weight loss: bad feeder/low milk supply?

[fififlores]

hello, my baby's two months old and seems to have a weight problem. i'm hoping someone can give me some advice/suggestions.

he was 3.45kg when born, then dropped to 3kg at 2.5 weeks, and climbed back up, reaching birthweight at 6 weeks. In the meantime, the pedaitrican said to give him formula - i did 2 bottles a day, 10am & 10pm, the rest breastfeeds (usually 4/5) and pumping after bottle, to keep milk supply up and top up feeds with EBM when neccessary.

when he got back to 3.5kg, I dropped the morning bottle. now he hasn;t put on weight for the last 2 weeks, so i;m back on the 2 bottles, pumping etc.

he's a bad (sleepy/slow/inefficient) feeder - some times latches well, sometimes not - i;ve tried all the opening mouth/waking up tricks.

but i don;t know if maybe my supply isn;t good - short of talking fenugreek and feeding him as often as possible, does anyone have any experience they can offer re weight loss/bad feeding/increasing milk supply (i saw the post re a nutricious s'wich lunch, so will trying that!)?

Or should I just stop stressing out so much,give it up as a bad job and switch to bottles - feeling so disheartened right now! but i love breastfeeding him, and i know i;d be gutted to stop - but is there any point, if it;s not giving him what he needs? thanks.

tiktok can i ask if that's right about the babymooning after dd had regained her birthweight? or would thta still have been dangerous?

Er.....what's dangerous about a babymoon at any time, Aitch? It's a lovely thing to do, and it's perfectly ok to do it for fun! What gave you the idea it was something to avoid?

i mean from my very singular perspective, in that i was told i had to give formula as dd wasn't regaining her birth weight. i think she made it back at about 6 weeks, by which time she'd been on formula regularly for 4 weeks. i was also bfing, pumping and giving her ebm, anything to get food into her and get that weight back, right?
however, what i mean is that it only occured to me a long time afterwards that i wished that once she'd got her birthweight back (dd was never in the slightest bit sickly, i must stress, always very alert and active, just not very heavy...) i had pulled back on the formula to encourage my breasts to make a bit more.
because wasn't i just filling her up with formula and ebm by that time? (i understand why i had to, but...) that's what i mean by dangerous, would it have been wrong of me to cut out some formula in the hope that it would encourage her to feed more at the breast?

Oh...you mean babymooning instead of topping up/giving formula, not in addition to...I see.

This is such an individual thing, and it's a judgement call. If a baby's weight is no longer a cause for real concern, then yes, it's actually important to deliberately withhold some formula, to prevent the baby from filling up on it and being reluctant to take from the breast.

When I help mothers with this, I always urge them to get any new regime overseen by the midwife or health visitor as well, though.

A typical 'programme' would be to cut back each top up (of formula or ebm) by an ounce or more, and to always make sure the baby had four sides to a breastfeed before offering it. It's not uncommon for mothers to be giving a (say) 10 lb baby six feeds/top ups of 100 mls and then trying to breastfeed in between. There is no way milk supply will be retrieved that way - the baby cannot have much room for breastmilk! In those cases, as long as there is no weight crisis, the mother can be encouraged to offer three-to-four breasts, and then at the times it is needed, say 70 mls top up - and thereafter you are playing it one day at a time, making sure the intake of formula goes down over each day.

HTH

well i wish someone had mentioned that to me at the time... ggrrrrrrrrrrrrrr.

i remember very clearly the day when i realised i'd stuffed that up, just had a classic 'lightbulb moment' and thought 'but if i'm giving her all this bloody formula and ebm, how am i stimulating myself to produce more milk?' but by that time it was too late. i do think i had other problems, by the way, so i'm not sure i'd have managed exclusively, but i could maybe have gone on a bit longer .

i am not kidding tiktok, there were about twenty people involved in m bfing care (moral of that story is don't have a baby at christmas if you fancy some continuity of care) and nobody mentioned this...

Well, Aitch, you were let down.....mothers in the middle of a crisis (esp if they have had a real fright with the baby losing weight or similar) can't be expected to have the logical, dispassionate view of the situation that's sometimes needed, but even so, rocket science it ain't, and even the most useless HV should at least be able to suggest it (or breastfeeding counsellor, come to that).

Trouble is, there's sometimes a view among HVs (and others) that mothers may be secretly 'seeking permission' to stop breastfeeding and the HVs etc take this as a cue not to give them information about continuing to breastfeed. I don't work like that.

to be fair i think that there were so many people involved with different agendas (get weight up, keep bfing, use formula, pump more, bf more) that it could easily have slipped by, each thinking the other had told me. next time, tiktok, next time...

You're very kind to them, Aitch

I think your outlook is great, though - you are learning from the experience, you're open to a 'next time', and you are stoical rather than bitter

oho, i've been bitter too...
(actually i really think doing BLW has helped a lot with my 'healing' on the matter. no point worrying about the things i can't control, but i can do my best for her future nutrition in other ways.)

