3 week old losing weight - suggested I top up

[Underbella]

I was advised today to top up exclusively breastfed baby with a couple of 4oz feeds of formula a day.

HV also said that baby looks well, good colour, very alert and responsive. She poops twice a day at the moment and they are big poops. Her wet nappy output has declined a bit I'd say. But she usually pees during most nappy changes. Urine looks fine, pale in colour etc.

She was 7.14 at birth, lost 8% of her weight, she then gained up to 7.8, and today she's 7.5.

Breastfeeding feels alot better now in that it's not painful anymore. I feed baby whenever she shows signs of hunger (all the time when awake).

I'm not keen on introducing formula because I'd have to express while she was getting fed a bottle. I can't do this by myself or want the extra washing up.

So surely if baby looks OK, can't I just keep putting her on the boob?

I'll be contacting breastfeeding support folks in the hope they'll come out and see me.

I'd first and foremost talk to a lactation consultant before you make any decision.

Were they the same scales used? That could explain the discrepancy in weight.

Yeh same scales, except the first time she was weighed (7.8), the scales were placed on my rug.

Today the Hv said she would do it on the floor (have laminate).

Why is she being weighed so much? If she regained her birth weight and then some, which is great, she doesn't need weighing again for 4 weeks.

If you overweigh it can cause differences like this. Could be the scales, surface, a big feed/poo. I wouldn't top up if you think the feeding is going well, just feed frequently and re weigh at the 6 week check.

Sorry looking at the weight again she hasn't regained her birth weight. In which case I would get some support with breastfeeding.

Has she been checked for tongue tie by a specialist? This can cause problems with milk extraction and feeding. Would be worth getting the latched checked to make sure she's on well.

Breast compressions during feeds will help to maximise the volume of milk going in and increase your supply. Do you offer both breasts? Does matter if she doesnt take it, not all do.

Yep, you definitely need to speak to someone about this. It's very unusual not to be at birthweight at three weeks. If those weights are correct, then it's serious. She appears to be losing weight. Now, the weights might not be accurate. She should be weighed using metric weights ( not translated into imperial, as errors occur) and without clothing on decent scales.

An Hv who weighs on a rug is not doing her job correctly.

You don't say how many times she feeds in 24 hours or other details. These matter.

Hope you get things sorted. If she needs more breastmilk, then there are several ways to ensure this.

I know it's frustrating if people keep suggesting tongue tie and you've had it checked, but just want to let you know I could have written your post when DS was that age, and he had a 90%, thick tongue tie that was missed even by lactation consultant for 7 weeks. Took him 5 weeks to regain 8%.
I am no expert so can't really advise re. topping up, but your OP definitely struck a chord and is exactly DS' story so thought I'd mention it.
FWIW We did top up from about 3 weeks, and as he had such a bad tongue tie for so long by the time it was cut (8 weeks) my supply was shot and we only limped along with BF and top ups until 4 months. So thought I'd mention it!

Hi curly

A breastfeeding support worker will be coming to see me tomorrow.

The lady I spoke to on the phone said that this situation is not uncommon at this stage.

We will probably be looking to boost supply by expressing (not sure when I'll fit that in she's on the boob alot.)

So therefore topping up with breast milk, rather than formula at this stage.

She said that it's sometimes the case that the baby is not strong enough yet and feeding inefficiently, and falling asleep before full.

I usually offer three boobs for feeds!

It's hard to say how often we feed because the feeds kind of just blend into one another.

I remember this happening with DD1, I just persevered and we got there in the end. But if I need to boost supply then I'll be getting my pump out.

Hv thinks latch is good.

Tongue tie wise I think she's been checked. She's got no bother sticking her tongue out!

Cool that's good that she can stick her tongue out. I always thought DS could stick his tongue out fine, blast he spent all day doing so asking for food, but he stuck it out waaaaay further as soon as it was cut.

BFing never hurt for me, and his latch was always perfect, and he was checked for tongue tie and it was missed 6 times.

Good luck with the support worker! :)

It's absolutely not common for a baby to be actively losing weight at three weeks. This annoys me, sorry. In no universe is this something to be relaxed about. Babies who are not strong enough to feed efficiently and who fall asleep with the effort do exist - but it's something to tackle as a matter of some urgency, in order to protect the baby and protect breastfeeding.

If the BF support worker is clinically trained, then fine. But speaking as a BF counsellor, this is something I would want a clinical opinion on.

Having said that....my guess is the weights are not accurate. Babies actively losing weight have other symptoms (lethargy, difficulty in staying awake).

My ds took 3.5 weeks to get to his birth weight, but he did not loose weight again once he had hit the bottom iyswim.

