Oh God, he's not gained AGAIN. <<tears hair out>>

[suwoo]

DS2 is 6 weeks tomorrow. Lost 20 oz at birth. He is now 10 oz less than his birth weight. Last week he put 50g on and I was giving him the odd top up (was supposed to be doing 3 a day, but wasn't )

Today he has gained 2g with no top ups. I'm going to have to top him up again aren't I? I so don't want to, I really really just want to bf him. I can't pump as I just can't fit it in with the other two kids, so it will have to be formula . I am feeding him 2 hourly and he is really alert, lots of wees and poos etc.

I have tried waking him and he is too sleepy to feed.

Its a minefield.

that is weird isn't it? does he wriggle an awful lot?

how does your let down feel? i have posted about being unable to express any milk at all and i think its because i'm trying too hard. Do you think that's the case with you because you are now obviously being put under pressure to get him to gain? Does he make a swallowing action lots?

I really don't think it is though. I seem to have enough milk- have done fairly well from expressing. There is milk there when he pulls off, I can spray it out frequently. He possets are fair bit after every feed.

I had the reduction 14 years ago and know that the time elapsed helps the lactation tissues/ducts etc.

He isn't the best swallower, but I have been watching him and waking him when dosy. Have watched the Jack Newman videos.

Would he not scream all day if he was hungry? Just finished feeding him now and he is lovely and satiated.

Maybe you should ask for a paed referral to rule out medical causes?

I think thats what will happen next week after he has had a week of top ups as a comparison.

Its almost like I don't want him to gain next week as it really makes my milk supply questionable.

I am so upset, I really feel like this is the beginning of the end

Hi Suwoo - huge sympathy vibes to you. Keep at it - as tiktok said it is good to know the professionals are keeping an eye on you both and from what you say there is no huge cause for concern. Have you been referred to a paediatrician? Would it set your mind at rest? Skinny rabbit perfectly describes how my son was until about 17 weeks! It helped me to be referred because then I could say to myself 'appointment is in a month, don't worry till then, can't be too concerning to anyone else because otherwise appointment would be sooner, etc. etc.' It helped me get through it a week at a time.

It is a myth that babies always scream and cry when they need more milk, and it's not a helpful myth.

Babies can be laid back and relaxed and (this is my observation and experience only - I have never seen any real research into this) babies who get a lot of cuddles and attention (like baby suwoo) from mum or other kids in a busy household can manage on fewer calories than we would ideally like them to have.

I honestly don't think that babies necessarily feel a gnawing, painful hunger when they need to feed or if they are getting not quite enough to gain well - some babies seem satisfied and happy and sleepy on less. Clearly, he's getting enough to tick along and be basically ok, and he's also conserving calories by sleeping well.

Suwoo, I have been exactly where you're at. It went on so long that we were really dispairing, we tried absolutely everything to get him to gain weight.

One thing we did which is apparently very controversial but was useful to us was weigh him before and after every feed to try to get a sense of how much he was eating.

Once we figured out that on a very good feed he was getting at most 60 ml (2oz) we knew the problem was his eating and not anything else (including not my bm, as I could still express after he had fed).

In the early days he was very quiet, and slept a lot, even though he was going hungry. I was told that this was to conserve his energy.

I really sympathise with your feelings on seeing him fail to gain, I look back at the pictures of ds and he looked painfully thin at that age.

Thanks ib. I think I would like to do that weighing thing. I wonder if my feeding advisor who is based at a local hospital would do it. Don't they need to be special scales?

I am going to give him 3 formula top ups a day and see what happens on the scales next week.

He sounds like my ds. He gained normally for 10 weeks and then stopped. I had at least 10 weeks of being told that my supply wasn't good enough etc. He is now being investigated for a metabolic disorder. If you can pump at all it will be worth it as he can have a bottle when he is too sleepy for a proper feed.

suewoo i had big trouble with establishing bf and my supply was not good for a while. i didn't top up and it only lasted a few weeks but boy was it awful. ds was really so thin and with hindsight i probably should have supplemented bf.

i just wanted to say that i know it is horrible and also keep going, feed as much as you can. he isn't losing weight so whatever happens with top ups etc will get bigger and hopefully be able to get more bf.

oh and the gp got me to do that weighing thing, although idiotically with a nappy on and it was only luck that he didn't do a wee between the start and end of feed (baby in nappy not me or gp sorry mangled grammar). yes he took on some weight, but i have weighed myself at start and end of gigantic meal and not seen any difference.

