Breastfeeding Baby has not gained any weight

[chelsea2704]

DS is 8 weeks old and I have been EBF. He had tounge tie until 3 weeks and then we had a nipple shield so did not have the easiest start to BF. We have today had the 8 week check and doctor tells us his weight is 8lb 7oz which is less than his birth weight :( (8lb 9oz).
He feeds usually 6 times a day between 20-30mins, using both breasts. Very rarely sick, plenty of wet nappies, sleeps well, has grown since birth and outgrown newborn clothes.. the only issue we have is that towards the last 5 or 10 mins of feeds he latches on and off every 30 secs which I thought was because he was full! I now feel like a crap mum as he clearly isn't getting what he needs :( I really don't want to stop BF yet...How can I help him to gain weight???

@mrsp2015 thanks for your nice comments! He is my first baby yes! I think you are right about him not getting the hindmilk, this is why I dont try to feed until he is hungry as he would only have 5 or 10 mins on each side whereas now when he goes 3 or 4 hours he has a 15 or 20 min feed on each breast! I can't really stick to one breast as he definitely prefers the left and will never have as big a feed on the right! I think I am going to express the right to try and increase production.

@superscientist also thanks for your message. I swap sides when he starts to get fussy ( obviously I try to get him back on a few times before switching). The midwives in hospital were not great at helpful to feed, then afterwards we were all more concerned about the tounge tie and shields than frequency so it never came up before I was discharged! Yes pulling on and off is towards to end of each feed, i assume its when he's had enough but I did wonder if it was due to silent reflux as he is very rarely sick however he doesn't have other symptoms!

Re other comments, he is a very long baby and has got longer since birth as I said he has outgrown newborn and up to 1 month clothes and is now in 0-3! Both myself and his dad are tall!

OP, I’m sorry if I upset you, and I do completely get why you would be feeling so defensive about it - like I said, my own baby hadn’t regained birth weight by 7 weeks, so I get it, I really do.

But a mothers mental health comes second to her baby’s physical health, to me. Usual procedure if a baby hasn’t regained birth weight by SIX weeks would be for the midwives to weigh every other day. At week 8, a GP telling you she’s happy to wait another week is hugely worrying. By week 8 in my NHS trust, a baby that hadn’t regained birth weight would be readmitted to hospital and tube fed. Hearing this was the wake up call it took for me to start supplementing with formula temporarily.

You need to understand that although “starving” sounds like emotive language, if your baby has not regained birth weight by week 8, he is not getting enough calories. He is undernourished. That is a fact.

You think he seems happy, but like you said, you are a first time mum. A baby who feeds 6 times a day for 20-30 mins (and fusses for the last 10) is not feeding correctly, and you need professional help, not advice on a forum.

You shouldn’t have been discharged from the midwives if baby hasn’t regained birth weight - when was baby last seen by a midwife (not a GP)? COVID has meant that so many other services are lacking now due to immense pressures, and you need to be your baby’s biggest advocate here. Your baby needs to start gaining weight, and doing what you are doing hasn’t been working - I would suggest seeking advice from a lactation consultant ASAP, someone who can actually check your latch and watch you feed, and watch baby.

Your breastfeeding journey is about you and what you want. What your son needs is more calories than he’s getting. Don’t demonise formula. Any mum that gives her baby what he/she needs to be happy and healthy is doing an amazing job - however she’s doing it.

I’ll bow out now, but please ring your midwife team and ask to see someone. Don’t sit and wait a week for baby to be weighed again.

Sorry - one last thing. Just saw your last post where you said you're only feeding him every 3-4 hours so he gets the hind milk. This is definitely one area you're going wrong.

When a baby feeds from a full breast, the milk he gets at the start of the feed is relatively lower in fat and calories (the foremilk). As the feed goes on and he drains the breast, the concentration of fat and calories increases (hindmilk).

However, if a baby feeds often, chances are he is keeping his mother’s breasts relatively well drained. When a baby feeds from a breast that is well drained to begin with, he gets a larger concentration of higher fat/calories milk from the very start of the feed, compared to if he’d stared feeding from a full breast.

You need to feed your baby more often, not less. You need to feed him every 1.5 hours to start with, so your breasts never get "full". Try and see a lactation consultant ASAP, they can help with your latch and frequency, and help with any other misconceptions.

Op there are lots of signs in your post that you haven’t had good feeding support. Some of your understanding and info in these posts is inaccurate. You need specialist feeding support. Ask to be referred to your area’s infant feeding specialist midwife and speak to any of the breastfeeding help lines. You are looking to BFCs or IBCLCs not peer supporters.

