Slow gainer

[Lilkat]

Not sure if this is the best place for this, so apologies if not.

Bit of a long story here too. I've just had my third baby, healthy pregnancy, straightforward delivery and my third attempt at breastfeeding.

With my first she could never maintain a latch - now I suspect she probably has a tongue tie that was never picked up on - she had pretty bad reflux for the first year of her life, and unsurprisingly she was slow to gain weight. My nipples were very sore, and I never seemed to get past producing colostrum. By week 5 I'd given up on pumping and she was fully formula fed.

With my second I tried again. Lots of pain. Found out I had Raynaud's. Tried pumping but output was very poor. Fed on demand - feeds were frequent and she often fell asleep at the breast. Her weight gain was slow - around 10g a day. However she also had plenty of wet and dirty nappies, was alert and engaged when awake....eventually I saw a private lactation consultant and combi-fed. Although I still believe I had a poor supply as after one day of not feeding her my milk seemed to dry up.

So now baby number 3 is here and it feels like a repeat of last time. He has good wet and dirty nappies, he's bright when awake, but he's 16 days and still not back to birth weight - gaining around 10g a day. I'm feeding on demand and using nipple shields, doing breast compressions and switching sides. Some days he wants fed much more frequently, and given his slow weight gain and past experience, I'm worried he isn't feeding effectively. In the past when I voiced concerns I was told that I was just a nervous mum/they were just cluster feeding/my pale skin meant I'd be more sensitive to pain(!) it was only when an older midwife came out with my first and really spent time with me that she confirmed my concerns and we got some help.

I am going to a breastfeeding support group in a couple of days but just wondered if anyone had similar experience and what you did. I'd really love breastfeeding to work out this time but feel very discouraged and hate the thought of the wee man not thriving because I can't give him enough.

My gran never produced enough milk. She was fortunate that her sister had babies at the same time as her and her sister top up my mum and sister. I hope someone comes along with more recent and practical experiences. I just wanted to pass on that it's not a new thing and it is something our grandparents had to contend with too. I often see things like "out grandparents never had this issues" when it comes to feeding. They just had a village in the same situation.

Ok first of all amazing for breastfeeding!!

I have Raynaud's on my nipples too and only starts up when Im feeding.
It's often mistaken for thrush . As it can burn a bit.
You can buy breast pads that heat up so you maintain a good bloodsupply. I found once a good feeding routine is established it goes away .
Babies aren't supposed to gain weight super fast like they do with formula they take what they need and that's enough.
This is my third baby too 19 weeks. And he is a slow gainer but gaining and doing all his milestones.
Some babies are super fat on human milk and others skinny and both are ok .
Just have faith your baby is getting what they need and you're doing great. Keep going to the groups .
My Third baby is by far the hardest to feed. If he was my first it wouldn't have happened.

Definitely avoid a bottle 🍼 make sure breast is always given first.
However this time round as he's my third and I have other kids to put to bed and I took worried about weight gain . I feed on demand all day long and then bath and have a final feed at night then after the breast I offer a small 2oz bottle just to top him up . He doesn't need it but I do it for my benefit lol.

You can also do what's called double creaming if you really were worried about weight gain . Pump both breasts whatever milk you get don't put the milk together in one bottle keep it separate and put both bottles in the fridge the next morning there will be a fat plug on top. Scrape the cream off one of the bottles and place it in the other bottle then feed. So he's getting double fat. Save it for bedtime and he will be fuller for longer too.
Also if you like coffee add a spoonful of coconut oil known as a fat bomb coffee to up your breast milk fat intake

I can't rate spectra pumps anymore they're amazing.
Add a power pump at night (pump for 20 min rest for 10 pump for 10 rest for 10 then one more pump for 10 1 hour total.

Would getting a Lactation Consultant or a Tongue Tie Practitioner to have a look at LO be an option?

2 days is a bit of a wait with a newborn. Could you call one of the BFing Support Helplines this evening?

I'd also add you can call the NCT feeding line if you have any issues. And they'll talk you through it.
The feeding groups will help you with the breast shields too

Evening, OP. We've moved this over to Infant Feeding for you at the suggestion of another poster as we think you might get more targeted replies there. Best of luck with it all.

