Help needed - bf 3 week old not gaining weight

[Gidders]

Hello, I'm hoping some of the breast feeding experts on here can help me.

My dd is 3 weeks old tomorrow and has been exclusively bf since birth. She fed really well from the beginning and at her two week weigh in was gaining weight really well - she weighed 3259kg, birthweight 3110kg.

But for the last week/10 days, she has suffered really badly from what we think must be wind - she started screaming from about 5pm, right through the night until about 5am. She seemed like she was in pain, drawing her knees up and seemed very distressed. She was fed on demand, but I noticed that during these episodes she wanted to feed more, but that the feeding made her worse, she would be frantic.

So, I stopped feeding her on demand and have been feeding her every 3 hours - she feeds for about an hour at a time. The wind has got a bit better - we can get her to sleep a bit at night now, but the midwife weighed her today and she hadn't gained any weight. Midwife thinks I should feed 2 hourly through the day and night, which I will do, but I wondered if anyone had any advice to offer - my instinct is to go back to feeding on demand, I feel awful - like I have been starving her - but I don't know how on earth I am supposed to tell when she is rooting/crying because she is hungry and when she wants comfort because she is windy.

We have tried infacol, slinging and burping as well to help with wind, all with partial success.

Midwife said I should also be expressing after every feed to increase supply - but I don't feel this is a supply issue - she was gaining weight fine until I started timing feeds, so I'm not sure this is necessary? Also mentioned topping up with formula, which I am keen to avoid if I can.

Sorry for long post, thanks in advance for any help,

Amy

Hi Amy,

I'm afraid I'm not a BF expert (hopefully one will be along soon) but just wanted to say sounds like you are doing fab and that you are not alone! My situation is almost exactly the same as yours... though I started off with timed feeds and am now trying out on demand feeds.. my dd is also 3 wks, was doing fine at first and recouped birthweight at 2weeks, but is now gaining weight too slowly and dropping down the percentiles.

The only things that have worked slightly for us in terms of her not screaming so much at night is for me to express a few oz of breastmilk (this wasn't as bad as I thought, I'm using an Avant hand pump), which we use as a late night top up after a medium length feed, also DH can give it.

I saw a health visitor today and her suggestion was to up my own feeding... I thought I was doing quite well but she suggested a lot more in the way of high carb snacks every few hour, especially late afternoon and last thing at night. The idea being that a well fed mum produces milk more quickly for the baby and less likely for the baby to fuss around at the nipple (that's another thing that's kicked in during the last week or so).

Anyway.. good luck with it all!

hi, my situation is v similar but a few weeks on. dd had slow weight gain at 3 weeks - still not back to birth weight. i stressed and started topping her up with formula which helped the weight but i am now trying really hard to wean her off this which isn't easy. i'm not an expert but have bf my 3 with varying success (!), i would say absolutely go back to on demand, that is the only way to keep up your supply effectively (pumping is great if you can do it but a real pain in the bum and not as good as a baby at increasing your supply). in terms of the crying i really feel for you, have no real suggestions on that one but hopefully she will grow out of it in time. keep at it and good luck!
ps sorry for lack of grammar dd is sleeping in my right arm!

Gidders,can understand why this is concerning for you.

Three hourly feeding is usually not enough for new babies, and it is possible this is linked to the lack of weight gain.

Expressing will increase your milk but the real issue is getting milk into the baby - unless there is a real issue with supply, such that you need to 'rescue' it, then time spent expressing may be better spent feeding direct - though check this out with the midwife. It does depend on your baby feeding effectively direct.

It's a good idea to deliberately offer at least both breasts every feeding session, and 'switch nursing' (swapping sides again and again) boosts supply and intake. It is volume of milk that makes babies gain weight, so ignore anything you might have heard about always feeding on one side only 'to get the hind milk' - this is an erroneous and sometimes highly damaging interpretation of the research that some HCPs, books and mothers have made into a mantra. Some mothers and babies are fine with this, but a few simply do not make sufficient milk/get sufficient milk with it.

Diet - hi or lo carbs or no carbs - will make no difference to this and comeonbishbosh's HV needs to stop telling mothers this misleading stuff (It will do no harm, though - just won't make any diff!)

Anyway - what does this sound like so far? As for the wind - not sure. Feeding may seem to make things worse, but there needs to be other ways to help her stay more comfortable, if wind it is, than restricting her feeding, I think.

