How do I get her to nurse longer?

[Birdie B.]

My daughter is 4 mos. old, and is gaining weight very very slowly. She is currently gaining about 1 oz/week. She is up 3.5 pounds since birth (started at 5lb9oz, now is 8lb14oz).
She is very tiny, and I know from the skinny babies tribe here on MDC that some babies are naturally small and perfectly healthy. Meadow does have as-yet undiagnosed health issues, but the doctors suspect she may have a thyroid disorder, or a genetic issue that causes small stature.

Our family doctor is wonderful, and says that breastfeeding is the best thing for Meadow right now. I also think Meadow is getting plenty to eat and I'm making enough milk (she has the correct # of wet/dirty diapers, I can feel letdown and know that she's drinking at the breast, she seems happy and content after feeding, but she's not gaining weight very fast.

I have always nursed on-demand and co-sleep with her, but her frequent doctor's visits, surgeries, and the associated car time has interrupted the "flow" of our lives. I started seeing a LC, and she suggested trying to feed her more frequently, so I'm doing that. I am planning to rent a scale to measure her intake, but the 2 times I've used the scale Meadow has only taken in about 2 oz.

Sorry this has gotten so long! What I really want to know is HOW do I get her to drink more milk?? She will only nurse for 5 minutes most of the time, 10-15 if she's sleepy. She won't comfort-nurse (she cries if I offer the breast and she's not hungry). I try to keep her at my breast, but once she's done eating, she's done and gets upset if I try to keep her there. I think she is getting enough hindmilk, but I want her to get more. What should I do??

[Moonk'sMommy]

I have been going through something similar. My DD had been eating just fine until around 3 months and ever since then she isn't eating the same. She will eat anywhere from 6-16 minutes total, and has gone from about 5-6 feedings a day to 8-10 for the last month and a half.

When I weigh her before and after feedings she has only gotten about 1.5-2.5oz. I can still get a bit more milk out and am doing things to increase my supply in the event that is the issue (fenugreek, mother's milk tea, power pumping, pumping during her nap times, increased fluids, etc). I haven't ever felt when I have let down and don't usually have any engorgment (only occassionally if she sleeps long periods at night and I don't get a chance to pump), but when I do let down, I know it isn't very fast. It almost seems like she is just not as interested in breastfeeding and will take a bottle of pumped milk just fine. It makes me wonder if she just gets frustrated with slow let down or something similar.

My DD is gaining weight at a slow rate and her pediatrician said she is otherwise healthy, but to keep track of her weights before and after feedings for a while and possibly supplement a little with formula. After seeing how little she was getting I have been giving her a few additional ounces of formula or a bottle of breastmilk to help ensure she is getting more.

I know that I don't have any advice for you, but just wanted to let you know that you aren't alone. I know it can be frustrating not knowing why they won't eat longer/more, especially when they were previously doing well.

[sattygirl99]

I hate to be the one to say this, but I think you need to supplement. A weight gain of only 1 oz a week is not a sign of her getting enough.

My DD went through something similar an was on her way downhill.

I would recommend getting an SNS and supplementing at the breast.

Sorry so short, baby in arms.

[Bluegoat]

Have you tried breast compressions? If she gets sleepy when the letdown is finished, that might keep her awake and eating. Does she take just the one side at a feeding? Do you switch to the other for the next? You could try putting her to the same side twice. I agree that more frequent feeding might help a lot.

[Pookietooth]

Have you had her latch examined? Does she have tongue tie? Have you read Jack Newman's book or looked at his videos?
Can you obtain donor milk?

[Megan73]

I'm sorry, mama, but I agree with Sattygirl. A baby who is gaining 1 oz a week is not getting enough to eat, whether it's because she has problems feeding or you have low supply.
I would get assessed by a IBCLC right away. There are lots of things you can do to improve her feeding - breast compressions, switch nursing, etc - and to increase your supply, for example domperidone and power pumping.
But you may well need to supplement in the short term so she can catch up, in which case supplementing at the breast - and with donor milk if you can swing it - is ideal.
Hang in there, mama. You can overcome this.