Tiny sleepy baby - scared she's not eating enough

[ja99]

I'm a first time Mum who's dd is just 2 weeks old. She's basically remained the same weight since birth (5lb 6oz) but in that time has been weighed 4 times & needs to be weighed again next week. I was pretty confident to start with that b'feeding was going well but am now totally paranoid that she's not eating enough.
Have been following all advice about stripping her down to nappy, tickling various bits of her, putting her down etc... to keep her awake but really, she won't feed if she doesn't want to - lips v. tightly pursed indeed! Have also been told to wake her every 3 hours, which I have been doing but this has meant nearly all her feeds have gone down in time so she's hardly doing any of the 25 - 30 min sessions she was doing in Week 1 after a good 4 hour nap. Quite often now she'll only feed for 12 - 15 mins before falling asleep. Not sure if I'm silly to be panicking this early but feel quite tearful every time she stops eating & am desperate to make her eat more so that she starts gaining. Also am paranoid because they're keeping such a close eye on her that I feel like she HAS to have gained weight by next week. Additional pressure because she's a tiny baby too I think.One midwife has already recommended supplementing with expressed milk (altho' I thought you weren't supposed to do this until 6 weeks) but am not sure when I give this to her?? After she's refused the breast? V. confused. Would really appreciate any similar experiences / ways to 'make' them feed when they're this tiny? MW's happy with all else by the way - she's pooing & weeing, is not dehydrated & is alert (when not asleep of course!). I guess I'm also wondering when is 'normal' for her to start to gain?

It sounds to me that you are doing everything right and indeed so is your daughter she is feeding up to 15 minutes...thats a good feed...so the next thing is to try and increase your milk supply...because she's feeding...and sleeping why not try for three days having a restful time...get up after the late morning feed...then shower and dress! and eat ...eat really well and snack every three hours to keep your insulin levels steady then your pituitary gland and therfore your hormones will be steady.and then go and sit on the sofa!!!whilst feeding ...close your eyes if necessary or let your eyes go out of focus whilst gazing at your tiny one! and feel your breasts really full in your minds eye!...really feel having copious amounts of milk...see in your mind, milk oozing out of the side of your feeding babys mouth...really get into it..maybe have a nap later and bed...the thing is you are just shifting your body clock after all you are up a couple of times at least at night I expect and not sleeping deeply as usual so... ...then after three days your should have confidently increased your supply....when i was feeding my son i remember I mowed the lawn when he was about 6 weeks old blimey did he cry that night ...my milk was low!!..The prolactin that is the hormone that is involved in milk production is mostly secreted at night when you sleep, which is why in the morning your milk is always richer and you feel fuller..and by evening your less full...so sleep ironically is the name of the game!!Also after three days of rest and sleep and food you could start expressing for ten minutes each breast after your morning feed...but it is a hassle and adds stress but it may do the trick so that could be plan B!! Good luck diana x

Ah, - you're doing everything right. Try not to worry.

Things you could try:

Keep the baby close, - very close (your smell and closeness triggers the feeding instinct).

Put her to the breast more often than every 3 hours in the daytime. It doesn't matter if she has a hundred sleepy snacks.

As often as you can spend time snuggled on the sofa or in bed. It doesn't matter if the babe is asleep on you. Offer the breast now and then even when she is asleep. Babies are capable of feeding when aslep

diana I'm a bit worried about your advice. Not because it will interfere with bfing, or because it is bad, but because it is a little bit too prescriptive. What you suggest looks like hard work to me and makes bfing look complicated. I suppose in a nutshell what you are saying: 'look after yourself, take it easy, relax and try to connect with your baby' is all quite sound, but breastfeeding really will work without all of that and just frequent access to the breast.

don't worry. the weight issue is probably not really one. yes you have a small baby BUT they usually lose about 10% of their weight in the first couple of days. So you've got her back up to her birth weight.She might be feeding less because she's learnt how to suckle more effectively over the last two weeks.

with my daughter i found tickling her chin and or toes helped keep her focussed on the job. the boys never seemed to feed for more than 10 mins - i think they just were better at feeding.

MW's and HV's tend to offer more support to first time mums because it's natural to worry that what you are doing is working, so please don't worry about that. And rest and sleep as much as you can - get your mum or a friend to come and help with the housework so you can just focus on getting your strength back.

