Slow weight gain (breastfed baby)

[Db721]

Hi,

I am currently dealing lots of concerned noises from various people and looking to see if I have missed anything obvious.

Baby is nearly 5 weeks old, second baby born at 40+6, normal delivery. I would however describe her as “waterlogged” and she was 9lb 6oz (first was 7lb 1 so a bit of a shock!)

Lost 9.6% on day 3, 10.4% by day 5. Plateaued for a bit and now gaining but flat lining on chart. This week, she’s gained 120g (17g a day).

We’ve twice been sent to PAU, everything fine both times. Been told today to do compressions and to express after feeding and give whatever I get when she’s done (so far about 5ml at best). If this doesn’t work I will be “given a more formal feeding plan” whatever that means.

It’s not particularly practical to do this but will try, with school runs and general life I don’t think it’s particularly realistic. Baby feeds every 2 hrs during the day, cluster feeds in the afternoons/early evening but sleeps well at night - 3-4 hrs after last feed then 2 hourly.

Baby is otherwise perfect. No jaundice, lovely colour, very alert and active, getting stronger, and the “right” number of wet and dirty nappies.

I feel a bit deflated by it all as it’s going much better than with my first, I don’t feel there is anything wrong with her and have been told this by 2 doctors. It seems like I would get everyone to leave us alone if I topped her up, but I’m reluctant as I did this with my first and it made bf much harder in the long run.

Hi, couldn’t help replying as I’m in a very similar situation too so thought I’d share my experiences. Third baby, now 13 weeks and Just above 2nd centile after being born around 25th-50th. Feeding going “well” in all the ways you’ve described, just the scales that are slow to creep up! Very deflating after not being very successful with my other two children and in every other respect she appears satisfied, sleeps pretty well, plenty of nappies etc. She did have a tongue tie that was snipped at 4 weeks so there were murmurings about that having reduced my supply but I’m not convinced that’s the case.
I held off topping up too, although with the agreement of the lactation Consultant at baby cafe, as she was having some ok gains (still not the 30g/day they’d like though).
I have this week started giving her about 50ml expressed milk on an evening and again in the morning. She’s managing to stay on roughly the same growth curve for about 3-4 weeks but only just hanging on really.
I feel like I can’t feed her any more than I already do so kind of resigned myself to it and getting fed up of everyone’s comments about how tiny she is! I’m using a haakaa to get the milk though as I’ve no time for actual pumping!
Sorry I’ve not really got any answers, just to say I know how you feel and you’re not the only one with these frustrations x

Thank you
It’s just annoying isn’t it when you’re doing as much as you can and you still don’t get the numbers on the scales!

You’re doing well to get that much expressed to top up, I am nowhere near that. Every time I’ve tried she’s woken up within 10 minutes of me finishing pumping and been feeding straight off so it feels pointless as I’m only feeding what she would have drank anyway, maybe I’m wrong about that but it feels counter productive and I don’t magically seem to have increased my supply.

Sending chubby vibes!

Yes definitely-I feel like the efforts I’m putting in just doesn’t reflect in the scales at the moment.

Yeah there’s no way I’d have time to use a proper pump, that’s why the haakaa is so good. I’m hoping it ups my supply a bit by using it too. I do have to be careful when I use it to avoid ‘stealing’ her milk but I tend to put it on the boob I’ve just finished on when she has the other side. Or mornings are good as I have more than she wants at that time. It does tend to take all day to get that 100ml maybe from 3-4 separate haakaa sessions so I definitely don’t have a super abundant supply but then she’s feeding so frequently in the day that I don’t think you can expect to pump much in between?!

Did you decide whether to top up or not? X

Have you had a check for tongue tie?

If you would rather give EBM than FF if you must top up, have a look at human milk 4 human babies

My DD3 lost a bit more weight than they would like, a lovely experienced midwife told me it's more important to look at the baby in terms of nappies, skin colour and alertness instead of weight alone. If the first 3 are good then slow weight gain isn't necessarily an issue. I also believe it's possible for a baby to be on a high percentile during pregnancy but once they're here they follow a much lower one. Also re the pump, some people are just not able to get much out because after all it's not a baby.

I honestly don’t understand why they tell you to express rather than feed- surely a rooting baby is better for upping supply than machine!

