Slow weight gain - when to worry ?

[Wheelybug]

DD2 is 3 weeks old tomorrow and breastfed. Born at 7 lbs 1 oz, dropped about 9%. Last week was up to 6 lbs 13 oz and was weighed again today and had only gone up to 6 lbs 15oz.

She had seemed to be feeding virtually non-stop - every 2 hours during the day and on for 30-60 mins. At night often wants to 'feed' for an hour or more.

So when does this become a matter of real concern ?

HV seems sensible and not panicking - she's told me to continue breastfeeding and not let her go more than 3 hours (which she doesn't anyway) and not let her feed for more than 20 minutes as she obviously isn't actually feeding more than this.

My dd1 was born at 4 lbs 9 oz and couldn't latch so was almost solely formula fed. As a result, put on weight no problem so is all a different situation !

I disagree with HV about not feeding for more than 20 mins. I know lots of babies who take longer than this to feed.
Does it feel comfortable to feed her? Do you offer both sides at every feed? Feeding at night is the best thing for breastfeeding as this is when you produce more milk and also makes you produce more of the hormone needed fo it.
Her feeding pattern seems quite normal to me
Have you contacted a breastfeeding support group in your area? They may have more information to help you.

BTW your DDs look gorgeous

Thanks Queenfee.

its generall ok feeding her once passed an initial excruciating moment. I don't offer both breasts every feed - should I?

I think its the combination of feeding a lot - even if a normal pattern - and not much growth. I don't know how much one would 'expect' her to have put on though ?

Another qu on this subject - when dd comes off and there is still some milk in her mouth it looks almost sticky - can't really think how best to describe it. Does that make sense and if so, is that normal ??

All I can say is not to be pressured into giving up. DS was born 8.7, and after 2 weeks was still only 7.13. I caved into intense emotional pressure from a (stupid...) and inexperiecned HV who implied I should introduce a 'bit of formula'... And there is no going back.
If DD seems happy (although hungry), keep going; it's hard to match the growth charts as they were designed for bottle fed babies. I had a friend who just stopped going to get her DD weighed in the end!

Thanks Zil - TBH at the moment the HV was quite keen for me not to formula feed and to make a go of breastfeeding.

Having a very healthy, slim 4 year old who was formula fed does make me not feel like formula feeding isn't the end of the world - its just that as it seemed to be working this time wanted to give it my best shot.

I'll persevere for the time being - I have been giving one top up already in the middle of the night, after I have breastfed as otherwise she was feeding for up to 2 hours and then not settling. It appears to be helping a bit and although am sure not advised here but as I am feeding during that feed as well shouldn't be effecting supply.

It's great that HV is supportive of you wanting to bf but oh dear, she does need some training on breastfeeding. Your baby should stay on the breast for as long as wanted - there is no "set time". DD1 would take 45 minutes to empty a breast, her gannet of a little sister was done in 10mins. Even if the baby isn't swallowing the nipple stimulation will stimulate your supply.

Breast fed babies do gain weight differently and there are WHO charts - link anyone? . The main thing is that she gains weight. all babies differ as to the rate. You should also be seeing lots of wees and poos and noting whether she is generally pink and healthy. I know it's easier to say than do but try not to fixate too much on the weight alone.

You should be aware that giving a formula top up will have a negative impact on your supply. those night feeds are particularly effective in increasing/maintaing supply (I know, a bummer) You might want to think about talking this over with a bf counsellor. If you try the NCT ones they will not "tell you off" for topping up nor will they tell you what to do. You should get some info to helpyou make your own mind up about what is right for your family. It can also be helpful to talk over any concerns or questions with someone who is an expert on breast feeding 0300 330 0771
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GL

Thanks both - She is cluster feeding in the evening and during the day (and evening) rarely goes more than 2 hours (and can be much less) between feeds.

Will the top really have a negative impact on supply if I she is breastfeeding for 40 minutes first and breastfeeding 3 hours before this and 3 hours after ?

Any thoughts on the sticky look of the milk after a feed ? Possibly haven't explained it well but basically it looks stretchy....

Wheelybug - I have the same too. DS2 was almost back at his birth weight at 2 weeks and then put on 30g in 2 weeks . However, looking at DS1s chart his weight gain was exactly the same - nothing between 2 and 4 weeks then whoosh! Although I seem to have an abundance of milk and he was feeding all the time, it obviously takes a while for my milk and baby to sync up.

He then put on 150g the following week. I'm trying not to get him weighed too often as I don't want to fret about it.

Good luck!