Good luck and happy times together

ja99, first, congratulations on your baby!

From what you say it appears that your baby is only feeding every 3 hours; is that right?

A "good 4 hour nap" actually spells trouble in a newborn who isn't gaining weight.

Despite what you may have been told, this is very probably not often enough for your tiny baby. It is very usual for such young babies to feed far more frequently than this, every 1 to 2 hours is completely normal. If your baby was gaining fast, then 3 hourly feeds may present no problem, but when weight is static, you would certainly increase milk intake with more frequent (rather than longer) feeds.

Sometimes babies with difficulties gaining conserve energy by sleeping rather than eating - this is something you can turn around by increasing the frequency of feeds - even more than you have already.

How do you feel her latch is? Do you have any problems with soreness? If so, you should get your latch watched by a trained breastfeeding counsellor (not a HV or midwife) as this will affect milk transfer into your dd.

Do you offer both sides at each feed? When she stops actively sucking on one side, offer the other as the increased flow may wake her up and ensure more sucking. You can repeat this swapping as many times as you want - it's called switch nursing.

Also have you tried breast compressions? I'll find a link in a minute.

I'd advise stripping off naked to the waist and having a skin to skin babymoon, where she has instant access to your breasts round the clock too. Do you have a sling to carry her in?

She hasn't lost weight - which is a good thing. There are lots of things you can do to increase her milk uptake.

Diana - please don't feel ganged up on, but a couple of things in your post should probably be corrected.

Rest, and food, and fluids, and visualisation are all good things for a mother's wellbeing. But they will not impact milk supply. There are studies showing this.

The way to increase milk supply is to ensure more milk is effectively removed from the breast, by improving the latch for more effective feeding, and through increasing the frequency of feeds, or by expressing.

Milk isn't 'richer' in the morning - a common myth. Some women find it easier to express in the morning because they have had a larger gap between fees overnight. However, the longer the gap between feeds, the more the body gets the message "not much milk is required, please reduce production". This is particularly important to understand in the early days when supply can be very fragile.

Everything that very little carrot said - especially the breast compressions - google 'Jack Newman videos'. That site has good videos of feeding which are useful.

And try not to stress about the weigh ins - I had exactly the same - a very small (5lb 7), sleepy, slow gaining baby & remember trying desperately to feed her up the night before the weigh in & getting more and more worried about it.

Congratulations! Small babies are scary but sooo cute!

Thanks v. much everyone. I'm really relieved that a few of you think 10 - 15 minutes is a reasonable feed. One of the MW"s said I needed to get this time up as this was how she'd gain weight (I assume by reaching the hind milk) & I was stressed out because I couldn't see how I could get her to eat more frequently AND for longer - I seem to be able to only do one or the other as she seems to self-regulate!

I don't think my milk supply is a problem & I was told her latch was good. Had sore nipples for first 2 days but all fine now - hence me being initially confident that all was going well....

verylittlecarrot - Am now offering the 2nd side at feeds- had purposefully NOT been doing this as was worried she would just get loads of foremilk.

So will persevere with the frequent waking & of course the closeness (which of course I love, but worry about as she almost instantly falls asleep on me!) Will update following next Tues weigh-in....
thanks again

ja99 - shame you have had to cope with some conflicting and not v. helpful info and advice.

If your dd is at birthweight, then she has almost certainly gained at some point, and she has recovered her birthweight. This is good

I agree that because she is on the small side, you might need to be a bit more proactive than mothers with a 10 lb bruiser But it is frequency not length of time at the breast that ensures supply and intake - clock watching to check how long the feeds are is not helpful.

VLC is right to correct some of Diane's info.

Using both sides each time is a very good move - I wish mothers were not told they should not do this. The reason for them being told not to is really rubbish.

Your baby sounds fine....keep her close and skin to skin when you can so you can respond to any little feeding cues. Don't make it a struggle and don't fight with her to 'make' her take more. You will find it gets easier, I am sure. The fact the m/w pronounces her healthy is a good thing

Hi ja99
My DD was sleepy after feeding and initially reluctant for a second breast. I found a good session of winding after breast 1, followed by a nappy change tended to rouse her enough to be more interested.