5 week old not feeding

[Bobbots]

I’m so worried about my newborn. She was 3.6kg when born and we had to do a feeding plan with her when she was born because of jaundice so I was expressing and we were giving 60ml every 3 hours. However she regained her birthweight within 10 days so we were told we could go to EBF and stop the bottles. However I like her having bottles sometimes as it means I can share feeds with DH and takes the pressure off me a bit. Since about 2 weeks we have been reducing the number of bottles per day and gradually increasing breastfeeds. Up until last week she was having maybe two bottles of expressed milk, 2 of formula and the rest was BF. We have now dropped the formula and just do BF and two bottles of expressed.

However she has been so unsettled, screaming in pain a lot, gagging, grunting, writhing around etc. Only occasionally sick. I suspected silent reflux which my first had and GP have gaviscon which didn’t seem to do much so then we were given omeprazole however this was almost impossible to give her as she would spit it all out and choke on it. Whereas gaviscon she took ok so we have gone back to that for now.

I have wondered about cmpa as she does seem more settled since we dropped the formula but for the last week or so she just doesn’t seem hungry. Barely feeds, only takes about 30ml from the bottle. Will wake up seeming hungry but then latch on and fall asleep again or she will have a couple of sips and then stop. Some feeds are only 30 seconds before she stops.

She was 3.9kg when she was 14 days old and now at 34 days she is 4.2kg which doesn’t seem enough of a gain. Previously she gained 300g in less than a week and now she has only gained that in 3 weeks.

I don’t know what to do, I’m so worried. If she wasn’t getting enough milk from the breast then surely she should seem hungry? She won’t even drink much from the bottle. She just sleeps a lot and barely feeds. However she is having wet and dirty nappies and because she has regained her birthweight the GP isn’t interested. She is obviously feeding enough to not be dehydrated but she is dropping off her centile and seems to sleep literally all the time. I feel like I’ve tried everything to encourage her to feed well, strip her off, tickle her feet, blow on her face etc and it just doesn’t work. Please help! Sorry for long rant.

Have you been weaning her from the bottles of formula with the support of a BFC @Bobbots? If not, you might benefit from a bit of support from a BFC.

If you don't know any in your area, I'd talk about reducing the formula too ups and everything else that's going on with a BFC on one of the BFing Helplines, if you haven't already.

Kellymom have a good guide for weaning from formula top-ups here but I still think you'd be best getting some RL support.

Has she been checked properly for tongue tie as well? My DS was very similar and it turned out to be TT.

Thanks for your reply, I have had some help with BFing but none with dropping bottles specifically. I am seeing a lactation consultant on Tuesday so I’m hoping she can help more. I will also get her to check again for TT although I had baby checked when we were in hospital and the midwife said she didn’t have one. She was a specialist feeding midwife so I’m hoping she knew what she was looking for!

That is weird about her sleeping so much and not seeming hungry. Talk to the breastfeeding consultant about it. Might be helpful to record how often and how long the baby is feeding for. If she is still having wet and dirty nappies that is good. Could try having her upright in a sling to help with digestion. They are still so little at 5 weeks - I think you are right to try and wake her up to keep feeding.

I’m wondering if the breastfeeding is a red herring because if it was due to a problem with that then she would surely take the bottle much better? But she’s awful on that too. Either cries and screams or just doesn’t seem interested at all.

You have my sympathy OP. My DD had silent reflux and was exactly the same. I was told I was being over dramatic and reflux sorts itself out but she also started to refuse feeds which worried me. We ended up using gaviscon too and it was a life saver - we also held her upright after feeds for as long as it took to get a burp (45 mins or more sometimes), tilted her cot a bit and also gave her less milk bit more often (I formula fed so I'm not much help with the breastfeeding I'm afraid). I think the smaller feeds was the best thing we did out of all of it, just gave her tummy less to work through and she seemed much more comfortable.