Slow weight gain newborn - help?!

[catsdontgiveafck]

Hi,

Hoping someone can share their experiences / offer some reassurance. My DD is 3 weeks old. She lost more than 10% weight after birth (which was emergency c section / and she had to be in NICU for a bit). I had significant blood loss and was in hospital for over a week due to complications.

Was not able to establish bf from the beginning as she was in nicu and I was too ill to be moved around hospital to be with her. So she has been a mix of formula / expressed milk from beginning and now formula plus some breastfeeding but my milk hasn't come in (as a result of blood loss the midwives reckon).

DD has slowly slowly gained weight over last 2 weeks or so but no where near her birth weight yet (normal nappies and midwives have said she seems really well in terms of alertness etc). Midwife has recommended upping formula and reducing breastfeeding in case it is exhausting her / using more calories than she's gaining.

I don't know whether to give up bf totally - would formula only help her weight gain more? or to keep at it. I wanted to exclusively bf but feeding specialist has advised that isn't going to happen. I'm pretty sad it's all come to this after a difficult birth/post birth period :(

Does anyone have a good news story about weight gain after slow start and any suggestions re formula/bf challenges?

Thanks x

Hey, this same situation happened to me, my son lost 12% of his birth weight in a matter of days and we were encouraged to top up with formula which we did. He was then hospitalised with a virus and had formula with a feeding tube but I got back to breastfeeding a couple of weeks after we got home, and we weaned off the formula top ups (he started rejecting them).

Unfortunately at 6 weeks he lost 250g again and was below birth weight. Essentially he was not getting the calories he needed from me.

I also had an emergency section with blood loss and was told the same about my supply, I think it's definitely true but what has helped me get a little more out of pumping is iron tablets and the herbal supplement Moringa. Totally up to you if you want to try things like that tho.

My son is now 10 weeks and is thriving on triple feeding - I'm breastfeeding, pumping and giving formula. It's definitely not sustainable long term but I'm trying to come round to the idea that I won't be able to exclusively breastfeed, so take your time with your decision. My son is rejecting breastfeeding more and more, it can be heartbreaking at times.

It's really tough, I'm so sorry this is happening. The best advice I was given is to grieve the idea of not exclusively breastfeeding in my own time. And also this could not be helped.with the blood loss, your body is recovering and will naturally find it harder to provide milk for your baby.

PS I'm so sorry if that's not reassuring about getting to exclusively breastfeed, but hope it helps to hear you're not alone! Hipp formula is the closest to breastmilk in my opinion too if that helps

I had a planned preterm section so a small baby, he was about 4 lb when we brought him home and wasn’t gaining fast enough and was jaundiced. I topped him up with formula once or twice a day for 10 days while pumping to avoid reducing my supply. After that he went from 24th to 96th percentile in 2 months while ebf and I fed him until 3. Mixed feeding is fine and easy to stop when you no longer need it

OP, can you tell us what volumes you are giving your baby now? Are you getting help from your local infant feeding team?

My baby was in NICU / SCBU for two weeks with sepsis. The stress of that, plus my PCOS absolutely knackered my supply. She is now 4.5months and we mix feed. To start with, we were breastfeeding for 30- 45mins, then formula top up of 30-45ml. I then expressed after every feed. She was born on the 9th centile and ended up dropping to below the 0.4th centile. Around 6 weeks, we upped the top ups to 70ml (basically one of the little ready made bottles) and i ditched my home pump and hired a hospital grade pump. Her weight started to stabilise and as she got stronger her suck got better. Then i slowly reduced the number of expressing sessions to one a day at 3am. I dropped those at 3.5months on the advice of HV so we could both started sleeping longer through the night and so far things are holding steady. The infant feeding team advised me that the only other thing to try would be domperidone but it doesnt work for everyone. I was happy to carry on mixed feeding by then and i intend to keep mixed feeding until we wean.

I was devasted when i couldn't EBF - it was all wrapped up in the stress and worry of her being so ill and i felt like I'd totally failed her. But she's thriving on the mix of bf and formula top ups and she's still getting plenty of the good stuff from me (although still a small one on the 2nd centile!). Plus its nice to share feeds with DH.