Is she happy and alert? I'd be reluctant to introduce top ups. It can be so hard to get back to 100% bfeeding. But obviously health of baby is the most important thing, so if that what she needs that's what she needs.

Tiktok I can't remember if she was aware of the fact that baby hasn't got back up to birthweight yet. It was a quick conversation.

She is very alert when awake, follows your eyes and turns her head to a voice speaking.

But she does tend to fall asleep on the boob a lot.

I agree with Tiktok - it's not common and I suspect the scales were to blame and she may not have lost weight at all.

You should still be under the midwives until the birthweight has been regained. I would let them to do the weighing for now as it will give you a more accurate picture.

I'm terms of being not strong enough to feed, if that's really the case, then clinically speaking you'd be back in the hospital. Babies can get tired when feeding when there is an underlying problem, for example with the latch, TT or milk supply, feeding is prolonged as they have to work harder at extracting the milk. Babies often fall asleep at the breast when the milk isn't flowing, breast compressions can help keep them actively feeding and help your supply.

It's great your offering three boobs a session, keep doing that as much as you can.

If she constantly feeding I would get her checked for TT and ask someone to check the latch throughout the feed. TT babies often start ok but slip off and nipple feed, then drop off to sleep as the milk slows. Sadly TT are often missed or dismissed as irrelevant. If your not happy with how it goes tomorrow and you can afford it, I would get a lactation consultant to help you both.

We are not under the midwives. She has been weighed on three different sets of scales throughout her life so far!

I don't understand the loss. I really don't think I could have done anymore. I let her feed until she comes off herself. I always wind her after a boob, which usually wakes her up to go again.

And if she's bright and alert during her waking moments, peeing and pooing... I just don't get it.

Op did you get any help?

Just want to reiterate two points above - from personal experience. HV is not qualified to spot a good latch from a bad one. And whilst there's lots of great BFIng support available please see a BF counsellor as they are qualified and trained to advise

Sorry am I misunderstanding this?

Birth weight 7.14
Now weight 7.5

Where is the not regained birthweight coming up? I see she has well crossed birthweight?

Sorry please forgive my rubbish reporting of weights.

She was 7 pound 14 Oz at birth, then lost 8 percent of birthweight. She then gained at next weigh in, I didn't catch how much but midwife was pleased, the next weigh in was with hv. She had gained a little at 7 pound 8 Oz, hv wasn't that impressed but said it was at least in the right direction. A week later she's lost three ounces and now weighs 7 pound 5 Oz.

All the midwives I saw in the early days were happy with latch.

I'm still waiting on call from breastfeeding support worker, I'll be having a visit from them at some point.

She's had four big poos in the last 24 hours. Surely this shows she's getting milk?

And I've started breast compressions!

It's the weight loss that's the concern. A baby losing weight and nine ounces less at three weeks than birthweight is a worrying situation, and unusual, esp in a baby who seems healthy, which is why there is actually more likely to be a fault in the weighing or the scales or in the record keeping or even in the translation from imperial to metric. Do you have her metric weights, OP?

Only from the two weigh ins with the hv and birthweight (kgs) :

3.58
3.41
3.34

OK, translation is correct, thanks.

Other things could be awry, though....will be interesting to see what the bf support worker says and it would be useful to have another weight.

I've a lady coming to visit me late morning. It happens to be the same lady I saw over five years ago with DD1.

I'm amazed the midwives discharged you. That's really poor care.

Hope it goes well this morning. Four big poos is really good going! I would also get another weight on the same scales, weighing in the same place for accuracy.

I have the same thing OP - big baby born at 4592g now at 3 weeks weighs 4090g - plenty of wet and dirty nappies, very alert

The hv did say that it was a good job she wasn't a small baby. What did that mean? That they insist you top up with formula?

Curly - maybe it's because everything was going well. I had a really good birth, stitches were no problem, I've recovered really well. Baby's jaundice was clearing, I've been low risk throughout my pregnancy. Think it's just common practice to handover to hv on day ten of babies life? I'm in Scotland, don't know if that's got anything to do with it.

Liberty - It's nice to know I'm not alone with this although obviously we want our babies to gain weight!

I remember with DD1, it was suggested I top up, but I just had a feeling that it was all going to be fine, then she started to gain well. She made it back to birthweight weight at two weeks though but was a bit slow to gain overall.

So Baby has had a bit of a puking episode all over kitchen cupboards as I was making a cup of tea. It seemed like a lot of milk she brought up. She is now if course back on the same boob, feeding happily. I can hear her gulping occasionally.

This just doesn't add up!