weight gain

[Rose-Roget]

Dd is 2 months old and just had her well-baby check. She seems very healthy overall. She was born a big baby - 8lb11oz - and has been nursing well and often - every 2-3 hours during the day, usually. I had overactive letdown and an abundant supply early on and went to block feedings. We don't do block feedings anymore, but I usually just nurse on one side per feeding because she seems finished at that point.

Anyway, she has only gained 14 oz in the past 6 weeks; she is not even 10lbs. She grew almost 2 inches, though, so she's 93rd %ile for length an 28th for height. Dr. was a little concerned, saying that we'll monitor and hope that things work themselves out but if not we may need to supplement. About how many oz. does a 2 mo need per day? Dr. suggested I pump before feeding her to see how much I have when full (and also to increase supply). I really don't want to supplement - anything I can do to help her get more/gain more in addition to feeding on both sides again and pumping?

[MamieCole]

How is her wet/poopy diaper output?
What color is her poop?
How much weight did she lose after birth? You should use that number to calculate her total gain so far.

The doctor is misguided to ask you to pump when full to evaluate your supply. Pumping is less effective than baby's nursing, so you really have no way of knowing if your pumping output is a true representation of your supply.

14 oz gain in 6 weeks is lower than the optimum range. (Most breastfed babies gain between 5.5-8.5 ozs per week during the first 4 months.) Here is a link to some suggestions for increasing weight gain.

Hope some of that is useful and that you find some solutions.

[Rose-Roget]

Originally Posted by MamieCole

How is her wet/poopy diaper output?
What color is her poop?
How much weight did she lose after birth? You should use that number to calculate her total gain so far.

The doctor is misguided to ask you to pump when full to evaluate your supply. Pumping is less effective than baby's nursing, so you really have no way of knowing if your pumping output is a true representation of your supply.

14 oz gain in 6 weeks is lower than the optimum range. (Most breastfed babies gain between 5.5-8.5 ozs per week during the first 4 months.) Here is a link to some suggestions for increasing weight gain.

Hope some of that is useful and that you find some solutions.

Her wet/poopy diaper output is good. She poops about every other day, but then it's usually two or three times.

She was 8-11 at birth and went down to 8-3. At her 2 week checkup, she was 9-1.

I took the "pump to check your output" idea with a grain of salt, because I know that I get less when I pump. I usually get about 4 ounces with a manual pump. I tried out my electric, double pump the other night and got 6, but that was after having nursed her a little just before she fell asleep. So I imagine that should be at least adequate, if I feed on both sides more consistently. How much do bf'd babies usually eat?

Thanks for that link - I'll check it out.

[MamieCole]

I'm no expert, but 4 or 6 ounces from one pumping session sounds awesome!

It is certainly a great sign that she is gaining length and that her wet/poopy diapers are good.

As far as how much breastfed babies eat, I'm sure it varies from baby to baby.
I've heard the general rule is about an ounce per hour. Kellymom says that the range is between 19-30ozs per day for babies age 1-6 months.

I'm sure a great lactation consultant could help a lot in trying to figure out if she is just a small baby or if there are some other issues as to why she is gaining so little.

[Bokonon]

Were those weights taken on the exact same scale? If not, they should not be compared, as different scales can differ by up to a pound.

If she's gaining in length, she's getting enough. Weight is only a small part of the picture. Many babies grow in length, then gain weight, then repeat the pattern. I agree that your doctor is giving you misguided information. Keep breastfeeding on demand, maybe go back to block feeding so she gets lots of hindmilk. Are you and/or baby's daddy thin and tall? Genetics sometimes plays a huge part in babies' growth patterns, so it's not unreasonable to think that a baby of tall, thin people would be long and thin too!

[PatioGardener]

If the weights are real, and not from different scales, etc., I'd be concerned with a 14 oz weight gain from 2 weeks of age to 2 months of age. Typically a baby would grow at least 30-42 oz during that time, so she has only gained 1/2 or 1/3 of the weight a typical baby would at a time when rapid weight gain is normal. I disagree with Bokonon that growing in length is enough at that age.

Working with a good IBCLC to evaluate actual weight gain in 24 hours (on a good, accurate scale you can trust), latch, milk transfer etc would be a prudent course of action at this point. Any chance that baby is tongue-tied? Would you consider supplementing with your pumped milk at the breast until you figure this out?

Good luck, Mama! I'm sure you'll get it figured out. I'd urge you to see an LC asap.

[ewe+lamb]

This is actually quite common with mothers who have had an over active letdown/high supply issue at the beginning. I would definitely have the latch evaluated, check out links like www.biologicalnurturing.com and www.drjacknewman.com to see good latches and positions. When confronted with an overactive letdown most babies don't have to work very hard to get the milk out, it usually just pours into their mouths then a few weeks pass and the flow of milk regulates and now the baby has to work harder at the breast to stimulate the supply - this is the bit that they are not used to and therefore don't have the sucking skills that a baby has when there is no letdown issue, I'd take a few days in bed with your wee one and stay there take the phone, tv, books, water and snacks and only really move out of the bedroom for going to the bathroom!! Let you baby nurse nurse nurse all the time - she'll have to work hard and you'll probably have to work on the latch a little but I reckon that it should work out after 2-3 days of doing this. Good luck and let us know if all is working out.
PS contact your local LLL Group and try to go to a meeting - there's always lots of mothers there with same/similar issues and definitely a friendly ear!!

[Rose-Roget]

I'm getting some good information here - thanks!

The weights were taken in the same room at the ped's office - I can't guarantee that they were the exact same scale; however, she'd been weighed a few days before on a different scale in the office and was the .5 oz lighter, so it seems to be pretty accurate.

I pumped and pumped with my Medela double electric between feedings today - hoping that that might stimulate more milk, if that's the problem. Ds was at school, so I held her and fed her at least every 2 hours for most of the day. Unfortunately, I had to work for a bit this evening. I sent her with expressed milk to my mom's. When I was leaving, mom was giving her a bottle of 3 oz. When dh came to get her a couple of hours later, my mom had just sat down to give her the last oz. of that bottle, but she wouldn't drink it. Dh tried to feed her a bit at home from 7-8, but she was exhausted and wouldn't eat (she normally eats last around 8 or 9). I pumped when I got home and had missed feedings, but got way less than usual. I think I'm stressed over this and I barely get a letdown with the pump. I called a LC from the hospital I delivered at. Unfortunately, I wasn't available when she called back. I'll try again tomorrow - maybe I can get in to get the latch evaluated and weigh her before/after and get more advice.