Panicked about slow weight gain

[BlueLilyLilyBlue]

Wondering if anyone has any advice.

My DS is 7 weeks old. I didn't get off to the best start with breastfeeding - my DS and I were both on IV antibiotics in hospital and he was very jaundiced, so was far too sleepy for the first few days, so I syringe fed him hand expressed colostrum. He would latch on but then immediately fall asleep. I didn't have the best experience there as the midwives were so adamant I should continue breastfeeding and the paediatricians were pressuring me to formula feed. I felt so intensely guilty and then when I got upset about it acted like I was being hysterical. I was transferred to transitional care after that for poor infant feeding and was forced to top up with formula. I tried expressing but could hardly express anything. Eventually I was allowed to go home once he started latching on properly. I breastfeed during the day and then retained one formula feed at night after offering breast.

He initially gained weight very slowly so I was going in for regular weigh ins with the midwife. He was born at 7lb 5oz, lost 6.7% weight first time round and then eventually got to 7lb 7oz after 3.5 weeks so I was discharged.

He had his tongue tie cut 2 weeks ago as his latch kept getting worse and he wasn't feeding well at all. That has definitely improved bf although I still have to unlatch and relatch him several times when he's fussy on an evening, although latches fine in the day usually. He cluster feeds pretty much all evening every evening and has done for weeks. He gets very very fussy feeding in the evening, crying and pulling off and feeds almost continuously, although how much of that is nutritive sucking I'm not sure. He refuses a dummy. He sleeps around 5 hours at night and normally has really good nappy output- poos 3/4 times a day and wet nappies every 2 hours or so. He's alert and active, holding his head up really well during tummy time and even rolled himself over onto his back yesterday. I've kept the formula feed once at night as its the only way I get any sleep at all. He doesn't nap well and definitely does not feed to sleep with bf. I was cluster feeding constantly throughout the night without it so I'm reluctant to lose it. It also feels like at least I know he's getting that much milk, whereas I have no idea what he's getting via bf.

He's quite small and a few mums at baby sensory asked me if he was preterm as he's so small. I weighed him on my own scales just by weighing myself with him then just me to get an idea. Now I'm ridiculously panicked as it looks like he's only about 8 and a half pounds. The last time he was weighed was nearly 2.5 weeks ago and he was 7lb 12oz then so its not much at all. He's due to be weighed again on Friday and I'm so panicked that he will won't have gained much.

I just feel like I'm trying so so hard feeding all the time and I genuinely thought he was doing ok and I had really improved with bf. It just feels like I'm just not doing enough for him and I'm so tired. I'm worried the HV on Friday is going to force me to bottle feed or that there will be something wrong with him health wise. I'm so worried my milk supply is low and I'm starving him. My breasts never leak and they rarely feel engorged - they're a bit bigger after his longest sleep but not painful. I don't feel anything with a letdown and I can't hand express very well - literally only drops. I can't tell whether he's swallowing a lot of the time as he doesn't make any noise. He clamps on sometimes and I get vasospasm in my nipples but I think this is just while he's being fussy rather than a flow thing. I'm taking fenugreek capsules (although I don't think im taking enough) and starting from today eating oats. I've had some help from breast feeding advisors but they just say to keep going as long as his latch is fine. I think I've partly been put off asking for help as I felt like such a bad mum in hospital.

Does anyone have any advice? I'm so emotional about it and really don't want to have to give up breastfeeding but part of me thinks at least I will know he's getting properly fed with bottle feeding. I'm so worried that I'm just not doing the best thing for him.

I really feel for you and think that you've been put under a lot of pressure for not a big initial weight loss, especially with the tongue tie.

I know that it's tempting to offer the bottle so that you can see how much they've had but there are ways you can tell with BFing too. Have a read of is my older baby getting enough milk?

Also, I'm not surprised you can't express much. Sounds like all of your milk is going into him

As for the active swallowing, have a look at this video from Dr Jack Newman. If you don't think he's actively swallowing, try some breast compressions.

If he's still not settling after that in the evenings I would hand him over to DH. Some find that a quick walk around the block is rough to get them to sleep and then you can leave them in the hall in the pram whilst you get a break.

This article from Kellymom called "How Might I Increase my Babies Weight Gain" might be useful too

Thanks for all the really helpful links and support @JingleJohnsJulie - will definitely have a read of those. The swallowing video helped confirm he definitely does swallow something which makes me feel better.

