Newborn failing to gain weight

[Notquiteagandt]

Unsure if this is right place. But here goes.

Was induced last week at 37wks. Had horrific labour that ended in emergancy csection.

Baby at 5 day weigh had lost 12% body weight so on special measures and kept in hospital. Topped up with donor milk and expressing.

Baby was jaundiced and only came off billibed today.

I am bf. Everyone been saying how well baby feeds so thats a non issue.
Shes seen several lactation consultants said not issue with her feeding technique.

Expressing and at most 15ml but today dropped to 5ml a time.

I feel my boobs dont go big and hard, dont leak dont hurt etc so concluding I dont have good milk supply.

10 days in hospital now so my anixity is sky high. Which wont help.

My options for top up are donor milk which i wont have access to once discharged or formula. The hospital are really anti me using formula. But realisticaly I cant see what other options there are as cant stay here for ever.

She didnt get discharged due to no weight gain since weds. So here under peadiatrician until after weekend now.

Im a hormonal mess and been crying all day. Feel like im trying so hard but starving my child 😢

Any tips advise or anyone been in same position?

I remember that awful sinking feeling every time they said we could probably go home then changed their minds. It’s just horrible. Once you’re home though it will seem like the shortest time ever. It’s reassuring to know that they won’t discharge you until they are sure that your dd is ready. I hope you get discharged soon.

I had a very similar situation to yours, my milk wasn’t coming in after school emergency CS and my baby was getting dehydrated by day 3 and so I basically told the hospital to give me formula. They too didn’t want me to but I said to them that at the end of the day BF was not working, they were not helping so demanded formula and baby picked up pretty quickly. Yes I wanted to BF but didn’t feel a failure at all, I kept trying in between FF and ended up mixed feeding until 5 months. Absolutely nothing wrong with FF, do NOT feel bad, you are feeding your baby and that is all that matters. Congratulations to you as well 😊

A few things. I had a prem baby so have lots of experience of expressing. But I also fed my full term baby and never managed to express a single drop. So don’t worry because expressing may not give you an accurate indication of supply.

I know they have said the tongue tie isn’t an issue but the poor weight gain and the cluster feeding makes me wonder if it is. I would ask to have it clipped anyway and see if it makes a difference.

A jaundiced baby who is 7 days old who is holding their weight doesn’t sound immediately concerning to me but I am not a medic.
I would take advantage of the time in hospital and constantly ask for someone to check your latch and time your feeds etc.
Btw with DS1 the full term one, he was born with low blood sugars and so on the ward I breastfed and topped up a bit with formula and then over time (the first 3 weeks) as his latch got better I transitioned to fully breastfeeding and continued for a year.

Oh also. When I brought my prem baby home (roughly weighing 4lbs) the advice was to feed properly from both breasts, wind, burp and in that golden time when they are in deep milk coma, quickly express a bit more (so to have the expressing stuff ready before feeding). And that it was normal not to get more than 10-15 mls after a full feed. When in hospital they would just tube feed that excess milk but once home I would just store it in the freezer. Sometimes if their latch isn’t particularly strong they don’t stimulate your supply enough so expressing can keep up your supply while your baby grows in strength and learns to latch properly.

One thing you could ask for is a supplement nursing system. It’s a little tube that runs from the bottle to your nipple. It means that while you are topping up with donor milk you are still stimulating your supply.

For pumping there’s a great video from standford University called hands on expressing. It’s worth having a watch as it might help

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I’ve been there too. My twins were delivered by c section at 37 weeks in October, we left hospital the following day (Wednesday) and by Friday afternoon we were back in hospital, both had lost way too much weight and one was on a bilibed.
I sat crying my eyes out, trying to pump milk or cluster feeding them both while literally forcing as much food in me as possible. They managed to gain enough to leave a after 36hrs or so. I gave them both formula top ups for a bit once we got home. I know what you’re going through, I had community midwives telling me I didn’t need to use formula. The smaller twin got really sick on formula, the bigger twin wasn’t too bad but she screamed the house down when pooping so I’m assuming it didn’t agree with her either, but it did build their weight up fast. They only had a couple of bottles (1oz) a day and that seemed to be enough. I stopped the top ups after a few weeks and went back to EBF. It didn’t affect my supply. I think the jaundice lingers longer with BF babies, but my Dr and health visitor said not to worry. It cleared up around 12 weeks. Don’t feel bad about using formula, you’re surrounded by experts who can help you overcome allergies and find a suitable alternative if you need one.

