Weight gain battles

[gingerbaby]

Hi! I've been lurking on this board for ages and have read some really good advice so I was wondering if anyone can help me for my specific problem... DS is 20 weeks BTW.

I was exclusively BFing and thought we were doing really well until his 3 week weigh in where we found he had lost weight. Went along to a BF group who were all smiles and 'don't start on that nasty formula', which I stupidly listened to. Meanwhile DS cried AAAALLLLLL DDDDAAAAAAYYY and we thought we had 'one of those babies' until 5 weeks when he still hadn't come anywhere close to his birth weight so we combination fed. Best thing we ever did! I stopped going to the BF group as they'd make me cry with their 'no woman cannot BF' attitude. During this time DS did not sleep at all, he was too hungry but as soon as the bottles were introduced it was like having a different baby.

Fast forward 3 months and DS is now point blank refusing bottles and his weight is plummeting again. I've tried and tried with cups/spoons/witchcraft (joke!). We've introduced things like very very milky sweet potato and banana to get the calories in him but still no gain. I'm still BF, which I LOVE and don't want to give up but am under a lot of pressure from my HV due to his weight.

Sorry this is a bit ranty, sometimes I just need to get it off my chest. I worry about his feeding so much cos it impacts on everything. I've stopped going to baby groups cos it's such a nightmare feeding him out and I'm so tired. Everyone seems to cope with a smile on their face but I just can't.

Thanks.

gingerbaby - that's a sad story about the lack of knowledge and support you have had. A baby who has actually lost weight at 3 weeks needs careful assessment, and it certainly sounds as if bf alone was not going well at all - hence the continued poor weight at 5 weeks.

What was needed was help to fix your breastfeeding, probably earlier than 3 weeks in fact, if there were signs things were not going well. Sometimes, when there's a real crisis, short term use of formula is needed, and I think sometimes, breastfeeding support groups do not have the skilled people to actually resolve problems. If all that's needed is encouragement and friendship, then they're fine....but you needed more than that.

Is his weight actually 'plummeting' - ie is he losing weight rapidly? If so, then you need medical advice, honestly.

If he is merely not remaining on the same growth centile, then this might be perfectly normal for him One response would be to breastfeed him lots and lots, which is more likely to get calories into him than solids, to be honest. If he is not taking bottles then of course he needs the milk.

I am an NCT breastfeeding counsellor; you can also get in touch with breastfeeding counsellors on any of the bf helplines.

Hope this helps.

Hi tiktok, thank you for the reply, can I bombard you with some more questions?

We didn't know before 3 weeks that I was having problems, I went to the BF group when DS was a week old and was told we were 'doing excellently... don't give up' despite worrying about wee/poo output. The midwives noted slow weight gain but they also weren't consistant with nappy on/off weighing and I just didn't think about that at the time. I could kick myself.
Because it went on for so long without him feeding does that mean I may never be able to produce enough milk? I remember reading somewhere vaguely about putting down enough receptors or something.

He is losing arounf 2-4oz a week and has been for a month, the implication seems to be from the HV is that I am being cruel for continuing to BF even though it is so evidently not working but as he won't take a bottle when he cries for food I don't know what else to do. I try and feed at least every 2 hours during the day whether he displays signs of hungar or not, and he feeds pretty much constantly at night. I did listen to my mum's/HV's advice about trying to not feed him at night as he's 'getting mixed up' but from reading on here it looks completly normal for babies of this age is not want to feed much during the day.

WRT weaning, our main aim is to get milk into him so everything is pretty much thickened formula, he has lunch and dinner and usually has 2-4oz per meal. Should we be aiming for more? I also try to feed before and after meals.

Also, the best feeds he does are the ones where he falls asleep. Is it best to try and get him to stay on for mulitple let downs? When he's wide awake it's a battle so I usually try to feed him to sleep at naptimes and keep him on. We don't have a 'strict' routine but I do take him for walks around the same times every day and meal times are the same.

Sorry to bang on but in the NHS leaflet it says they'll come off when they've had enough but he'll either fall asleep or keep pulling off then wanting more say, 10 mins later. I feed on demand but it seems he's never had enough. We also do breast compressions and if he won't feed every 2 hours I try to express if I can, although this isn't always possible.

I guess I'm just looking for the magical BF answer, if you can give me any advice based on what I've told you it would be greatly appreciated. My HV is less than useless and doesn't really have any BF knowledge. I've tried helplines but always forget to ask everything.

