Normal weight loss in breastfed babies?

[Runningupthathill82]

OK, I know this must have been done to death before but I'm struggling to find the threads.

I'm trying to establish bf with my DD and have been having problems, which is a whole other thread. Anyway. I was feeling a bit better about things when she was weighed on day three and had lost 6% body weight, which I knew was normal.

However, today (day 5) she was weighed again and has lost a further 35g. That brings her weight loss to 6.7% since birth.
She also has very mild jaundice.

I wasn't too worried as I thought our feeding was improving. DD is sleeping better and is also very awake and alert at other times. We're seeing six or seven full mustardy nappies a day, plus another couple of wet ones.

The midwife, though, says that I should now be expressing after feeds to up my supply, and is concerned about the further weight loss. DD was 8lb 12, and she's now 8lb 2oz.

Has anyone got any advice on how much I should be worried? Next weigh in is Tuesday when she'll be 7 days old - should her weight be increasing by then?

Hi!

I had a similar problem to you- DS was actually readmitted to hospital following his 5 day check. He had lost 15% of his body weight (started at 5lb 1oz though so not much leeway for weight loss!).

I struggled to establish feeding as well. He was slightly premature so hadn't developed his suckling reflex properly. I knew that he hadn't been feeding properly until day 4 really, at which point he just 'got' it. I could definitely feel the difference in how his latch and feeds felt (and my boobs afterwards!).

When we got to the hospital the consultant wanted to top him up with formula from a tube. I stuck to my guns and said no. They agreed (reluctantly) to let me just feed for another 24 hours and if he didn't lose more they would discharge. In those 24 hours he actually started putting weight on!

However, I had a very supportive midwife, and had already nursed one baby. I don't think I would have argued with health professionals with my PFB. Doctors know best right?

I guess in a long winded way what I'm trying to say is if you feel like the feeding is improving, then it probably is. I'd give it a few more days and look again. If she hasn't put weight on by day 7 I'd look for some support with feeding. But not from the NHS- they're good for telling you to breastfeed, but not so good at the troubleshooting part!

I was always told they don't like weight loss of 10% or more. Had 12 and 14% respectively with my two children and had to supplement with formula. Expressing isn't a bad idea as it will help stimulate your supply. It would seem that I am one of those people that don't seem to make enough breast milk but told that the vast majority of women do. Try pumping - and avoid formula if you can as it will reduce your supply. Assuming you want to continue breast feeding, not critisising formula.

I also wouldn't read too much into 35g. Most the scales only measure to nearest 20g and a feed or a poo could account for this difference.

Hope it helps and good luck.

One thing to look at is that bigger babies tend to lose more weight and then put it back on more slowly. There is an academic paper on this. Matlock I think? Try and have a look.

Having said that, formula isn't the devil, neither is expressing. You should do what you think is best taking account of advice from doctors/MW. Good luck.

I think when I had my DD they see up to 10% as normal ie not needing any intervention, so your dd's weight loss does not indicate needing to express etc to up supply to me. My milk did not come in until day 4 so weight loss probably stabilised by day 5, and certainly had started gaining by day 7. I think we were discharged at birth weight at about 2 weeks old. My DD lost just under 10% of her birthweight (just under 8lb) but I was never advised to express or anything, just feed as much as possible! If you're getting plenty of wet and dirty nappies, just relax until day 7 and see what has happened. Jaundice at that stage is also completely normal, again lots of feeding and direct sunlight eg lying under a window to feed her. Good luck.

Between 5-8% is normal. Sounds like loss is slowing down, you have an alert baby and changing stools. Sounds like breastfeeding is going really well. Personally I wouldn't be worried at all. Expressing won't do any harm I guess apart from maybe being a pita for you when you probably have enough on your plate.

I had 11% with mine but he wasn't latching so just wasn't feeding enough. I refused formula so I cup fed him until he started latching properly and then just fed and fed him round the clock. He caught up within a couple of weeks and tracked his percentile line perfectly thereafter with not a drop of formula.

Sorry, I should've said in the OP - I had 11% weight loss with my DS, we were readmitted to hospital twice, and I had to express round the clock for three months to establish bf.

That's why I'm so nervous this time and am wondering if DD's weight is going to go the same way. I honestly can't express this time and feed from a cup - it was hard enough with one baby but I just can't face it with a newborn and a difficult toddler.