Thanks SM - will try swapping. Actually I did that last feed (tried to restrict to 20 mins on HV advice but dd was v. unsettled so put her back on, but on otherside and once she'd finished on that side she not had milk still in her mouth so must have been feeding and has ben more settled). Will have a think about the top up although am reluctant tbh as it means I get a little bit more sleep (and am really not getting much so its not quite as selfish as it sounds).

Fruitstick - thanks. Actually last week dd had put on almost 200g, this week about 70g. Trying to remember if I have done anything different this week. (wracks befuddled brain...) Its possible I was swapping more in the early days as I stopped doing this when my nipples got sore to give them a longer rest in between....

Wheelybug - my DD3 is now 15 months, she was a big baby (9lbs) and was BF until 11 months. She didn't double her birthweight until around 12 mths - HV was not at all concerned, nor was I. Basically, so long as she maintains or slowly gains weight, and does all the "normal" things at around the right times, it is not a problem. I let her feed as much as she wanted, sometimes it was just one side - it all sorted into a routine in the end, I found that by the end of BFing that was our routine, one side and a bit each feed, just had to remember to start on the other side first next time or I would be severely unbalanced!

I would try to wind down those top-ups. In the long run it won't help. DD3 seemed to be permanently feeding at first, but after a couple of months it dawned on me that we were going for longer chunks of time between feeds, and the feeding itself wasn't taking as long. I think the constnat feeding in the early weeks really gets your body off to a good start at milk production (and while I didn't do the Gina method, her book was useful at saying what ages babies have growth spurts - at least I knew t expect a hungry baby at around those stages)

at the not-well-informed HV. She really has made that advice up from her head.

Your dd's weight gain is not the only way to assess health - is she pooing lots? She should be.

The weight gain is not very reassuring, sorry, but of course it could be ok...but it is sign to ensure she gets maximum opportunity to bf and to stimulate your milk supply. This means feeding ad lib - many, many times day and night with at least two 'sides' each time. A 20 minute maximum limit is daft. She may need to feed on and off and on and off for a lot longer than this at times and at other times she may be completely done in much less. Behaviour is a better guide than the clock.

The current growth charts are not 'just for bottle fed babies'. The charts are made up of data from babies whose feeding was not differentiated. Switching to breastfed only charts will make no difference to babies as young as this, as the charts are so similar, with if anything, bf babies being slightly heavier.

Ah....have just seen your other post. So overall, in a fortnight your baby gained 270g? This is good, and is actually quite reassuring. Babies do not gain at the same rate every week. It woud be sensible to increase feeding opportunities still, however, and weigh her again after a week..hope this helps

Thanks Housemum and Tiktok.

Ok have ignored the 20 mins advice.

This has made me think - I think there may be a correlation between the change from a decent weight gain (200 - 70g) and dd becoming v. unsettled in the last week (which makes sense) and, I can't quite remember, but it may also fit in that this was when I started to feed only from one side as my nipples were getting sore and I thought I'd read that was ok to do and thought it would mean each side would get a longer rest. Arrrggh - clearly this is wrong and as I fed from both sides earlier and she's been really calm and settled since makes me think maybe I've been starving her [feeling v. guilty emoticon].

That said, she does poo a lot and wee a lot and looks healthy.

Thanks everyone - will continue to feed both sides for as long as she wants and see how things are next week.

Hi wheely - good to see you here on the other side! Ds was 7lb 10 oz at birth lost 7oz in the next five days and took six weeks to get back to his birthweight. I was having kittens. In fairness we did have every type of bf problem going including horrendous cracked nipples, but he always seemed the picture of health (although he poos very infrequently and has done form the start!) I have always bf on demand and for the last 3 weeks he has put 6oz every week. I think some just take longer to sort themselves out than others. As long your lo seems healthy and happy do not give in to pressure over top-ups etc. Keep fighting the good fight and get to a bf support group - they have been invaluable to me. My local ones are based at sure start centres, yours may be too. Keep up the good work!

Something someone once recommended to me was a baby moon. I know this is difficult when you have an older child but if you could get someone to help for a couple of days and basically go to bed for that time feeding and sleeping when you can. It helped me partly because I was more rested and partly because DS was feeding more so increased my supply quicker IYSWIM.
Just a thought - everyone is different and I had a 2 year old when I did this so I know what its like balancing the 2!

Good Luck

Hi DBNO - Nice to see you ! Thanks for the kind/wise words.

Queenfee - I don't think its an issue of getting more feeds in as dd feeds very very frequently so don't think the babymoon would help and would be very difficult to do but thanks for the thought.

Will press on with the swapping sides/ feeding as and when etc and hope for the best !

Thanks everyone for your advice.