Still losing birth weight- B/F advice please!

[Rosebay]

Hi,

well I thought it was all going really well until they weighed Sam today and he's still losing weight . He had lost 8% on day 5 but now it's day 8 and he's lost 10% so they have told me express at the end of each feed and offer it to him and perhaps top up with a small amount of formula if I'm not getting much.

I'm really upset as I'd thought we'd got it cracked, he's not dehydrated, his jaundice has gone, he is pooing and weeing and he's incredibly content. The midwife checked me feeding him and said my latch was fine- he feeds for a bit and then can't really be bothered to go at any big pace. I've tried stripping him off, being in a cold room, flicking his feet etc but he's not asleep as much as very laid back she thinks. I've been feeding him every 3- 31/2 hours even when he isn't asking which he doesn't seem to much (my first screamed the house down- you really knew!). He's well, his tongue is fine....I think I've checked all the other obvious things it could be.

Help! Any suggestions? They are coming back on Sunday to weigh him and if he's not putting it on then we'll have to go back to hospital. I feel like all the confidence I had has just gone in an instant and I've been in tears ever since- I thought it was all going so well

Is it possible to successfully do both formula and b/f for several weeks? I mean is it possible not to give up completely? Last time I was told it was all or nothing but some of my books suggest that you can do both, does anyone do this successfully and how do you do it? Do you just replace some of the feeds with formula? Obviously I'll try expressing first but the absolutely last thing I need is to go back to hospital as that's what killed it for me last time so I want to have a plan B in my head in case he doesn't gain by Sunday.

Thanks
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[x Naomi x]

If you can i would try and stick just with the b/f i was in SCBU with Macey and so had quite abit of pressure on me about Maceys weight gain, i ended up having to express due to the problems with her being under phototherapy for so long it caused havoc with our breastfeeding and when i tried to reinstate it after even expressing exclusively my milk supply had depleted quite quickly, and i never got it back,

At the end of the day you know your own baby if he seems happy and he doesnt seem dehydrated then stick to your guns x

 

[x Naomi x]

Just to add, i fed her my EBM for the first 3 weeks and then after that we had to switch to formula it really really upset me but she has been fine so if you have to do it please dont beat yourself up like i did

 

[Charlie:-)]

Im sorry youre having trouble with weight gain.

It sounds like you have checked and thought about everything that you can think of to try and sort this out and by the sounds of it everything seems to be ok. I really dont know what to suggest.

I personally would express after each feed and try and feed the expressed milk from a bottle. If he wont take that then whats to say he would take the formula? The only other option would be to do mixed feeding like you say, but that may cause problems with your supply as breastfeeding is not yet established. You could try feeding him every 2 hours I know this has been suggested by HV's when people have trouble with weight gain, but again he may not take it if he doesnt want it.

Just for information a baby's stomach at 1 day old is the size of a marble, then at 3 days old it is the size of a shooter marble (the bigger ones) and at 10 days old it is the size of a ping pong ball. With this in mind your baby is probably getting all he needs to fill him up from you, at such a young age any excess that he takes will be brought back up rather than the stomach expanding to accommodate the extra (learnt this on my breastfeeding peer supporter training this week). 3 to 3 1/2 hours is quite a long time to be going between feeds though I would expect a newborn to feed every 2 hours with the size of their stomach and also breastmilk is digested quicker then formula. How does he seem overall, does he have much awake time, is he alert, temp ok, and is his breathing normal? It just sounds odd to me that he is feeding really well but not as often as I would have expected and he's not gaining weight.

You could try and spend a couple of days in bed lots of skin to skin and just let your baby suckle as and when, that may increase the time between feeds if it is on offer all the time. Hope you find a solution.

 

[Rosebay]

Im sorry youre having trouble with weight gain.

It sounds like you have checked and thought about everything that you can think of to try and sort this out and by the sounds of it everything seems to be ok. I really dont know what to suggest.