I know they have said the tongue tie isn’t an issue but the poor weight gain and the cluster feeding makes me wonder if it is. I would ask to have it clipped anyway and see if it makes a difference.

Absolutely agree with this. Infact I'm amazed given they have actually identified one (albeit small) that they aren't at least trying this to see if it helps.

Many of the things you said happened to me with my DS. Excessive cluster feeds days on end. Not putting on weight (but he got skinnier and ended up with baggy skin, it was awful). He would often fall asleep on the breast which I thought meant he was done but he was actually exhausted due to the extra effort he was having to put in to get milk! He still had wet nappies and because he wasn't losing weight the midwives and health visitors said it wasn't an issue. I think this was because they are keen for you to keep breastfeeding.

Eventually at 4 weeks he was diagnosed with a tongue tie. But i now know it wasn't done properly so we carried on having weight issues.

It was the 6 week GP appt that changed things for us. She insisted it was serious and I had to top up with formula. Told me next time I saw her he wasn't far off being hospitalised. I mixed fed from then on for 8 months.

Ultimately though it was a tongue tie issue and because it wasn't diagnosed early enough, I never had a good enough supply. So it's really, really important to get TTs seen to ASAP for those that want to breastfeed.

OP firstly congrats and well done. Your post resonated so much with me I had to respond. 4 years ago I was in a similar situation to you after an emergency c-section. I was told there was nothing wrong with latch etc. and sent home (my bed was needed). Unfortunately midwife at home missed jaundice and miscalculated percentage weight gain so wrongly thought things were fine. Anyway, points I learnt at that stage were :

1. 8 hours sleep in a week : normal at that stage ime. It feels like they are on you CONSTANTLY and you are just so desperate for a break for sleep. It's utterly horrendous and you wonder how you will survive but you will.
2. I am so embarrassed and ashamed to admit this but although I could latch fine I never realised that they took little breaks from feeding whilst still on the boob so I was de-latching prematurely during these natural lulls . In the end I had success by basically shoving her on the boob at the slightest whimper and keeping her there until she was fast asleep despite me driving her feet /blowing in her etc. Also changed nappy in between sides to re-awaken her. Others will advocate different advice: I'm just saying what worked for me.
3. Based purely on my own experience and contrary to some medical research, I personally believe my c section delivery did not allow the hormones to flow as nature intended and that made it more difficult for my milk to come in. I base this on emergency c section for first child (bf, no formula ever until almost 1 year) to vbac for second child (still bf at 17 months, never had formula). I just "felt" different after the second one, like my body and hormones knew what to do. Maybe that was natural delivery second time, maybe it was just that I had done it before. I'll never know. The point is that bf after c section is really hard so any struggle you have is completely normal.
4. I personally found that first couple of weeks with newborn and c section scar the darkest of my life. The tiredness was indescribable and I was a crying, pitiful wreck with exhaustion. But guess what, we all survived. My child did put in weight with no medical intervention/top ups. To this day I remain glad the midwife couldn't do basic maths because it was proof that actually exclusive breastfeeding does work, even if it takes longer than "average" for baby to gain weight.

I didn't have the added issue of the kidney thing to consider so can't comment on that aspect.

Just know alot of what you are going through is really tough but really normal. Xxx

Excuse all the typos in there.
Should be tickling feet, not driving feet.
And by the way my child ended up completely fine after all these problems at the start!

Sorry, last thing :
I've successfully exclusively breastfeed two children (not twins) but have never, ever been able to express any kind of decent quantity (barely anything at all) so don't assume anything about your supply based on what you can express.

Sorry, can’t really add anything helpful, mine are 16 and 25 now. Just wanted to say congratulations 💐 if it’s worth anything at all, my boy, now 16, wouldn’t latch on properly for weeks, cried at formula, it took 2 hours to feed him a tiny bowl of Cheerios, one by one, when he was 3 and he was given a “golden ticket” by the school dinnerlsdies every time he managed his school lunch in Year 1. He’s 6ft 1” now and I can’t stop him eating. You have much joy to look forward to.

Well done you are doing an amazing job.

I would ask the midwives/doctors more questions - if they are anti formula then what are you supposed to do? Ask for second opinion, we had conflicting advice when my baby lost weight/blood sugars which sent us into a massive panic.

Try getting some floradix or something to get your milk to come in - it’s early days and your body is coping with getting over a major operation too

I struggled feeding- baby was tongue tied which we got snipped, he wouldn’t latch so I used breast shields and syringes but after couple of months we both got the hang of it and he’s feeding properly.

