelmed with a newborn. Again, very normal.

I was weepy for ages with both dd1 and dd2 and I am normally a bouncy, up and quite annoyingly perky sort, keep at it.

Re food, one tip I got was to make a huge mound of cheese sandwiches in the morning and wrap and put in the fridge, then you can eat one at each feed. Chop up fruit etc. Scones I liked too.

Getting out of the house - organise your pram with all the bits (nappy, wipes etc), then feed dd, burp if necessary, then go out straight away. I found I could walk for half an hour or so, get a coffee in before they woke, then feed in a cafe, then go home again. Not exactly thrilling, but it makes you get up, dressed and out for some fresh air.

xx

and can i just add to this thread that if your baby was putting loads of weight on every week, they would find something to worry about there too.
ds1 used to put 1lb a week on , he was a little porker and the hv's at the clinic used to stress their heads off and say' oh we need to keep an eye on this, have you been giving him chocolate etc'

he was just a big boy and is now. massive for his age but thin.

you trust your instincts.you are doing a fab job for your daughter- a fab job.cut yourself some slack.

Yesterday did not go well. I attempted to feed every 2 hours but by the midnight feed dd just used me as a dummy and wasn't interested in feeding in the slightest. I let her wake me rather than set an alarm and she did at 3am. we both fell alseep during that feed and I woke up at 5am still holding her to my boob Ive not idea how long she fed for so I fed her again at 6 when she woke and we both fell asleep again during the feed. I had to feed her perched on the end of the sofabed so that I couldn't get comfy! This morning I am shattered, my nipples are purple and have cracks across them and the lansinoh dosent seem to be helping this time. I want to get my latch checked a third time as this can't be right...

As for dd being alert during the day, she certainly wasn't yesterday. the constant feeding seemed to wear her out and I didn't get much alert time from her at all apart from lots of crying. she even cried at bath time which is very unusual.

Generally it is a little hard to tell if she is as alert as she should be, as she has inherited sight problems from me and can't open her eyes very well. I think I have a handle on what is normal for her now but I could easily be wrong. I have very limited vision myself (which makes getting out with a pushchair interesting) and we don't know how much she can see yet. I feel very responsible for her problems as even though I knew it was a possibilty that it could happen I really thought she'd be OK.

I have to go now as its been just over 2h since the last feed wish me luck.

entropy, sorry you had a bad day yesterday, it's hard isn't it. Do contact a breastfeeding support group if you can, and if someone could check your latch that would probably help too.

I know how wearing it is to be constantly feeding like this - all 3 of my babies have lost lots of weight and then regained ever so slowly. Ds2 lost over a pound at birth, and on the centile charts has gone from 99.8th centile at birth to 2nd-9th centile at age 4 months. But I'm sure all is well. BUT, it took a lot of work and heartache to get him feeding properly - what I did was to feed every 2 hours, but to supplement with expressed milk. I'm not necessarily recommending this, as it is a total pain to do, but my problem seemed to be lack of milk.

My routine was, immediately prior to a feed, express from one side, plus a little from the side I was going to feed from (in theory this makes the milk more calorie-rich and less watery - don't know if this is true or not...), then feed him from the side I'd expressed a little from. Then feed from the other side, if still interested keep switching, then only when not interested in the breast anymore, give him the 'top up' EBM. He would then be quite settled, so I would take that opportunity to wash and sterilise the breast pump and bottle, ready for the next feed.

To be honest I did wonder why I was doing it, and it did feel terribly alien to the 'breast feeding is so easy, you just feed them' mantra. BUT after about 3-4 weeks, he was feeding with no EBM, and his weight started creeping up. He's still a thin baby, but he's meeting all his milestones, so I@m not overly concerned. Having said that, he only weighs 5.95kg having been born at 4.58k.

Do hang in there - you'll get loads of support here. Don't try and do anything else except feed him - it doesn't matter if the house is messy or if you don't go out - just stay with your baby and feed whenever you can!

Entropy, all you are feeling is entirely normal - the post birth hormones and sleep deprivation mess with your head and I don't know if it's any consolation but most people I know had a nightmare with bfing. Have you thought of getting a sling? After a couple of practice goes with someone giving you a hand, you soon get the knack, and don't need to be able to see what you're doing. You can carry your baby easily when you go out and don't have to faff around with the pram. Carrying your baby is supposed to be very beneficial for them and help them gain weight and it sounds like it would do you the world of good to get a bit of fresh air. Also, don't know if this helps, but something that really helped me was to ban the word 'should' from my vocabulary and just watch my baby and develop my instincts. We all know someone with the 'perfect' baby who feeds and sleeps on cue but 99% of babies don't and once you go with the flow and ignore people who tell you what your baby should be doing, it all gets a lot easier. We are really fixated on routines and milestones in the UK and you have to let that sort of thinking go, or you just end up battling with your baby and feeling like a failure. Is there one midwife you particularly got on with? Why not give them a ring and get them to have a look at your latch again? It might also help to check out anything by Bill Sears (www.askdrsears.com), who has a totally different take on bfing to what you may have encountered before. You might not agree but it can be good to see some different perspectives.