I personally would express after each feed and try and feed the expressed milk from a bottle. If he wont take that then whats to say he would take the formula? The only other option would be to do mixed feeding like you say, but that may cause problems with your supply as breastfeeding is not yet established. You could try feeding him every 2 hours I know this has been suggested by HV's when people have trouble with weight gain, but again he may not take it if he doesnt want it.

Just for information a baby's stomach at 1 day old is the size of a marble, then at 3 days old it is the size of a shooter marble (the bigger ones) and at 10 days old it is the size of a ping pong ball. With this in mind your baby is probably getting all he needs to fill him up from you, at such a young age any excess that he takes will be brought back up rather than the stomach expanding to accommodate the extra (learnt this on my breastfeeding peer supporter training this week). 3 to 3 1/2 hours is quite a long time to be going between feeds though I would expect a newborn to feed every 2 hours with the size of their stomach and also breastmilk is digested quicker then formula. How does he seem overall, does he have much awake time, is he alert, temp ok, and is his breathing normal? It just sounds odd to me that he is feeding really well but not as often as I would have expected and he's not gaining weight.

You could try and spend a couple of days in bed lots of skin to skin and just let your baby suckle as and when, that may increase the time between feeds if it is on offer all the time. Hope you find a solution.

I've been trying more frequent feeds today (2 1/2 hrs onwards) but he's not interested. He's not awake lots- probably only a few hrs and not much at all today although possibly I'm now extra paranoid. Breathing, temp etc fine. I've had him in bed with me at nights, not quite skin to skin but almost, doesn't seem to make much difference. I'm starting to wonder if he's not so tired that he can't be bothered to try. I just fed him for 30 mins where he was latched on fine and sucked for 5 mins then just kind of sucked every 2 mins or so. Tried to express and got nothing so gave him 2oz formula to see if that might give him the boost to try at the next feed as I don't want to leave him after a feed being hungry given he's still losing weight. He took it so quickly despite having been feeding for 30miins as far as I could tell and he hasn't been sick so...? Guess I'll do the same at the next feed, feed, express and if there's nothing, formula...?

Thanks
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[Mildly]

Hi just wanted to post to say that I have been mix feeding pretty much since birth due to Oscar's tongue tie and ineffective breastfeeding. He lost about 10% and didn't regain his birth weight until 6 weeks after birth.

The best way to mix formula and breast without damaging your own supply is to designate a certain feed or feeds for formula and make sure they are given at roughly the same time each day. For the first 3 and a half months the last feed of the day was formula for us, which meant my milk supply was able to establish during the rest of the day.

At 6 weeks old we stayed in hospital overnight (in order to try and get a referral to see a consultant about his tongue tie) and they weighed Oscar before and after a boob feed which was really interesting to see how much he'd taken on board during the feed. It might be worth asking your HV to do this in order to see how much Sam is getting from a feed. The doctors did tell me that breastfeeding is a real workout for a baby so sometimes if they aren't feeding effectively, they are using as many calories as they are getting, although as they gets stronger they will get better at it.

I think the key thing is that you say your LO is looking well, my HV said that she wasn't worried about Oscar's slow weight gain because his skin looked healthy, his eyes were bright and his soft spot on his head was concave so she could tell he wasn't dehydrated. She told me that bigger babies (O was 9lb 14) often lose a lot of their brown fat and take longer to regain birth weight. She also said that his head circumference was on the 50th percentile and in her experience babies weight tended to level out at the percentile that their head was on at birth. This has indeed happened, Oscar was on the 98th percentile at birth but now is just above the 50th percentile so it turns out she was right in his case.

Good luck with whatever you decide and hope Sam starts gaining soon

 

[Rosebay]

Thanks Mildly for the mixed feeding advice, that's really helpful. After his half hour feed and 2oz formula he has just had another 30 mins good feed as far as I could tell on the boob and has still taken 1oz formula, still couldn't express anything although that said I'm pretty stressed right now so that probably isn't helping...?