The main thing is your baby is well and you are well. Sending lots of love

@Oct18mummy imteresting you mention floradix as I was severely anemic in pregnancy duebto hyperemesis. As well as a massive bleed during surgery.

Wondering now if they are contributing 🤔

Yes it probably is contributing to your overall levels of tiredness. And I understand that as a FTM and a single parent there isn’t anyone you can hand the baby to and have a nap.

I would push push push for the TT to be sorted. I would also recommend fenugreek capsules. And this is going to sound v stupid but are you drinking enough water? I found that I really really wasn’t. And not being able to just jump up and make a cup of tea in hospital left me a little bit dehydrated. You need to drink constantly. It’s easy to underestimate how much breastfeeding quite literally sucks out of you.

I have a couple of C section tips as well. The first is please take all the painkillers. Don’t skimp on them. The second is to put a pad over your scar as well. It helps with getting out and sitting and the baby won’t accodentally kick your scar but it also prevents the ‘my insides are falling out’ feeling. I also fed DS1 in a rugby hold position and found that easier. DS2 (the prem one) fed in the more ‘normal’ position.

Are the hospital anti you using formula? I find that surprising. However could it be that hey just don't want to be seen promoting formula? I was admitted to hospital with my DS who lost weight after leaving hospital. I was EBF at the time. Initially when born he couldn't latch but I also didn't seem to produce a lot of milk. I certainly could barely express any (I was anaemic after the birth and have since discovered that this affects you milk supply). In hospital they would monitor us feeding and he would just lazily feed for hours and hours and I would continually have to wake him up. We were eventually discharged with no real advice.

I subsequently decided to give up on the breast feeding as my son started to refuse the breast and was obviously struggling to gain weight (probably because he was not getting enough food). He went from strength to strength as did our relationship! I struggled and barked for about 3 months. No health professional ever said at any point, maybe you should just try formula. I wish they had as I was trapped in a crazy "must BF" tunnel.

If I was in the same position again I would get BF a go but if it didn't work for me or baby after a few weeks, I would just switch to formula.

Having said all of that it is very early days for you (ask then to check you for Anaemia and if anaemic ask if you can have an iron infusion). If I had access to donor milk I would take it and top up. As he gets bigger and older and has a stronger suck and as you get home and feel less anxious it may all come together. If not I wouldn't worry about topping up with donor milk and then formula when you get home.

Remember though it's up to you and if you think for baby's health and your mental health you would prefer formula do that. Baby will be fine.

Honestly I despair sometimes. People seem to fetishise breastfeeding as perfect and now when this poor baby is suffering from being under fed, the proposed solution is to push to perform surgery that doctors have said isn’t needed, on an underweight, recovering-from-jaundice fragile, hungry infant. Instead of just giving the supplemental milk the baby clearly needs.

OP I had read your post perfectly well; my comment on the 8-weeks was referring to the poster who shared her experience as a reassuring story. Sleeping only 8 hours total in a week is not normal for a newborn. In any case, at over a week, the baby should be well on the way to regaining. 12% at day 5 is a worryingly large drop. Jaundice is a potentially serious illness. Dehydration is too. You say you haven’t had severe engorgement. Your baby isn’t gaining weight. You’ve lost lots of blood. You are exhausted. All of these things point overwhelmingly to one conclusion: for you and your baby at this time, breastfeeding is not cutting it. The baby needs more than it. Why your medical team aren’t advising this is beyond me. Why people on here can blithely reassure you that all is well and all will be well is also beyond me.

Please please give the baby as much supplement (donor or formula) as she needs. By all means, keep working on the breastfeeding as well. But a baby that is getting enough through supplementing will be in a much better position to feed vigorously and may improve the breastfeeding.

I genuinely am worried by what you have described and what others have said.

@sycamore54321 surgery? Also the baby is pretty much sleeping most the time. Its me whos not sleeping. Between cluster feeding, pumping and the whole just watching her checking shes ok.

On a plus I woke up this morning in a pool of milk!! So im clearly doing something now.

Baby also had her 1st yellow poo in the night.

Baby had a bottle of formula this morning. Shes not seemed in any pain or discomfort. So thats a plus. Wanted to test it in hospital just incase. It was a struggle to get it down her. But she took most of it.

Oh for the tounge tie. Her peadiatrician as well as feeding consultant and an independant lactation consultant. All say they dont think neccessary. The price they charge youd think theyd be pushing it just for the money if nothing else.

