Baby slow weight gain. Worried

[Lullaby88]

Iv been exclusively bf for 2 months. Its been challenging but baby is doing loadsa wet and dirty nappies which is a good sign. Baby is alert after feeds etc. Things were looking good. So it came as a suprise/shock when HCV said he isnt gaining the amount of weight he should be and i might have to supplement if it doesnt improve. I cant understand why he isnt gaining weight. She checked the latch and how he feeds and said it looks perfect. I feed every 2-3 hours and put time in so feel upset and disheartned that my hard work isnt paying off. Anyone help or been through this? Any advive or experiences are welcome.
Just to add she said he might hav to be seen by a gp if he doesnt gain more in a week.
Hes content after feeds so im confused. Once i fed him every hour as i was adviced he needed weight gain a month ago and it really unsettled him with gas and spit ups.

*he is gaining but its slow weight gain

Are your breasts comfortable? Are nipples round when he comes off or pinched? How long is he feeding for at a time? Do you let him drain one breast and offer the second?

what do his growth charts look like? I'd probably try and get a 2nd opinion, ideally from someone with lots of breastfeeding experience

They feel ok, im not sure about draining but do feel an emptiness with long feeds. I used to offer the second breast but he doses off and seems ok so i offer th other breast on my next feed. Sound ok?

Iv not looked at my nipples but will do. Is pinched better?

His growth charts show he is gaining weight but its slow and dipping slightly.

@Lullaby88 pinched is not good, you want them to just look normal. mine used to come out pinched in the early days but as the latch improved it got less sore and also no pinched nipple appearance.

it doesnt sound too worrying and might just be how he is growing, but also definitely worth keeping an eye on and getting more advice.

www.carolsmyth.co.uk/breastfeeding-resources/posts/2015/december/my-breastfed-baby-has-low-weight-gain/

Thanks, il hav a read. If its his natural way of growing id feel a lot more settled and happier as i dont know what more i can do bf wise. Im exhausted and feel dishesrtned

it is exhausting even when everything is going perfectly, don't be hard on yourself ♥ lots of wet and dirty nappies and alert sound good. I would check what sort of breastfeeding support you have locally, GPs aren't usually too knowledgeable about breastfeeding especially when the problem isn't obvious. so if you can find more specialised support you can be best supported in how you want to feed your baby. I found our local infant feeding team at the hospital, and a breastfeeding support group to be really helpful in the first 6 or 8 months. and if you can afford it then an IBCLC.

Sorry I didn’t reply.
Nipples should be round after a feed. If they are pinched it could be that the latch isn’t great, and that means milk transfer isn’t as efficient as it could be and therefore not getting as much milk.
Please don’t feel pressured in to topping up with formula unless you want to, or there is genuine medical concern.
Definitely try and seek help from a lactation consultant. This is what the HV should be suggesting in the first instance, not formula!

I just re read your original post and you haven’t mentioned formula sorry I don’t know why I thought it said she had suggested giving formula.
I would, for now, make an effort to offer both breasts. Full feed on one breast, then change his nappy to wake him up and then offer the second. Even if he only has a few mins. Then offer that second breast for the full feed next time if that makes sense

Hi @Lullaby88 this happened with me and my DS almost exactly as you’ve described! I was shocked when HV told me and felt disheartened and worried I was doing something wrong. HV advised formula or breast milk top ups, no more than 45 mins feeding at a time and increasing his naps. I followed the feeding advice but stopped after 2 days as expressing was painful so I couldn’t do it, formula gave DS bad wind and taking him off the boob at 45 mins made him cry. He went from being a happy content baby to being pissed off those 2 days. The only thing I changed was making sure he had a morning and afternoon nap by getting him out in the pram. He ended up gaining weight twice as quickly as he needed to by the next HV visit.
Every baby is different, it might just be that your DS is growing in his own way, i suppose what I’m saying is that if he is happy and content then trust your gut and keep going with what you are doing as I bet your doing an amazing job.

