Ebf newborn not gaining weight fast enough. ..

[oneofthosenicemuslims2015]

DD lost 10% of her birth weight at four days old. Weighed at day 5 and gained 85g. Weighed again at day 10 and lost 40g. Weighed again day 15 and gained 10g. The midwife said I now needed to give DD a top up of formula after every feed as baby should be gaining faster than this and we have to go back for another weigh on day 17.
Of course I want what's best for my baby but she is having wet and dirty nappies, doing well other than not gaining weight fast e.g. lovely and alert in between sleeps and feeds. I bf Dd2 and although it was a while ago I remember she gained weight really slowly but surely.
I'm now filled with dread at the thought of another weigh in and midwife not being happy with the weight gain and judging me for not giving dd formula. I don't want to formula feed dd. I want to continue to ebf and give it a bit longer. Had a lovely hv today who agreed and said I should pump after every feed instead. Completely unrealistic with two other dc but I said I would try and have managed to pump once today. I get about half an oz for each breast.

This has all knocked my confidence after a physically amd emotionally exhausting couple of weeks following the birth. Its hard to know what to do and hard to try and pump all the time. Today's been a real down day and I'm not sure where to turn.
Thanks if you got this far.
^that just came out as thanks if you git this fat. Bloomin fat fingers.

We had a difficult start when DS was premature and I remember the pressure and dread of visits. I was very unwilling to start formula despite pressure and discovered there is a lot that you can do to increase supply/increase the amount the baby is getting but it's very hard work.

I have an adult DD who also had problems but for a different reason. Can you pump at the same time as feeding?

I hope tiktok is along to really advise.

Sending lots of love and empathy, you have taken me back to January when we were just out of hospital

thread about similar problem

I had this with mine. Turned out he was fighting a UTI and formula wouldn't have helped. He also had an undiagnosed tongue tie. This HV weight obsession can be really destructive.

Yes I had this. In the end he lost 12%. We weren't even allowed home from hospital.

He had an undiagnosed posterior tt. Despite me asking both a mw and a registrar to check. In the end I gave a few (like 2?) formula top ups but stopped as soon as they released me. They also had me expressing for bm top ups. I was feeding him by cup as didn't want to use a bottle.

A very lovely and experienced community mw told me it was all silly to stop before I drove myself into the ground and just to feed feed feed. We had his tt snipped privately at home.

He's still bf and is now 18 months.

are you saying then that he is generally content after a feed?

I take it he has recovered his birth weight?

Is your baby being weighed by the same scale each time? And remember a weigh in on a full belly (of poo) vs an empty belly the following weigh-in can negatively influence what the looks like.

HVs and MWs aren't usually very good at the whole breastfeeding knowledge and rely on top ups and pump after a feed advice o protect themselves when they have nothing else to offer.

Can you wander down to a breastfeeding cafe and get the input from other people?

I am not a medical expert but here is my experience with DD.

DD was born on the 50th percentile, shot to the 98th percentile and then kept going up abandoning the curves altogether. My doctor was freaking me out telling me she was too big and growing too fast so I did some reading. Everything I read suggested that birth weight is a function of the placenta and then newborns adjust up or down until they find their genetically predisposed weight. This was easy to accept since DD was putting on weight but I always wondered what would happen had she been born on the 50th and then made a dive to the lower percentiles to find her weight. How does one tell the difference between a normal adjustment and failure to thrive?

I appreciate this is of no help to you whatsoever, but perhaps it's worth getting a referral to a specialist just to set your mind at ease.

Ive experienced this and adter a few fomula feeds i stuck to my guns and continued to ebf. Dont let them pressure you, you know best if your baby is generally satisfied and alert . Get baby checked for tongue tie etc but generally if baby is happy and gaining some weight i dont thibk formula is necessary. Its tough to bave to deal with all this especially when you might not yet have recovered from the birth.

I had similar issues with my dd and hv. She wanted me to get up at 2 am to express or to ff. My dd was a rubbish sleeper but she slept at 2 am so guess what so did I and like you didn't see a reason to ff.
When dd was 4 months we moved house so had to move surgery. I expected more confrontation but the new hv laughed at me said she wasn't even going to weigh her as she been done a couple of weeks previously and was obviously happy and content. She also said someone has to be small which is what I had been saying all along.
Such a refreshing change from my previous hv who was saying she would have to refer my dd as she was failing to thrive, she was very clearly not.
Hopefully when you transfer from midwife to hv they will have some common sense.

