Really slow weight gain

[Johanne]

DS2 was weighed by the health visitor this morning. He has only gained 2oz since Friday. I need to get a pump to help stimulate my supply and continue to feed him with no longer than three hours between feeds - 5 at night. My right breast is sore so hopefully I can get some help with latching on from the midwife this afternoon. The health visitor is going to speak to the midwife and ask her to come and weigh on Sunday, then the health vistior is coming again on Monday. He can still have the one bottle a day he is having as back up but no more.

I am not intending to stop breastfeeding. I fed my son exclusively, really successfully for ages. i don't know what is going on this time because we've just had problems from the start. I had thought things had turned around and were going really well. At least it's not a loss

Jo

[Samuel's mum]

Today is only Wednesday am. The LLL breastfeeding answer book says 4oz + is acceptable in a week. Who's to say what might have happened by Friday? He might have had a full bladder/bowel last time. I'm not belittling your worry but I would certainly agree with you it wasn't a loss!

Really hope you can get latching advice - very common to only have one sore nipple due to latching problems on a particular side.
There are some great videos about latching here:
http://www.thebirthden.com/Newman.html#Video%20Clips

Don't forget your can hire a mega breast pump from most local NCT branches.

I'm sorry things aren't sorting themselves out as quickly as you'd like - you sound so determined. Hopefully very soon you can put all this behind you.

[Johanne]

Although I know I should be feeling cheerful I am still feeling rather despondent. The midwife was not very helpful - yes she will send someone on Sunday but basically the matter should now be handed over to the Health Visitor and I should follow her plan (no more than one bottle per day, concentrate on stimulating supply through feeding, rest, eating well and pumping, make sure I offer both sides and at least 20 mins on both sides, feed at least every 4 hours in day and every 5 hours at night).

I asked her if she could show me how to latch on and she said she couldn't because LO was asleep and if we woke him he wouldn't feed anyway - personally I would have woken him up but nevermind. She said maybe the midwife who comes on Sunday could have a look if he is awake and if I am using the Lansinoh cream that should get rid of the soreness, so I am making sure i use the cream religiously after each feed. The health visitor said this morning "I need to get someone to check my latch" - so it is obviously not her job. Not sure who I go to next other than places like the NCT or LLL. I don't drive so it's a little hard to get to people in person :S

Jo

[Samuel's mum]

I think the lansinoh suggestion is a cop out. I think if you were happy to wake him it was your call to make. It's important!!! As you know if latching is the issue, a ton cream wouldn't resolve anything. I think your best bet is phoning a UK helpline like NCT/ ABM/ BfN and asking for details of a local support network. Most areas have some sort of NHS/charity/sure start funded breastfeeding group e.g 'breastfeeding cafe' where you can go along and chat to others but also make use of a counsellor on site. I know the not driving thing is a bit restrictive but the helpline might also be able to organise a home visit. If you are happy to PM me your location I'll do some research for you.

Health visitors are not routinely trained in breastfeeding - some choose to be, few are. Midwives also vary widely in confidence.

The first question I'd ask is when your nipple comes out - does it seem misshapen after the feed or lean to one side? Or is the soreness on one particular side of the nipple. Some mums have a problem when their nipple is slightly pulled to one side by positioning.  Another common issue is the baby needing a tad more support around the head and neck area so they do not pull their weight on the breast ( especially a problem with bigger babies like yours). Also making sure if you have larger breasts it is supported fully to prevent 'pull'. 
I'm assuming you are checking for big wide gape, baby moves to breast not breast to baby, baby's head/shoulders/hip in a line so nothing is turned?

[Johanne]

You have brought up lots of really helpful things there Samuel's mum.

The sore part is actually right at the end of the nipple on the "point". In fact, sometimes when he has finished sucking my nipple is cone shaped, in a point and white looking - like all the blood has been drained from the end. You have identified a couple of potential problems - I will check baby is going to breast and not breast to baby as I think we are meeting somewhere in the middle at the moment lol

I do support my breast with my other hand (and also intent it slightly - though not where the nipple is - to keep it away from DS's nostrils as I do have big breasts), which is how I was shown in hospital.

His body is not in a straight line. Now i confess that I know that this is wrong but because I need to support my breast I need to have a third arm to support his back as well in order to keep him in a line. He is generally lying kind of nearly on his back but with his head turned sideways.  I do try and pop him up with pillows if I am feeding in bed but I imagine that would be harder on my breastfeeding chair. I will have to try harder to find a way to support him and get his body in line though.

I bought a medela mini elecric breasstpump this morning. i am just waiting for it to cool down after sterilising it - but I will give it a whirl today. I'm kind of nervous about using it, so we'll see how I get on

Jo

[Samuel's mum]

Good Luck with the posh pump!

Yes, I would certainly aim for baby ear, shoulder, hip in a straight line. It is quite important the head isn't turned - imagine swallowing yourself in that position.

I have much boob and understand the supporting boob dilemma. I was pillow queen. When they grow it gets a lot easier.

[Johanne]

I fed him earlier and moved my arm over more so his head was nearer the crook of my elbow and I could get my hand further down him nearer his bottom. This did seem to support him better.

It's a posh pump? I have no idea - the instructions are pretty hard to understand though - all diagrams and not much text. I'm a text sort of girl myself - asked hubby for help and he decided he'd rather leave me to my own devices! I think I have it figured though, but by the time it was cooled after sterilising it was nearly time for DS's feed anyway so I fed him instead. I will need to pump later - though DS goes through a bit of an evening feeding marathon. The marathon is starting now....

Jo