Baby not gaining, what am I doing wrong :(

[tollyfeeder]

I’m 11 days into breastfeeding (FTM) and I our baby is having issues with her weight.

She was weighed on day 5 and had lost 10.3% of her birth weight.
I was told up to 10% is okay but as she was over this we needed to have her weighed each day and monitor feeds.
She was only 6lb 6.5oz when she was born, induced at 37+4 weeks.

I’ve been to a local breastfeeding group and had a breastfeeding support worker do a home visit. Midwives have also observed a feed and said our latch looks good.

Day 6 she was weighed and has gained 10g
Day 7 she lost 10g
Day 8 she gained 40g
Day 10 she lost 40g

So over the course of the week she’s stayed at her weight loss of 10.3%

The midwife told me yesterday that I should top up her feeds with 20ml cup fed formula to get to up her weight, she’s also jaundice so said this will help clear that.
I feel so upset about this and I really don’t want to give my baby formula just yet.

I just don’t understand what we are doing wrong.

I’m also really worried that baby isn’t actually swallowing when we feed. I don’t hear anything at all. She looks like she’s suckling but I don’t hear any swallowing.

I’ve tried expressing my own milk so that I can top up her feeds, but each time I try I can only get 5-10ml from each breast, this is with an electric pump.
It’s so mentally draining seeing such small amounts come out.

I don’t leak any milk in between feeds and I don’t really feel as though my boobs feel full.

I’m just starting to think that I’m obviously not producing milk and she’s not getting what she needs from me.

She’s been having wet nappies but doesn’t have a dirty one every day.
Our midwife said this was okay for now.

I really don’t know what to do.
I’ll be absolutely heartbroken if we have to stop breastfeeding but at the same time I just want our baby to be fed, happy and well.

Can you call one of the breastfeeding helplines for advice? Your mw seems to have jumped v quickly to formula top ups rather than trying to help you with the cause.

Does your area have any peer support or other bf support? Just someone to come to see you (or you go to them if that's the option) and watch baby feed.

I'd you want some advice to read Kellymom site can be good.

I think there are numbers to call on the Mumsnet bf page, I'll try to find the link.

Honestly this sounds normal to me. If she's stayed at 10% I wouldn't worry too much. I would keep on with breastfeeding and regular weighings. Could you see a lactation consultant to ease your mind? My son was born at 5lbs and lost 13%. I didn't give formula and he eventually caught up. I'm not a professional however and wound always urge you seek professional advice or a second opinion from a breastfeeding consultant

You’re not doing anything wrong Op. I would seek advice to put your mind at ease. I supplemented ds2 with formula after experiencing similar issues but you may not feel this is right for you.

We have breastfeeding support groups, I went there on day 7. I’ve also had two of the support workers come to my house.

I’m going to go to another group tomorrow and ask them to observe.

I feel really frustrated with the midwives, it’s been a different one that has weighed each time and they all seem to give different advice.

I feel as though I’m just being told to formula top up instead of being given any real help with what could be happening with my milk supply.

They are coming today to weigh her again and I think I need to push to get a second opinion. I just don’t understand what’s going on.

Not expressing is definitely not a sign of no milk.

A lot of issues are about the milk transfer, i.e. how we'll baby can get the milk from your breast. They're can be plenty there but if there's a problem with feeding technique or if baby's mouth is a bit wee or like one of mine had a tongue tie it can make it harder.

Helpline numbers etc on this page:

www.mumsnet.com/babies/breastfeeding-advice-and-support

Good luck and congratulations :)

How often are you feeding? Are you making sure you eat and drink enough?

Hey well done!! You're doing a great job, it's so hard at the start.

We had really bad latch and had to use nipple shields, I mix fed for the first ten days formula and expressing and then a lactation consultant fitted me with the shields (I could have bought them myself but didn't know they existed) and we stopped formula and pumping, the bottles stopped at ten days and we've been ebf ever since (8months now).

So keep going but don't let your own self judgement stop you from using formula as a top up, it saved my breastfeeding journey, it certainly wasn't the beginning of the end like people fear.

There's something called power pumping to get more out by pumping but you're so early into this I'm not sure that's advised. Anything you can get by pumping through the day could be given by cup?

I hope you're ok

11 days post birth, your milk should be in. You can't judge your milk production with a pump, especially if it's not hospital grade. Is your baby happy and settled? That's important.

As for the jaundice, is she very yellow to you? I was told mine looked jaundiced, but I think it was more that he was ethnically mixed race.

Can you find any information on breastfeeding clinics run by the NHS? They used to have one at a SureStart center in my town once a week. I found it very useful and went in regularly when starting and if I had issues with breastfeeding

OP babies who have a slightly greater weight loss on day 5 sometimes take a little longer to get back to birth weight. I would not be suggesting formula at this point as it will not help your milk supply.

Is your baby going off the breast spontaneously at the end of a feed, and are you offering both sides? Wet nappies suggest that baby is hydrated, but lack of poo might mean that she is not getting all the fat, and that is contributing to lack of weight gain.

