newborn weight loss at 12%...anyone been admitted

[muddylettuce]

So on day 3 I was told my baby had lost too much of his birth weight. 12%. We narrowly avoided being admitted to hospital and we're put on a feeding plan which specified 3 1/2 hourly breast feeds with top ups of expressed breast milk or formula. Now, day 5, baby has put enough weight on so that weight loss is 8% but we're not off the hook, he'll be weighed again on day 7 because I didn't top up. I don't want to use formula (my daughter has cmpa, there is a higher chance he will too and I don't have alternative formula until I can see the GP) and frankly it was difficult enough feeding him from the breast let alone a bottle. Plus he cluster fed all the first night of our plan- hourly- so there was no way I could express or feed him more. Anyway, that's the background. I wondered if anyone had been admitted to hospital for this reason and what happens? I will continue to breast feed on demand but if he doesn't continue to increase 'we will be straight into hospital' midwife's words.

I was readmitted on day 5 as DC had lost 15% and had raised levels of sodium in her blood. It sounds like you are on top of feeding now, and your midwife sounds like a nightmare.

Sounds like you are doing brilliantly. Aim is to have regained birth weight in two weeks which sounds totally possible.

Ignore your midwife - no need to go to hospital! Enjoy!

Thank you guys, I didn't know the aim is to have regained in 15 days that's reassuring. Got made to feel terrible for not topping up! X

It sounds like you're doing great, and there doesn't seem to be any reason to believe he will lose weight, so try and put your bullying MW out of your mind and focus on demand feeding. . The aim is to regain in 2 weeks, but it sometimes takes longer, and as long as baby is well, lots of dirty/wet nappies and gaining some weight then it's not necessarily a concern.

Three and a half hourly doesn't sound very often for a baby where weight is a concern. I had similar and was told to try to feed every two hours. Once DD was gaining weight and pooing fine they were ok.

What's "top up with expressed milk" this seems to me a weird request, just making extra work for you-why not just switch sides for another 5mins each side instead?! I'm not sure of your rights, and obviously the health of your baby is the most important thing here, BUT I'm not sure you're obliged to get her weighed or to go back to hospital at the midwives request or anything like that. Don't let them threaten/bully you. Good luck.

The whole thing has been really stressful. I have just woken him for his scheduled feed at 4am as per their instructions. I had to change him to wake him enough to feed but he just screamed and wouldn't latch. He screamed for an hour and fed for 5 minutes. I finally settled him and gave up. It was awful, distressing for all of us. I just don't think he was hungry. That would have been his 9th feed of the day. If he fed religiously every 4 hours he would only be feeding 6 times. I am genuinely concerned he only feeds for 10 minutes at a time mind you. Are some babies just super efficient?

How often is he wearing/pooing? Is he floppy or lethargic?

Iirc when they go quiet and don't want to feed you worry, if he's energetically not wanting to feed and the nappies are ok and he is waking to feed at times through the day I would think things are ok.

Does he seem satiated after the 10 mins?

Yes, this has happened to me with dc2! I was re admitted when dc was 2 weeks. It was terrible, topping up with a syringe every two hours from the START of the last feed. We were admitted on a Friday and didn't see a consultant til Sunday, just registrars. The immediately sent me home. I was just getting over mastitis, dc was jaundiced, trouble establishing bf - as I did with first dc. Said this was likely to happen to all my DCs - just tended to suffer from bf jaundice, trouble gaining weight. It was true. All 4 DCs v skinny til they weaned, three v strapping girls, the mirror image of their rugby-football player shaped father!

Oh, top up with bf made me cry with rage, but I did use to dutifully express into a syringe....