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[beanie]

have you tried lying down and letting him feed that way - when he goes to sleep does he still have the nipple in his mouth. If so what I used to do was gently push my breast in which made my nipple move away slightly, this made C start sucking again. I would stay with the same side if he wants to feed again within an hour. Perhaps start expressing till you feel your letdown and then latch him on so he doesn't have to work so hard for the milk.

this is a good article with some tips on rousing a sleepy baby

I remember the nightmare time you had with feeding Elliot, and I understand how upset this is making you feel. If you feel better giving a top up of formula (because whilst it is not recommended, your peace of mind is important!!!). Mildly gives great advice, I did top S up with formula and she went on to exclusively breastfeed. PM me anytime if you need to - or I am happy to PM you my mobile number if you want

 

[Melly+2]

Hey just thought id post, i wqasnt expressing long but i found massaging my breast while pumping really helped the milk come out easier, it took a while for it to flow too so just persevere

 

[mumtotwo]

I really struggle with expressing. The only way I can do it is to express off the other side at the same time as feeding . It's a bit tricky at first and you might need someone to help you but it can be done. If you can't do this then you can get containers to catch any drops from the other side as you feed. It might not seem like much but it can make a big difference. When my baby was a newborn he had low blood sugar so i was asked to express. I only managed to express 5 ml but even that really helped.
Just one other thought - have you asked the midwife if you can borrow a hospital pump. I think they tend to work better. good luck.

 

[mum's the word]

I'm sorry I won't be of much use as I HATE expressing milk, I had to do it every 3 hours day and night for a week when Sonny had bronchiolitis and couldn't breathe properly when feeding. I didn't manage to express evrey time as I was sleeping sometimes and other times I let Sonny have a feed when he was able to latch on. The health visitor had me panicking about weight loss, milk supply dropping etc but luckily he didn't lose or gain weight and my supply was fine.
If a baby is settled, weeing and pooing, jaundice gone, latch fine and as you said very content, then can someone please explain what the problem is? I thought these were the signs that everything is going really well.
Also, are the scales 100% accurate, is he being weighed on the same surface with same scales which have been set accurately each time? Hospital and midwives/health visitors scales are notoriously out of sync, maybe his birth weight would have registered different on the scales he's being weighed on now.

 

[Rosebay]

Well he seems to be only wanting the top up when he's been on my left breast for a feed before. To be honest I've felt that they're different for a few days as I can see the milk on the other side but on the left I never have and he doesn't seem to feed so well. So, I'm still feeding him every 3 hrs, on me first then with a top up if he wants it but he only wants it after the left breast so what can I do to increase the supply to that side? Am I naturally lopsided? It is actually smaller by a cup side but I guess that makes no difference. Is it possible to just feed on one side in the long term if it doesn't improve?

Scales-wise it was the same scale on the same floor as last week but not the same as in the hospital at his birth so...? He still seems the same as before, i.e. not any perkier etc, just the same kind of calm laid back mood despite the fact that he must be taking more in so I don't think he was that hungry...?

Thanks
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[mumtotwo]

I had the same problem with poor supply on one side. I spoke to a breastfeeding specialist at the hospital and also a support worker from la leche league. They both said that it was fine to feed long term off just one side. It was hard though to start with because you have to work at doubling your supply on the chosen side. Now I mainly feed from the left and only occasionally from the right if baby is still hungry after a full feed. I express from the right occasionally while feeding from the left so that I can freeze some if I ever need to go out.

So - to answer your question - yes it is possible to feed from just one side. However, I would run it past a breastfeeding specialist first. The reason I say this is that you are concerned about weight gain and have a baby who doesn't want to feed often so it might be difficult to build up your supply to your chosen side.

Have you plotted your babys weight on a breastfeeding growth chart? Just wondered if that would make any difference?

