2 week old still losing weight - but don't know how to do combined feeding

[pollyr01]

My dc3 is 13 days old and today we had a disappointing trip to the midwife - I thought we'd get signed off but turns out my dd has lost more weight. I'm now so worried I can't stop crying and I'm not sure what to do. I have to go to a feeding session on Monday and midwife seeing me again on Tuesday. She checked my latch today and it's fine: I feed her approx 8 times in 24 hrs and she's having lots of wet and dirty nappies. I b f the other 2dc for months and months without problems. Midwife checked her for tongue tie but said nothing wrong,
So. I came home and tried to express to do next feed in bottle but only got 1oz out in 1 hour.
I gave in got some formula and she took 3oz from bottle easily.
I'm now wondering if maybe I don't have much milk as I'm exhausted with a 3 and 5 yr old and I can see that f f will have benefits eg for a start she actually puts on weight, that I have more time with other kids etc
On the other hand I feel Massively guilty and a major failure especially given I did it so easily with the other 2dc. I also understand the benefits if great feeding eg health/bonding / these are drummed into you, and my healthy husband was only f f so it can't be that bad.
If I now move onto f f / combination feeding, not sure if the best approach. Any ideas?

Could you continue bf with top up ff in a bottle or a cup if you want to limit the impact on bf
But do what you need to to get through a fed baby is what matters at the end of the day

What did your baby weigh when born and what does she weigh now?

I ask because our HV was troubled that my DD2 hadn't got back to her birthweight by 2 weeks and was close to referring us to the GP. However my DD was born rather heavy 98th centile) and was just 'catching down' to where she should have been (50th centile). My DD was entirely formula fed on demand and wouldn't take extra milk or feed more frequently, so I wasn't at all sure what the GP might say other than 'she looks fine'.

I suppose I'm also saying that formula might not be the answer as it clearly wasn't the solution for my DD (for something that wasn't actually a problem anyway).

If you haven't already it is also worth asking midwife what she recommends - had similar issues with DS and midwife was very exact on formula dosage in cup etc - made it easier as wasn't left up to my anxiety and it didn't disrupt bf.

Can you see a breastfeeding expert? Any local groups? Also if baby was on a drip after being born this can "add" to the birth weight, making baby seem heavier than they really were. Can anyone take the other children for a day or two during the day? Give you plenty of time to have skin to skin and to let baby cluster feed

Hope this improves soon

Your poor thing

Exactly the same happened to me with DC3. Had no problems bf DC1 & DC2 for 9 & 8 months, but DC3 just wasn't gaining weight despite a good latch & no tongue tie.

I struggled on until he was about six weeks, then at the clinic one day the HV strongly advised me to move to formula. I didn't want to give up bf completely so I decided to try combined feeding.

For each feed I used to bf for as long as he'd stay on, then switch to a bottle. We kept going like that until he was just over 4 months, when he finally refused the breast completely and I knew it was the end.

I know I did the right thing as he started gaining weight very quickly and was soon back onto his birth centile. I also had much more time with the older DC, and was much less stressed out because I knew he was thriving.

I found it all very hard emotionally though, and after I what I knew would be his last ever bf I sobbed for hours.

The bond I have with him is just as strong as with his older siblings, and he has always been just as healthy.

Only you can decide what's the best approach for you, but I just thought I'd tell you my very similar experience in case it helps you decide.

All the best

If you had certain blood pressure medication in labour it too can artificially inflate the baby's weight as they take on wAter, but I guess you would hope she gain a little by now. The feeding clinic can tell you exactly how much formula in a day, it is a little less than the formula box says- I think our 8lb ish DD1 was 240mls a day. To improve supply they reccomend you bf- then top up with formula (about 30 or 40 mls we found). Then express for ten or minutes on each side. Make sure you feed every three hours (which btw is almost impossible without loosing your marbles). Night feeds are the most importBt for setting up supply so I usually left her to sleep longer for one period (skipping a feed) and it seemed to be ok. Just try to ensure you feed a couple of times between 11pm and 4 or 5 am.

