Slow gaining baby? Not enough milk?

[missmama]

DS is 10 weeks old and exclusivly BF. I have expressed a couple of times just to try him with a bottle as we left it too late with DS2 and he would never take one.
But it took me nearly an hour to get 4oz of BM and he could have drank more.
I know that the amount of milk I express has nothing to do with the amount he can hoover out but I am concerned that he is not getting enough milk and is not gaining enough weight.

His birth weight was 8lb 4 and he went down to 7lb 13.
The midwife signed us off at 12 days when he had reached 8lb as she said that even though he had not regained his birthweight he had gained weight and was obviously happy and active, lots of wet nappies etc.

So, 2 weeks ago on the Tuesday I took him to be weighed by the nursery nurse (8wks) he was 8lb 8 and then on the Thursday he had his injections and was weighed again by the HV and was 8lb 11.
So I know he is putting on weight, just not a lot of it. In all he has dropped from the 75th centile to the 2nd for his weight and his length is steady on the 95th.

He is happy and active, sleeps well and smiles alot . We have wet nappies but only 3 or 3 dirty ones a week.
But I have decided that he is skinny. He has no fat on his arms and legs and his little belly seems to stick out. I cant get him weighed until tomorrow and now I just seem to worry about him.
He looks as though he will break he is that skinny.

missmama - it's sad to be worried about your baby's growth

It's good he is active and sleeps well and smiles - shows he is basically healthy.

However, you may be right in suspecting he could grow better. Some babies are naturally skinnier than others and naturally grow more slowly - impossible to say if your baby is in that category, but whatever...it will not harm him in any way to get more breastmilk into him

This is not rocket science - he can feed more often, he can have two, three or four 'sides' every time, he can be held close to you much of the day and night so you can respond quickly to feeding cues. Extra feeding like this means he gets extra milk, and of course you make more at the same time.

What does that sound like to you?

Remember that breastfed babies are leaner and that the charts in the red book show the normal progress for formula fed babies. The height and head circumference charts are more standard for all babies so if he is developing upwardly on them he is likely fine. If your baby is well and meeting all his developmental goals, I wouldn't worry too much. Here's a link I've been referring to and it keeps my spirits up. www.drjaygordon.com/development/bf/scales.asp

Another thing I came across recently is that weight loss in the first few days can sometimes safely be up to 13%. If you drink lots of water through the pregnancy the baby can have an elevated birth weight. If baby soaks (with urine) more than 3 or 4 nappies a day in the first few days this can be a sign of that. The BFN recommend that progress is charted from the lowest weight not the birth weight to allow for this.

You also need to remember that no breast pump is as effective at getting milk out as you baby. Some folk can only ever get an ounce or so despite thriving babies. Expressed milk can be kept in your fridge for about a week and so if you don't make a full 6 oz feed in one day you can keep adding milk through the week. You can also mix breatmilk with formula if you need more volume.

Obviously if you're concerned get the health visitor to come out and weigh your baby every few weeks. Or perhaps see if there is a breastfeeding support group near you? Every baby is different and some of us have to have the skinny ones. When we are facing an epidemic of obesity, I personally don't think it's necessary a bad thing.

PrettySprinkles, the chart is not an issue here. The charts using data from breastfed babies only starts to show a difference from age four to five months at the earliest - sooner than this, and the OP's baby is only 10 weeks - breastfed babies are a tad heavier. On average. In general. May not apply to individuals - doesn't matter.

US information about charts does not apply to the UK - they use different charts.

Weight loss up to 13 per cent is a sign all may not be well - do you have a reference for that figure? Drinking lots of water in pg will have no effect on the baby's birthweight - how would that work? If you have evidence for this, though, do share - I am very sceptical!

A skinny baby needs checking out - always. Most skinny babies are just fine. A few aren't.

Sorry to correct you like this, but good info is important

It's good tiktok. I appreciate some of us mums share info we've been told or read as we assume it to be true. There are a load of breastfeeding myths and I understand the need to quash them.

I was referring to UK growth charts (I know the US ones are worse). My DS lost just over 10% birth weight, put weigh back on slowly just like the OP and I was similarly worried. Consequently, I was under the impression that even the UK charts start to show a difference from the first few weeks as they make no allowance for neonatal weight loss. My midwife wasn't overly concerned because in all other developments, pees/poos/nail growth/bright eyes/etc., he was doing well. Also the BFN supporter said to take growth (and to determine the need for intervention when crossing two centiles) from the lowest weight reached. The quick search I did at the time through the BMJ and Athens seemed to agree (studies at Depts. for Child Health in Glasgow/Newcastle Universities).