Thank you, it must take a lot of your time.

gingerbaby, happy to help if I can.

Your situation is more or less outside my boundaries, though....a baby losing weight over a period of month needs a medical assessment and it's not clear if this has happened. I would share your concerns about the health visitor especially if she has told you that your baby should not feed at night (this is crazy - a baby whose weight is causing concern having nightfeeds withheld? Dear oh dear....)

It may be your baby needs extra calories and that is all - which is relatively easy to fix, one way or the other - but a baby who refuses food (formula or solids) and is still losing weight needs checking out, and obv this can't be done by a breastfeeding counsellor on a talkboard

Sounds to me as if your bf support group has totally missed the signs of early bf difficulty - and weighing is useless unless it is done consistently and correctly. Why bother, otherwise?

Yes, breastfeeding can be saved - early bf does lay down prolactin receptors and it can be more difficult to retrieve bf after a difficult start, but it can be done.

In your own situation, my at-a-distance guess would be your baby may need formula, but this does not mean cessation of bf, and bf can be increased alongside whatever is done to address the weight issue. I think you'll be best helped by seeing a well-informed on breastfeeding medical person, like a paediatrician who knows about bf....it does not sound to me that you will get the informed help you need from your HV and certainly not the bf support group.

Hope you can sort something - your GP would be a good start. If the GP is good and knows about bf, then you may not need a referral. Though it would not surprise me if the GP wanted a paed's opinion about your baby, too.

bumping to get an update from ginerbaby

er, ginger not giner....

Hi, I took him to the GP and he's gained half a pound in a week! I'm over the moon. We've also got a referral to the hospital for bloods etc but he doesn't think anything is wrong, just that DS needs more calories. I think the weight gain is due to the extra 6-8oz of formula he gets in his lunch and dinner but I'm still BF on demand, although this seems to be mostly at night at the moment.

Is there anything I can do to boost my supply at this stage?

I'm so pleased with the gain!

Good to hear from you, gingerbaby and that's great news!

Shows this was a calories issue not a metabolic one or anything to do with your baby being ill. It's good your GP reassured you on this.

The only surefire way of boosting supply is frequent removal of milk from the breast, inc at night. This means that a baby only feeding at night, or mainly feeding at night, is prob going too long between breastfeeds, and that increasing production is important....for you, that means consciously and often offering breastfeeds. Might be worth your while getting someone who knows what to look for to observe a feed.

I try to feed him every two hours during the day and if he doesn't want to feed I express (double pump for 10mins) - well in theory pump every two hours but sometimes I can't for whatever reason. The main problem I have with daytime feeds is that he is too distracted. I go to a darkened room whenever possible but find often he just isn't interested. At night he will feed anything from every 45 mins to every 2 hours, although sometimes this is just a few sucks after a let down. I don't particularly have a problem with the frequent night feeds as we co-sleep but I would like it if he could take more in the day.

Also, I've noticed my left breast doesn't produce as much as the right, could this factor into his poor weight gain when it's just me feeding him?

I feel a bit uncomfortable at my local BF support group cos of their opinions on my use of formula but I think it'd be best if I went back there.

Thanks for your help again.

That should be at least every two hours, if he has gone two hours between feeds IYSWIM.

gingerbaby - most women have unequally-producing breasts

I think too it would be good to find real life help - is there another support group you would trust more? If not and this group continue to make you feel uncomfortable for having used formula, then you need to report this somehow. It's not on.

Gingerbaby, much of your story is familiar to me, however finally got paed appt yesterday and all is well with our LO (28wks)

A couple of things we tried that worked, was a toy or scarf tied around my neck during feed times (you can get special brestfeeding necklaces).
My friend brought me tea from a herbalist (a fennel and fenugreek based mix) it really helped boost supply, loads of water.
Everytime she fell asleep I swopped breasts.
HTH in some small way, really I know how frustrating and worrying it is.

Gingerbaby, if you can bring yourself to do it, I found a homemade supplemental nursing system worked to get extra calories into the baby who wouldn't take a bottle. You feed a tube into the baby's mouth while they are at the breast and give extra milk from a syringe or tube. You can buy a system from medela but I hated it, I had a lactation consultant help me construct one from a syringe and a feeding tube. You could then give formula at the breast - give him calories and stimulate the boobs at the same time.

Good luck!