4 month old poor weight gain

[SukieCat]

Well, DD was up 4 times overnight, which she hasn't done in ages.  4 month sleep regression? growth spurt?  uncomfortable from not pooping for 8 days? teething? something else...?

I felt some gurgling overnight, but it's not loud or anything.  She's always been one to eat vigorously during and shortly after let down, and then kind of give up.  I try breast compression and it kind of helps.  I'm not sure what else I can do to "make" her eat more. She'll hang out on the breast for a long time, but not really eat much.  But I'm afraid to take her off since she has poor weight gain and I don't want to cut her off early in case she is actually eating more.

Is there anything I can do about OALD? I hesitate to take her off during LD bc that's when she takes the bulk of her feed, I think.

[*Ali*]

Oversupply and Overactive (Forceful) Let-Down
check this out

[clazzat]

My ds was 90th percentile at birth and down to 8th by about 5 months.  He fed well, met milestones, was bright and alert and happy etc and when I took him to the health visitor I was lucky enough to get a guy who looked at him, said "he looks pretty well to me, don't worry about it" and we carried on as we were.  We had him weighed more often to keep an eye on things, but other than that we didn't change a thing.  He did really well, thrived, and stayed pretty tiny until he was about 18 months when he started to climb back up the charts again.

It sounds to me like your dd is doing fine and in your position I would be waiting another month before jumping to formula (unless you want to supplement).  I think that if she was really not getting enough from you then she would spend all her time at the breast sucking to try to get milk out, but you say that she feeds greedily to start with and then stop - that sounds to me like she is full.  I can totally understand why you don't want to cut short feeds, but if you don't think that she is actually feeding then it is okay to stop her unless you want to give her the comfort.

[SukieCat]

She has some of the OS/OALD symptoms, but not all.  Sometimes she'll cough while nursing (not as much recently), but never pull off or clamp down (but she does go shallow).  She used to make a clicking sound when nursing sometimes, but she hasn't done that lately.  She loves comfort nursing.  She spits up some.  I don't know, it's a mixed bag.  That's part of what makes it hard to decide what to try to do to help her!

We are going out of town for a week, then we're going to have another weight check done when we get back.  While we're gone I'm just going to focus on eating healthy, drinking lots of water, and nursing frequently.  I'll check in when I have another data point.

Thanks for your replies!

PS - still no poop today.  I think it's day 9...

[becj86]

It might be worth trying to relatch after LD? Then her sucking can be more effective and give her a better chance at getting the hindmilk.

WRT poo - that can be normal thought its getting to the long end of the normal range. Might be worth a tummy massage (gently sweep hands from right hip, around the bottom of her ribs and down to the left hip and/or gently push her legs up into her tummy) to get that moving. 

[weaver]

Just to say if she is small and hitting a GS (hence getting up lots to eat at night), the no poop may be to do with her absorbing everything she's taking in. Mine were both small, I'm a small person, was a tiny baby, it's just the way they were/are.  I would keep feeding lots, make sure to take care of yourself and see how you go. 

[SukieCat]

We are back from our week out of town.  DD had a weight check two days ago and she's gained a pound since her last weigh-in (which was 2ish weeks ago)!  She's 13.8lb and back up to 30th%.  We have been nursing pretty intensely to try to get more calories in her, and I guess it's working.  She also finally pooped last week on day 10, then she went another 7 days before pooping again.  And somehow they are not epic explosions, just kinda big poops (sorry, TMI). 

We're going to try to keep doing what we're doing but it's kind of challenging now that we're back to the real world, hubby's at work, and no one's around to help me with my toddler while I nurse all day long.  Do you think we need to keep up nursing all the time (we are talking every 1.5-2 hrs during the day), or at some point will my supply be built up and we can go longer stretches?  We're also having the problem that we recently stopped swaddling her for sleeps and she's not napping well at all anymore, so I've been nursing her to sleep a lot.  We've pretty much given up EAS for EAES, which I know is just setting me up for trouble, but that's where we're at.   

[*Ali*]

Glad her weight is increasing. The extra feeds seem to be working so I would try to keep them up as much as you can if she is demanding them. Hopefully as she starts sleeping better as she gets used to sleeping without the swaddle she will need feeding a little less often.

[SukieCat]

She doesn't demand feeds so much as she never refuses feeds if I offer.  So it's hard for me to tell if she's really hungry or just comfort nursing.  I think she'd nurse all day long if I let her.  She also takes a long time to nurse, and never comes off on her own.  She either falls asleep or I pop her off when I think she's just comfort sucking.  I don't think she's taken a nap longer than 35 min since we stopped swaddling 2 weeks ago. 

[*Ali*]

Could it be a routine issue do you think? Might she need more or less A time?

Feel free to post your EASY if you want us to take a look.

[SukieCat]

I think it's a combination routine and sleep prop addiction problem.  I just started a thread in the Naps forum to try to get advice on our EASY.  Basically we were doing 2 hr A time, now we're trying closer to 2.5 hr A time.  Transferring her from nursing asleep to her crib has been very challenging recently.

[*Ali*]

Why did you wean the swaddling btw? Do you think she still needs it?

[SukieCat]

I stopped swaddling because she seemed like she was really fighting it and she seemed mad when she'd wake up and couldn't use her hands. I've also read conflicting advice about stopping once they can roll back to belly, and she's been able to do that for awhile now. The first time I tried arms out overnight she did great, so I thought she was ready.

However. I read your question in the middle of an awful morning. I had nursed or rocked her to sleep 4 or 5 times and failed to transfer every. single. time. She was crying, I was crying, we'd been trying for a nap for almost two hours and I thought of your post and decided to try swaddling her. She slept for 3 hours!!! Best decision EVER. Thank you for putting the idea in my head.

 So does that mean she's not ready to give up the swaddle? What about the risk of rolling? Should I just swaddle naps and not over night?

[*Ali*]

Is she rolling in the swaddle? What sort of bed does she sleep in? My DD is swaddled in a Moses basket and cannot roll in it. You are right that if she can roll it is not safe to keep swaddling her. You could try propping her in position with a rolled up towel or sleep positioner if she hasn't ever rolled in the swaddle but they aren't really recommended JIC, yk?

You have to do what you're comfortable with. If you feel better just swaddling for naps when you can watch her then maybe try that. Or did you try swaddling with just one arm out? What do you use to swaddle her? I'm just wondering if you could swaddle her with a hand up by her face so she can suck on it through the swaddle.

I never swaddled DS1 but I kept DS2 in a Woombie until he was 8mo and then he chose to go straight to sleeping on his side in a kind of recovery position almost. I hope to keep DD swaddled until she can comfortably choose her own position. After 6mo the SIDS advice is that you can leave them on their front or side if they roll there by themselves as long as you put them down to sleep on their backs on the first place.

[SukieCat]

No, she has never rolled in the swaddle.  Even when she is in regular sleep blankets with her arms out, she rarely rolls in her sleep.  She doesn't really like to sleep on her tummy, so I usually hear about it if she ends up that way, haha.  I use the velcro SwaddleMes, although she's sort of in between sizes - small is too small, big is a bit too big.  I've used the big one twice today and she does end up with her hands up by her mouth, sucking on them. She was so happy after her 3 hr nap. She sleeps in a regular crib.

I think I will swaddle her for naps for now, and go back to using the sleep blankets at night.  I have been checking on her frequently when she's swaddled during the day.