I hope that makes sense. The feeding clinic may give you domperidone to boost your supply, but you have to follow this gruelling schedule for it to work.

I know it is tough, but hopefully after a few weeks you will be producing enough and can just feed normally. With DD2 I did similar for the first few weeks, but was soon able to give up.

Also midwives try to encourage you to use a cup instead of a bottle to avoid nipple confusion. Give it a try of you want, but it is stupidly hard. We used a bottle with both DDs from early in with no problem. As one bf consultant pointed out to me- it is not likely they would use a bottle once and suddenly forget how to bf so just try it and stop if you notice any problems.

Good luck. You aren't a failure- you will manage to feed this DC as you have the others. And even if not- formula is not poison. Be kind to yourself.

Also- if you are worried about bonding- I just made sure only me or DH gave DD a bottle. That way I was still mostly the one meeting her needs and looking living at her. It was still a binding experience.

Don't be sad it sounds like you're trying really hard and doubt the best thing for your baby by trying to BF. My DS2 (now 12 weeks) lost weight a few times too and t was very stressful. My HV referred me tons lactation consultant who checked the feeding position to make sure baby was in a good position to feed more efficiently (this took feeds from lasting 45 mins to 20mins). She also got me doing breast compressions at every feed which has had a remarkable difference to endure my supply increased (it was very very low due to having a very slow start to feeding this time around) and makes sure my baby gets as much milk as possible at each feed. He is now 12 weeks and doing brilliantly despite a very slow start and slow weight gain. I'm still exclusively breast feeding so just wanted to let you know, with the right support and help, it is absolutely possible to move forward from where oh are now and EBF if that's what you want xx

Oh and he other major too was to have a babymoon to help increase supply. Stay in bed/sofa for a couple of days with the baby and have constant skin to skin and let her feed as much as she wants. It really helps

Thank you all. Birth was quick and drug free, so no hangover from that. she did weigh 9lb 11 and is still within 10% weight loss, but not gaining...
Today I let her have 2 X bottles of formula and she took about 3 oz each time. I then gave her a breastfeed and will do another 2 X bf tonight. I just wanted to get something in her and am so stressed and knackered I'm not sure there 2 was much in my boobs.
drama like you I think I'll go to b f topped up with ff and dad can do one ff at night.
cherrybaeeibg lactation experts on Monday....although reading up on it, I want them to check again for tongue tie as I really think she may have this. I realise a little internet knowledge is a dangerous thing, but I've got a feeling this may be the culprit. A lot of factors stack up : falling asleep at boob, nipple sucking after good latch at first, long feeds, slow let down,

From what you've said re her weight loss and birth weight, I really would try not to stress about it too much right now. Bigger babies often (not always, but often) lose a higher amount initially, simply because being out of the womb uses more energy, and they have more to lose.

If giving the formula now is reassuring you, then by all means continue to do so - but it might be worth holding off until you've seen the lactation specialist (is it an independent lactation consultant, or a breastfeeding group?) before you make any long term decisions.

Either way, see if you can try and make some observations regarding the breastfeeds for now so you can discuss them - the things you've mentioned, plus roughly (no need to clock watch, just an idea) of how long she's feeding for each time, if she's taking both boobs, if there's any clicking, vomiting, nappies etc. They may not even want all that info, but if nothing else it might help you feel a bit better armed.

Tongue tie is very very common, but is often missed because it can come in so many degrees.

You sound like you're being really proactive, and you have nothing to feel guilty for.

Wow that sounds a completely normal weight loss, my baby weighed much much less than yours and lost much more, bf just takes a while to establish. I think your Midwife is being overly cautious. Please please see a bf expert tomorrow and get them to check again. It's not too late but jt sounds like your support hasn't been adequate , please shout and shout until you get the support you need

Was she weighed on the same scales each time? Even tiny variations in accuracy can look significant with a newborn. I second seeing a breastfeeding expert - it sounds as if you're doing all the right things. X

I completely relate although with us it was the other way around. DD1 didn't put on weight and was really hungry on the breast - so at a week we topped up with formula and I pumped bottles too. Luckily she was my first so I had time to do this. Stopped breastfeeding completely at 14 months. I thought it might be the same with DD2 but she's a month old and is 2 and a half pounds above her birthweight and feeds really well- sometimes these things just happen.

