slow weight gain-how can I improve 'routine'

[mrsjuan]

I've posted a few times about my daughter's slow weight gain. She was 5lb 7 at birth and now at nearly 9 weeks is only 7lb 8. She is gaining about 4oz each week which seems ok ish becasue she is just a petite baby but I still wonder if there was anything I could do to help her put on a bit more.

For the last couple of weeks we seemed to get into a bit of a routine which was roughly:
4am big feed, doze in bed with me
7.30am quite big feed, changed & dressed
8.30am out with dog in pram - fall asleep
10am wake up ,changed, 'playing'
11am medium feed, 'playing'
out in car / for walk, fall asleep
2pm medium feed
4pm small feed
5pm small feed
6pm medium feed
6.30pm bath, bit more feeding, settling
7pm-10pm asleep on our laps
10.30pm or 2am- medium feed

For the last couple of days I have tried to get her to feed more often especially in the mmorning but she just seems to fret at the breast and doesn't really want it.

Any ideas what I can do to improve things? I must stress that I haven't tried to engineer the routine as such and I'd happily feed her in between the long stretches (7.30-11am and 7pm to 2am )on demand if she actually 'demanded!'

She's still being a bit of a nightmare to feed, especially in the daytime feeds - lots of pulling/ slipping off etc.

Sorry for rambling on! Just need to know i'm doing everthing I can.

mrsjuan, she may well be just a petite baby, as you say.

It makes sense to offer more opportunities to feed,because she is right down there at the bottom of the charts and is moving off the 2nd centile that she started on...so one way of doing this would be to 'switch nurse', by giving the second breast and then the third and even fourth each time. She might also benefit from more night feeds.

The good thing is that she is gaining, and I assume she's healthy and thriving. So she may just be physiologically small

She doesn't need to put on any more really. That's a good average weight gain, ime and if she's falling into a routine of sorts then she will be eating enough. If you're feeding her on demand and she's feeding well off each breast then you really don't need to worry, honestly.

Are you getting pressure from HCPs or is this just something you are fretting about yourself? She was dinky at birth - was she early or just very small? If she's just petite then no amount of feeding her is going to change that. I had a 10lb 2oz baby who was 98th centile at birth and he steadily dropped through the centiles for months until he settled on the 25th. I doubted my bfing so mcuh but he is still on the 25th at 2.6yo and is obviously just destined to be small (poor boy!). Some children have to be smaller than others or there would be no 'averages'.

How many sides does she have at each feed? Does she just have one breast, or both and do you ever go back to the side you started on? If she's pulling off of her own accord, appearing 'milk-drunk' and sated and is content but alert for most of the time until her next feed then she should be absolutely fine, ime.

Try not to fret, it honestly sounds as though you don't have anything to worry about .

Olihan -she wasn't early, they picked up that she was small from scan etc and induced me a few days before my due date.

She normally has both breasts at each feed - I will try swapping back to the one I started on.

The thing is she is not feeding that well - she very rarely take herself off nicely looking content. Most feeds end with her thrashing about so much that I give up, settle her down and try again later. the only feeds that she 'behaves' for are the ones where there's been a longer gap in between which makes me think that she's not actually hungry in between?
She seems most happy when her stomach must be least full!

Sounds like you're doing everything you can, that's alot of feeding. I had a similar problem - bw 5lb15oz, then kept slipping below the chart. Of course all the stress and feeling I was bad mum meant that my flow was affected as well - vicious circle, but persevered with the bf, waking DD even if asleep (I know, you're not supposed to wake a sleeping baby, but...)

Another point - are your health professionals using the new charts recommended by the World Health Organisation? They have recently revised their advice based on statistical analysis, and it can make a difference of a KG or so over the first year, and if using the old charts, it can make it look like your DD is slipping down the percentiles, whereas in fact she's doing just fine.

See here for the new downloadable charts. Hope this might help put your mind at rest.

My DS is a slow gainer (maybe 2-4 oz a week) and also won't eat if he hasn't asked for it first! I love feeding him and would do it more if he would let me! I have finally (15 weeks in!) managed to step away from the charts...On the old AND new charts he comes out LOW and this made me feel LOW (and then some!) when no one else had even mentioned any concern about him. Follow your baby and your HV, if they're any good. As people above have said, some babies are small! (Oh and grit your teeth when people gasp in amazement that your baby is xxxweeks old and ask the birth weight and tell you how SMALL she is...)