Breastfed newborn losing weight

[Reddy01]

My 2 week old has been breastfed from birth and although I found it extremely painful initially I continued and she lost 7% of her weight then put some back on. However at day 10 the hv identified that she's lost weight again and is now below the 10th percentile. I feed her on demand and it's often. I pump in the morning when she finally gets a sleep above an hour but otherwise she is feeding at least once an hour (sometimes every 20/30 mins).

The hv has told me to feed her when she wants, Pump straight after and feed her that and then top up with formula. I have no issue with formula but I want to keep bottle feeding down as we have had a few episodes where she struggles to stay latched after a bottle feed. I also don't get that much from pumping the used breast after and I only really get 30ml from the unused breast.

I don't want to give up breastfeeding as it was going so well but I don't know what else to do as I'm tired from constantly feeding her and she wk take foress than 10 mins then sleep where she is difficult to wake (not in a worrying sense). Even her paced bottle feeds are 70ml and take over an hour for her to take.

Do I just give up the breastfeeding and stick to formula to make her gain weight? Is there any way to do this without more than 1 bottle a day?

We have no other concerns for her but it is starting to affect her sleep now as she won't go down longer than an hour without waking to feed.

Have you had her assessed for a tongue tie? I’d get a full assessment and plan from a skilled lactation consultant - https://lcgb.org/find-an-ibclc/

What does she do when she latches on, does she relax and actively feed? Can you hear her swallowing? Plenty of wet & dirty nappies, at least 2 poos a day?

Trying to offer some solidarity and hope here…
My first baby (born two years ago) was 5lb13 at full term n birth so obviously very small- she dropped to 5lb7 and took 3 whole weeks to get back to birthweight and it was the third week till she put on ANY weight at all. We did give her formula once a day (at 6weeks she was having it twice a day for a week or so after being checked for tongue tie as she still struggled to put on weight at the time expectation of health visitors.) By 9 weeks old she completely refused to have any bottle at all no matter how many we tired and she chose my breast instead…I ended up feeding her for 18months and then when she turned 23months I had my second baby and he never lost any weight as my milk came in so fast.

Not every baby follows those percentiles- my daughter started on the 4th percentile and by 4months got to 25th and now aged 2 she’s between the 25th and 50th- still dinky wearing 12-18m clothing but a healthy child and doesn’t look little compared to peers. She used to wake hourly/two hourly as she was hungry but that eased as she put on the weight- my son woke every two hours until recently and now I’ll get 8pm-midnight sleep and then he will go 12.30-2 and then he’s up hourly from then onward and he’s 10weeks.

if you offered one or even two formula bottles a day in these early days it won’t affect your feeding. The best advice I had was “never give up breastfeeding on a bad day” and honestly it helps to have a break for you and you can tell the professionals you’re doing some combination feeds with the intent to reduce/eliminate those feeds in time.

wishing you the best of luck in your journey

Tongue tie is very likely here. I would pump rather than top up with formula whist waiting for an assessment. The top up trap can really curtail bf.

I would also add it is quite normal to take up to 4 or even 5 weeks to regain birth weight. Even if gain is slow it's often good enough to avoid needing to see a paed.

A private tongue tie practitioner will likely see you within a week so this will all be resolved soon

Join your local bf support group. HV and midwives rarely have any specialist training in bf so offer poor advice.

@Flittingaboutagain @OrangeSlices998 shes been assessed by every member of staff since birth but no sign of any tongue tie but it's funny because that's what they all thought too. She latches really well, always has done. Even if she moves to a shallow latch she readjusts herself pretty quick.

@MrsN3 thank you for that. She was the 17th percentile full term although she's the 99th percentile fir length?! Good to hear someone with similar story. I'd happily exclusively pump if I knew I could get enough but I think formula it will have to be at times to keep hv happy 😔. Stupid that we all just fit into certain boxes

@Reddy01 it really is tricky.. I didn’t pump as I was scared to cause an oversupply as mastitis is such a fear of mine 🫣

in regards to length they don’t measure that where I am(Gloucestershire) I have no clue of that for a percentile.

try to relax as much as you can (easier said then done) and enjoy your newborn bubble as it goes to fast. I wish I enjoyed it more with my daughter and didn’t fret so much about her being so small

Could it be cmpa? It wasn't a symptom when my daughter was diagnosed but she moved from the 9th to the 35th percentile after i removed dairy and soya from my diet. I had been told she was just a 9th percentile baby

You mentioned she’s been assessed “by every member of staff since birth”, not sure if you mean the midwives and HV team but they don’t always have extensive breastfeeding knowledge. A face to face feeding assessment with an IBCLC would be really helpful to see if there’s a reason she’s not gaining weight despite feeding very frequently. Most breastfed babies go through periods of cluster feeding but her feeding pattern and weight gain suggests she’s not feeding as efficiently as she should, which will impact your milk supply. It can be pricey to arrange a home visit from an IBCLC but it would be well worth it if your goal is continue breastfeeding her.
While she’s at the breast, use breast compressions to maximise milk transfer, and also google switch feeding. Hand expressing after pumping can also really help supply.
Best of luck.