Like the poster above me says... we are right on this - I know it gets really confusing with different answers

In the middle of cooking dinner so sorry for brief message but the kellymom page on how do I increase weight gain is really helpful. Breast compressions made a massive difference to my baby's feeding (instructions are linked from the page on increasing weight gain). I phoned one of the national breastfeeding helplines who were very helpful. It does sound like more frequent feeds are needed too though. It must be so hard having a newborn at this time - look after yourself and good luck!

Actually I hadn’t seen selfloves longer post - yeah I wouldn’t put it like that. It is great that your hcp was happy but their response is unusual and I wonder if your baby has lost weight as usually you would still be under mw care and baby would be on a feeding plan.
You will ah e great local support - it’s juts a bugger to find when you are so busy and at the moment.

Ps my baby was latching well but not sucking efficiently - I thought all was well as didn't realise he wasn't extracting the milk properly but once we got the feeding sorted there was a massive difference in his weight gain and sleep pattern.

Feeding frequently is better for your supply than long gaps between feeds. If he's not gaining weight it doesn't sound like he is getting enough milk or milk transfer is not good. The more often he empties the breast the more you will make

Did you read the link I posted earlier?

OP, I had immense oversupply with DS1. Huge weight gain, bloating, explosive nappies and endless wailing. (I subsequently ebf'd twins with plenty to spare.) I was eventually placed on a 6 feeds a day schedule to reduce my supply which it did within a day or two.

My dd didn’t gain any weight until past 12 weeks and she was on the breast constantly. We actually had daily weigh ins at home until 10 weeks and then two clinics where she gained and lost the same 20oz. And she was a tiny 5lber. My rather useless hv told me to just keep doing what I was. I eventually broke down in a clinic after she had lost the same 20oz again and started supplementing with formula after a breast feed. She was also a great sleeper in between feeds but she was also a very angry baby.

My excellent GP referred me to a consultant for failure to thrive (unknown) and he agreed what we were doing with the supplementing was fine and then she gained weight normally after that if still a little slow. She was also long.

Two visits with the consultant and he was happy with what I was doing and discharged us back to the GP. The final conclusion was that despite her feeding enough my milk is just not calorific.

We are still breastfeeding at 2 years old and she stopped the supplement formula around 9 months. Supplementing absolutely saved her and was nothing to be ashamed off. We did everything right it just wasn’t to be. It never stopped me breastfeeding, and I always gave her the breast first and the bottle after. Don’t be worried to ask the weigh clinic for more help with this, don’t be scared of supplementing it is exactly what it says on the tin, it isn’t a failure, and just go with your gut instinct on it. I wish I had with mine earlier because I had initially brought up supplementing from 5/6 weeks ish.

@chelsea2704 interesting about you being tall too. I'm 6ft and dad is 6'7. Our son is super tall already and tbh I think he is just made long and thin.

Like you he was alert and playful when awake. He just didn't put on weight and then when he did the gain was slow.

Don't worry about supplementing with either expressed milk or formula. Give it a try and see what happens. It didn't work for us but it might do

Did your baby loose weight and is now regaining at a rate you expect? If the answer is yes then you should be more comfortable. If the answer is is only the odd oz here and there then you are right to be concerned.
I wouldn’t quite put it like self love but ultimately she is right, a baby is not getting enough calories if she is not gaining weight. I would make sure you are getting your baby weighed twice a week. We actually had one of those expensive baths with weight scales in there. Good for peace of mind

Skint Santa - I am pleased that you found your way through. Can I correct you though - no one could have said your milk wasn’t calorific enough and certainly there are a few likely explanations for your situations non of which involve reduced calorie milk - and this is something that I only mention not to say you are wrong but because it feeds in to so many women’s fears about breast milk. This has been studied and the calorie variations are small really. Even when women are unwell, in restricted diets and for any other reason. It may be of course that a baby who doesn’t feed very well takes in fewer calories and less of the high fat higher calorie milk. Quite often you hear things about women who make full fat or semi skimmed and it doesn’t reflect what research records. It sounds like you - like many- have had good support for your baby but poor feeding suooort.

I have not had good feeding support at all, no BF, weight, support clinics are running in my area because of covid. I will be getting him weighed weekly at drs from Monday.
As per suggestions I will increase his day feeds and do every 2 hours, I do think this is going to set us back with sleep but we'll see. I will try every 2 hours before trying expressed bottle if that does not help i will then try formula bottle.