I had just the same and my baby was diagnosed with a posterior tongue tie at 6 weeks old, which had been missed at birth, by midwives, and an independent lactation consultant(!). She gained weight extremely slowly before getting it fixed as she wasn’t able to swallow the milk properly and used to fall asleep feeding through exhaustion, I’d feed her every couple of hours and it still wasn’t enough. Looking back now I realise my milk was probably starting to decrease as she wasn’t able to “demand” enough to keep my supply up. Immediately after getting it fixed she started to gain much more weight. It might be worth asking for a referral to the tongue tie clinic from your HV.

Hi @Lullaby88
I am new to mumsnet so hope I am actually replying to your original post.
This exact same thing has happened to us.
I got my daughter weight checked at around 13 weeks and was horrified to find out that she didn't put any weight on for more than 4 weeks. I was also advised to either supplement or top up with breast milk/formula. She is a super easy baby, sleeps through the night and is very content and just happy and I know this as my first born was an absolute nightmare compared to her and he was bottle fed. I was so upset and went to a breastfeeding clinic to get latch and technique checked out just to be sure. All fine there. Getting my daughter to take a bottle has been a challenge. Waking her up at night to take an extra feed has been a challenge. Feeding her more during the day has been a challenge. I actually think it made her miserable as I changed her routine and started extra feeds and night wakings. Well since then she has started putting weight on again but as she had dropped two centiles they are still concerned. Well I no longer am and I am trusting my gut feeling here. I think all babies are different and if your baby is content and happy after feeds I would not be worried. She is now 17 weeks and started putting weight on again! I really think all babies are different and sometimes they just don't follow the charts/centiles and settle on their own centile if that makes sense. I might be wrong.
How is your little one getting on now?

Hiya everyone, thank you for all the advice and your experiences it's really helpful to know.
After the HCV's last visit I saw a GP and he just checked baby over as this is what the HCV had suggested. I also saw a lactation consultant who booked in for a tongue tie appointment. She checked the latch and gave me tips to achieve a deeper latch. She suggested I express for 10 minutes after each breastfeed or atleast 5 times a day. I told her I really don't think I can do it as I have no energy. I also have a toddler who needs a lot of attention. She said if he still doesnt gain weight then it would hav to be formula supplementation. Anyway, the HCV is coming to weigh him today. The only thing Iv changed is the deeper latch tip from the LC. Forgot to mention the GP referred us to a pedetrician just incase he didnt gain weight after trying all these things. Just troubleshooting. But as many have said it is probably just nature and charts might not be realistic as babies grow at thier own pace and if he seems happy all must be well. But we dont hear this from HCVs and professionals so it's tough to know.

The Hakka type pumps are good as they just collect let down whilst you are feeding.
How many dirty nappies? My second lost a lot of weight after birth and I kept saying she’s doing a lot of poo. They kept saying it was normal until a doctor witnesses it in hospital. She had severe cmpa and everything was going straight trough her!

How many percentiles has the baby dropped. What’s the weight difference between where you are and what a good weight gain should have been for that period? Are you getting enough rest, food and water? How are you feeling anyway? Have you had any health problems In the last few weeks?

Ah tough. Is it possible to give him formula top ups one in the morning and one before bed? That way he is getting extra but you are mostly bf all day.
I heard fenugreek is good for boosting milk supply and also doctors can prescribe medication to boost it as well if that is the issue.
You could also try different bf positions, I had great success with the rugby ball hold for getting a deeper latch.
Unfortunately I was told that with bf they don't gain as much weight as formula simply because formula fed babies are given more milk whereas bf they have to work a lot harder. If he's gaining but not losing I wouldn't be freaking out but that is my opinion.

So glad that you're getting LO checked for Tongue Tie

It can be exhausting with a toddler can't it?

When my DD wasn't gaining I started offering every two hours in the day. Do you think that's something you could try? You could feed and read to DC1 or just put CBeebies on or maybe get out a different toy for them to have a look at?

Have a read of How might I improve my baby's weight gain? from Kellymom as well. It's a really useful article.

A PP mentioned it, but just to check, are you in touch with any local BFing Groups?

