BF baby has lost weight - help!

[Hybrid]

I'm really worried about the amount of time my 16 week old DS is BF for. He literally feeds for about 5 mins then pulls himself off to be winded. Once that's done, he absolutely refuses to go back on, wriggling away and ends up crying if I try to force him. He then seems absolutely disinterested in any further feeds.

I don't get why this should happen as I give 7oz of EBM for his evening feed and he guzzles that happily and screams if I try and take the bottle away to try to wind him.

He'd previously been suffering from reflux for which we've been given infacol and initially for the first week he seemed to be feeding much better.

I wouldn't have worried too much except that he's been steadily reducing the amount of weight he was gaining (which I know isn't unusual) and then last week, they found he'd actually lost 2oz. He's gone from the 50th percentile to the 25th.

The HV said not to worry about it as he seemed fine within himself and to come back in 2 weeks time for another weigh in. But this week, the feeding seems to be getting worse. Now his poos are also becoming dry and much harder to push out which I can only put down to the lack of fluid he's taking in. Having said that, he does have lots of wet nappies!!

Help!! I'm at a total loss and am fully expecting him to have lost yet more weight at the next weigh in as nothing's changed and if anything, it's getting worse. I've resigned myself to the the fact we'll have to stop the BF and just give bottles. I'm not hung up about giving formula but I'll really, really miss that closeness BF gives you. Bottle feeding seems so functional. But all I really want is to make sure that he's getting everything he needs to eat and is thriving again.

I'm feeling very sad about the whole thing!

Any advice anyone?

not a popular viewpoint on here but you could carry on with bf and offer formula top ups.

he's prob taking in quite a lot more than you think at the breast, they get quite efficient at it.

maybe get him checked out by gp/paed if prob continues?

sorry you're worried about this, Hybrid.

I don't agree with minx, though....what you're describing is indeed a baby who's taking less at the breast, but fortunately this is often swiftly remedied.

Of course one option is to up the formula, but this has the downside of reducing your milk supply and as this has likely caused the issue in the first place, why would you do it...unless you were ok about going over to formula feeding completely and your post makes it clear you are not happy about this.

So...a call to one of the bf helplines should help. You can discuss with them how best to increase your baby's intake of breastmilk and consequently your supply. It will prob mean breastfeeding a lot more (you don't say how often you feed, but whatever it is, he can do it more!) inc at night, and inc giving at least 2 and poss 3 or even 4 sides per feed.

What do you think?

Ditto tiktok.
You could also try lots of skin to skin-leave your baby in just a nappy on his front between your breasts . Do this as much as pos and just enjoy the closeness. Self attachment usually happens within 5 to 30 mins .
Also look at the nappies more than the weight.
6-8 wet and 3-5 dirty nappies is a good indication of having had plenty.

Your baby may be a little confused - try asking someone else to give the ebm if you want to give it .

fakeblondie - that number of nappies would not be a sign of adequacy in a baby of 16 weeks. Many babies of this age do not poo anything like as often as that.

Yes - skin to skin is really good for helping babies feed more, even at this age.

Thanks so much for your replies.

Tiktok - I'm not convinced that DS is coming off due to lack of supply as my breasts still feel full and when I've been able to pump afterwards I can still get a couple of ounces from each breast.

This morning, I BF for 15 minutes which was really good going but then he was starving again 90mins later so I gave EBM - of which he demolished 7oz. And that's a feed that he would never normally get (we're on 3 hourly feeds).

I've tried so many times to get him to feed more from the breast but he absolutely refuses to the point of crying (no way would I be able to offer him 3 or 4 sides per feed)

As I said, I'm not too worried now about going onto formula as I feel I've given him a good start. And to be honest, I'll probably feel an element of relief knowing exactly what he's getting and that he's not starving.

I'm just really confused as to why he should be so fussy with the breast.

Fakeblondie - I'll try the skin to skin contact and see if that helps. Even if it doesn't, it'll be a lovely way to retain that lovely closeness.

