Breastfed premie, slow weight gain

[bushymcbush]

My 2 week old dd was born with IUGR at 35 weeks weighing 3lb 4oz. She is being allowed home today although she has gained only 3oz more.

I'm thinking about giving her a cup feed once a day with expressed milk to try and boost her weight gain. This is because she falls asleep very quickly at the breast and I'm worried she's not getting full feeds as a result. She is quite good at cup feeding and stays more awake.

Would that be ok? Sorry if it's a silly question - I'm completely new to issues of prematurity.

Hi Bushy, congratulations on the birth of your daughter and on getting her home! I remember your first thread about IUGR although I have name changed since then. [stalker emoticon]

It's great your DD has been allowed home so quickly. When my DS came home I would express after his morning feeds and give him the milk at night, he was quite a lot older and bigger though. I don't think it would do any harm to give her the cup feed except that it will put pressure on you having to express. But it is totally normal for a baby to lose weight/gain slowly at forst, and also to be sleepy, especially when premature. You might find that she gets more alert over the next week or so, and you can help her by undressing her to feed, changing nappy if she falls asleep, offering lots of feeds at alert times. I realise that all of this feels strange after the regimented NNU regime!

So, I suppose the summary of that ramble would be - do what you think is right for her and you. Some IUGR babies grow more slowly anyway. My IUGR DS is still small aged 2.5 but noone is worried about him, it's just how he's made.

Congrats again. I am so pleased you got so far along.

Thank you Celtic. I will definitely try those things. I'm stressed about it because they almost didn't let us come home due to her tiny size. I have to get her weighed every day to show she is gaining weight. So no pressure!

Every day! Wow that is tough on you Bushy. Even in NICU DS was only weighed every three days after the very early days. It is bound to vary and stress you out. Try to look at it on a weekly basis if you can, you will probably see a steadier gain.

Are there any BF support groups near you? I never went to any with DS but now he is older I am getting involved with peer support and I wish I had, they are so friendly and supportive. Might be a place to get more ideas about keeping her awake.

Hope today's weigh in was not too stressful! Best wishes to you and DD.

Hi bushymcbush, My DD was born at 34 weeks and there were issues around her weightgain when we were discharged (although she was 6lb 6oz, so not really little considering). The pressure that I felt in regards to the daily "weigh in" was horrendous so I really feel for you.

In relation to the cup feeds, I was advised not to give big amounts but just do this when something other than breastmilk needed to be given i.e Iron or vitamins. I will say that after about 4 days DD really woke up and suddenly realised that sleeping was not for her and she would infact spend every second attached to my boob and her weight really piled on (at 6 months she was and still is now on the 91st centile for height and weight and was EBF until we introduced solids).

I would say as long as your LO looks healthy and is having plenty of wet/dirty nappies I would keep on as you are. Good luck and many congratulations.

Hi bushy many congratulations. I've not much advice I'm afraid but I am watching with interest. My HV appears forever unhappy with my daughter's weight gain even though it doesn't seem that bad.

Gen is ebf and the HV recommended to me that we could introduce one expressed bottle to her each day. I have no idea if this is worth it, as she has gained 7oz this week without me doing this. After four months of expressing the last thing I want to do is start doing it again every day!

I second the advice re changing nappy/undressing mid feed to help your daughter wake up, it worked for us (mostly!). And I agree that as long as there are plenty of wet and dirty nappies, then try not to worry too much. Easier said than done I know.

I wish you lots of luck.

Hi bushy, daily weigh ins are enough to frazzle anyone's nerves! It sounds like you are doing a fab job. I found little and (very) often the key, also totally agree about the nappy chage, when our LO was first home we changed her nappy before every feed which woke her up. Our weight gain has been slow but steady, and once home we EBF (no cups, bottles etc). I have heard that those dratted charts are based on FF babies and not BF babies who gain weight slowly and more steadily. The other thing that surprised me when I came home is that LO would only feed for 5 mins at a time and I could not believe that she was possibly getting what she needed in that short time, but it turns out she was.

LO was also IUGR, born at 2lbs and we came home at 3.5lbs so I know what it feels like having a tiddler home. Even at that weight she was only weighed weekly, certainly my NNU's school of thought was that daily weigh ins are useless as things can fluctuate, and she was weighed weekly in SCBU (twice weekly in ITU). Maybe you could suggest that daily weigh ins aren't doing you any good, my stress levels would go through the roof at every single one (still can't quite escape that feeling even though we are now 9 months corrected and on the 25th centile - proud mummy here!).

Hope you are enjoying having your LO home, I remember those first weeks, you want to enjoy it, but inevitably spend most of the time worrying!