Does she sick up a lot/have a lot of wind? My sisters little boy has this and it was milk protein allergy.

I wish you the best of luck with lactation consultant tomorrow.

I mix fed due to low supply. I originally went down the breastfeed first, formula or expressed milk top up, and then express afterwards route, but feeding every 2 hours it just consumed my life. Did it for 6 weeks and then decided enough for enough.

Mix feeding really worked for us. All night feeds were breastfeeds and then I alternated breast or bottle during the day. Eventually got into a routine. It definitely let me continue to breast feed for longer, as I would have given up completely if it was all or nothing.

8x a day doesn't sound very frequent to me. Did the midwife discuss ways of helping her to gain through breastfeeding? Because the most obvious one I think is to feed more often and using both breasts at each feed.
Most newborns feed 10-12 times a day so there's definitely plenty of scope for a good few more feeds in there. Just keep offering even if she's not particularly asking for it.

I agree with pp, try to feed as much as you can

I hope it goes well with the lactation consultant tomorrow. Both my babies had tongue tie and both lost weight and then had very very slow gains until they hit 3 months old when it all got much better.

Would like to second other posters who said increase the frequency of feeds if you can. 8 feeds a day is not very many for a newborn. My DS lost 11% in the first few days but the midwife didn't panic, just advised 2 hrly (I know but it's not forever) feeds and breast compressions during feeds. I offered the breast at every peep and we got back on track. I'm sure face to face help from the lactation consultant will be ideal re. tongue tie and other help, I saw one too and she was amazing.

My dd was born at 9lb11 too. It took her nearly a month to get back to birth weight. She also didn't lose more than 10%

Hv had me stressed out no end. I was referred to infant feeding teams then eventually ended up In alder hey as my hv was concerned she wasn't feeding properly.

In alder hey we saw two paediatric consultants. Both told me "you have a perfectly healthy baby here, you merely fed her too much in utero, you had an overly efficient placenta. She's probably not destined to be a 91st centile baby and is catching down to her genetic weight"

They were bang on. By 12 weeks she had gone from 91st centile to 50th where she has remained for the last two years.

Sadly all this stress re: Weights and bf led me to have pnd.

I know how damn stressful this whole weight chart/centiles is.

My baby was under the 0.4th centile and lost more than 10 per cent and he also took more than two weeks to regain his birth weight. I topped him up with formula until 6 weeks and then went back to just breast feeding. I wouldn't be too worried about a larger baby that hasn't lost over the 10 per cent. I would wait to see the lactation consultant. If you still have to top up then atleast your baby is still getting somw breast milk. Best of luck

Oh and the paediatrician told me that a child's birth weight is down to maternal factors but after they are born it is down to their genetics.

Sorry one more thing, I also agree that 8 feeds in 24 hours may not be enough. Feed on demand.

PLEASE get her checked again for TT as you suggest because with both my DC (different hospitals and diff parts of country) I had DC weightloss with BF and many midwives and paediatricians said there was no TT but then it took a real lactation/TT specialist to spot the posterior TT, it was snipped and then BFs improved and DC weight gain was dramatic. If I hadn't gone to the specialist I was referred to I'd never have known - I'd have believed all the midwives and Health Visitors. Costs of a check are £40 (outside of London) which is worth it given TT doesn't just affect feeding but also speech, kissing etc so worth doing for peace of mind if this could be a risk. Other classic signs of TT which you might have are sore on upper lip -the DC tries to hold on while slipping and latch sometimes starts well and gets worse, long feeds and demand for frequent feeds - often hourly.
Best of luck - the midwife and HV visits and theories can wear you down even when they and/or you are in the right as you have to try and sleep sometime!

Thanks all for suggestions- on 5th midwife check (!) tt diagnosed finally and we had 80% tt removed privately yesterday. Feeding a bit hit and miss as she relearns but a def improvement already.
Also with top ups she put on 280g in 3 days (!) so weight going quickly back up :)