Minx - thanks also . I have occasionally topped up - it's such a vicious cycle isn't it. If weight isn't improving then will be speaking with HV.

Is it possible that you have a fast flow? If your milk comes very quickly it may put your ds off a bit, especially if he's had issues with reflux.

He may seem to prefer a bottle if the flow of the milk is a bit slower than from bf.

Have you ever tried expressing a little milk before you bf? Your ds may then find it more manageable.

Sorry you're having a hard time. Hope you find a happy solution soon.

Maybe there is nothing wrong at all?

IME HV weigh-ins is not an exact science so unless you get another drop in his weight then this on its own would not worry me.

Similarly some babies do feed very quickly (mine included) so maybe he just gets full quite quickly.

Obviously I'm not saying that there is definitely nothing wrong, but just pointing out that all may in fact be fine. Your HV desn't seem overly concerned.

How often does he usually feed?

Hybrid - giving a bottle of EBM because he wanted feeding 90 mins after the previous feed is a sure way of undermining bf...really it is. 90 mins later is not very soon, perfectly within normal, and putting him to the breast again supports your body making the right amount of milk for him.

I agree, there may well be nothing wrong and that the scales are not showing anything conclusive anyway...5 min feeds are within normal for older babies , but there is an issue with those nappies as dry poos are not normal (could be the formula effect, though).

Could the infacol be a factor?
DS2 got a bit constipated whenever he was on any meds?

Infacol doesn't work systemically or on the gut - just stays in the stomach and acts on the gas inside it, not on the milk. So I can't see it would affect the stools.

Thanks for the info TikTok .

TikTok - you're completely right re. the EBM feed. I did actually feed him from the breast initially but without the gaviscon (don't know why I wrote infacol, don't know what I was thinking!!) and he promptly threw up everywhere. I guess I panicked maybe as it was easier to mix the gaviscon within the bottle rather than mixing and syringing it into a screaming baby. But yes, that will completely affect the milk supply.

Brocco - I've been thinking my DS is probably just a really efficient drinker but then I realised that with a bottle, it takes him a good half hour to drink 7oz and bottles are meant to be easier than BF I think. Therefore, 5 mins at the breast can't be that much surely? Although, fast flow might be the answer there...mmmmm

Muddle - I also wasn't too worried initially about the drop in weight but I guess it's just seeing him feed so little helps to fuel the concern. I'm now desperate to weigh him which is silly!

Anyway, thanks for all your advice and help. I'm expressing as I type to try and encourage my milk production and will see what happens!
x

"TikTok - you're completely right"

She always is!

That's what I tell dh, muddleduck

No, no, no... If you say it then it stops being true!

Well I'll say it then - TikTok, you're right!

Hybrid, please consider giving the gaviscon via spoon/syringe/whatever is easiest! prior to a breastfeed. Your baby is probably not getting enough breastmilk - hence the drier poos, and the top-ups of formula would also contribute to this. I would also beg to differ re. the breast versus bottle on the issue of the flow. I rather think the bottle flows faster (and, of course, differently) to the breast. Babies of his age DO have the ability to breastfeed very efficiently, so 5 mins at a time would be ok if he was feeding frequently enough.

Also, no-one here has mentioned the 16week frequency feeding - and the joyous erratic feeding behaviour that goes with it. Your baby needs to boost your supply at this age - to meet his growing needs (getting ready for rolling over; sitting up; crawling; playing with toys ..etc). The 90 min gap between those couple of feeds is completely normal - and your baby was telling you he needed to boost your milk supply. Frequency feeding and cluster feeding may continue for a good couple of weeks before things settle down.

If you find he isn't initiating the feeds, then you need to do that for him. Try and spend a few hours at a time together, perhaps in the bedroom - skin to skin is good - and have a breastfeeding marathon - just keep your breasts exposed to him, avoid the EBM for the day, and just let him remember what your breasts are for! Spend lots of time cuddling him and playing with him and just let him feed whenever he wants to, for however long he feels like. If the feed is short, try and encourage him to have a bit more - but don't worry if he doesn't, he will when he's ready. With no other distractions you will probably find things start to improve.