Thanks so much. I feel like I'm already emotional about breastfeeding and have this constant anxiety around it - which probably doesn't help anything!

Will definitely try the double cream. We haven't used a bottle yet but I assume I could use syringe or cup?

Looked into hiring a spectra pump perhaps with a more powerful pump I'll get a bit more.

Thanks for the advice, I really appreciate it.

This article on increasing baby's weight gain might offer some reassurance too

Yeah I use cups and syringes works a treat. In the early days I used it as a top up .
You're doing amazing 😊

I could have a chat with the midwife who specializes in breastfeeding support, although I think it's a me issue rather than a baby issue. I've had times when he latches, it doesn't hurt and he seems to feed well, it's just so inconsistent.

i could have a chat with the midwife who specializes in breastfeeding support, although I think it's a me issue rather than a baby issue. I've had times when he latches, it doesn't hurt and he seems to feed well, it's just so inconsistent.

I don't think it matters what the issue might be, I if there is one, I'd access the support available

I just fed as much as possible until I felt I needed a break and then gave formula. Probably as much as 40% at one point. Since 8 weeks he is only on breast (now 19 weeks). His weight is much less stable than my first 2 (formula fed) babies, he seems to make big gains and then sits at the same for a bit then had a big jump again. Nothing changes in our feeding so not sure why🤷‍♀️ He’s super content and lots of nappies so I assume all is ok. Keep doing your best - and don’t feel bad if you Combi or turn to formula for support xxx

Have a read of Breastfeeding your Newborn, what to expect in the early weeks. I think you'll find a lot of what you're experiencing might be newborn behaviour?

Thank you. I'm open to combi feeding if needed, but I think there are latch issues going on and if I don't resolve those, I think introducing a bottle could be the beginning of the end of my supply. It's good to hear from people who have used bottles and still managed to keep up bf though, gives me some hope that it's possible!

I did give it a read - thank you! I do go back and forth with myself a bit as I know the constant feeds could be cluster feeding, but because of the slow weight gain, and how things went with my other two, I worry.

Last night I gave him a small top up of expressed milk with a syringe and him sucking my finger. He took it all but within half an hour was really cranky and unsettled - that continued all night and into the first half of the day. I'm guessing I didn't do it quite right and the poor wee man took in a lot of air along with the milk 🤦🏼‍♀️

Going to the breastfeeding clinic tomorrow, the midwife who runs it seems really helpful and supportive so hoping I can make some improvements to things!

If you think it could be your latch, does this video help at all?

Thank you, I've been looking at a lot of his stuff. I trying to go with this technique. Sometimes it works, sometimes it doesn't. I feel like I do the same thing every time, it just doesn't always seem to work. Or it feels good initially but by the end I'm sore. My nipples aren't cut up and broken so much, but frequently look bruised.

Breastfeeding group were really helpful. Baby boy was up 50g in 2 days so that was encouraging and they lent me a hospital pump. Advised me to pump for 15mins after every feed. This hasn't been happening as feeds have been longer and with 2 other kids, I just can't logistically so it. In the pumps I have managed I've only been getting 10mls which is discouraging.

I was hoping that if I could pump a decent amount I'd maybe be able to give a bottle but that doesn't seem likely. I'm reluctant to introduce formula at this stage as if my supply is low and I don't pump much, I think formula now would just worsening those issues. So for now I guess I just watch and wait 🤷🏼‍♀️

Really don't worry about how much you can pump. It really is no reflection on how much you're producing or how much he's taking.

Were the BFing group able to observe a feed or assist you with latching?

They were yes, midwife had me basically hitch my boobs up with a muslin and then latch him, to which did seem to help, it's just a faff. She advised doing that for now, starting with the shields just until milk is flowing and then putting him on.

He's definitely much keener during feeds now - screaming the place down to get fed, and seems to prefer feeding without the shields - but I'm using them as I need to to manage the pain.

I know the latch must be shallow at times as my nipples are a bit lipstick shaped, but even when they're not, I still get pain/discomfort afterwards. Sometimes it feels like teeth grating along the bottom of boobs - as if he's sliding off from the bottom. Not sure if that makes sense.