Oh Suwoo, I know exactly how you feel. It's devastating when they don't gain isn't it?. I stuggled for 12 weeks with a fussy feeder and slow gainer. In the end it got too much - I could have coped with fighting with her every feed if she was gaining well or vice versa. I've been giving formula + expressed milk + a few breastfeeds for a month now and she's gaining much better. Her nappies are also a lot wetter (as a first time mum I didn't really realise that they weren't heavy enough . It broke my heart the first time I gave her a bottle but now we are all much more relaxed. She was also very contented on a small amount of milk and slept 5 or six hours a night with lots of long naps in the day so I think she was conserving her energy.

I think it is like going on a diet in that the less they take, the less they need so it's a bit of a visious circle.

I don't know what to say really - I think you are right to persevere with the breastfeeding and I think you're doing ever so well but wanted to let you know that it's not as bad as you think to top up.

I don't know if this is right - I'm sure people with more experience will correct me if I'm wrong but I think that as we were / are still havng problems this many weeks/months in then breasfeeding for us is never going to be as great as it is for others. I could never feed my daughter in public because of the fight we'd have to have and the length of time it took to get her to take even a few sucks so at least by taking the middle ground we can be more relaxed about the whole thing.

BTW - we're not far from you so if you ever wanted a skinny ribs meet up we could get together

I don't know - the lactation consultant told us our scales were OK. They were digital scales, accurate up to 10 g. They cost less than 100 euros.

In our case it was good enough as ds was getting soo much less than he should have that whether or not it was accurate to the gram was not critical! We did it ourselves, but ds was our first, not sure if we could have coped if I'd had to take care of anothe two kids. It was very time consuming and frankly, pretty draining, as instead of being able to give him a sleepy feed in the middle of the night I had to wake up fully to weigh him, remain awake for the whole feed and weigh him again after.

But it was worth it as I discovered he was falling right asleep on the breast and getting NO milk in his night feeds.

When I was having trouble with BF I was told as long there's a gain even if it is the smallest gain ever that's ok. It's when they lose weight that it's time to start worrying.

Are you sure it's a supply problem?

I'm asking because I had big problems with dd not gaining weight, though I was squirting milk everywhere and filling the freezer. Turned out she wasn't sucking strongly enough, so progressively getting weaker and weaker= less able to suck. In my case, I just carried on bf'ing and ignoring any warning signs until we both ended up in hospital: obviously not the right way to go about it. We did turn round in the end, but the process was long and painful, could have been much easier if I had reacted earlier. Topping up at an earlier stage would clearly have been much better.

Dd seemed so happy and contented, though, that's what fooled me for a long time.

Have you got a breastfeeding counsellor at your local hospital? Ours was really good.

About mixed feeding, I've been talking quite a bit to Swedish mums over the years (=country with highest breastfeeding rates in the world), and funnily enough, they all seemed to have given the odd bottle, or topped up breastfeeds at some stage.

So as bit of toppping up may not spell the end of breastfeeding for you, just maybe a temporary measure while you get his weight up (even if this does mean you will then have to work at getting your supply up again).

Could you get your dh to wake him and night and try and dream feed him a bottle? I could never get mine to dream feed bf but could with a bottle.

Suwoo, you sound like me 3 months ago. Also had breast reduction, was EBF my DS until he was about 5 weeks, and he just would not go above his birthweight and dropped from 25th to 2nd centile and I was frantic... And he seemed happy and alert, but would take forever on feeds (feeding hourly day and night) and fall asleep on the breast. Everyone kept telling me it could be normal, but I felt something was wrong. Best advice I got was from a LLL advisor who said - make sure your baby is fed enough first and foremost, and that made me think: who am I BFing for? to prove to myself that I can EBF? or to nourish my baby? Also, because DS was so small and skinny (and also turned out he had slight tongue-tie), he did not feed efficiently and would fall asleep at the breast - I thought because he was full, but probably because he just got so tired from trying to feed and not getting enough milk. I was told if I can get him to gain some more weight, bigger babies feed better and may boost my milk supply as well. I started topping him up and offering as much as he wanted, and within days he was like a different baby, and in a few weeks caught up with his birth centile. He is still not a fat baby and will probably always be slim, but he is clearly thriving so much more. I still feed him a combination of breast, EBM and formula - he is 4 months now and am happy he continued to get breast milk in some form. And formula is not poison, it is specifically formulated to nourish babies if they can't get breast milk for any reason. Try to speak to a lactation consultant if you can (ICBLC accredited if possible). And don't feel bad if you do need to top up, feeding your baby is the most important thing, and he will still get your milk and antibodies anyway. You are doing the best you can, and have done a terrific job until now.

