doc said baby not gaining enough weight - any BF advice?

[shellki]

My dd2 is 1 month old. She was a big baby at birth, 4580g and 56cm. She was weighed today and is now 4670g, and the doc said that this is not enough, though her head and height gain is good. She does not breastfeed for very long, usually coming off after about 7 mins completely drunk, and fals asleep. I then spend ages trying to get her to take more, she usually has a little bit more but not much. She is hungry every 2-3 hrs. I tend to feed her off both breasts, so am not sure if she is getting enough 'hind milk', but when I have expressed my breast is empty in about 5 mins (automatic breast pump).
Does anyone out there have any advice? Is she just an efficient feeder, and because she was big at birth she hasn't needed to gain much weight, or do I need to try doing things differently at the feeds?

Do you know how much she lost in her first week?

she lost 400g in the 1st week

So in three weeks she's put on 490g, is that right? That sounds fine, especially for such a big baby.

Is she weeing lots? Alert?

When she's finished, offer her the other breast as she might drink more then.

This sounds exactly like my son - he was 4.4k at birth, lost 11% in first week and was 'only' 4.8k at 1 month. He took 3 weeks to regain birthweight. Is your baby alert, peeing & pooing, happy and healthy in other ways? I think your doc might be a bit of the old school fatten 'em up brigade - please don't be pressured into FF top-ups (unless of course you want to move to mixed feeding or fully FF in time). She is likely to be going through a growth spurt in the next week or so as well so will never leave the boob!

Big babies tend to lose more proportionately and take longer to make up ime - I may be wrong and an expert may be along to correct me. My baby is now 7 months and exclusively breast-fed to date (aside from solids of course).

shellki - I am not sure why your doctor is worried. Would be helpful for you to speak to someone else about this, I think. The sort of weight and weight gain you're describing is not something that would be thought of as a concern in babies who are otherwise healthy, and there is a known tendency for big babies to revert to a closer-to-average weight as the weeks go on.

Spending 'ages' trying to get her to take more is stressful for both of you, and you do not need to be concerned about hindmilk, truly. I am not sure of the value of expressing, either.

I agree with wasting - offer three or even four sides at each feed, but if she is zonked out, she is unlikely to take, I know

Best thing to do would be to speak to someone whose knowledge of bf you trust, and who can see and assess your baby.

Bear in mind that expressing is no indication of anything. The amount you can get out with a pump isn't related generally to what your baby takes or how much milk is actually in the breast (which is never technically empty anyway). The fore/hindmilk thing's misleading as well. It sounds as thought you're doing the right things, offering both sides and letting baby come off when satisfied.

A bf counsellor perhaps or midwife/hv trained and knowledgable in this area.

If all else is well and your baby is alert, weeing and pooing, the weight and feeding pattern alone doesn't set off alarm bells at all.

Congratulations btw.

Thanks for your reassuring words, my inclination is to not be worried as her peeing, pooing, sleeping and general state are all fine. She's quite peaceful and smiley too, and has good kicking time in between naps. Its never nice to hear something like this from a medical prof, so its good to hear from other mums!