Baby poor weight gain

[Thefaceofboe]

Posted in here a week or so ago as was unsure why baby was so fussy on the breast.

we were discharged from the midwife even though I was concerned over babies weight and reflux as my 1st baby really struggled to gain weight but she reassured me all was fine as baby was gaining (slowly at 20g a day) and was back to birth weight

I had a bad feeling so I weighed my baby today and shocked she’s only put on 115g in 16 days :( is this an immediate cause for concern? I’m stressed with it being the weekend and don’t be able to speak to the HV till Monday. She’s having wet and dirty nappies.

I don’t know if baby isn’t getting enough milk or if it’s purely down to her being sick which is causing the poor weight gain. Any advice?

Should also say baby is 4 weeks old

How heavy was baby at birth and how heavy is she now? X

2810g at birth, now she is 2975g. She did drop down to 2590g but was over her birth weight 16 days ago at 2860g

How did you weigh her?
At that age there's massive discrepancies between scales and small errors can look like big problems when it's mostly the difference in scales.
Definitely worth a chat with the HV on Monday in the meantime try not to fret x

When my baby didn't gain weight, my midwife told me to feed her on both sides, then pump and feed her the pumped milk on top from a bottle. I use a hand pump a fair bit. You can probably buy one in the chemist on a Sunday. You could also try breast compressions while she's drinking so she gets more milk, although see how she reacts to that in case the milk coming out faster makes her fussier.

Under 3kg is light. Make sure you get the right help asap from the HV on Monday or maybe you can talk to someone at La Leche League or similar before. There's also a Mumsnet "/feed the world/infant feeding" thread. You'll probably get a mix of responses there though and it's obviously just more Mumsnet and not professionals.

It's horrible when they don't gain weight right. I was so stressed. My baby was throwing up milk too. I thought it was normal that they "spat up" 50 or 100ml after a feed, but now I'm on my second baby who doesn't do that, it's not obvious to me that it shouldn't be like that.

I would say, my daughter is now a toddler and the whole low weight gain is behind us and she's a happy, slim but healthy weight little girl.

I have some baby weighing scales as I was slightly obsessed with weight with my first baby as she had IUGR (I think that’s why I’m panicking so much!)

I appreciate different scales can be different and will definitely have her weighed next week with the HV. I don’t doubt the weight though tbh, I had a feeling as she’s been so unsettled and doesn’t seem satisfied but I was reassured she was just cluster feeding

I have been feeding on both sides so thought all was okay, although feeds have become fussier and shorter. I have been topping up feeds today with expressed milk, do you have any guidance on how many ml I should offer? It’s hard as obviously I don’t know how much she’s getting from the breast.

my first baby was born 4lb 9oz as she had IUGR and had huge weight gain issues due to reflux, so I just don’t want to have the same struggles again :( but as you say, mine is also a slim but healthy 3 YO now

I would contact the HV as others have said my DD was a very similar birth weight to yours at 6lbs 1oz (Im not sure on the Kg I have just done the conversion on Google for the weighs you gave). Is she drinking all the expressed top up?

I've just had a quick look in DDs red book at 8 weeks she was 8lbs 13ozs. I don't have any in-between weights as due to COVID they only weighed her at 2 weeks and her injections.

I can totally understand your stress. I bought a baby scales and weighed her myself weekly. I would say at that age she was gaining roughly 4-5ozs a week. She's 4 now and has always been slow to gain weight and stayed at the 9th centile. Very healthy and active though x

She has drank about 60ml top up with persuasion as she’s not keen on the bottle.

was your daughter BF?

im not sure when the next routine weighing is usually? Because my first was tiny she was being weighed weekly, I’m a bit frustrated we got signed off so fast and I let my guard down thinking all was going well.

When I first started pumping I was getting 20ml extra. Then I got it up a bit after a few days. It's less about worrying exactly how much, and more about just topping up. My midwife thought they can get into a bit of a rut with undereating and then your supply drops to match. Pumping helps them gain weight and appetite, and pushes your supply up. Then your baby will start taking more so you'll not get loads more pumping. I think the reflux is another problem, but this worked for my daughter in spite of her throwing some back up. After about 10 days I was able to stop the pumping
It does sound like you need to speak to your HV though

That's 20ml after every feed btw

She was combi fed for 5 weeks (probably 3 breast feeds a day) and then exclusively bottle fed from 5 weeks.

I was too worried about her weight to exclusively breast feed with her being so little, no weight checks and no breast feeding support during COVID (other than phone which wasn't very helpful). She was also my 1st child so I wasn't very confident in what I was doing. She didn't take a huge amount from the bottle, maybe 2-3ozs at that age but I don't think she was hungry as she was very content. Is your daughter content during the day and night?

DD2 was only 2ozs heavier born and has gained weight so quickly it's has shocked me in comparison.

My youngest was a slow weight gain baby BUT he was born at 4.5kg. He had a tongue tie which was snipped but the weight gain was so poor that the hospital wanted to see him (he was my 3rd so I wasn’t bothered). The consultant examined him and concluded that was just the way he was 🤷‍♀️

he was a tiny dot of a thing until puberty and he’s now 180cm and still growing

try not to lose any sleep over it.

My daughter had great weight gain but was fussing with feeds from the first week. The midwives weren't helpful and told me it was her trying to get milk so give expressed milk but I can see milk before she feeds oh in that case it's too much milk give expressed milk..
I saw the infant feeding team three times and they were pretty useless and focused on her latch and not the fact she was on and off every few seconds. At her worst she only fed for a few seconds and no more than a minute or 2 total between 10am and 8pm. She did better overnight

My daughter's feeding issues were due to severe silent reflux - GP was only treating her mild-moderate actual reflux and multiple food allergies - the final count was 20! Her reflux needed a lot medication to control it - highest dose omperazole, gaviscon lactulose for the constipation and domperidone. She was 17 weeks before we had proper treatment as the GP was a bit useless. The only person in my corner was the HV.

Baby scales are good but even a 2% difference between the midwife and your scales could mean she's actually put on more like 200g which still is on the low side but in a less panicking way so I would try to take some deep breaths until you can speak to the HV tomorrow.

Sorry I'm not sure what the normal weigh in schedule is either. My daughter was weighed weekly but midwives until 4 weeks and the fortnightly by HV as they were having to come and see me so they weighed baby at the same time. It's always ok to reach out when you need them though. It's a service that generally works by you get more if you ask for more, say nothing and they will assume all is ok

@Superscientist

thanks for that - I do wonder how much reflux is playing a part.
Can I ask how you go about seeing an infant feeding team, is this something you can do through the HV?

Ours was a self referral system. I got the number from my HV though. If you search your local area plus infant feeding team you will probably find your local one.
Breastfeeding support group might be helpful too