Hi fifilores - if he's only having 2 bottles a day, then that's not too catastrophic - I've had 3 slow gainers, and the first was supplemented by ff from 1 week, but the other two I did manage to b/feed completely. Ds2 was having a formula supplement in the evening - like you I was expressing, giving EBM etc. Once his weight started going up, I dropped the supplement out, and fed him as much as was humanly possible, including lots of EBM, and within a few days he was exclusively b/fed again. So you could do one bottle at a time.

This might be rubbish, but you could try dropping the evening bottle rather than the morning one - I'm sure tiktok will correct me if this is wrong, but formula seems to knock them out a bit more than b/milk, and you really want him to be feeding at night as this builds up the milk supply ( I think there is more prolactin at night). The morning one should be easier to drop anyway as you'll have more milk in the morning.

Don't give up - even if you don't drop the supplements it is possible to mix feed - that's what I did with ds1, and although I regret that he wasn't exclusively b/fed, I'm quite proud that I kept going with mixed feeding for 13 months.

(which is NOT to say that peopel who feed puree are doing anything other than their bast... oooooh it's a minefield, all this. )

sorry, dd was helping me type that...

I wish I'd seen this when I was BFing, if only to know I wasn't alone. Aitch and Fifi, my experience was very similar to yours, my baby constantly fed but put on very little weight, only I had no support at all the 1st month as everyone was on holiday (never have a baby in Italy in August).

I also mixed fed, from 6 weeks to 18 weeks, then dropped the bottle as it was making very little difference and I was losing my milk. Everyone thought I was mad and I was a bit scared, but I eventually did get excellent help from the baby clinic as they're very pro BF here. Like Aitch I did everything possible to increase my milk supply, inc getting up at 2am (my DD had always slept through) to express as I was told that night feeding influences supply a lot more. Is this true or is it another of those myths?

BTW just an aside on what you eat affecting your milk quality, this absolutely untrue as I caught a bug and couldn't eat or drink except for the odd sip of water for 4 days and the milk kept coming nonetheless and it had the same fat content as before (could see from expressing).

What really helped me in the end was chilling a bit more about it all, as all the stress about weight gains and whatever ends up affecting your milk supply. In the end it turned out my DD has a high metabolism as she eats like a horse yet at 16mo is still tiny. Can't tell you how relieved I was when I could finally see how much food she actually put away. Oh, and I'm still BFing, albeit morning and night only, but a year ago I would never have imagined getting to 6 months, let alone 16!

blimey miao, well done for keeping going. you are right about the night feeding, by the way, something to do with prolactin levels. i used to sit there feeding for hours at a time in the dark of winter thinking 'god is a man and he's a bastard'. (soooo funny that the good-hearted tiktok thinks i've not been bitter...

it'll be lovely having a birthday in august in italy, i used to live in rome and my friend's b'day was during the feria season and we all would head to the beach at san nicola and live high on the hog to celebrate.

Yep - it's true about night feeding, as prolactin levels are higher at night. I think, though, given than prolactin levels fall quite markedly after the first week or so, it's the lack of frequency that's the main issue - like tortoise says, formula can knock babies out for a long time, and going several hours between feeds at any time is not good.

When it comes to boosting supply, then you have to shelve the desire to see the baby 'go through the night'....those night feeds are crucial.

I used to try and wake my DD at night but the little so and so was having none of it, hence me having to express. Probably because she'd never sleep during the day unless attached to my breast. Sigh, I shudder when I think of what I went through/put my DD through (I used to get quite angry with her!) and all the probable cock-ups I made trying one theory or another. It's interesting that no one prepares you for this shite, we were only told in antenatal classes that the baby might want to feed a tad more often because it's summer and they'll be thirsty, but nothing about not being able to detach her to go for a pee.

Oh well, I'm wiser for the next time (I hope!).

Great having a birthday in August? I think so but don't think DD will when she discovers birthday parties as there'll be no one to come to hers because they'll all be at the beach with their nonni! Poor mite. Never mind, at least I'll be saved from having to hire some place with a naff clown or the latest entertainment craze (bah humbug bad mummy alert).

RE what tiktok says about cutting back on formula, funnily enough my bf counsellor suggested same (by email), as he's knocking back 180ml bottles which is a lot for a 3.5kg baby!! So i'm going to try 165ml, then 150ml, softly soflty, cos when i tried 150ml the other day, he screamed for more. while of course i want him to put on weight, if he can do that without being so full he doesn;t want or need my milk for hours afterwards, that woudl be nice!

also interesting re stopping night bottle cos of pro-wotsit levels. i'd been enjoying the sleep rather selfishly!!!!! although i;d been advised to wake up to pump at night, to avoid long gap between feeds/expressing, i;ve never quite managed it. as a result i was finding all this palaver not as hard to deal with as i would have if exhausted from sleep-deprivation. but i guess if that determined to stick it out, i'll have to.