I've calmed down a bit this morning. I've decided to pump after every feed and then give him the ebm in the evening when he's really fussy as the milk flow is really slow. I've got about 70ml so far today (50ml just from the first feed this am) so at least that's 70ml more than he would have had plus it'll help to up my supply. It's not very sustainable as I'm constantly feeding or pumping and sometimes both. But if I can keep it up for the next few days and up my supply a bit, at least then I'll have done everything I can before Friday. Or at least I'll feel like I have. If not I'll consider switching to formula. No judgement on formula whatsoever, I just really want to continue bf.

Let us know how you get on

@BlueLilyLilyBlue I have had a very similar experience to you. Also was in hospital with infections for both DS and myself and he was jaundice. He didn't latch and took 4 weeks to return to birthweight.

I've been going to my hospitals breastfeeding clinic and they urged me to get Donperidone from my GP to increase my milk supply. They were very reluctant but they did prescribe it in the end and my milk definitely has increased. Could be a thing to look at with your GP or breastfeeding support?

DD didnt gain weight for a about a month after her tongue tie revision. It was really distressing as my other two were absolute porkers and i had this tiny baby not putting on weight. I watched her nappies (5-6 a day plus poos) and was doing some pumping and some top ups. Plus seeing a lactation consultant. Then she just seamed to turn the corner.

It sounds like you are doing all the right things and really keeping a close Eye on him. You can do this.

Thanks @ablisha - have heard of that and definitely something to push for if my milk supply doesn't increase with all this feeding and pumping!

Thanks @DrJump. Funny how so many babies with slow weight gain have tongue tie issues so maybe I'm not taking that into account enough. Glad to hear your dd did gain a good amount of weight eventually, I'm hoping he'll be the same.

I'm a bit more resolute now than I was to continue bf - it's their responsibility to help me with breastfeeding and I won't be pushed into anything I don't want unless it's really necessary.

Have you seen a lactation consultant? Can you afford to see one privately?

@Thatwentbadly I haven't - I'll push to see one when I see the HV. I can afford it but I'll see what help I can get from them first!

Not all health authority have one.

Thanks @Thatwentbadly I didn't realise that was the case! Useful to know.

Have you plotted his weight on the chart in your baby book (do they do them in your part of the country?- if not google them)

Just looking at the numbers you gave and although the start was no growth, at 3.5wks he was just above the 2nd percentile and now I think he’s just below. But really not much, a full nappy would make all the difference.

My dd was very small and they didn’t worry as long as she was roughly tracking a line. Your ds looks fine to me.

The difference between 2nd percentile and 50th (average) is less noticeable as they get older.

Well it's not great news. He's only 8lb 2oz and has slipped 2 centiles to the 0.2nd centile. Obviously my scales were off. I don't understand it. I spend most of my day half naked on the sofa breastfeeding and he eats basically every hour. The HV observed me breastfeeding and said it's really good technique and he seems to be feeding fine. She said we're doing everything right but he should be putting on more weight than this. She tentatively suggested giving him another bottle of formula a day if I want to but I'm loathe to unless it's necessary.

They're going to put me in contact with the lactation consultant and he has his GP check on Monday. My efforts to up my milk supply have helped as that's definitely increased with all the extra pumping. Maybe now I just need to give it time to filter through to weight gain? I'm just so despondent as worked so hard to get to this point but just want him to be OK.

Definitely contact LLL and a lactation consultant. Unfortunately most HV dont have the training to help with breastfeeding in the way they should be able to.

I agree, you need to speak to a lactation consultant.

But I will tentatively add, and please don't think I'm judging as I'm definitely not and you're entirely justified to do absolutely as you see best, but why would you be 'loathe' to give an extra bottle of formula? If baby has dropped two centiles I might consider it personally to help baby get back on track. Many people combination feed successfully.

Just try not to get too absorbed in the 'not wanting to fail' mentality as really the only important thing is baby is healthy and fed, not whether you're doing 'the right thing'.

I feel mums but themselves under such intense pressure. Don't torture yourself over it. If it doesn't work out, your baby is still going to grow and thrive if you introduce some more formula.

Sorry OP, my post doesn't quite come off right.

What I mean is it sounds like you're absolutely torturing yourself in your desperation to EBF and it's okay to give yourself a break. It doesn't always work out. Hopefully it'll improve and everything you're doing will start coming together, but if not you really shouldn't feel guilty about combi feeding or formula feeding as you're simply doing what's necessary for baby's growth.

I was also going to say, please don't put too much pressure on yourself. It's ok to combi-feed and may be better in the long run but only you can decide that.

Thanks both.

@sockywock I just mean I don't want to affect my supply and end up reducing it by supplementing. Maybe I need to think about giving him a formula feed and expressing at the same time to stop that happening. Fed is best, I just feel a bit all over the place now. Feel like I have no idea what I'm doing so definitely need to seek help from the lactation consultant.