Top up with expressed is so you know baby has taken 10/20/30ml on top of a breastfeed.
We were admitted on day 5 as DS had lost 12%. On day 3 I was advised to top up with 10ml after every feed. Different midwife saw me on day 5 and said it should have been 30ml. His latch was fine but he wasn't getting much milk out. In hospital he was fed every 3hrs with formula or breastmilk. My day & night went like this: feed him (could take an hour as I had to get 70ml into him), change his nappy, settle him back to sleep, express milk for an hour. I had no sleep at all. He had a cannula in and was very floppy. At one point we thought we were going to lose him, he looked so poorly. I felt like a massive failure and despite seeing many breastfeeding counsellors, I lost all confidence, fixated on getting so many mls into him every 3hrs and felt terrified whenever I put him to the breast so I stopped BF. He had a mixed diet of expressed milk and formula for 3 months - not easy to do when supply was never established. 5 months on and I still cry over it. Sorry, not very positive but the whole experience was awful. If you can avoid going in, do so. Express one boob whilst he's feeding off the other if you can.

Now, I have a lovely little boy who has dropped from 50th centile to 9th but has found his line. Neither of us are big people so it was always considered odd that I had a baby over 8lb anyway! He took 3 weeks to regain baby weight but my HV are a lot better than the midwives were.

What exactly is going to happen in hospital? You both will get stressed it will affect your milk and make the whole thing even more stressful. Then they will whip out formula before you know it.

If there are plenty of wet nappies that is the best indicator.

I had the same thing, but was forced to top up with formula, thereby avoiding hospital. But looking back it wasn't very helpful. I had a baby with dry nappies for days and being my first didn't know. I did tell the HV but they weren't overly concerned until my 10 day check in hospital and then everyone was very concerned.

If you need any advice or support there is a NCT free phone line, available for everyone you can get advice and support for trained practitioners. 0300 330 0700

Thank you everyone. codandchipstwice we are having wet and dirty nappies. After 10 minutes of feeding during which I can feel, see and hear he is guzzling he falls asleep and drops off the breast. I then wind him, and have been stripping him off etc to get him to wake up for a second go. Sometimes it works, sometimes not. He's not floppy or displaying any symptoms that might make me worry. Except obviously the weight issue. We went into the local breastfeeding support centre on day 2 as he was biting and screaming when I tried to latch him on for a feed. They gave me advice on positioning and checked his obs and said he was fine and arranged for me to come back the next day for the day 3 check. My milk only came in on day 3 and he was an elcs at 39+3 so I just think they caught us at a low point, milk not in, latch issues etc. I never had any of this with my first, in fact I had to time her otherwise she would never come off the boob. I used to look longingly at other mummies whose babies were quick feeders! Be careful what you wish for I guess.
After the hour long screaming match he woke up naturally and hungry an hour later and fed like a dream. I would tell them to stick the plan except I'm worried he's not getting the fatty milk if he only feeds for 10 minutes.

You could try breast compressions while feeding to increase the amount he's getting.

www.nbci.ca/index.php?option=com_content&view=article&id=8:breast-compression&catid=5:information&Itemid=17

I had a similar problem with both mine who lost over 12% and took a month to get back to birth weight. I have big boobs (not sure if that matters) but it seemed like my babies got full quickly on the thin milk and never got to the good stuff. I saw about 15 lactation consultants and no one could resolve it for me. I ended up mix feeding with formula (neocate) as mine were intolerant too which worked well for us. Hope things get better x

To he honest it depends on how fast your let down reflex is. After 10 mins the fatty milk could well be there. A newborn's stomach is the size if a walnut so longer feeding or more frequent feeding might not help. If you over feed he could bring the excess up.

If the nappies are wet then he is getting milk.

Your milk will change according to the age of the baby, so right now it will be perfect for a newborn.

Don't dispair you are doing really well. Your MW sounds like she needs some better training. Milk normally comes in after the 4th day, before that it's the colostrum. In my experience MW have poor bf knowledge.

It's not just wet nappies you need, it's plenty of pooey ones too. A baby can be having wet nappies but there still be problems with milk transfer.

We were kept in hospital for 8 days because of this (weren't discharged in the first place) they didn't do anything useful to help and to be honest I think we would've been better off at home. Sorry you're going through this OP. Was your baby a good weight at birth? I think they were more concerned with my DS as he was premature and only 6lb9 at birth so had less to lose if that makes sense

Noble, can you just clarify the 'plenty of pooey' nappies remarK? Breastfed babies don't necessarily poo much as less waste to get rid of. Mine typically went 3 days between poos and that's not unusual.