Entropy, Hope you are doing better today. Just a little note to tell you about a friend of mine. Both her babies were about the same as your dd, and both followed the pattern your dd is showing. in that they both lost weight for the first 5 -6 wks. And HV were on her back, but she never did supplement and fed both until about 18 mths. Now DD is 5.5 is energetic and average weight, DD2 is 22 mths and is the same. Both of their feeding sounds like yours (1 hrs to feed and such) but they stopped this about the time they put on weight. So as long as DD seems happy to you, stick with it. and feel good. You are a good mummy

Don't know if anyone else has suggested this but it sounds like you doubt whether there is enough milk sometimes as well as whether your daughter wants it (I was the same when bfing twins - don't get a complex I didn't last long). Have you tried expressing just to see how much you get, it can be really reasuring if you realise you could answer to the name Daisy - mooo!

Stick with it though it does get easier after a couple of months and if you can make it to then in most cases you can carry on as long as you like then.

I dont want to post any feeding advice as im not really qualified and there are others better placed too, but i wanted to say how i empathise with your situation, the first weeks are hard but my dd is 4 months now and it's all a blur already!
But if you can get out do, i always made the effort and gradually it got worth it, i used to go to my clinic as there were lots of activities arranged for new mums and a group of us formed and used to meet up regularly, or is your library close? i used to take dd to music time just to get out and she seemed to enjoy it, or a good starbucks with sofas!

entropy I hope today went better for you.

if 2 hourly feeds don't work then I suggest you go for one of tiktok's other suggestions.

but also i just wanted to say that if you tried 3under3's suggestion of expressing and didn't get very much, then not to let that worry you: some people just seem to be able to express more than others. I fed ds for 15 months - 6 exclusively - and could never express more than about 2oz.

Quck update whilst I have a second.

dd was very very difficult to wake after her afternoon nap on thursday and then refused to feed. (she went 4h without food) naturally I paniced, and phoned NHS direct as my GP surgery does not open on thursday afternoons. To cut a long story short they insisted I tried formula which the little minx lapped up like she was starving (which she probably was) and as far the NHS is concerned that is the problem solved. I was accused by my HV of being selfish by trying to persivere with breastfeeding. Then yesterday her soft spot on the front of her head was really depressed (I paniced again) but was told it was dehydration and to give her lots more formula...

The approach I am taking now is to attempt to breast feed at each feed. Sometimes she refuses (towards the end of the day) Other times she feeds quite well. if she refuses or pulls off during the feed and starts to scream and beat her hands on my breasts, (and wont be talked into latching back on) then I have to top her up with formula to make sure she is getting enough. I know this is not helping my supply and I am trying to express (too painful with the pump and slow by hand) but I don't get much at all. dd would still sleep all the time left to her own devices and I think the bottle is making her too lazy to breastfeed. when she is awake she seems as alert as usual. she is just awake a lot less. I got her checkeed over by my GP on friday just to be sure there was nothing wrong.

I'm hoping its a growth spurt wearing her out as she is finally fitting into some of her smaller clothes! I will see the HV again on Tuesday but I'm not expecting a great deal of help....

My son is seven months old and I am still breast feeding him once a day on the breast but bottles (formula) the rest of the time but from three weeks until five months I fed him expressed breast milk. I had to use an electric expressing machine FIVE times a day. Oh how I hated that thing but my son would just not breast feed properly but he lapped up whatever I put in the bottle no problem. Then I tried him again at ten weeks (I was worried the supply might dry up as so many people told me expressing only works for so long) and he managed fine! He is still choosy though and seems to prefer a bottle but he is not fussy first thing in the morning because he is starving so that's when we still breast feed. I will never know why. The pump cost £85 from the NCT magazine and it arrived 24 hours after I ordered it. It was the best money I ever spent on my son's health but oh how I grew to hate that machine!!!

enteropy - I really hope you can talk to someone about this and get help maybe from a breastfeeding support group.

I really doubt very much your baby was dehydrated - I won't go into all the reasons why I feel this diagnosis is flawed.

Your HV is not being helpful at all.

My heart goes out to you - you are trying so hard, despite your problems, yet you are being undermined.

I hope you can phone one of the support lines and can hook up with a support group.

Hi entropy
I have a 5 week baby girl, birth weight 6lbs and now only 6lbs 2oz (she lost then gained then lost and I will be having her weighed again tomorrow). I am breastfeeding and can totally empathise (so much of what you said sounds similar!). I want to continue bf and have been told by hv that I can but need to supplement with a bottle - she seems more unsettled since the bottle and has less poos (one a day) but when it comes boy does it come! I also brought the feeds closer together and she does seem to be always wanting more when she comes off now (however she then settles). I often put her back on put she just suckles rather than feeds. She also seems to be more colicy since the bottles too. Will let you know how I get on with my hv tomorrow - she is very supportive so far (has no probs with me putting her on a bottle but I really don't want to). I have had 3 bouts of mastitis since feeding her and so haven't had the best start but I'm determined I want to continue - cracked nipples and all. I use kamillasan for the nipples which helps. I also find a dummy helps (despite not ever wanting to use one she finds it comforting). I do have a friend who had a 6lb baby who went down to 5/4 and she bf and now he is really putting on weight so I guess we should have some faith!!!!! Let us know how you get on - be interested to find out. Good luck!