One thing that the neonatal doctors and the HV have said to me is that it can be bad for some babies to jump up between curves. So if she is steady on her curve and mix feeding is working for you both, then there's no need to ditch bfing completely purely for weight gain.

Thanks all - really good to hear some positive stories about mixed feeding.

@Baberinos Thank you iron tablets is a good shout so may give that a go. You are so right about it being a grieving process - I really feel this is the one thing I should be able to do!

@DressedUpAtAnIvyDressedUpAtAnIvy Yeh mixed feeding sounds like the way forward for now. Thank you for your reassurance that it works!

@GuidingSpirit not getting any help from feeding team yet. She was on 300ml of formula a day with as much bf as she would take, but as weight didn't go up midwives suggested upping formula again and then again (today they said 700ml/day - which is basically exclusively bottle feeding) and reducing bf to twenty mins a time so it doesn't prevent her feeding from bottle. I think I probably need to follow the new plan and dial down the attempted bf - i just hope it doesn't stop my pitiful supply altogether . i can't take the domperidone because of the amount of blood loss at birth.

You are so right about feeling like I'm failing her. it is just a bit heartbreaking and I spend most of my time feeding, worrying about her feeding or crying about it. Hoping things feel a bit more hopeful soon.

It will get better, I promise. My baby is on 5 regular formula bottles and now we save breastfeeding for comfort/cuddle time, so in the morning and after baths and before bed. It means I haven't lost the closeness, he's still getting the benefits but then I also know he's getting the calories he needs.

I always expected to be able to do it, but wow having a baby is truly humbling. Are you having a debrief session with your hospital about your birth? Mine is this week and I'm hoping it helps me come to terms with it all.

You are absolutely not failing, but I 100% know how you feel! Another good piece of advice I was given is that all they need from you is your love

Has baby been checked for tongue tie? DS2 really struggled to gain weight despite being on a feeding plan due to jaundice.

One TT was cut there was instant improvement in weight gain (DS put on over a pound in the first week post divide). Really worth checking out. I was also able to drop top ups and ebf.

I sympathise, I burst into tears on the midwife when, despite half killing myself feeding, pumping, topping up with formula etc DS put on only 40g in 3 days. It was really stressful.

Have a look here, see if anything seems familiar. We had DS's TT divided privately, cost £150.

www.tongue-tie.org.uk/

@Baberinos thank you. I think the best case scenario is as you describe - bf for closeness and comfort but calories from formula.
I'm so glad you are having a debrief - I'm having one in a few weeks which I think will help as I have so many questions and feel so overwhelmed by it all. I really hope it helps you.

@Sunshinegirl82 ahh! snap! literally sobbed at midwife today. I think she was a little surprised as i went from alright to full on tears in seconds. DD had tongue tie and it was cut about 10 days ago - but thank you. It's possible this may have been, at least part of, the problem at the beginning. I just had no idea feeding was going to be this stressful and upsetting - probably very naive of me....

I had this with my DD. I had a traumatic emcs, lost a lot of blood and caught an infection. DD lost quite a bit of weight so had to top up with formula. My milk finally came in at 6 weeks and I switched to fully breastfeeding from there until she was 1. Difference was she is my 4th DC and I'd bf the others so I knew it would probably work eventually. But it was a very stressful time. If mixed feeding is working well then I'd stick with that. No point making life more stressful than it needs to be!

[quote catsdontgiveafck]@Baberinos thank you. I think the best case scenario is as you describe - bf for closeness and comfort but calories from formula.
I'm so glad you are having a debrief - I'm having one in a few weeks which I think will help as I have so many questions and feel so overwhelmed by it all. I really hope it helps you.

@Sunshinegirl82 ahh! snap! literally sobbed at midwife today. I think she was a little surprised as i went from alright to full on tears in seconds. DD had tongue tie and it was cut about 10 days ago - but thank you. It's possible this may have been, at least part of, the problem at the beginning. I just had no idea feeding was going to be this stressful and upsetting - probably very naive of me....[/quote]
It's really tough! Have you tried nipple shields with the bf? I found them really helpful initially in getting DS to latch. The Medela ones are really good.