The excessive weight loss info comes from a book I just read this weekend, called 'The Breastfeeding Mother's Guide to Making More Milk'. I believe this happened with both my two kids. It says that on occasions excessive weight loss occurs even though baby is nursing well. In some of these cases it is believed that the baby's birth weight has been artificially inflated by excess water acquired by the mother during pregnancy and labour. When excessive weight loss occurs together with multiple wet diapers in the first few days, this non-critical cause can be considered.

I wasn't meaning to disagree with tiktok or to offer alternate amateur diagnosis but to reassure the OP not to worry until she can get the baby weighed tomorrow. My circumstance a few weeks back just sounded so similar to the OPs concerns, I thought I'd share what info I had unearthed. Please delete my posts if you feel they are inappropriate, there wasn't any bad intention.

PrettySprinkles, the UK charts have a notional allowance for neonatal weight loss - it's not correct that they make no allowance for it, it's just not based on collected data. Go figure

I don't agree that it is any better to start tracking from the lowest weight reached and I don't know of any studies that suggest this is any better than birthweight....which can be misleading, I know, but lowest weight is no better. You're misinterpreting the literature if you've read this. You can start measuring weight gain from lowest point (ie the baby has gained x ounces or y ounces) but you shouldn't start plotting the chart.

Excessive weight loss can happen even with good breastfeeding - though it's unusual. But '13 per cent' is not in the literature anywhere - if a baby loses as much as this he may be ok, but his feeding definitely needs checking out, along with the output of wee and poo, by someone who knows what to look for.

No need for deletion!

My DS had a similar problem, lost just over a pound in her first week and took 6 weeks to recover her birth weight. After 10 weeks of exclusive bf and numerous meetings with health visitor and GP we were referred to the paediatrician who recommended introducing 1 bottle feed per day. The impact was almost immediate and showed that DS was simply a lazy feeder - present her with food in a bottle and it's less effort! She's now nearly 6 months old and thriving. You could try 1 bottle per day of formula or breast and see what happens. Also, try not to get too hung up on the scales as they all weigh slightly differently. Use how clothes fit as a better guide of weight gain.

Re the looking skinny thing - Mine looked v skinny and was born 8.5, he still has long skinny arms and legs are a little fleshier - its just his body shape - same as DH. My DS never had that round chubby baby look and has always been healthy - good eater etc.

sorry to hijack, but my nephew has been slow to put on weight,he is 12 weeks old now. my SIL was trying to BF, but has now been told by her HV to bottle feed . Is this normal??
I thought it would have been more use to check he was latching on properly etc...

mabel - start a new thread. It gets confusing otherwise

missmama - I totally sympathise. I am in the same position. Ds was 7 10 at birth, is 5 weeks now and is only just 7 9. For the second and third weeks I was giving a small top-up bottle and he gained a little weight, but weight gain now remains the same in the weeks since I stopped. I stopped the top-ups as every breast-feeding supporter I consulted said they would interfere with bf-ing and sure enough he seemed to feed worse at the breast when they were introduced. I worry constantly about him as he looks so frail (although he cries lustily enough!) I am assured by everyone that he will be fine, but it's hard to believe isn't it? I hope that you find increased breast feeding works for you.

Thanks everybody.
I feel better about him today, must just have had a bad day yesterday.
Went to clinic this afternoon to find that they had changed it to Mondays, so all that worrying yesterday and I could have gone. Now I have to wait until Thursday!

Tiktok my other two (now 8 and 10 so its been a while) were larger born and then sort of 'caught down' IYKWIM. DS1 was born on the 75th and stayed steady on the 50th.
DS2 was a v. skinny baby and dropped from 75th to 2nd but not until he was a little older and we were put under the hospital dietitian for him, but he had other problems(allergies and eczema)so it was all bundled together.

I thought at first that after DS2 I would be ok with him being skinny as I was used to it, but it is still quite scary even though I have been here before and everything was ok then. DH is tall and skinny (6ft and 9 stone) and I am short and round (5ft 1 and ) so obviously they take after him

I expressed more yesterday and got 5oz which is sitting in the fridge still.

If he is not asleep then I am feeding him! I just hold him all day and as soon as he starts rooting I help him latch on. Most of the day is spent sitting on the sofa wearing half a bra and a hitched up tshirt with a dozy baby lying on me.

I am not against giving formula DS1 was on it at 8wks and DS2 not until 7/8 months but I have never been able to mix feed, once I start to give a bottle I find it difficult to carry on with the BFding and I am not ready to give it up yet.

I had started to not let him sleep for more than 2 hours at a time in the daytime and just keep offering him the breast when we have a cuddle as well.

Sorry to go on but it helps me to organise my thoughts to write them all down.
I was ready to switch him to formula yesterday, but today I really dont want to.

Pleased you are feeling better Miss

Hi missmama - glad you are feeling better, but if you are interested a thread for slow gaining babies has been resurrected here.