There is a thing called catch down growth that a very knowledgable poster on here called TicToc explained to me- sometimes babies are born bigger than they “should” have been and adjust during the first few weeks. Maybe that’s happening? It certainly seemed to explain the way my second dc grew-because he was my second I had the confidence to think that so long as he was well and perky and peeing and pooing and gaining some weight it was fine. And it was!

The other thing to do if you can is just spend a day in bed together with the remote control, drinks and snacks and just feed and rest and doze and feed. It’s lovely anyway and will be good for your supply.

Tongue tie has been checked for, all ok.

Am trying what was recommended (compressions and expressing after) for the week first to see how that goes before I think about topping up.

I’m not anti-formula, if I felt she needed it she’d have it but I just don’t think she does. Enough people have said she’s fine, I’m just really frustrated that it looks like we will end up back at hospital with a perfectly healthy baby, then back at a support group, repeat repeat repeat .

She’s been cluster feeding today, so I’ve been expressing whilst she feeds. The house, the washing, the cooking can all wait but the school run can’t!

And thanks for your stories of similar babies, it helps to know we’re not out there unusual!

Can I suggest a call to the National Breastfeeding Helpline? 0300 300 0212

You'll get a knowledgable breastfeeding counsellor to talk you through how to ascertain if there is a weight gain issue or it's normal, how to increase your supply if necessary and unpick the various potential issues/non issues that might be happening.

It's really easy for us to say this is okay/not okay online, but there are so many factors always at play we can't give you a certain answer - they can help you get some surety and make a plan if needed.

There is also excellent support available via Facebook group 'Can I breastfeed in it- breastfeeding support'

There are a good number of trained peer supporters there and many other BF women many of whom will have had similar issues

Hi OP,

Not sure if this will work for you but I’m the early days I bought a Haakaa pump which I suctioned onto the opposite breast every time my son fed. It collects the let down and by the end of the day I’d have a combined feed of 70ml or more. Then you can do a top up bottle feed before bed.

I honestly believe this was vital in helping my baby back up to birth weight (he also dropped 9%) and getting rid of his jaundice. I see you have been checked for tongue-tie but make sure there is no thrush either. My boy had both and once all these things were sorted, it was plain sailing (minus a few blocked ducts here and there).

Dc2,3 and 4 had catch down growth. All born way too big, 10.9, 9.14 and 11.6lbs. They all lost on average 12% of birth weight, took ages to regain it and only ever gained minimal weight from there. Dc2 and 4 started off the top of the centile charts and by 6 months old were on the 40th line and thats were they have stayed for weight, dc2 was bottle fed and dc4 was breast fed. Drs, midwife and health visitors all unconcerned as babies all alert, meeting mile stones, peeing and pooing, i just grew them too big and they adjusted themselves.

Thanks everyone for all the advice. We were back at bf group today, she has gained another 3oz but that has made her dip down again on the b graph.

Hv checked again for tongue tie and says she is, although not “badly” and said we don’t have to have it treated but to consider it as an option. So 3 midwives and 2 paediatricians have all missed it.

We now have a feeding plan to give 6x30ml top ups during the day. I have no idea how I am supposed to achieve that when she pretty much feeds constantly through the day and when I do express I get nowhere near that amount, but was just met with vague “do your best” noises.

Op = 3-4 oz a week along with

'Baby is otherwise perfect. No jaundice, lovely colour, very alert and active, getting stronger, and the “right” number of wet and dirty nappies.'

Is PERFECTLY fine for a breastfed baby. Slow, yes, but maybe you just had a super good placenta!

Midwives usually not trained to check for TT and to be honest I'd be rather surprised if the HV was really.
You need to get a qualified practitioner to assess this

The HV who looked at her mouth is one of the team who do the procedure to release it at the hospital, so I think she would be the person we’d be sent to anyway.

I managed to get 4 top up feeds into her yesterday, between 15 and 30 ml. There is no way I could get 6, I just don’t express (produce?) enough.

I think my placenta combined with huge amounts of water inflated her to twice the size she should have been

If it wasn’t for the scales I would have no concerns at all. The hv commented on how strong she is, then in the next breath says she “needs formula to get her going”