Slow weight gain, no poops

[Keggles36]

Hello

After an IVF pregnancy our beautiful miracle girl arrived at the start of December. I love her so much, and for the first cuddle of weeks everything was perfect.

She had a tongue tie which was separated at 11 days old and her feeding seemed to get worse afterwards. However, she only lost 7% at day 5 which is normal, and never got jaundiced.

Over the next few weeks she gained weight REALLY slowly - 10-15g a day. She always gained, was never static or lost, but just slow. The HCPs always commented on how alert she is, and healthy she looks and then kind of switched and panicked about the slow weight gain. We've ended on a slippery slope of intervention - first triple feeding for ten days which pushed my mental health, and then adding in formula to top up when my supply isn't good enough.

She has loads of very wet nappies, but hasn't pooed for 48 hours now. She always needs waking for feeds every 3 hours overnight but will generally feed once woken up.

My mental health is wrecked. I can't stop crying. I feel like a failure. I just want her to poo. And to wake and cry like babies are meant to. I just feel like we're slowly starving her. No health professionals seem worried but I feel so alone and just want to enjoy her. She was so wanted and such a miracle but I feel like feeding is causing me to get depressed.

Hey I’m so sorry you’re going through this it’s so stressful.
what do you want to do? Do you want to breastfeed? What makes you think your supply isn’t good enough?
There are very very few women who don’t have a good enough supply, but a lot of the advice were given hinders supply (like if you’re feeding formula and not pumping at the same time)
and lack of knowledge often from those around us can make us think our supply isn’t good enough (like when babies cluster feed and we’re told you mustn’t be giving them enough)
did her weight gain change at all when you were triple feeding?

honestly if her drs happy, she’s gaining weight, having wet and dirty nappies and seems bright and alert I’d be tempted to say that’s just her weight gain and her natural pattern, some babies gain a lot more and some gain less.

I appreciate she’s not pooed, if this is a one off I’d maybe not stress, keep offering the boob, maybe offer more often during the day than every 3 hours. And you could try some bicycle kicks and a little stomach massage. Does she seem constipated or uncomfortable?

Thank you @Purinea . She doesn't seem uncomfortable, just no poop!

Hey, I'm in a similar situation with my 4.5m old DD, it's tough and I really feel for you.

What centile was she born on and what is she now?

For me, DD was back up to birth weight quickly but mostly slow weight gain after that. Has dropped from 89th centile to 40th. HV has suggested interventions - pumping and topping up with either expressed milk or formula. I've ignored and stubbornly continued breastfeeding! I'm petite, DH is slim, DS (now 3) has always been between 25-50 centile. Dd is alert, rolling, chatting, content, if a bit sicky. I think she's just finding her line. She also hardly ever poos! Maybe once every 3-5 days.. I've decided it's normal for her! She also didn't want to feed overnight at first but is naturally asking for more in the last few weeks.

I fed DS for ages which has helped my confidence this time around but all the focus on her weight and weekly weigh ins have still given me anxiety!!

I've been intermittently cutting out dairy and soy in case she has CMPA but not convinced it's made any difference.

Trust your instincts, if she's content, hitting milestones and gaining weight and you think she's fine then I'd guess she is. I keep saying that if I just looked at my baby and ignored the graph of what she 'should' be doing then I'd have no reason to be concerned. I'd carry on breastfeeding if you want to and enjoy your baby! Congratulations!!

@fairydell21 thank you for your reassuring reply. I do wonder if I should have ignored the extra advice as now we're on s slippery slope with the formula etc.

I also wonder if the no poop corresponds with introducing formula. She doesn't seem uncomfortable but it could be the change in diet.

I'm not sure what to do if she hasn't pooed by the morning as it'll be coming up for three days - but have been told it'll need to be GP and they're not specialists so feel they won't know what to suggest.

I just feel so alone and miserable. She was so wanted and I'm missing the joy because feeding is destroying my mental health.

Have you been offered support from a breastfeeding specialist to check latch and position? Definitely ask if not. I think la leche league and the national breastfeeding helpline can also offer advice. If you want to keep breastfeeding then I'd express for every formula feed and it should build your supply back up. Stay strong - having a newborn is overwhelming and you're doing brilliantly.