Sorry, cross post. Don't worry @sockywock it came across fine. I think you and @orangejuicer are right that I'm putting a lot of pressure on myself and need to back up a bit. Mixed feeding now does not mean that's what we'll do forever necessarily. And if it helps him to gain that's what matters.

Exactly! Can I ask, are you enjoying your LO right now? Cos I remember having breastfeeding struggles (traumatic delivery under GA, blood transfusions etc) and I felt like my whole day revolved around pumping, breastfeeding, and crying about the latter. I didn't enjoy my DC at all. Breastfeeding was supposed to be this awesome bonding experience and I just felt stressed out like crazy.

When I gave up I felt SUCH relief. I started bonding more with my DC. I started to enjoy motherhood. He's 6 months now, growing beautifully, absolutely spot on and we're starting solids now. The feeding stuff feels like so long ago, and how much it mattered to me at the time, and the guilt etc., is gone.

Not saying that's the same for you of course and you know exactly what's best for you, but just that you're a great mum whatever you decide. And this isn't a reflection on you, and not a failing. Fingers crossed for you that a LC can really help!

My son was born 0.2 centile and preterm. I tried to breastfeed but actually decided for my baby formula was the right thing. I could track how much he was drinking and he couldn’t even latch so I gave colostrum and some expressed milk at the start and moved to formula Soon after.
There’s no right or wrong but you also need to
Consider yourself in this.

Hopefully baby will improve on growth soon enough.

I'm having similar issues, and have been trying a supplemental nursing system. You can get them off Amazon or from the medela website. It's a bottle with a thin tube that you tape near your nipple so baby gets the formula or expressed milk at the same time as breastfeeding.

It's a bit finicky and takes some practice, but I've found some useful tips online from women who have used them for months. Maybe worth looking into if you need to supplement but don't want to use bottles, it will help your supply to increase, baby is fed and satisfied and will gain weight, no nipple confusion and lovely skin to skin benefits for you both.

When my baby (preterm) was down to 0.2 she was given some fortifier to help her grow. We put it in a bottle once a day.

You possibly won’t get access to fortifier but maybe high calorie formula would do the same. One bottle a day was all it took to get her growing faster. We stopped it at 5 months and breastfed for 2 years.

If your dp can give the formula then it’s less likely to cause confusion. I wouldn’t feel bad for supplementing a bit to help with growth. If you pump at the same time your supply should stay high.

Thanks for the advice all. HV rang me just to reiterate to keep pumping and I've got an appointment at the clinic again Monday, after his GP appt in the am.

@sockywock I love breastfeeding him I initially didn't have strong feelings either way but we've really built up a bond through it which is why I'm trying so hard to make it work.

I've decided to keep going with bf and pumping until he's weighed again Monday. If he's not put on anything significant by then I'm going to look at at least supplementing with formula if not switching. Life is too short for me to be this upset, I don't want to look back on this time with him and remember me crying on the sofa! I think I've agonised over it so much and it's ok to do what's best for him and for me.

The only other thing I can think of is whether it's CMPA - he does have quite runny poos (frothy the last few days), is very windy (strains a lot, legs lifted), possets sometimes (especially after formula) and obviously slow weight gain. But all of those things could just be him and me trying to diagnose. I'll see what happens. If it is an allergy then switching to formula won't help, so hopefully either he'll have gained a reasonable amount by Monday or supplementing/switching to formula will help.

So my LO is 10 weeks and is currently having extra weigh ins with the GP for dropping from 25 centile at birth down to 0.4 line at his 8 week vaccines (still just on it today having gained 4oz in 2 weeks). We've actually had a really smooth breastfeeding journey. Latched well from start, my milk came in on day 3, he was back to birth weight at 5 days! He still seems to feed well and appears satisfied. So slow weight gain was a suprise. I got lucky it was noticed by an excellent GP who has been really reassuring. She mentioned that it is thought that birth weight reflects the mother and that baby might have genetics that makes them bigger or smaller and so can track up and down centile lines initially until they find their own trend. We're not out of the woods yet. We're having fortnightly weigh ins to make sure he stays on the 0.4 line at least. If not we'll get a paediatric referral but my GP reassured again that this is likely just for them to sign off that he's fine and just small. She also said at this stage she isn't advising top up feeds as long as LO doesn't seem hungry just on the breast. I hope this is reassuring or at least some solidarity. I'd say get help and advice from as many sources as you can as opinion seems to vary so much. It sounds like you are doing a wonderful job. Be gentle with yourself.

Oh and the other thing my GP said is that weight gain over short periods of time at this older age aren't reliable and she wants to track over at least a month to really see how he's gaining.