is 11 day old bf low birthweight son getting enough milk to gain weight?

[asparagusaddict]

my baby was a low birthweight of 4lb 14oz when he was born at 38+4 weeks (pre-eclampsia) and we've finally been discharged from hospital since they were happy with his weight gain - he was 1oz over his birthweight at discharge.

We had the health visitor round yesterday for the first time and she weighed him but he'd only put on half an ounce in two days since he was last weighed.

She has booked us another weigh-in on wednesday and i'm so worried because he is being exclusively bf now whereas at hospital he was being tube fed 47ml formula/expressed breast milk every two hours to get his weight up and cure his hypoglycemia.

now we are home he only breast feeds for 5-10mins at a time (i wake him every 2-3 hours) and today has started throwing up his feeds when i try to burp him. whhen i try to get him latched back on he won't have any of it. he seems to be pooing and weeing fine.

i'm so worried that as he has no fat on him due to being so small he's going to start losing weight and we'll end up back in the scbu.

should i just give up on the bf-ing and ff just to make sure he's gaining weight and is healthy? i don't want to be labeled as a bad mother by the hv. it's upsetting because i had thought bf-ing was going so well, i have loads of milk and baby has a good latch - i just wish he would feed for loonger, they told me it should be over 20mins per feed, now there is the additional problem of the vomiting

does anyone have any advice? i really dont know what to do for the best

I can so see why this is worrying, but it's good you have been seen by the HV.

Feeding 2-3 hourly is not usually enough for small, new babies - if you keep him skin to skin you will not need to actually wake him, but instead you'll respond to early feeding cues, and probably feed much more often. 5-10 min feeds are within normal but to ensure he's getting what he can, when he loses interest you can switch sides, and rthen switch back again, and then use breast compression (google it) to keep him going.

If he brings milk back when you burp him, simple solution is not to burp him! Burping is a cultural practice, anyway, and hardly ever really necessary

thank you tiktok, i'm so glad it's ok not to burp him!

if i keep him skin to skin, will he wake himself to feed? i just mentioned this to my husband and he's concerned that baby will never learn to sleep if he's not in my arms.

if i aim for a 5-10 min feed per hour during the day would that be better? will he get enough sleep this way? the two-three hour feeding schedule was what the hospital had us on. will he need a feed per hour at night too?

before he was born i had hoped to demand feed, but he just doesn't demand it!

if you keep him skin to skin he will more likely wake up as he would smell your milk. He should be latched on whenever he wants to. There is no 2 - 3 hour routine for a newborn as they have a very tiny tummy and can not take in so much that it would last so long. Do not worry about that he could not sleep alone - he will, when he is ready. Just follow your instincts and keep him close to you.

Ignore (in the nicest way possible!) your husbands concerns.

Firstly (imo) you cannot hold a newborn enough and it will not stop them from learning to get off to sleep by themselves.

Secondly, even if you are in the camp that believes you can hold a baby too much, your priority at the moment is to nourish your son, not to worry about sleep training. If it becomes an issue later down the line, deal with it then. But at the moment concentrate on cuddles and feeding

I don't know for sure, but I would think feeding every hour through the night isn't necessary and you'll get knackered. How about every 2 hours?

I think it's quite normal for small babies to not demand milk. But don't worry, that will change

Oh, and I have never winded my bf babies.

asparagus - this is a very new, tiny, less-than-five-pounds baby we are talking about here, and one whose weight gain is giving you some quite understandable worries. This is so not the time for your dh to be concerned about where he learns to sleep Your dh will help much more effectively by looking after you so you can give the intense care your baby needs at present.

Your baby needs you to be close so he can get a quick response to any feeding cues he gives, and staying close is part of you building your relationship - the relationship that leads to him gaining confidence in your love and in the world in general

Deliberately waking a baby to feed by the clock is often not a great idea - you end up trying to wake a deeply sleeping baby who then switches off because he's just not ready to feed...and feeding becomes harder.

Hope you can see someone face to face tomorrow who can offer real life support for you.

I just wanted to add some empathy (and agreement with tiktok). My first DD was 5lb1oz (induced for IUGR) and my second was 5lb8oz (5 weeks early). So I've been through the low-birth-weight experience twice now, and it really is scary in the early days (I used to feel like I'd break DD - she looked so small).

Small babies are more likely to have reflux, so if the spitting up of milk carries on or worstens then don't hesitate to get him to the GPs and push for help (a combination of ranitidine, domperidone and infant Gaviscon worked for us).

I ended up pumping for 13 months with my first DD because she ended up swallowing so much air when she bf'ed that she burped and vomited almost constantly if not held bolt upright. Feeding fortified breastmilk with a Dr Brown's bottle worked for us on that occasion.

For my 2nd DD, we are having much more success with bf'ing. The following things helped in the first couple of weeks when she was really sleepy and jaundiced and not waking to feed:

• feed really frequently. Don't time feeds, just go with baby's rhythms, and don't worry if some of feeds are quite short.
• I used to try to feed directly after a nappy change, and sometimes initiated a nappy change if I could see she was sleeping lightly but not quite waking.
• drink tons of water and eat well yourself: a tiny baby is even more exhausting than the average newborn
• do a few breast compressions during feeds, as helps baby get more breastmilk for less effort.
• I sometimes expressed a little before a feed so the let-down wouldn't choke baby and cause her to gulp air, and I thought that maybe she'd also get more of my hindmilk this way too
• if DD fell asleep on the breast, I'd blow on her head / tickle her ear and she'd sometimes resume feeding for a while
• remain relatively calm even if health professionals seem to be losing their heads. A lot of HVs and midwives get very twitchy about low birth weight babies, which one can understand, but have faith in your ability to nourish your son. If they advise giving formula, make sure that you are completely happy with their reasons for recommending it before following the advice - I encountered quite a few paediatricians who advised formula just 'because' it was how things were meant to be done for small babies.
• Try and resist having him weighed too much once the early days are over. I was paranoid about DD's weight right up until she was about 6 months old, and had her weighed every week / couple of weeks. I'd agonise about loss/gain of a few ounces, and it really wasn't helpful for either of us.

Congratulations on your new son, and I hope that things progress well for both of you. There's amazing advice to be had here that I really wish I'd had with DD1 - please keep us updated.

hi there, just a quick update and thanks for your advice!

we had our appointment yesterday and baby had gained 7oz in 4 days!! the health visitor thinks he is feeding so efficiently that he is actually taking in more than his stomach will allow and it is this excess that is literally overflowing. he obviously likes his milk!

i am so relieved i'm praying he will keep this up and catch up with his weight before too long.

thank you all for your advice and support

Great news....your baby knows what he likes

That weight gain is just what he needs for a bit of catching up!

Well done both of you

Well done Asparagusaddict and Baby Asparagus! 7oz is amazing for an average baby, let alone such a dinky one!

Congratulations!

Well done Asparagus! I'm so glad things have improved for you...Keep doing what your doing and your lovely little baby will have caught up in no time!