I also agree with changing the nappy after the first breast and then offering the second. I'd also try some Breast Compressions with the first Breast.

Sounds like you've had some pretty poor support so far though.

Have you been vaccinated? If it can give people wild periods then presumably it might impact milk supply for a bit?

Thanks all so much for the information, advice and links.iv bern adviced to express or top up with formula 2times a day. Iv also been prescribed a drug for lactation called domperodine. Has anyone tken this?

And no i havent been vaccinated yet.

Hi @Lullaby88 @Smiths84 @JanaKovacs @prettygreeneyes12 I just wanted to jump on this thread and say that I too have had this situation. DD was small at birth 5lb 9oz/2.7kg and at her 6 week weigh in I was told she wasn’t gaining weight fast enough. I was told to express and feed from a bottle even though she wasn’t exhibiting any underfed behaviours, feeding every 1-3 hours day and night. I told the HCV that I would struggle to pump as she spends a lot of time attached to me either feeding or cuddling and I was told to offer the breast more instead. My daughter isn’t one of those babies who will take the boob whenever, she only wants it if she’s hungry or distressed so we went through 4 weeks of me essentially trying to force feed her from boob/bottle. We tried topping up with formula before and after feeds which were also unsuccessful. She’s on the 0.4th centile currently and tracking since week 6. My mum was shocked as was my GP when I explained what had happened and said that HV are obsessed with weight and forget to balance the need for baby to gain weight alongside all other thriving markers. The whole situation has been hugely stressful and really robbed me of joy during those early weeks. She is now approaching 16 weeks and around 10lb/4.6kg. She smiles and giggles, grabs toys and interacts with everyone she meets. Some babies grow slower than others just like some adults gain/lose weight slower than others. My mum showed me my growth chart as a baby and I was weighed every week, I hardly ever gained more than 100g in a week (current advise is babe should be gaining 200g) and some weeks I actually lost weight, my mum was never advised to top up or told There was an issue with my weight. I think this new weight guidance is based on more formula fed babies, some babies just eat and sleep but my daughter is very active and alert; she loves to kick and play and wave her arms around so obviously she’s burning more calories than a baby who’s happy just chilling out and snuggling. She was diagnosed after the first ‘poor’ weigh in as having a tongue tie which we had snipped but it’s made zero difference. I have seen 3 lactation consultants none or whom have been successful in making her latch any deeper and I think it’s because I have an overactive letdown/over supply so when she takes a deeper latch she quite literally gets drowned by milk. She often starts with a shallow latch and then comes off, needs burping and when she goes back on after the letdown her latch is intuitively wider. Babies are very smart with strong survival instincts, if a baby is going without food they would be crying a lot. My HV suggested that she was exhausting herself at the breast and was unable to get the milk she needs but if she’s able to stay awake for 2 hours smiling and playing that doesn’t sound like a malnourished, underfed and exhausted baby to me.
Anyway, super long post to just say that I feel like this prescribed weight gain thing is a new initiative/focus for HCV and unfortunately it means that healthy babies with loving mums who are choosing to EBF are being stressed out unnecessarily xxx

I also want to add to this and say that when I was advised to pump and feed from a bottle that baby should be drinking a set amount each feed (60ml at the time) but every website/lactation consultant/BF mum I’ve ever come across has said that babies don’t take the same amount at every feed, just like some times we have a smaller breakfast and a bigger lunch, it’s normal for feeds to vary in time and length throughout the day so to insist that she take the exact same amount at each feed even when she doesn’t want it seems counterintuitive. My daughter nurses a lot through the night (we bed share so I offer when she stirs and if she wants it she takes it) but consequently her morning feeds are quite short, sometimes it’s literally just the letdown from one breast and then she doesn’t want any more but my HCV said she should be taking a big feed in the mornings. Well if I’ve had a midnight feast and snacked through the night I don’t fancy a huge breakfast personally. I’m sure that by trying to get my daughter back onto the breast when she doesn’t want it has caused her distress and gas and me as a mum huge distress. Sending all of you mummas huge hugs xxx