Has whoever you've seen observed a whole feed? It is important that they see baby go on, and come off.

Is feeding comfortable to you?

Expressing and leaking are not reliable signs of good milk supply.

That should read coming off the breast spontaneously.

My ds was bottle fed and although je only lost 7% it still took about 18 days for him to get back to birth weight.

It sounds like your getting the right suppot inr and credit to you for wanting to persevere x

UPDATE

Today the midwife sent us to paediatrics the hospital as she weighed her and her weight hadn’t gone up and was still at 10.3% loss and she’s jaundice.

There they checked her blood sugars, which were fine, they check that she’s not dehydrated, they aren’t concerned about her jaundice AND she weighs 200g more than ANY of the midwives scales (who have all weighed on my carpeted floor, apparently not advised) so she’s only 100g less than her birth weight, 3% loss.

The Dr has told me to stop trying to express do not give her formula and to just keep on doing what we’re doing with breast feeding.

It really has been so tough this week and I’ve cried so much over it.
I would be happy to give formula if she absolutely needed it but we’ve just not been convinced she has with how inconsistent things have been.

I really hope that with the right support and some confidence boosts I can continue with our feeding journey!!

Great news! :)

If you want to up the milk transfer offer more feeds per twenty four hours and switch breasts a lot. Try to get in four sides per feed - or more. It’s really effective

Oh - my second baby was jaundiced at a few days old and I got some advice ( on here I think! ) to cuddle up with him skin to skin for as long as possible and keep offering him feeds, as he'd gone a bit sleepy. I went off to bed with him on my chest under a blanket and it seemed to work, he started to feed a lot more and woke up a bit. :)

I did wonder about the scales!
I had a baby who lost weight and I felt the same as you. I hired a lactation consultant, who made a plan and predicted that dd would be back at her birth weight at three weeks, it helped having something written down to show the paediatrician, and yes, she was back at her birth weight by three weeks, as predicted. She had a slight tongue tie, so her weight loss was more than your baby’s.
I also couldn’t hear gulping, it is normal when babies are so small. I never managed to pump much, even when I had to pump all the time while dd had a brief nursing strike when unwell. I remember crying at how much it hurt to pump and how little came out .
Anyway I breastfed with no top ups, until she was two and a half. It will be fine OP, it all sounds normal and fine.
And congratulations!

I also wondered about the scales as the ones used at my son's birth were definitely not very accurate. Consequently, every weigh in there after didn't prove any weight issues...

Hi there, my son lost 15% of his body weight over the first 5 days, all of which were spend in the hospital. On the 6th day we were discharged and the community midwife was shocked at the mis-information and lack of support we were given in the hospital, it was actually very dangerous. Anyway, we got his weight back up by trying breastfeeding each time but also expressing and topping him up with this every feed. We started topping him up by 30ml and gradually increased. I found a manual pump was a lot better for me, I hardly got anything with an electric one! It took 3 weeks and visits from the community midwives every other day (over xmas and new year!!) but he managed to put his weight back on in 3 weeks and is now doing really well. I hope its going well for you now - it will get better!

Hi there, so sorry to hear of the difficulty you're having, but I hope you can gain some reassurance from the doctor and maybe even this thread, that you're doing the right thing. If you weren't producing any milk, your baby wouldn't be gaining weight AT ALL. So the fact that she's gained, then lost etc shows that she is taking milk she's just not taking as much as you would hope right now. But that doesn't mean she won't. In my humble opinion, topping up with formula will exacerbate any supply issues - you want to keep feeding her exclusively from you, and as often as she wants to (or as often as you can). Your supply is still being established so feed her regularly and it will build up. My son also lost 10% of his birth weight and had jaundice as a result (it's quite common with bf babies). He ended up back in hospital and had blue light therapy for a week, during which time I breastfed him and expressed, topping him up with expressed milk and he eventually got back to birth weight but it took a while.
Please don't be disheartened and don't give in to pressure to top up with formula. It's not necessary at this stage. Continue doing what you're doing, and remember stress can affect your supply. So try to sit calmly, cuddle your baby and stick to your guns. You will get there together in the end. Best of luck

Also forgot to mention, when my son had jaundice it made him vvvv.lethargic and sleepy and it was a real struggle to wake him to feed, which made it even harder to flush the jaundice out and put weight on. So you need to feed her regularly even if she's sleeping. I'd say minimum every 3h but more if you can

My baby was hospitalised for being severely underweight due to breastfeeding, my advice from the hospital was:

Pump, breastfeed and then bottle feed expressed milk to baby each feed so you are confident baby is receiving milk.

I was also advised to combi feed with some formula, which I was upset by but in the end a fed baby is a happy baby.

Hope everything is still going well op. DC3 lost more than 10% weight but luckily with her being my third and having a supportive midwife we just rode it out. She's lovely and chunky now. Just some advice re the pump, it definitely isn't indicative of your supply, especially in the early days. As a FTM though you've done so well to stick at it without proper support.