Side note. I think mumsnet is great for advise and other perspectives on parenting however I do think people need to think about how they word things in order to be helpful and not hurtful. I am trying my best and I thought I was doing a good job with breastfeeding its clear I'm not but I would like to try and persevere with it. We had a tough start to BF due to tounge tie and we got through that and he only lost 2% of birth weight in the first week which I was proud of. So I will keep going with trying to improve the feeding now as I did in that first week and I try my HARDEST before I give up. Thank you for your help.

Ah you poor thing - we are in a similar position my little one is 6 weeks ebf and not gaining as much as I’d like. I do think squeezing at least another feed in would help. I’m also pumping a couple times a day after feeds (morning is best) and then doing a top up bottle feed in the evening which she is absolutely loving and that might be an easy way to fit in an extra feed ?

If you do pump don't be disheartened if you don't get a lot, it isn't reflective of what baby is getting from you. I never got more than 4oz but DC grew well.

The phone lines are still running - give them a call. The Nct will call you back and keep in touch and link you to people in the area, if they have any. You haven’t been doing a bad job - you have worked hard but you have been let down:(

@QualityFeet yes of course but I do have a consultants letter stating exactly that for being a reason if you wish to see it. I’m absolutely not disputing I had horrific feeding advice for a long time and I still breastfeed now as stated. I just wanted OP to know that she should trust her judgement as well, because my daughter slipped off the centile charts whilst I was insisting that she needed a supplement. I did have a breastfeeding advisor who was brilliant but the local area could only fund her for a couple of days in the early weeks.

Equally I might add it was not a volume feed that was the cause of this, she was weighed prior to a feed and after and it was determined that she was taking on a sufficient (average) amount of liquids. What indicated the calorie deficiency was the green frothy stools and gas that we had with her. It is not a regular situation but it appears my breasts did not synthesise the fat content in my milk sufficiently. She was feeding a sufficient number of times in varying lengths and appearing to be satiated as she finished. I am categorically not saying that this is what is happening here, and as many women on here have stated it took a long while to get back to birth weight, I just wanted to point out that you can trust your own judgement too with this to get further advice. We were lucky that my doctors and consultant were brilliant and supportive of breastfeeding. It was never suggested that I should stop regardless of the issues.

Equally please make sure that you’re taking care of yourself too op. I understand it’s hard to come in public and hear snap judgements made. I’m not suggesting you have my issues at all, it’s not a common occurrence but if you think you need to supplement then talk it through with a professional. It is so very scary when they aren’t gaining weight at the expected timescales.

@SkintSanta sounds like lactose overload

www.llli.org/breastfeeding-info/foremilk-and-hindmilk/

Honestly i really didn’t want you to feel attacked - I don’t want to see your letter I just don’t want women to read your post and think their milk is a likely problem. Fat composition and make up is the most variable ingredient in milk but not in a way that leads to complications for uk born babies. I have seen lots of consultant letters and many full of inaccuracies about feeding. Paeds are wonderful but having trained a fair few in bf many know much less than you would imagine - unless they or their partner has had a baby. What you describe is not unusual at all and having worked with 1000s of babies have yet to come across a case where the composition of the milk was the cause - the composition of the milk per feed can be but that is part of a bigger story. Test weighing for some feeds certainly couldn’t confirm anything either way.

Re: Sleep

There is a reasonable chance your baby is sleeping so much/well because of lack of calories.

@dementedpixie obviously I can only go on what was told to me at the time, and what I have on the consultants letters and that is failure to thrive due to insufficient calorie intake. I will add they did consider all of my breastfeeding habits, I was requested to keep a breastfeeding journal over many months, I had multiple observed feedings and latch was perfect, she would only feed properly in the rugby hold regardless of which side it was, but there were no issues with frequency or volume intake. Their conclusion was the inability to synthesise fat into my milk which coincidentally has the same results as the lactose overload has with exactly the same ramifications so I will concur that could have been a reasonable answer. Obviously we are well past that now and I shall never know which is the true answer, but it won’t put me off breastfeeding again either way. If I have the same issues with any future child I will just start top ups with formula a lot sooner. She was on approximately 10-12 feeds a day on demand up until weaning, and then it was 6-8 feeds a day on demand so some days were many more and some a little less. I would have tried pumping top up feeds but they were concerned with the fat issue and I was never able to pump that much anyways. Certainly not to the same amount of formula she had as a top up.

Both my sister and myself had similar issues with our babies. We bottle fed alongside breastfeeding. Then we could see exactly how much the babies were drinking. I used formula and my sister expressed. It worked very well. Definitely worth a try. Good luck. Xx