Forgot your hv suggested pumping after every feed I agree unrealistic with two other children. Maybe get your other dc red books out and compare their growth patterns it will restore your confidence if they did similar.

Thank you all for your replies.
Thanks Isabeller and for the link to the other thread. Dd wasn't premature though but there is some good advice on there.
I asked about tongue tie in the hospital and they said she was fine.

ixqik she seems content after a feed and sleeps for a bit. She is not back to her birth weight yet, she needs to gain about 250grams. Is that really bad for her development? No @ same scale. Two different ones have been used. There is a breastfeeding drop in near me this week so will go there but just feel like I will get more of the same and may as well just start ff.

booboo that is helpful! My other dd was a slow gainer and she is still naturally small and slim. I wonder if dd3 is finding her natural curve?
If she has gained tomorrow I will stick with bf but if not I guess it will have to be top ups. I already feel stupid for agreeing with mw I would top uo and then not doing as they said. It just all seems so hard right now and I'm struggling emotionally as it is due to other issues and hormones etc.

You'd think after 3 kids I'd have a clue by now.

Booboostoo - that's exactly what happened with ds. Started on 91st centile, dropped to just below the curves ( big initial drop, then extremely slow weight gain) and then gradually moved back up, eventually (after over 3 months) getting back to about (I think) just under the 50th centile.

Fortunately I had brilliant support from the bf counsellor/midwives at the maternity hospital (who said he was a perfect example of a non "Failure to Thrive" baby who didn't follow the growth charts) and avoided HVs

I did supplement with ebf for a while - made no difference to the rate at which he gained weight. I was feeding on demand all the time anyway.

bonny the hv was definitely bit more supportive than mw, the mw said she would be referring to paediatrician at next weigh in if no gain! But baby is happy, having wet and dirty nappies, no other issues and yes very very slowly but IS gaining some weight. The whole thing is making me feel depressed tbh. Am filled with anxiety at thought of weighing tomorrow.

Snugnbug, that must be so confusing and undermining for you :(

No one here can tell you to ignore what the midwife says, but we can suggest some questions to ask them, and yourself, and some further sources of info. It's still not clear from your posts if we are talking about a small, more vulnerable baby, so it's hard to make suggestions about what you can do.

• ask about the weight/weighing accuracy...though any baby apparently losing weight is cause for concern...what action did they suggest you take at day 10 when it seemed your baby had lost weight? From what I see here, they should have said something at that point to address the weight loss. If they didn't, why not?

• would 'switch nursing' and breast compressions be helpful to you?

*can you ask to be referred to the local infant feeding specialist for an overview?

• what is the reason for the 10 per cent loss at the beginning? Was this accurate? Were there events after birth - separation? - that slowed things up?

how often is your baby feeding now? Is she using at* least both breasts each time?

• tongue tie been thoroughly checked for?

Pumping after every feed is not sustainable, but if there is any reason to think your baby is not transferring milk well or is too tired to feed consistently well, pumping at least sometimes is good to boost supply and of course you can give this expressed milk in addition to feeding often.

Glad you have support around you. It is true that some babies are fine despite the non-textbook weight patterns - babysnugbug may be one of them :)

Hi tiktok thanks for your post.
Dd was overdue and a healthy weight so not any smaller or more vulnerable than your average newborn. No health issues etc. At day 10 mw said to express and/or gitvw top ups. The thing is I then bought a pump on amazon but it didn't arrive til sunday so in reality baby only got one extra top up on the monday. I did mention this to mw at last weigh in though I.e give me a bloody chance.
No idea@ switch nursing and compressions? Off to google those in a minute.
10% is accurate from her weight readings. She was feeding fine in the day but sleeping alot at night, around 6 hours. I was (shamefully) also sleeping and didn't wake her. At the moment she is feeding between every 2-3hours in the day and every 4 hours at night. I was only giving one breast but have started giving both for most feeds in the day for the last few days.
Tongue tie was checked for at the newborn check at hospital, I'm assuming it was thoroughly checked? Is it worth asking mw again?
I wad thinking about fenugreek seeds to increase milk supply as I know this can work for some mums and I happen to have a massive bag in the cupboard! Not sure if this would be too little too late as weigh is tomorrow.

