My daughter won't gain weight

[ejk80]

My daughter has always been tiny - she dropped to 5lb 12oz after a birth weight of 6lb 11oz due to jaundice and lack of interest in feeding.  She's now 3 months old and has dropped off the bottom of the clinic's growth graph as she's still only 8lb 11oz.  I have been exclusively breastfeeding and have now been told by my health visitor that she needs to be given two 2oz bottle feeds of formula as a top up.  I'm distraught as I've worked through mastitis, blocked milk ducts and a blistered nipple to keep breast feeding and I'm desperate to keep doing so.

She guzzles the formula, but it's made me realise how slowly she feeds on the breast, how much she falls asleep and how she gives up towards the end of a feed when it's too much like hard work.  I'm so upset and don't know what to do any more.  I've hired a hospital grade breast pump to try to express more as I'm worried that I'm not producing enough milk for her and she stops trying when it comes out more slowly.

I don't know what to do anymore.

[Shiv52]

Hey hun

Huge {{{hugs}}}

Don't want to go against your HV advice but I would think supplementing with formula will decrease your supply more.  Are you in UK?  My HV was totally not for bfing and the first time I encountered a problem she recommended formula.  Straight away.  No advice on how to increase supply or encourage my DD to feed more, just top up with formula.  The problem I had read is feeding from a bottle is easier.  BFing is harder work in a way for them so often if LOs get used to a bottle they are less keen to feed from the breast IYSWIM.  The main problem is the effect on supply. 

Is there a way you can give express and top her up with your BM?  At least that way you are stimulating your supply.  At this stage you are you still setting up your supply and by using the formula that is two feeds you are not stimulating your breasts to make.  I know my supply was less in the evenings. 

There is some great info here.  It mentions about supplementing and ways you can help your LO bf more effectively.

http://babywhispererforums.com/index.php?topic=94121.0

If you find she is getting sleepy, strip layers off her and waken her up a bit.  My LO used to always fall asleep at the breast but I think it was because it was so cozy all cuddled up. 

Am sure the experts will be along soon.  Have a read through that thread though. 


Huge {{hugs}}  You're doing a great job.  You'll get there xx

[lilisuze]

I second shiv's advice that supplementing decreases supply. Within 4 weeks of my HV suggesting top up's with formula we had switched full time to formula. TBH i was ready for it, I was suffering with some kind of PPD, and stressed stressed stressed about him not growing, it probably was the right decision for me. Even thought I was keen to BF initially, it meant i could deal with his smallness better knowing it was not my milk causing the problem! But, if you WANT to continue breastfeeding then follow all the sticky advice in the BF'ing forum about increasing supply if that is the problem.

If she is falling asleep, the waking up a bit also does work. And there is loads of advice on pumping around here to (but as I say I gave up BF'ing so am totally the wrong person to give advice!)

If your HV seems good (there are good ones and bad ones!) then I would try to keep her on side. If she recommends formula because she wants to see weight gain in your baby , and you refuse then it leaves it difficult should you need advice or help from her in the future. Can you have another chat, explaining how you feel about having mastered BF'ing and that you'd like some help with establishing a better supply? Also do you have a breastfeeding support group/BF'ing midwife? They can be a mine of information, and obviously are much more pro-BF'ing.

You dont say if the baby is not growing at all, if she is following her own little curve thats going up then normally a consultant paediatrician won't worry too much. The health visitors are kind of on a target if you know what i mean, they have to ensure all their babies are growing well, and start to panic when they see one drop off the scale. Have they arranged a doctor appointment for you?

Massive hugs for you, this is such a hard time for you, but you can get it sorted with the right help and support.

Lili xx

[15milner]

She sounds like Matthew.  He was 6lb 10 at birth and by 11 or so had dropped off the bottom of the charts.  I was sent to the local paed to get him checked out and they came to the conclusion that he was 'small normal'. 

Here's the plan that I put into action with the help from my lc.

I started doing 'switch' nursing - ie feeding from both sides at least twice in a session - helped to keep him awake etc.
Breast compression
Some top-up of breast milk from a syringe when i expressed a little.
I went back to feeding 2.5hourly and making sure i woke and fed 3hourly at night too (a pain but so worth it)
I went back to doing skin to skin contact too.


the first week i did this he gained something like 6oz which for him was HUGE - it was normally only about 2oz a week.

In terms of hv - some are good and some bad.  Mine turned out to be ok, but as already said, they do get worried about babies not gaining etc and they do sometimes look like they are being overly nit-picky etc, but as one said - in these days of hearing shock stories about neglect etc they have to make sure that they do everything that they can.  Mine had me in tears many a time, i got so worried and in turn beign worried didn't help my supply.

Take care and make sure you are resting and eating / drinking well.
Alex

[spodnic]

Hi, having the same problem with my LO, she won't take a bottle yet though, and she's 14 weeks. She's off the chart, though she started at 6lb 10.5oz. The HVs really worried me at first but I got a second opinion from an NCT Breastfeeding Counsellor. Now I have calmed down a bit - I'm tiny after all - the GP is on it, just to rule out any problems, I'm sure she's just a small baby.

I'm feeding every 1.5 - 2 hrs now as I really want to get her weight up and it took me about a day and a half for my milk supply to ramp up to meet this demand. I have to make sure I eat loads so I'm not exhausted and depleted. I don't want to feed this often so would appreciate anyone elses view on feeding this frequently, I don't clock watch, I seem to have sussed her hunger cues and this is how she seems to want it. I worry she's not getting the hindmilk enough, but 99% of her poos are yellow (not green as lack of hindmilk can cause).

At the moment I'm not doing a dream feed as she has been impossible to wake, but as soon as she accepts a bottle I will give her a formula one at 10pm so it is not affecting my supply. Don't think there is anything wrong with your supply, there's not. They can make you feel so rotten with their offhand comments.

So, ejk80, hang on in there, we're in the same boat. I get so cross with the HVs sometimes, they are all over the place.

[ejk80]

Thank you so much for your comments and help.  My daughter does sound like your babies too.  She's going to a hosptial consultant on Tuesday to check that everything's ok.  Have been doing a week of 2oz formula top ups and have continued breastfeeding as well.  I think the top ups were handy because as I'm quite big up top it's quite difficult for her to get the last of the milk out and she falls asleep.  Am doing switch feeding now and have been to a support group near where I live in S.E England. 

At the clinic last week, she had put on 6oz (exactly like your baby!) and am continuing this week.  I'm hoping to eventually be able to drop the formula feeds to exclusively breastfeed again.  You're all so encouraging.  Thank you!!!!

My milk supply seems a little down, particularly on my right side.  My GP in typical cavalier attitude said maybe my mil's drying up.  Does this really happen?  I thought that was a bit of a myth.  Am still breastfeeding like mad and expressing.