Not enough weight gain - advice pl

[EvieG]

Hi there. My baby is 6 weeks old and is finding it hard to gain weight. Her birth weight was 7lbs and she's only 7lb 3oz now.

I cant for the life of me work out what is preventing her from putting on weight. She's been a keen eater from birth who has naturally fitted into a 3 hourly feeding routine and she only wakes once - occasionally twice - overnight. I've been to a breastfeeding clinic and they say her latch is good and I find bf good now that the initial pain has gone! However, she is a slow feeder, taking at least 40m and often both breasts. Last week she went through a constant-feeding spurt where she fussed a lot and grizzled when not feeding so I supplemented her feed with a few bottles of formula which she took to with a depressing enthusiasm Tonight - after a pre bedtime 2 hour feeding session, she wouldnt go down so I offered her a bottle and she guzzled down another 3 oz.

Is this just an ordinary slow-weight-gain baby - going through growing spurts at 5 and 6 weeks - or could there be another reason for her slow weight gain?  Is my occasional supplementing with a bottle going to harm my supply and is there a better way to ensure she gains the weight? My GP wants me to just give her as many calories as possible but I dont want this to be the start of a gradual decline in bf.

Any advice at all gladly received!

[15milner]

My baby was a slow weight gainer.  I took advice from my breast feeding counsellor and at 7 weeks this is what she advised me to do.

* Go back to feeding every 2/ 2.5hrs during the day and three hourly at night - I set my alarm to feed at 10pm, 1am, 4am and started the day at around 7am.  I had been told that the best breast milk was made during the night.
* I learnt how to do breast compressions
* I 'switch' nursed.  ie - once matthew stopped feeding well from one side I fed from the other side and then back to the first side again and then back to the second breast.  So each time he was having to 'wake' a little, relatch and feed. 
* I took him to cranial osteopathy.
* I learnt to express by hand to squeeze out any last milk after a feed.  It might have just resulted in a tiny amount of milk -but I gave that after the next feed. 
* Make sure that when I got matthew weighed I did it after a feed and not when he was due one and hope that he didn't wee/poo before.  I actually got so worried that I worked out the difference in weight between a dry and wet/dirty nappy to find out what the difference in his weight would be - it was significant.  I related it to being the opposite of going to weighchers, where you do everything during the day to weigh as light as possible, whereas gettign Matthew was to have him as heavy as possible.  I ended up just playing the game.
After doing this for just 1 week - he gained a whopping 9oz in one week.!!
* Feed feed feed.  Most mums here will say that adding formual could jeopardize future breastfeeding success as your body might not recognise and respond to the demand.

However at 16 weeks he dropped off the bottom of the blasted graphs that the health professionals go by and sent us to the hospital to get him checked over.  The dr decided that he was growing in proportion to him - he was in line weight and height (still is).  She said that the slow growth was either because he was active and using all the calories he was getting (he rolled at 11wks) or he wasnt' getting sufficient from me.  One way or the other she classified him as 'small normal'.  She didn't bother to do any blood tests as the charts suggested nothing wrong.  But we were sent to this dr just to make sure that there was nothing medical to worry about.  The dr actually looked at how matthew was developing and not just at the charts.  My personal feeling is that too much notice is taken of the charts and not at if they spend some time awake, alert, are developing, are happy, producing sufficient wet and dirty nappies etc. 

Ultimately you need to do what you feel is right for you and your baby.  IF you think that something's wrong then persue it.

We are always here for you.

Alex

[isaac'smom]

Hi there,

Ds was slow to gain weight as well. I went to the hospital and saw the Lactation Consultant. I would recommend not supplementing with formula...it could affect your supply and mean the end of breastfeeding for you. If you do supplement (I had to for a few weeks), ask a LC about a feeding tube (I think that's what it's called)...it's a tube that you stick one end of into the bottle and the other end you slip into the corner of your baby's mouth as she feeds. That way, she's still on the breast, but she's also getting a bit of formula, if necessary. You need to get in as many breastfeedings as possible, which means feed on demand or every couple of hours, whichever comes first. That will get your supply up. The LC told me about Fenugreek (herbal supplement) to increase my supply. I think it worked, however it's hard to tell if it was a placebo effect, if I was more well rested and settling in to the new Mom role (tiredness/stress can negatively affect supply). She taught me the breast compressions as well. You say she is a slow feeder, is it possible she's sleepy when feeding and not really doing too much on the breast? Sometimes babies can be sleepy and need to be kept awake by stroking feet, cheek, etc. or sometimes even stripping down to a diaper. If your area has a Lactation Consultant/Breastfeeding Counsellor, I would strongly advise you get an appointment. It made all the difference for me. They will weigh her before and then after a feeding to see how much she's getting. You could also see if there's a La Leche League in your area. Otherwise, I'm sure you'll get some great advice here! Another great site for breastfeeding is  http://www.kellymom.com/.
 
Good luck and let us know how it goes!
 
(((((HUGS))))

[EvieG]

thanks so much - funnily enough we're off to see a cranial oseteopath tomorrow so already I feel better about the course of action.

On the issue of bottle supplementing, how did you bf to meet your babies (voracious) demands and ensure that they slept?? At the moment, I am feeding her on both sides for up to 1.5 hours and then, if she's still hungry, offering her a bottle top up so that we can squeeze sometime in the day for her to nap as well as eat. else she falls asleep on the breast, only to wake up and grizzle as soon as I put her down.

thanks again

[daisymelan]

Evie, offering a bottle is a slippery slope, if you allow her to nurse, your supply will increase.  If you keep supplementing with a bottle, it will hurt your supply and your body won't produce what your little one needs.  Our breasts are amazing things and adjust very quickly to the new demands put on them.

If I were you, I'd steer clear of the bottles and offer breast instead.  Breasts are never empty and although she may not be getting much the first day or two, the nursing will stimulate more milk to meet her demands. 

A lot of moms worry that their supply is not enough, but trust me, this rarely happens.  And I mean rarely.  But all moms worry at some point.  Trust your body is doing what it should.

I would suggest going to a 2 hour feeding routine.  Does she always fall asleep on the breast because she may not be getting the necessary hind milk for good weight gain.  Also, can you hear her swallowing during the 40 minute feeds?  She could be using you to pacify, so listen carefully to make sure she's nursing proper through the whole feed. 

You could also try breast compressions and that may help her get more of the hind milk and keep her actively sucking.

I hope this helps you a bit.

Good luck.

BTW, how did you make out at the osteo?

[EvieG]

Osteopath fantastic...thinks he can help with the feeding and since the visit, baby has been moving her limbs in a much more varied and childlike (rather than newborn) way. everyone should go!
ps thanks for advice. bottle not needed today so will stay strong and anchored to the sofa to be able to dedicate enough time to feeding in days to come.

[daisymelan]

YEAH!!!!!

 

[First Time Mom]

My dd has always been on the small side as well and at 4 months she fell below the chart lines. You need to make sure that she is always weighed at the same time (vs. one time before a feed and one time after a feed) also weigh without a diaper. One thing the bfing clinic mentioned to me is to limit the use of a paci. Dd used to suck on a paci 24-7 and this could possibly make them tired to bf'd so if your lo uses a paci limit it for naps and sleep. Once I limited the paci I found my dd had a stronger appetite. I also had increased her feeds and added an extra cluster feed once she dropped her night feed. My dd's weight gain continued to be slow- no change but my doc was eventually not concerned as she is at least gaining steady plus there is now a new chart for bf babies.