Hope this helps.

Gidders, have been through a similar sounding situation.

We tried cranial osteopathy for the trapped wind and it seemed to work well. Maybe find a local practioner and give it a go.

Good luck with the weight gain mission too, I'm sure Tiktok's advice will sort things out. smile

ds was a little bit like this when he was tiny - I had to wind him quite a lot during feeds, which was a PITA, but worked. Sometimes you can tell by gently feeling the abdomen when they're sitting up (and not crying!) - if it's quite hard it can be windy - if they're crying they tense up, so you can't tell then. That's no a guarantee, but worth a try - when ds's tummy was quite soft, he was more likely to settle to a feed better.

Thanks for all the replies - it's reassuring to know other people have experienced the same thing!

Tiktok - that does make sense, especially since I have been feeding off one breast each feed. I have been trying to offer her both today but I am finding she loses interest very quickly after the first swop. I supppose that means she has had enough?

re. the wind, I agree of course that restricting her feeds isn't the answer - I am just worried that I can't tell the difference between hunger and need for comfort, but the comfort feeds are making her stomach more painful, or seem to be. Either way, I end up feeling so guilty!

have you had someone check that your dd is correctly attached to the breast? also, how long does she feed for at each feed? it sounds to me like it may be a case of too much fore-milk and not enough 'fatty' hind milk. Too much foremilk can cause colicky symptoms in babies and also slow weight gain. I would have a professionall check your positioning and attachment to make sure your dd is effectively draining the breast on one side before then offering the other side - offering both sides should help increase your supply, but you need to ensure dd is getting all the hindmilk from the first breast firstr iyswim.

other ways to increase your milk supply would be expressing (by hand or with a pump) in between feeds, putting baby to the breast more often, having some skin-to-skin time with your baby (maybe in the bath) and not using a dummy.

how is dd apart from the weight gain - is she having plenty of dirty and wet nappies? are the stools a yellow colour?

with regard to why she is crying - you may find skin to skin helps to soothe her, and also when babies are hungry then give signals of wanting to feed before they cry - rooting, sucking on fingers etc, so hopefully you can tell she is hungry before she gets to the crying stage - crying can make babies swallow wind and also it can be difficult to get them to feed when they are very upset.

finally well done for getting this far - you are doing a fantastic thing for your baby and all problems can be overcome with the right help. xx

try swapping again after the first swap, if she loses interest, just to be sure she's done. Both of mine have gone through phases where they like to switch a lot - no idea why!

Hi Amy, sorry you're having a tough time, reminds me of how it was for us with our 3yr old girl, it was really tough but in the end i fed her for 21 months. Stick to instincts bout supply and demand, timing it is rubbish, unfortunately if she feeds for a long while she'll get higher lactose may make her a bit colicy but at least you'll also know she's getting enough, take calcium tabs yourself, plenty of water, work away on winding her. I would avoid topping up with formula, it's early days, and it will unbalance things.

You know, I think girl babies are just harder with feeding, I have an 8mth old boy now and he feeds without demanding it endlessly, so he never got terribly windy. I remember being told by a doctor about 3 weeks in with dd it was just a bad patch which was true,v soon feeding will produce no wind just happiness!

Hi Amy, sorry you're having a tough time, reminds me of how it was for us with our 3yr old girl, it was really tough but in the end i fed her for 21 months. Stick to instincts bout supply and demand, timing it is rubbish, unfortunately if she feeds for a long while she'll get higher lactose may make her a bit colicy but at least you'll also know she's getting enough, take calcium tabs yourself, plenty of water, work away on winding her. I would avoid topping up with formula, it's early days, and it will unbalance things.

You know, I think girl babies are just harder with feeding, I have an 8mth old boy now and he feeds without demanding it endlessly, so he never got terribly windy. I remember being told by a doctor about 3 weeks in with dd it was just a bad patch which was true,v soon feeding will produce no wind just happiness!

Jackiepaper - i was concerned she was getting too much foremilk a week or so ago because she was doing green poos, which was another reason I started feeding on one breast. It seemed to work, because she is doing yellow poos now, about 3-4 a day, so I thought she was doing well, but obviously the scales say otherwise!

Been feeding on demand today, which has been a lot, and she's not a happy baby at all - won't be put down, constantly crying or grumbling. I really think my milk disagrees with her somehow.