I'm really wondering if I should be OK with the weight loss of almost 7% or if I should take it as a sign bf really isn't working as I thought it was.

Actual percentage weight loss is not the only part of a newborn assessment - weight loss should have stopped by day 4-5, no matter what the birthweight, but it's not a crisis if it hasn;t. All it means is that action should be taken to make sure feeding is effective and frequent, so the baby gets plenty of opportunity to increase intake.

You don't say how often your baby is feeding, so maybe she could feed more often. She needs at least both breasts offered each time. It's not so much expressing to up your supply, as getting more of that supply into your baby :)

Having said that, if you are confident the scales and the way your baby was weighed are correct, then I think it sounds like you are getting good, sensitive care.....and I can't see any reason for formula at this stage.

I wouldn't give up on breast feeding yet unless you want to (and try not to beat yourself up if you do want to stop). It is difficult with two children and I can completely see why you don't want to be expressing all the time. I never managed to exclusively breast feed but I did manage to combination feed for 5 months. Probably would have been longer but two weeks of flu and vomiting made me too dehydrated for her to get anything. It didn't turn out how I wanted but having had to abandon breastfeeding with my first after less than a month I'm glad I carried on trying.

Good luck.

You say you're getting plenty of wet and dirty nappies, so that's a good sign.

Did you have any fluids in labour (epidural or drip)? Those fluids can artificially inflate your baby's weight.

Sometimes when feeding seems to be going well and many output is good, weight gain can still be slow, getting checked for tongue tie would be a good idea in case your baby is using too much energy extracting the milk.

Breast compressions whilst feeding can squeeze a few extra calories in at each feed and can make a difference.

Weight loss of 7-10% in breastfed babies is normal, 5-8% in bottle fed. DS lost 9.7% on day 5, My midwife was very relaxed about it. Never mentioned expressing or formula and by day 9 he'd regained his birth weight plus 2oz, now, after 4 weeks he's 1lb 9oz heavier. He was only 6lb 6oz when born. Try not to worry too much.

Oh, and DS had jaundice, almost treatment level with blood tests but not quite.

I would say that 7% weight loss is entirely normal in a breastfed newborn.

My ebf ds took 3 to 4 weeks to get up to birth weight. Midwives and health visitors didn't bat an eyelid.

It's really not about percentage weight loss - or at any rate not only about that. It's not necessarily a terrible sign that a baby takes weeks to reach birthweight.

It's important that a newborn does not continue to lose after the first days.

OP - any news?

Yes, thanks for asking - we're doing better, I think. DD is now gaining weight and is 5% below birthweight at 7 days old, which the midwife seemed reasonably happy with.

Feeds are still painful, but the breastfeeding support worker I spoke to yesterday seems convinced that it's due to my inverted nipple rather than tongue tie.

We're getting lots of wet and dirty nappies so I'm ploughing on for now and hoping we're going in the right direction. It's just so stressful, especially after having a DS who lost too much weight and had to be readmitted to hospital, topped up with formula, etc.

Sounds like things are getting better, running. Hope the soreness goes.

Just a bit of an update in case anyone was interested - DD is continuing to lose weight and we're on daily weighing sessions with the midwives.
She's also been diagnosed with tongue tie (after two midwives couldn't spot it) so I'm feeding her on EBM and formula until we get that snipped.
It would be really good to hear from anyone who has experience of re-establishing breastfeeding after a tongue tie snip.
I'm feeling very low at the moment and am struggling to cope.

:( what a blow.

So she started to gain weight and then started to lose it? Are you confident the weights are being done accurately?

Yes, she put on around 55g, then lost that and more at the next weigh in. Since then she's lost small amounts each time.
I'm fairly sure the weights are being done accurately - they've all been done with her naked, on the same floor surface.

Sympathies my ds is now 9 weeks and has his third tt snip on Wednesday. Like yourself I've had to supplement feeds. I've tried to put him to the breast at most feeds and then top up afterwards. Also expressing from the other boob while he is on the other. I've no idea if I will be able to get back to EBM after this long but we will see

My post got eaten but have a big hug. My DS has been slow to gain weight and I've found it really stressful (despite plenty of dirty nappies and that he seems a happy baby most of the time). I know a couple of people who have reestablished breastfeeding after tongue tie. It did take a little while for things to improve for one of them and the other gave up Bf due to her DD'S allergies. I hope things get better soon.