Also this hospital specialises in toungetie one of few in area that does. So the waiting list is 10wks atm.

Plus it is not with out risks. So I am reluctant to give it a go just in case. If several people have said they are certain be no benefit to it as she can roll her tounge all directions.

Not sure why sycamore is intent on panicking you op, you’re in hospital. They are well equipped to deal with a jaundiced baby and help a mother establish breastfeeding alongside that. Part of treatment for jaundice is to flush lots of fluid through so it will have been worked out exactly how much baby needs and they have offered to top up with donor Milk which is great(our hospital only offered formula top ups and they have baby friendly status). It sounds like your milk has possibly been slightly delayed in coming in, normal for a csection or induced birth. But it has clearly come in now. I would say if you are not experiencing pain when feeding don’t rush into tounge tie cutting, especially if they don’t think it’s necessary. I’ve seen latches get worse and mothers in pain where they weren’t before after a cut as the baby has to relearn how to suck. If it ain’t broke....good luck op it sounds like things have turned the corner.

hi there, excuse my username. I lost my password and just relogged on to reply to your post. Just wanted to say that I was in your position in terms of breastfeeding and lack of weight gain and I totally understand the emotions you are going through. Unfortunately it's not necessarily true that everyone will have enough of a supply to fully breastfeed. After hiring a lactation specialist, I found out (on my third child) that i didnt have enough milk glands (insufficient glandular tissue) and only had about half a supply. So i topped up each feed with formula and kept breastfeeding i.e. combination feeding till last week when baby was 11 months. its an awful rollercoaster of emotions to deal with at the start but once i accepted the situation in a matter of a days i didnt mind as i saw he was thriving on both. I could have just given formula either but I wanted to do as much breastfeeding as possible. Just a personal preference as I had only done a few weeks with baby 1 and 2. I remember the first 24 hours we both hardly slept and he was latched on the whole time. I kind of knew he needed a bottle though and gave him one luckily as his blood sugar level was dropping. As someone else said, fed is best. Be kind to yourself, you are doing a great job and trust your instincts. It sounds to me like baby just needs a bit more food. Formula is absolutely fine and we're lucky to live in an age where we have the option. xxxx

Could you ask the Lactation consultant about a supplementary nursing system (sns). That would help baby get milk in while cluster feeding. Having all feeds on the breast (even through the tube) will help stimulate supply.

Oxytocin helps supply (relaxation hormone) and adrenaline limits it. Most people feel some degree of stress in a hospital. I’d be asking if you could have 24 hours supply of donor milk, an SNS system and then go home for 24 hours before the 10 day weigh in. Spend the entire time at home in bed with both of you as naked as possible, Fred every time she stirs. Eat as much as possible yourself!

I have a 10 day old baby and have been in the same position as you, OP, except our hospital pushed formula top ups hard (I didn't want this as want to EBF). I had a planned c section and was discharged next day. For 2 days after that, baby was feeding constantly but not settling. I asked about tongue tie and about half the midwives said yes and half said no.

My milk came in around day 3-4, but still baby was unsettled. On day 4 she had lost 10.5% of birth weight, by day 5 it was 11.5% and by day 6 they said if it got to 12.5% they would readmit her. We started formula top ups after each feed and 2 days later she had put on 65g.

I've been expressing as want to boost my supply. I have 2 older children and BF them with no problem and used to expess loads, but this time my supply seems low and I struggled to express 15ml a week ago. Now I am up to about 100ml a day so more of the top ups are BM than formula, but this has taken a lot of work expressing. Are you getting support from the hospital feeding consultants with expressing? This is key to building your supply.

Also, re the tongue tie, I felt very fobbed off by the post natal staff, none of whom wanted to give a conclusive answer, and we couldn't see the tongue tie specialist on the ward as she was too busy. We managed to get an appointment to see a maxillo-facial consultant, who said yes there was a tongue tie and divided it there and then. Baby has been breastfeeding better since then. I would say: you know your baby better than anyone else and if you suspect a tongue tie, be persistent until you get someone to review it. It is much better to get it dealt with in the first month or so, when they can just divide it with no anaesthetic, than later as by 3 months there is more nerve sensitivity there and the baby needs anaesthetic so it's a more traumatic procedure. My baby barely even woke up when hers was snipped.

Sorry that was a bit long. You aren't alone going through this- I know how stressful it is. I hope you can get some support to help with building up your milk supply, and that your baby starts to gain weight.