Snug, based on what you say in your last post, it sounds that she was just not feeding sufficiently often in those early days - someone should have pointed this out to you. 6 hours is too long to go between feeds at any time for most babies.

Not sure how long that persisted - maybe until day 4-5 when she was seen to have lost 10 per cent?

Whatever...can you start feeding her more often and giving at least both sides each time? She is still not feeding anything like often enough to address slow weight gain - at a rough guess 8 times in 24 hours? That's right at the lower end of frequency for a young bf baby, and if you could bump that right up and increase the switch nursing, this would have a good effect on her weight, withing just a few days.

The reason behind most instances of worryingly slow weight gain is usually the bog-standard simple one - the baby is not getting enough chances to feed.

Some babies are laid-back and chilled, and don't 'ask' for feeds as often as they might - they take in sufficient to tick along, and avoid any serious under-feeding, but they don't get sufficient to really grow as they should. Could be babysnug is in that category....it's usually easy enough to turn round, though, once you really start feeding more. You may need to concentrate on this for the next few days so she turns a corner (help with your other dc is going to be important, I would guess).

Pumping, in these circumstances, is an added thing to do - worth doing, but it's not as important as getting more milk down direct :)

Thanks again for advice- have started switch nursing, from what I gathered online you switch breast whenever the baby slows their sucking down from the initial part of the feed. Is there any more to it or is that about right? Am trying with breast compressions but not sure that's working or making a difference or maybe I'm not doing it correctly.

I dug out dd2's red book - she gained 3oz a week consistently since week 1, so although she didn't lose as much as dd3, she gained quite slowly. If dd3 has gained a bit tomorrow I will ask for another weigh in next week and make the case to continue to bf based on previous dcs slow weight gains.

Feeling less sorry for myself and just a pit peeved that mws did not explain about switch nursing or breast compressions - why is formula the go to solution as soon as there is a slight hiccup? Either way I have some sort of game plan and am facing the next weighing head on - with boobs out, baby in one hand and laninsoh in the other... Fingers crossed baby has fattened up a bit.

Have a look at the front of the red book I'm pretty sure it recommends weighing no often than fortnightly. I didn't read it until after I moved surgery and wished I had seen it earlier, I was having to attend weekly and if I had seen it I would of asked the hv why she was going against advice. Obviously my dd was bright and alert and had plenty of wet and dirty nappies and I had no concerns.
If your other dc gained weight slowly I would be less concerned. Seems you are doing a good job and glad you are more confident.
Btw my dd is now 2 and is slightly smaller than her pals but not by a lot.

Bonnylassie,you're right about the red book. Once the baby achieves birthweight and is clearly gaining normally and there are no concerns, the book states babies need no more than fortnightly weighing, moving to monthly weighing.

But OP's baby is not at birthweight.

Yes that's the main difference between dcs, dd is not at birth weight yet where as dd2 was almost back to birth weight at 10 days. I think you're right tiktok, this baby is not as demanding as when I bf dd2, she was permanently attached to my breasts day and night whereas dd3 is happy to sleep through most of the night.

Weighing today...

Not read all responses but hugs and have you got breast fed centile charts? If not get thrm

Thea all the centile charts in use in the UK are breastfed charts - they have been for several years now :)

In any case, the breastfed centile charts don't show breastfed babies growing any more slowly or being slow to get back to birthweight - breastfed babies only slow in comparison to formula fed babies from about five to six months on.

And the charts are only in use from the time the baby is 2 weeks old - the OP's baby is not there yet.

Sorry - OP's baby is now 2 weeks old....but in any case, charts not really relevant here!

Hope the weighing went ok op. My DS was still losing weight at 10 days and it's incredibly stressful.

My red book says monthly!
My HV also marked weights on the chart in the 1st 2 weeks which caused anxiety. The MW disregarded these and used "her" scales which thankfully made more sense.
In fact she said very matter of fact lying that the 2 week "cut off" needs to take the general health of the child into account and some take 1 week, some 3 weeks. She said just feed on demand as she was pooing, weeing and healthy pink.
scary how mw/Hv calmness varies place to place! Mine is now increasing so it's all in the past. Still get nervous before clinic though.