Totally agree with this pp. DD2 was seen by 6 or 7 different MW, breastfeeding specialist MW, HVs and noone spotted her 90% tongue tie. It took until she was 8w and we saw someone that i found in the link that @OrangeSlices998 posted. Unfortunately, we never got back to EBF but I did combi feed breast and formula until she was 8months, plus she started to gain weight and get back on her centile which was the main thing. Sorry to bang on about tongue tie but it is so often just overlooked.

You could try top up with formula with a supplementary nursing system. I didn't get on so well with it personally, but I know a couple of people that liked them. We had a similar issue to my DD....toped up with formula after every breastfeed (I couldn't express a drop). Over time we got that down to one bottle of formula in the evening and breastfed all other feeds. I kept breastfeeding until 15 months, which I wouldn't have felt possible at the beginning.

Oh and DD had tounge tie, missed by every midwife and picked up by the lactation consultant x

My little one is now 7 weeks. She never lost (except day 5 usual loss) but proceeded to only gain 10g/day even with breast and pumping. We had a tongue tie separated but didn't improve things.

I'm beginning to question CMPA or similar as looking at the volume she's getting I'd really expect more weight gain.

(I am a midwife and agree that we get very minimal training except on initiating breastfeeding in the first few weeks and so plans we make aren't always sustainable after this point.)

I've given up pumping every feed ast it made me miserable and am topping up with formula, but offering the breast every feed. I still pump 3 x - once in morning, evening and night.

It might be worth looking up your locar La Leche League group and go to one of their meetings - I was ready to pack in breastfeeding altogether which was making me so sad, and they really helped me to combi feed and I'll go back next month and we'll look at how to reduce the top ups etc.

However you feed your baby though, the most important thing is that you're well too - i really struggled the first few weeks (and still n feel anxious occasionally if I overthink) and in hindsight it wasn't worth it. Xx

Go private for a tongue tie assessment. NHS missed my DC's tongue ties. Also been through this. They wanted me to top up with formula or pump. I persevered with the breastfeeding and DS put the weight back on. These charts they are going by are all based on formula fed babies. Go with your instinct. The first 2 months are hardest as they feed on demand and feed constantly but they are a new baby and just want your comfort. They also digest breast milk a lot quicker so won't go the standard 3 hours that a formula fed baby will. Keep preserving with breast x

“My 2 week old has been breastfed from birth and although I found it extremely painful initially I continued and she lost 7% of her weight then put some back on. However at day 10 the hv identified that she's lost weight again and is now below the 10th percentile.”

Has she actually lost weight or is she putting on weight slower than expected?
A baby can drop from 17th percentile to 10th percentile without losing any weight. If she is steadily gaining weight, I wouldn’t worry too much.

I tried everything with DS, including having his tongue tie cut, but he continued to lose weight. At 6 weeks he'd lost 1lb 1oz and I was on the verge of PND I was so worried. I decided to formula feed at this point and never looked back. I will never forget how inadequate I was made to feel by health visitors for not being able to breast feed. He is a very healthy 6ft 16 year old now. I wish I'd formula fed much earlier.

How was your LO delivered? If C Section, that can artificially increase birth weight due to IV fluids, which then makes it seems like they lose more weight than they do. It also can delay milk coming in which can make weight gain slow to begin with

Does your LO fall asleep at the breast? If so, breast compressions can help keep them actively feeding. Can also help get out fatty milk from deep in the breast

You could also try "switch nursing" to keep baby actively feeding

You're doing amazingly well to be feeding so often and so responsively. It does sound like your LO might not be feeding as effectively as they could - if latch is good, then it could be tongue tie as people suggest above or that you have a sleepy baby who likes to snuggle rather than actively feed

If they are gaining weight slowly but dropping against percentiles that is different to losing weight - and dropping one percentile line is usually considered ok; dropping two is more of a problem. If they drop one percentile line but then stay on their new percentile, that's fine