 

[Tadpole]

Hiya,

I totally sympathise as Olivia lost 12% at 6 days after birth. They thought it was latching and so gave me 24 hours to see if she could put on some weight. I did manage it by keeping her on the boob for the whole 24 hours. Literally. I just lay in bed and held her there. It was quite tiring (and painful) but I was in absolute bits over it all. Doing this also bumped up the supply properly. Did they check your latch etc when they came?

Honestly, I would advise tucking him in your top and staying in bed if possible - if not try and sit/lay down as often as you can - drink loads of water for energy levels, dehydration and milk supply and just keep encouraging him to have a little suck every so often.

 

[Rosebay]

Hi,

well in the last 48 hrs I've been feeding him at least every 3 hrs- sometimes more like 2 1/2 and he's still taking the top up formula at the rate of about 1-2oz per feed (though he has thrown a bit of this up this afternoon but that could have been me manhandling him when I was winding him as I'm out of practice). We just tried weighing him before and after a bf on the side where there's more milk and he's taken in 1oz- is that right for now or not much? We did it with exactly the same scales/nappy etc. He then took 1oz formula- he'd been feeding for 45 mins on the breast before that and just kept drifting off after an initial enthusiasm. I took him off and woke him up, double checked the latch etc but it didn't seem to make much difference. He doesn't really take the formula with much urgency either- is he just not very hungry?

The midwife comes tomorrow morning with her scales. Tbh I'm so so tired and upset about it all because I've been feeding him so much it feels like one feed just goes straight on to the other since I'm doing both bf and formula and I'm just worried that he's not getting enough. Ho hum. We'll see tomorrow

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[keli]

I really feel for you It really does sound like your doing everything right, even without the top ups!.. maybe he just isn't a hungry baby. These 'professionals' are obessed with weighing and charts/graphs etc. So he's lost weight.. babies are born with extra fat, a store because it's expected that most will lose weight until feeding is established. Good luck for tomorrow, let us know how you go on xx

 

[keli]

ps i'm sure you'd know if baby wasn't getting enough.. as you say he's content has wet/dirty nappies. I'm sure you'd know as his mummy if there was something wrong. It's a shame that there has been a downer put on all this as it sounds like you were/are doing fab

 

[Rosebay]

Hi,

well the midwife came and he's gone up from 6lb 4 to 6 lb 11 in 3 days. In the last 24 hrs he has taken more formula than breast by his own choice (just not feeding and falling asleep while on me) and today he has been so much more alert and perky than he has been. The thing is that this is since I've been topping him up- before that he was losing weight. I guess it could be true that my supply could be up too but tbh I just don't think so. Another issue is that my confidence in the whole thing had totally been undermined by the weight loss and them mentioning us returning to hospital- I just kind of went to pieces about it, probably because I had a bad breastfeeding experience last time and still have a lot of issues about that as some of you know. He hasn't been pooing very much at all- only 2 since the meconium one at hospital, they did say that was fine but now seem concerned about that too. I know I'm being paranoid about his weight etc but I just can't help feeling more at ease knowing what he's taking in, especially since he showed no obvious signs of being really hungry unlike my older son.

I know a lot of you will disagree with my decision but I've decided to call it a day on the breastfeeding. Thanks so much for the advice and PMs. I just don't think it was working for either him or me and I think he needs me not to be freaking out about it and weeping and getting eggy with my other son while I feed him for so long by both methods. I don't know why it's such an emotional issue for me really but even before this I couldn't talk about my previous attempts to bf without crying either but that's just the way it is. I've had easy labours and then found the next bit so hard!

Thanks again everyone for the support
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[keli]

I don't think anyone would disagree with your decision hun, it's your decision to make. So glad about the weight gain

 

[beanie]

ah hun, you have nothing to feel bad for. Your midwives sounded as useful as a chocolate teapot and they have really undermined your efforts.