Don’t feel like you’re on a slippery slope with formula. I was pushed into it too at first. Those same HV/midwives then made me feel bad for not ebf and I really thought I was going to have to give up bf entirely, but since 1m old she’s been ebf.
Just do what you’re happy with, remember the majority of them aren’t looking at you or your babies individual needs, they’re looking at their averages and their policy and applying it to every single case, which makes sense a lot of the time but I don’t think they’re always great at being flexible or compassionate with hormonal and anxious new mums.

If you want to, make a plan and wean off the formula, id pump whenever she has formula and freeze whatever you pump. Get her on the boob all the time, whenever she’s awake, and do lots of skin to skin, take a bath together etc.
Theres normally some one to one breastfeeding support as well as groups and theres the places pp above suggested too. They might be worth a call, just for reassurance.

you’re doing amazing it’s so so hard in the beginning. Just try to snuggle and enjoy your newborn and enjoy her and I’m sure your supply will get there. Make sure you’re looking after yourself too, eat! Stay hydrated! It will all help, it’s such early days, try not to panic

When you say slow weight gain, what is the percentile comparison between birth and now? She may be having a growth spurt - using every last calorie to grow so no poo for now. Is she being weighed daily? I don't think this is necessary.

Congrats on your baby, OP! I've triple fed two babies - DD1 is now 3.5y and DD2 is 9m. It's so hard so I completely understand how you are feeling. I managed to combi feed both of mine to around 8months. Its really early days for you so please don't panic - you are doing a great job.

Are you working with an IBCLC? That would be the very best advice I could give as they are such experts and can you assess you properly. Some of the NHS services are a bit hit and miss. They can be quite reasonable for at least the initial consultation - i think I paid £50?

It's common for feeding to get worse initially after a tongue tie division. Imagine if your tongue was sore - you also probably wouldn't feel like eating! They then have to relearn and build up strength with their new tongue movement. So it's a big deal for a little baby.

On the poops, the NHS advice now is that babies should be poop at least once a day (really twice a day) before 6weeks old, otherwise it might be a sign they are not getting enough milk. After that, they may poop less frequently. So i think it's worth contacting your midwife (if still under them) or your HV tomorrow when the services reopen. DD2 had a very severe tongue tie and it took her around 6-8weeks to get strength in her tongue to bf effectively. I did have to up her formula in that time to make sure she was getting enough. But eventually we got back to a better mix of bf and ff with the help of a specialist team afterwards, it was just to make sure she wasn't getting dehydrated whilst her tongue function improved. This will go against the advice of the other pp, but I would actually just offer her an extra amount of formula with each top up today and see if she takes it / it leads to any poops, at the very least to rule out whether it is volumes going in that are the issue. But your HV might be able to help in more detail and knowing your actual history.

For DD2, I actually ditched the expressing early on and it massively helped my MH. I couldn't express 8x per day when I also had a toddler to deal with. I think i prioritised the 3am pump to maximise the prolactin levels but once she started sleeping a longer stretch, I stopped that as well. I put her on the breast at every opportunity, loads of skin to skin (basically sat in bed every morning with her on my chest watching Frasier repeats on C4 😅) and just offered formula for the top up.

I cried so many tears over my inability to EBF both of them and had awful PND with DD1. But I look at them both now and wonder why I put myself through it. As my HV kept reminding me, every drop of breastmilk will benefit them and we are lucky to live in a time when formula exists to support their growth and development when required. So please be kind to yourself and don't beat yourself up. Lots of us go through this and there is lots of support at bf groups and here on MN to get through this.

@Slowfeedingbaby thank you so much for your reply, that's really helpful. I'm working with the infant feeding team midwife - who has done lots of extra training and is very knowledgeable. We're split between two hospitals as I delivered it of area and the community area we fall under have been useless, but this infant feeding team are the hospital I delivered at - it's just a shame we've come to them late.

She had a much bigger top up at the last feed and is now refusing to wake for this feed in any form - breast or bottle - and I'm beside myself now that she's not pooing or wanting to feed. She handles well and isn't floppy, just doesn't want any food.

I've put her down to sleep but going to try and wake her in an hour and offer food again.

I really want to make breastfeeding work but I'm just so anxious she's not getting enough. The idea of going to bottle only sounds so reassuring.