Thanks Habbibu, swapping does keep her a bit more interested.

The first few weeks can be so hard going, the exhaustion can feel like your drowning, at least mine did, but there's NO way you milk disaggrees with her, it's the best thing for her, it's her link to being where she came from - your body! All babies drop weight after about 10 days or so, then they start gaining again. The weight charts are made from averages and most babies are on formula so it can be furstrating for bf mums. You're being too hard on yourself when really you are doing great.

Thanks for kind words Seashore, I think I need them, this is all just so upsetting.

She has been absolutely frantic this evening after feeding, really seems to be in pain, and rooting all the time so I just don't know what to do.

aww honey - don't lose confidence in yourself, your milk is the best thing for your baby, i know it is hard but try to hold onto that fact.

try the tips for increasing you milk supply that i mentioned earlier and hopefully that should help with the weight gain. Some baby's are very fractious - just because they cry a lot doesn't necesarrily mean they are always hungry, use a sling as much as you can, get as much rest as you can, and try going back to skin to skin as it really can help big time with both calming baby and increasing milk supply.

clearly your baby is getting milk - 6 wet nappies and 2 plus pooey yellow nappys are a good indicator that baby is getting the milk he needs, try not to lose faith in yourself and please seek some professional advice from a breastfeeding councillor or similar - there should be one at your local hospital. best of luck xxx

Set yourself comfy, with a big mug of water to your side, tv on, low lighting, relax and feed away, or you could try both going to bed to feed,before you know it weeks will have flown by and it will be easypeasy.If she is too upset though hand her over to someone else and you take a break for a while. What I always found was that my colicy dd always lost it the second I put her down. The first few weeks it was hard to even get to the loo whereas ds I could put him down and he'd be asleep by the time I'd have rushed to the loo and back. I really do think girls are just more demanding for comfort and connection from day one. And you are completely fullfilling those needs with breastfeeding, also, sometimes babies just cry!

also, small babies cluster feed in the evening and first part of the night, because the prolactin (milk producing hormone) is highest at this time and so babies are programmed to feed most at this time - it's totally normal for them to be unsettled and want to feed almost constsntly at this time. try not to worry, it's a phase and it will pass, although i know it is awful at the time, hang onto the fact that it won't be forever.

I really wish I could believe this was normal cluster feeding, but I'm sure it's not - she was doing that the first week and although she was grumpy if she had to wait fot milk, it wasn't this horrible frantic screaming. And it is definitely worse the more I feed her - I want to feed her to comfort her but I feel I'm making her suffer! Sorry to be so negative, you've all been lovely, I guess there isn't an easy solution. I have left a message for a breastfeeding coucillor today.

That's true, milk is richer at night, it's another reason I've always found it strange when folk decide to combine bottle and breast cause the night feeds always loose out and they are what is needed most, they bring you milk in. Long as you get some good rest at some stage in the day/night. My nights used to be long with dd. I remember it was winter(she was born in Nov) and for a while I never saw much daylight cause I would finally get to sleep at dawn. The plus side to sticking with it though is that the bond between us is so strong, we skipped the mythical terrible twos compleletly.It's hard to beat nature, put the pain in now, it will save you much later!

Hope this has been some help, also hope you get some good rest soon.

Yes, I've seen in a few dawns already with this one - actually love that time of night with her, she's calm by then and it feels like we're the only people in the world

Sounds like you're trying everything, and it's perfectly normal to be fed up with it, crying can be so tough to endure, especially if you think it's you causing it, and it's healthy to let it out and feel negative, but you're not causing her to cry, you are feeding her and comforting her. You need to try and ease into it, breastfeeding at this stage can seem so overwhelming, like it will go on forever, but it won't. For now, just try and get through it, long as she's is producing enough wet and dirty nappies, she's fine. My dd didn't enjoy her babyhood, I can see that in comparison to ds, but she's a really happy child and breastfeeding contributed to that. It'll work out, but stop being so hard on yourself, you can only do your best, give it all some time.

See, it's the start of plenty of special times with her,it's all so worth it for that we're the only people in the world feeling, I know exactly what you mean. I've got to go now and bf ds! Wish you a calm and happy night, X

ps - I used to stuff tissue paper in my ears when it got really bad, it helps!