my own view, and without anyone 'on the ground' here, so to speak (i live in spain, great weather, crap after-birth care), is that if he's gained a reasonable amount when we go to the pediatrician to get him weighed on monday, i woudl really really like to cut back one bottle and feed, feed, feed (and express too, while he;s asleep).

a question: has anyone else been made to feel guilty cos determined to carry on bfing in face of all these 'challenges', as if neglecting baby's welfare, ie weight problem? people have been a bit shocked that i'm so so concerned about bf when what i should be more worried about it baby putting on weight - ie if it;s not working, give it up and concentrate on getting the baby's weight back up, as if you can;t do both. pisses me off, as of course baby comes first, but bf is for his benefit too, for god's sake!!

fifi,

My family thought I was mad to want to continue bf with dd's weight situation. Dh was ok but he didn't understand why I couldn't cut myself some slack. I had an almighty row with my mom who thought I was starving my dd. We didn't speak for 2 months.

My mom has bottle-fed all 4 of us and she did not understand why I was so militant about bf. As a mom, you know instinctively what is right for u and ur dc so just follow your instincts.

Fifi

Everyone thought I was nuts too, and like Mellow I had my mum accusing me of starving my baby. I must admit though that I also had wavering moments when I asked myself why I giving myself so much grief, but I just decided that my BM (and my formidable antibodies lol) was better than any of those formulas out there. I mean, they really smell, don't they?

I was lucky in the end that I found a lovely nurse in the baby clinic who really supported me and encouraged me and gave me the confidence to carry on.

Aftercare is pretty crap in Italy too, or rather it's generally quite good but no one comes to your house so you have to get up and go to them, which is not easy in the early days with a babe permanently hanging off your boob, especially as most of these places are only open a couple of hours in the day, usually mornings. I remember for the 1st 4 weeks I never went as I just couldn't get out of the house before everything shut at midday. Is it like that in Spain?

good for you - i can really understand why you wanted to continue, and how hard it woudl have been with people close to you making you feel bad about doing it. and with a screaming hungry baby, stikcing it out, full credit to you!! you're both make of sterner stuff that I!! bottles give us calm, not sure how i'd cope without, if i ever manage to make it back to breast only. but mellow & tortoiseshell's stories are both a big encouragement to me.

Miao, there's a group here, La Leche, which has meetings (Mellow, i now realise i knew about them all along, doh) last thurs of each month, so i;m goign to the next one, but as far as i know, that's about it. they're militantly anti-bottle. i've left them numerous phone messages in the hope of being able to meet up with someone, but they never return my calls. if anyone tells me about a lactation consultant in seville i will pay gold to see them! here everything shuts at 2, which is fine, and my ds was born 2 weeks into sept, thank god, or the hospital woudl have been half-staffed!

my mum is kept informed only on a need-to-know basis, but as we live in different countries anyway, the distance probably helps to keep things relatively calm. she's always been v critical, but now that i;m a mum is actually pretty supportive.

Fifi,

My experience with La Leche in the UK with bottle feeding has been okay. They weren't judgemental but they did try to persuade me to drop the bottle saying that dd will not want to learn to latch as long as she had the bottle which was easier work for her. I had to say that I left messages and they did ring me back.

I did, in the end, because dd completely refused the breast for a whole day after she was bottle-fed twice in a row (with breastmilk I might add). That was really hard though and you do feel like the worst mother in the world watching your dd cry for hours and not offering her a bottle.

Good news! DS put on 240g last week, so he's now 3.74kg. Hurrah! thanks for everyone's input and encouragement, mumsnet has been my best source of tips, useful info and moral support, esp aitch, ciao and mellow!

My plan is to drop one bottle (the night one, as suggested by tortoiseshell) and feed, feed, feed - ideally every 3 hours, max 4. my bf counsellor suggested keeping one bottle for a week, then dropping that so finally back to breast only - next weighing-in is in 2 weeks' time.

I think that his weight gain is a good base to work from in terms of what he may now lose from the lack of bottles. We're cutting back on the amount of formula too. I don't want to tempt fate, but he's been latching on well too the last few days. Going to try porridge too. So I'm really hoping we're on the up.

Fifi,

That's great news!! I'm so happy for you. You go girl!

cheers mellow - but now everyone;s giving me a hard time for dropping one bottle, when he;s jsut had such a good gain - they all want a 250g gain every week and a baby stuffed full of formula milk. maybe he does need to catch up, but i want him to do it with my milk!

i seem like a real meanie to them, insisting on giving him less thick, rich, artificial formula and more boring old natural breast milk. Grrrrr. My brother warned me babies become 'common property'... everyone has an opinion about him... 'we were quite worried' - like i wouldn;t be taking care of him as I ought to, as it;s my maternal duty to. Sorry, whinge over.

fifi,

I know how you feel. My family was the same. They said they are really concerned about my dd's welfare which was why they were butting in. As if I wasn't!