So sorry you are going through this.
We had our miracle boy through IVF in October.

A few questions:

1. Is baby following her centile on her growth chart? If she is what centile is she? Generally as long as baby is on a centile and is following that then you're doing well!!!

A few things to clarify:

1. If babies having lots of wet nappies - we'll done!!! Again, you're doing SO well.

1. Babies bowel habits aftee five days are VERY irregular, sometimes babies can go several days without pooing so don't worry !!

Ive

@Slowfeedingbaby we saw the GP who did a full check and reassured us it's fine, as long as she poos before a week. She has lots of wet nappies 🤷🏼‍♀️ so apparently that's very reassuring. And they think it's probably the formula introduction.

@An89 congratulations! No one has actually plotted anything on a growth chart... I'll have a look now!

I'm so glad you've seen the GP. Glad she had a full check. Lots of bicycle legs and a warm bath and hopefully she'll have a big blow out today!

Still no poop though. Now nearly 72 hours. I know the GP has said it's fine but it's hard not to worry...

Are you based in the UK? Health visitors should be checking centiles and plotting on chart if you are !!! Please let me know if you need any help with this

Formula feeding will do this...I had 5 days with no poop in baby when he was introduced to formula ..he was jn a lot of pain and constipated:(

My HV complained that none of my midwives plotted my daughters weight. I think she said something along the lines ah they never plot the weights.

@Keggles36 get a very sharp pencil and a ruler/anything with a straight edge and place a small dot where the date and weight cross then you will see the bigger picture.

@Superscientist the HV didn't put either the one time she came. The only chart I have is in my red book? Is that the growth chart you mean?

🙄

Yep! That's the chart. This is my daughters chart. Her weights were all between the same two lines which is ideal. Falling through more than 2 is a concern. So if they started on the 50th percentile and are now under the 9th percentile line

@Superscientist She's been weighed so regularly it's hard to plot on the tiny chart... But looks like she was 75th at birth, dropped to between 50th and 25th on day 5 and has sort of followed that since then. A slower curve but hasn't crossed the line. Not due a weigh until next Tuesday.

In all honesty I'm hating breast feeding so much. I think it would be ok if I could just breast feed but the pumping and the formula and not knowing if she's ok, and still no poo at 3.5 days in just tired and miserable and feel really alone. It's affecting my relationship with her.

Huge poo! Soft, yellow, curdy. So relieved!

That's reassuring. They usually look at the graph once they have regained birth weight, if you look at my daughters, the first weight is day 15 although she had been weighed at day 5 and 10 too.
The who have a close monitoring chart which is over 6 months rather than 12 months so each square is a week rather than 2 weeks as in the red book which might be easier but if they aren't dropping percentiles the red book is probably ok (https://www.rcpch.ac.uk/resources/uk-who-growth-charts-neonatal-infant-close-monitoring-nicm)

I would try to cautiously relax a little bit, especially as she has had a poo. It sounds like they might have found their curve. I would keep an eye on the stool output - the consistency is as important as the frequency. My daughter on gaviscon was going most days some times twice but they were like little rabbit pellets and she had to have help passing them so we got a stool softener prescribed. Next time you get her weighed I would ask about whether this weight is "following her curve" to prompt them to look at the charts rather than focussing on the g per day gain.
One thing to keep an eye on is cmpa, it can be associated with slower weight gain and digestive issues. More commonly loose frequent stools but also constipation. My daughter was happily following the 15th percentile and I was told this was just her size. Until I stopped dairy and soya and she jumped up to the 35-50th percentile. If she's following a curve you could ask if you can go a bit longer between weigh ins to reduce the weight in stress - 5 days instead of 3 days, a week instead of 5 days and so on. Unless of course the weigh ins are comforting. My daughter was weighed frequently because of monitoring of my mood which meant more midwife and HV appointments and then because she had feeding refusals and was a pain to feed. It was reassuring that despite the fact every feed was a battle enough was going in!

Speak to you HV/midwife about how you feel. My HV arranged for me to have some baby massage classes at home. It helped me to reconnect with her. I was on a mother and baby unit for a while and all the nursery workers got trained in it whilst I was there as it can be really good for bonding. It might be worth looking into some local classes or YouTube videos....there are also some great tummy massages to help with the poos too! It might help you reconnect with your little one.