Getting help from a breastfeeding group like La Leche League could be very helpful and/or a lactation consultant. Heath visitors, GPs and midwives can give bad advice when it comes to breast feeding and tongue tie

@Justnevergetsthere i am so sorry the HV made you feel this way. I answered the door in tears with two vasoconstricted nipples and a bright red blocked duct (somehow avoided mastitis - it didn't need treatment) to mine last week and cried about how much I wanted to breast feed but also wanted to be mentally well and she was like "give formula, offer breast and pump when you feel well enough, if milk supply slows but you're feeling better you can pump more to increase it again, if you end up just formula feeding also fine. You're missing out on the joy by running yourself into the ground" and this meant the world to me to hear. I'm more doing some weird combi feeding but feel better.

This said I feel like all the panic about slow growth at the start set us on a slippery slope - but here we are!

Thank you all! She was a c section baby and lost 7% at day 3 then put on day 5 so it was only a 5% weight loss. She was 6lb 8 at day 5 and day 10 dropped to 6lbs 3.

I did have the breastfeeding team check her out and they looked at positions etc but they were more than happy with her latch and just told me the pain was normal initial pain (it is better now when nipples aren't sore/cracked) and she said I've just got sensitive nipples.

I did wonder about my supply and I've pumped both 3 times today and I've only managed 110ml max. I probably need to pump longer at times but the time I've done the 2 at 20 mins little one is wanting another feed or I've got to tend to her in some way. I do find the pump uncomfortable and always think it's going to fall off eve though I know it's pretty suctioned.

I will look into someone else looking at potential tongue tie. I can't see anything myself but I did wonder if she had a lip tie but I've been told that it's normal and most of us have that bit that I thought was a lip tie.

I also don't know if it is something mouth wise as she seems to have her mouth open and tongue up when sleeping (although she does breathe through nose too). She's such a nosey sleeper.

The cows milk allergy I'm not sure if tbh. I have googled but she doesn't tend to have the majority of the symptoms? I think there is more a supply or issue with her taking the milk more than anything.

I did wonder about a lactation consultant but didn't know if it is a one time thing or if you're paying them for a course of visits.

We are doing 1 paced formula feed a day currently which is nice to have a break and I normally pump then. I do have an issue with the percentile because I do think my little one is thriving otherwise but I also don't want her to suffer just because I am stubborn and want to breast feed her for the most part.

My midwife was excellent and very supportive of my decisions and she would highlight pros and cons of things and allow me to make the decisions wisely but I feel the hv didn't really care and it was just a thing of you need her weight up otherwise there will be consequences 😔. Sa dto hear that others have had similar issues.

Hi OP. Assessing for tongue tie isn’t a short process, an IBCLC will watch an entire feed then physically examine the babies mouth and score their tongue function. Checking a latch and saying it looks fine, especially when it’s painful, isn’t helpful. It may be that your baby’s oral function is totally fine but you really need a proper expert to know for sure. You usually get a home visit followed by email /whatsapp support. A baby shouldn’t be losing weight after day 10, so it sounds as if something unusual is going on. It’s not true as someone said above that the weight charts are based on formula fed babies, they’ve been based on breastfed babies for a long time now.
If you’re on Instagram I really recommend Lucy Webber’s page, she’s an IBCLC and has some great videos showing exactly how a deep latch should look.
As another poster said, you’re doing an amazing job, every drop of breastmilk your baby gets has so many benefits. If you’re comfortable sharing roughly what area you’re in then maybe someone could recommend a local IBCLC.

A lot of the symptoms of cmpa would probably come with time if that's the case. At 10 days my daughter did a lot of pooing but not something that flagged as unusual and wasn't a fan of the 3am feed. We went down the slow letdown then fast letdown route. It was only at 3+ weeks that reflux started and only by 3 months that there were lots of symptoms
Her main symptom was not feeding for long enough in the initial days and weeks. She fed just enough to satisfy the hunger but then stopped because of the pain of feeding. At 10 days it was only the 3 am feed that was a problem and the others seemed ok but on the short side of normal 3-5 minutes and they said they liked a minimum of 5 minutes. By 3 months she only fed for seconds at a time.

I'm pretty certain my daughter has a tongue tie that was missed in 3 infant feeding appointments. She was good mobility in and out but poor mobility up and down and since being a toddler you can see that there is possibly a tie to my untrained eye. I don't know for sure but what I do know is when they did the assessment they only looked at in/out mobility and I shouldn't have gone with no time just based on this