Not really a reassuring one but my baby lost 15% of her birth weight when weighed on the fifth day. She was put on a feeding plan with formula and I had to stop attempting to breastfeed. Once out of hospital she stayed on formula but I had started to express as I really wanted to breastfeed but couldn't because of my own complications from the labour and because of the advice from the baby doctor. I tried to slowly take her off of formula and onto breastmilk only but when she was next weighed I was advised to give her formula only. Because she was already behind on feeding, it wasn't okay to drop the formula and focus on breastmilk as it just wasn't enough.

Eventually I had to stop expressing due to the medication I was on because of the surgeries I had but I was so devastated. Even though I couldn't breastfeed I felt I was still doing something with expressing. But honestly as long as your child is getting fed and putting on weight that's the main thing. They may be formula fed but that doesn't mean you've failed them, sometimes circumstances prevent things from going to plan! Be easy on yourself

Heavy bleeding or not, I’m surprised that your milk hasn’t come in after three weeks. Have you had a scan to check whether there are any pieces of retained placenta that need to be removed? Are you still bleeding? Do you have any of the symptoms described here www.babycentre.co.uk/a562148/retained-placenta#section4?

I had a very similar delivery and my baby lost 14% of bodyweight. We were very lucky in having a local breast feeding drop in run by a specialist midwife, and her basic premise was that until the baby has regained their birthweight, they probably won't have the strength to breastfeed enough to bring the milk supply up. So she said don't worry too much about expressing, use formula to get the weight on the baby,ie basically supply all their calorie needs, and breastfeed for 20 mins 3 or 4 times a day, for comfort and familiarity etc. As the baby gains weight and strength, that will have the effect of increasing the supply and then you can reduce formula. It did work for us, I ended up BF for 2 years very happily, we never got up to EBF, we started on 6 bottles a day, and by 10 weeks we were down to needing just half a bottle once a day in the evening as a bit of a top up to breast milk.

I couldn't breast feed initially either so I expressed milk and cup fed for 8 weeks and managed to get off formula top ups completely by 10 weeks. I pumped 12x a day in order to increase my supply to be enough for baby who wasn't gaining weight. I felt a lot of pressure to give formula and the health visitor told me at 8 weeks that was because midwives aren't allowed to discharge you until baby has regained birth weight so they push for formula.

All the evidence suggests that relactation is possible and not that hard if you're prepared to pump pump pump - see Kelly Mom website.

Ds1 was useless at breastfeeding and struggled to regain the initial 10% loss.
I switched to formula at 3 weeks when attempts to increase my supply by pumping just weren't enough as he couldn't be bothered to feed if it was hard work (he's like that now as an adult - definitely an eat to live personality, not a live to eat like me and ds2)
Bottle feeding suited him as it didn't require as much effort and his weight shot up to 95th percentile (in keeping with his length)

Well, reducing the bf and doing it after the bottle feeds seems to have helped in last 24 hours and she's wolfed down loaads of formula. So maybe the bf was exhausting her / making her not want to feed when she needed to. Let's just hope the weight goes up with it. In the meantime I am expressing away (good excuse to sit and watch tv..). Thanks for replying -I do feel so much better hearing about other people's experiences and success stories!

@seaborgium I have some of those symptoms but would have thought that with a c section they would be able to spot any retained placenta at point of delivery? But def something I will mention when see Mw next week

@Sunshinegirl82 I have nipple shields but hopeless with them. Might try again!

@The4Seasons really positive to hear that yours came in after 6 weeks! Gives me some hope things might improve this end,.

@heebiejeebies45

'But honestly as long as your child is getting fed and putting on weight that's the main thing' THIS is so true and what I need to write on a post-it somewhere to remind myself that the important thing isn't bf but overall health for her. I'm sorry to hear about your challenges with it all - it's so tough at a time that's already really hard!

@Bumply yeh i think my DD may be the same. She was tube fed in nicu and I think doesn't like having to work for food (who does?!) and bf is probably quite hard work for her.

@Flittingaboutagain @RelentlessForwardProgress thanks for sharing - it's really positive to know that formula now doesn't mean that forever and that potentially bf could be increased over time. I don't know much about re-lactation but will have a look.