Also meant to add that I found expressing a lot less time consuming than fighting with her to feed every couple of hours. I was able to borrow a medela symphony from the health centre free of charge. Hope you are feeling ok. I know how gutting it is but just remember that very few people would have persevered for so long and you really are doing the best for him.

had this with ds2. was tiny anyway, born at 36 weeks and low weight 1.88 (4lbs) lost a bit, within the "allowed", and regained birth weight in about 6 days. however from then on for next 7 weeks or so he put on little or nothing. just a few grammes each week and his centile line was pretty flat. he was very sleepy and i would have to spend ages trying to wake him for his feeds (it would take 15 mins or so of squeezing milk into his mouth, trying to prise his mouth open and squirt it in myself! he would eventually get sick of me mithering him and comply, but kept falling asleep again. it was VERY hard work. like you i was told to express and use that as well, which exhausted me and half the time it wouldn't go in because he was spark out and snoring. the mat nurses told me to still bottle feed him while asleep which i tried, but had to stop because once he choked and it really scared me. advice in hospital was to leave for 3 hours and then he would be hungry. made no difference, so took to just sitting on sofa all day and whenever he flinched would shove nipple in! one day dp tried him with a top up of ebm and he wolfed it, so started that again. sometimes he wouldn't sometimes wouldn't. very slowly it improved and he now puts on 6oz a week. it's so difficult and worrying, but hopefully this will happen to you. i would say, don't leave him for 3 hours and set your alarm at night for every couple of hours and keep pumping it in. it's gruelling but hopefully it will pay off. i actually think the top ups gave him a boost. perhaps try giving him, say 10 mls of ebm to liven him up and give him the energy to bf. it might be he has no energy. sorry so long and waffling.

Suwoo

Can't really add anything practical but just wanted to let you know I was thinking of you.

I hope you manage to get hold of the lactation consultant soon.

You are one determined mother! I know it's not the done thing but some hugs ((((((( )))))) - you sound like you need them.

Thanks all and thanks for the hugs, I do need them .

Pinkpeony, that sounds exactly like us to the letter. I've spoken to the lactation consultant and she has suggested 2/3oz 3 times a day. I have my supplemental nursing system I can use too when I can be bothered faffing with it. I will express when I find the time.

One change I have made is to the sleeping arrangements. I have been cosleeping and maybe that is why DS2 has been sleeping so well, because he is lovely and snuzzly. I have put the bedside cot next to our bed to move him into after feeds, I am hoping this will wake him up a bit to feed more effectively.

I know formula isn't the devils food but I have invested so much into this it is gutting that my own body could be letting me down

Suwoo - we've chatted before, although I may have been whingingdailyhatemail then. I had similar problems with DS, here I did end up topping up similar amounts to what you have been advised, and it was only temporary, and we did manage to get back to excl BF once he was a bit stronger and feeding more effectively. DS is nearly 9mo now and still feeding, he was 50th centile at birth but now settled just over the 9th and has been for ages now.

I broke my heart over giving him formula as I struggled to just 3 months with DD, and always thought that adding formula was a one way ticket to ending BF, is isn't always. Hope he starts fattening up for you soon.

I got back to exclusively breastfeeding dd through syringe feeding dd with expressed milk- and frankly I wouldn't wish that on my worst enemy. Syringe feeding takes forever and I was worn out.

With ds who started going down the same route (has recently been diagnosed with same condition), I just topped up with bottles of formula. Didn't seem to have any bad effects on either my supply or his feeding.