Baby not gaining...what other options are out there (other than formula)?

[1babysmom]

My SIL's 2 month old baby is not really gaining any weight, MIL says she's almost like a FTT baby. She was born at 38ish weeks at only 5 lbs. and she's still VERY tiny- not sure of her weight exactly but I can tell just from looking at her that she's not gaining. SIL had a LOT of stuff done in early pregnancy that they wondered if it would contribute to the baby having issues (she chose to have some medical procedures done that aren't usually recommended in pregnancy, for one). The baby has also had some gut issues, MIL is going to put her on a good probiotic (supposedly a REALLY good one, MIL is really into natural stuff so she found one and is waiting for it to come). Well, they decided to start supplementing with formula to try to get her to gain. Not that it matters, but this frustrates me because SIL (lives at home, doesn't have any responsibilities, this is her 2nd baby, different dad, etc) is the kind of person who would love to give up the responsibility of BF'ing...and already, now that she has supplemental formula available, I'm afraid her supply is going to suffer (not to mention baby not getting as much wonderful BM in the first place!!) She chose not to BF her first DD after about 2 weeks because "it hurt her chest". And even though my MIL is one of the biggest BF'ing advocates I know and is very knowledgable (from personal experiences- nursed her 6 kids for at least couple years each, but was also a long time RN, and is now into natural medicine) it seems like that all goes out the window when it comes to SIL.

So regardless of my IL's issues (or what I think about them ) I'm just curious, what other things can be done for a FTT baby or just one not gaining weight? Is supplementing really the best option? I can't imagine that my MIL would have made formula first on the list, I'm sure they tried other things, but since I don't have experience with babies not gaining I was curious if there are other options. If there's something out there that MIL might not know about I'd love to pass it on to her. I'd love to see SIL successful at BF'ing this time, and I know MIL would too, as she knows it's by far best.

[Tee25]

Well, SIL could try nursing and doint breast compressions while nursing? Either that or pumping maybe? Just trying to get out that hindmilk. But if she's not dedicated to bfing, pumping is a PITA so she may not want to keep that up for long.

[dachshundqueen]

Has the baby's suck been evaluated? Does the baby have a good latch with proper tongue positioning?

ETA: At two months, a baby that is still not gaining surely needs to be evaluated for medical difficulties and may very well need supplements.

Liz

[Kailey's mom]

Has the baby been seen by a pediatric gi specialist to rule out serious medical issues?

[PatioGardener]

If supplementation is needed, there are options before formula:
1 Increase mother's own breastmilk so baby can take more at the breast
2 Give mother's milk (in a cup, at the breast (by tube), etc)
3 Give donor milk
4 Formula

As PP mentioned, there are many reasons for baby not to be gaining weight and a full evaluation is a good idea (breastfeeding and perhaps medical)

[Llyra]

My first thought would be that baby is being "scheduled." A mama who's ambivalent about breastfeeding, and a baby who's not gaining, would lead me to suspect that feedings are too infrequent, or that night feedings are being discontinued at too young an age.

That said, my next step would be to get hold of a good baby scale, and do before-and-after weights. Weigh before a feed, on a scale accurate to half an ounce. Let baby nurse until baby is satisfied. Then without changing clothes, changing diapers, or wiping up spit up, weigh baby again. That lets you see how much baby ate. Do this at a few different times of day, and you have an estimate of baby's intake.

If baby is taking in adequate milk, and the mother has been counseled about demand feeding, I would be looking into evaluation for metabolic disorders and other medical problems.

I assume the baby has a health care provider, right? That person should have an eye on the situation, especially with a baby born small.

If baby isn't taking in adequate milk, then I would start with a good certified lactation consultant-- evaluate baby's sucking, look for tongue tie, talk to the mama about supply-increasing measures, etc.

But with a mama who's not terribly motivated to continue breastfeeding, formula may be inevitable. All of this takes a committed mama who's willing to go the distance, and it seems like SIL is not. Formula, and a thriving baby, is better than a baby suffering long-term problems because of inadequate nutrition in infancy, KWIM?

[1babysmom]

Thanks everyone. I will mention the pediatric GI specialist thing, that might definitely be worth looking into considering the combination of things. She's definitely not a scheduled baby, and I'm pretty sure considering all that MIL does know about BF'ing they've likely paid close attention to her latch and sucking. But I'll pass the info on anyway! Thanks!

[1babysmom]

Well i JUST got an email back from my MIL (even though she lives across the road ) and she said that the baby's latch and sucking is fine. They did get some stuff to try to increase SIL's supply, so hopefully that will help. She's going to look into finding a ped. GI in the nearest city, too. So thanks for that suggestion!

[earthmommy2]

I wanted to add...when my son struggled to gain weight I started to block nurse him, he would do a few nursings on one side then a few at the other side. Best of luck and a million

[Llyra]

Originally Posted by earthmommy2

I wanted to add...when my son struggled to gain weight I started to block nurse him, he would do a few nursings on one side then a few at the other side. Best of luck and a million

I would be cautious about going to block feedings, if baby isn't gaining. Block nursing is a supply-reducing technique, used in cases of oversupply. If a mama's supply is already low, it can make it even lower. An example of a supply-increasing technique is switch nursing, where you change sides frequently during a single feeding.