Hybrid, when tiktok says to offer 2 3 or 4 breasts, she means swapping between breasts so that he gets the fast flow on each. TBH being able to pump after he's come off isn't an indicator that the flow was fast enough. I have low supply overall and I can often get an oz or two out of my boobs when the baby has given up - for me the pump is pretty efficient although I know that's not true for everyone. He may be fussing because of reflux, or because of low flow, or because of fast flow! One way to see is to put him onto the other boob to see if the flow is faster and therefore will keep him more interested

Plus what everyone else said about feeding more often etc.

Hi. I don't think TikTok meant only the "fast flow" as this would mean baby would only be getting foremilk - and that won't boost his weight gain.

I absolutely dont mean 'getting the fast flow off each', thanks, mummy, you're right!

Hi tiktok - nice to see you on the thread again. I am fairly new to MN but still remain a bit shocked at times as to how misinformed so many mums are. It's always good to hear accurate, research-based guidance and advice for Mums.

Hi there all.
Thanks so much for the continued advice.

I had DS weighed yesterday and bizarrely he had gained 13oz in a week...!!!!
So I am utterly confused.

Obviously I'm really happy that not only has he not lost weight but he's gained a tremendous amount.

BUT... at the risk of sounding like a neurotic mum who's never happy...

I am also wondering if this is true weight gain or if it's possible for a baby to retain weight by being constipated?? Poor baby is really having to push the poos out and they are now coming out a bit at a time and often as a very thick paste. One time, it was so dry I could have shaken it out and re-used the nappy. Am I being mad???

The weigh-in clinic was short staffed so couldn't really speak to HV for advice.

The week that he lost weight, he was poo-ing 2-3 times daily which is amazing for him (he has problems with pooing although never previously this bad) and now the week he's put on weight, he's been feeding worse than normal and been seriously constipated. Mmmmm, just thought, this could probably make feeding feel uncomfortable if he's constipated couldn't it?

The only other difference is the one bottle of EBM each night (total of 10 days now) but surely that can't make such a dramatic difference???

My HV also suggested the cluster feeding/encouraging feeding whenever DS wants but I'm just not in a position to do that due to the gaviscon.

Mummy369 - I do give it to him via a syringe prior to each feed but I'm not supposed to give more than 6 doses in a day and when I've tried feeding him without, even just 90 mins after the last dose, he always throws up dramatically. Also, I'm fairly sure the gaviscon is the cause of the worsening constipation so don't want to use it more than I have to.

I'm sure he's teething as well which HV suggested can cause erratic feeding (didn't know that 16 wks is also known for up and down feeding) and so I spend time trying to put him in different feeding positions to see if that relieves any possible discomfort on his gums. This can help.

I feel as though I'm constantly stressing about one thing or another - I'm sure DH thinks I'm crazy although he'd never say it!

I should probably just carry on the BF battles and see what happens I guess. It's just heartbreaking seeing him upset and not knowing what it is.

Sorry if I sound completely neurotic!

Have you tried reducing the gaviscon dose slightly and increasing the frequency? i.e. if, for example, you usually give 5mls every 3 hours, how about trying 3ml at one feed, then giving him the other 2ml if he needs another feed after only 90 minutes? The 6 doses per day would then stretch to maybe 8 or 9 smaller doses.

I think the weight gain is 'true'. Did they measure DS's length on the previous occasion? Or you may have noticed his toes are now reaching the end of his babygros?
If he was having a growth spurt, he may well have gained in length rather than weight, using up all his calories and energy in that way last time.

Genuine question - how can they grow in length without gaining weight? I mean - they don't stretch do they? [curious but possibly being thick emoticon]

They use their fat reserves.

Think of those tall, gangly teenagers - they often look like they've been put on the rack!

DS1 and DS2 lay down fat then grew in length - always looked chubby, then just right. DD1 grew in length first, then lay down fat - always looks slim - then skinny!

Sorry - wrong way round! DD1 skinny first then slim!