Every 3 and a half hours doesn't sound like a lot to me, DD fed at least every 2 hours for the first couple of weeks plus cluster feeding from 7pm-11pm every evening.
Sounds like you're doing a great job, and the midwife doesn't sound fantastic! Keep doing what you're doing ??

The 'breastfed babies typically poo less than formula fed' used to really worry me as bf DD poo'd about 8 times a day! I always thought it was because my milk must be poor quality and there was too much waste. My point being that there's a massive amount of variation between the number of poos in a bf baby so it can't be used as a reliable indicator of problems (or lack of)

My son is now 4.5 weeks old. He was born by elcs at 36+6 and weighed 5.15oz. He had lost 12.3% birth weight at day 5. He also had jaundice so we were readmitted. He was doing plenty wet and dirty nappies and was very alert.
Like you, I was put on a three hour feeding plan where I had to bf him then give him a top up of expressed milk and then formula (totalling 50ml) then I would be hooked up to the double pump to try to get 50ml for the next feed. The whole process took most of the three hours by the time id settled him and tried to force feed him as it ended up more like 2 hourly feeds due to the length of time to get him fed. After two days he refused to bf as it was easier to force a bottle down him (maternity assistants did this). One midwife said of course he doesn't want to bf, he's so full from the bottle feeding. Let him get hungry then he will bf.
He gained just enough after 4 days and we were discharged. He had totally stopped bfing by this point. I was expected to carry on with the regime at home and sent a hospital grade pump. I was utterly miserable.
I simply fed on demand at home and he started to bf again to my delight. I pumped for a couple of days to get my supply up but then just bf.
He regained his birthweight by 3 weeks which wasn't too bad seeing he was three weeks early and jaundice had affected his appetite. He had heat treatment for the jaundice.
I was finally signed off to the hv who has been a lot more laid back than the midwives who had me in tears daily and depressed. I would have changed to ff rather than go back to hospital again. I hated it.
Anyway, he's now over 6lb and is never going to be massive but is happy and content.
I really feel for you and I hope you get through it. Don't let yourself be bullied like I was.

I found this guide on newborn nappy contents useful: realbabymilk.org/babys-nappies/

But every baby is slightly different, its just a guide

I was still in hosp with DS my firstborn at 5 days and they were reluctant to let us put as he had lost almost 10%, they weighed him after a feed and cleared us to leave after I'd said I'd feed him formula, just so I could get out of there...I did top him up with some formula for about a week after we came home, then we carried on exclusively bf after that and his weight gain was good.

And yes 3.5 hours is a big big gap, I'd be aiming to feed every 2-2.5 hours tbh, my youngest had a bit of jaundice and this is what I aimed for.

spring going three days between poos for a bfed baby of a few weeks old is fine, it is not fine for a newborn.

I think it's horrible to hear how much pressure the mothers on here are being put under. I understand that weight loss can be a sign of problems but looking at it in isolation, and hospitalising a baby that is showing no other signs of concern, is counter-productive to my mind. Not to mention the flaws in using weight as an absolute marker - was the mother given IV fluids during labour, for example (which can artificially increase birthweight leading to bigger apparent losses), was the baby weighed before or after a big feed/poo - these things can make enough difference to make weight alone an unreliable marker in isolation.

I have supply issues so my midwives and I are aware of potential problems. My third baby is now 8 days old, and was a spectacularly sleepy newborn for the first three days, although not raising any concerns about her general health. On her day five weigh in she had lost 8 percent which everyone was pleased with, although she's still under review obviously. But I was assured that even if she'd lost more than 10 percent we wouldn't be sent to hospital because a feeding plan worked out at home would be more likely to succeed than one in a hospital environment. Unless the baby is dehydrated and needs treatment, they are better off with community support and oversight in my opinion.