Baby Not Gaining Enough. Need Advice!

[Gemini529]

Hi,
My baby was born about 2 weeks early. Since the beginning we have had issues with breastfeeding. He was born at 6 lbs 3 oz. When we left the hospital he weight 5 lbs 12 oz and I knew he was not latching right. I talked to the lactation consultants and they tried to help, but he just kept falling asleep and didn't seem interested in BFing at all. Well, by the 2 day checkup, he had fallen to 5 lbs 5 oz and our ped told us to supplement him with pumped milk or formula. I went back to the hospital and talked to the LC again and she basically told me to pump and supplement until he got stronger.

So at the 2 week appt, after supplementing and pumping, he weighed 5 lbs 15 oz, which the doctor was happy about. For the last week, I haven't been supplementing because I wanted to try to see if he could just breastfeed. I felt like he was doing well, latching on and seeming content after. But today at his dr visit, he only weighed 6 lbs 2 oz. Tomorrow he will be 3 weeks old. I'm so depressed I just want to cry. I really didn't want to formula feed and I just can't keep up with pumping constantly. What should I do? My ped wants us to supplement again because he said he didn't gain enough in the last week. I've become totally obsessed with his weight. I feel like if I supplement him with formula now the BFing will never really work out. And if I keep giving him bottles, I'll never feel comfortable taking him off of them for fear of him not gaining enough.

[Mosaic]

I'd get a non-hospital LC and do pre and post-feed weighs. DD1 was similar: 2 weeks early and a lazy, sleepy nurser, so we had to strip her down and wipe her with a cold washcloth, wake her up overnight for dream feeds, etc. In her case, she was nursing well but only got enough to maintain her weight. She just needed a teeeeensy bit more milk to grow, hence the merciless harasment. But it worked! Early babies sometimes need time to get the hang of it.

[Zangua]

Stick with it! He will gain weight. I would radically increase the amount of water you are drinking and breastfeed as often as possible. He may be gaining slowly, but he is not loosing, so you aren't in any real danger. Remind yourself over and over that your baby is healthy and you CAN breastfeed him.

[RedOakMomma]

ddcc

Take a deep breath. PPs have it right...he'll probably go through a few weeks here where he's getting the hang of it, but you can definitely transition to full breastfeeding. Slow weight gain is still weight gain, and he was a wee early one. Does La Leche League have a group near you? Give one of the group leaders a call and ask for help. I've had a couple LLL leaders as friends and they were specially trained to help, plus they made tons of homevisits to new moms when they were needed. I really think you could use the support and expertise. Posting in the breastfeeding forum would also be a good idea...LOTS of moms struggle with this in the early weeks. You're not alone!

[khaoskat]

Yes, go to an independent LC, if you are on WIC, you can contact them. If not contact LLL. I have been to the LC three times and DS3 is only 3 weeks old. I will probably be making another trip next week...as I am in excrutiating pain.

Also, have him evaluated for tongue tie, etc.

[Tenk]

Well Lilah was 6 weeks early and spent so much time in the NICU that I couldn't establish a nursing relationship with her as planned while there. Only nursing 1-2 times a day and even then they would tell me she wasn't full enough and make me give her pumped milk after wards.

Came home at 4lb 8oz (above birth weight of 4lb 6oz) and nursing ONLY she lost weight in 24 hours down to 4lb 7oz. I freaked out and started giving her pumped bottles of milk at night and nursing during the day. She gained a great amount like 6 ounces in 7 days or something. Then the PPD hit me hard and I couldn't find the time to nurse her all day long, pump all day long, and take care of my toddler all day long as well.

Now at 10 weeks, I nurse maybe 1 time a day and pump every 3 hours so she gets breast milk ONLY and she's gained up to 8lbs. I nursed my last baby, Bodie until 15 months and he was a slow gainer too. He weighed 6lb 14oz at birth and got down to 6lb 2oz, and by 15 days old weighed only 6lb 13oz. He continued to be a small guy until he started eating solids at 6 months and breast feeding, now he's perfect. My Dr referred to my milk as skim milk, and not fatty milk (silly saying, but true) no matter how much I ate or drank or pumped (I was working full time too) he still gained slow.

I would love to ONLY nurse Lilah, but my body just can't handle it right now, but at least I know she can do it and maybe eventually we get back there, for now she's getting my milk at least and gaining well. You'll figure out what's best for you both mama. You can do it!!!

[Gemini529]

Thanks for the words of encouragement, ladies! I have been really down about this all day. I think I will try to contact LLL. I also probably am not getting enough water. I have never been a big drinker. Before I got pregnant, sometimes I'd go all day without having anything other than coffee. I just never think of it, but I am going to make an effort to drink more water. How much should I be drinking?

I am worried that part of the problem is me. I start off the day with a very large supply and then by the end of the day, it's like I'm completely depleted. Just an hour ago, he was sucking away, clearly very frustrated for about 30 minutes. But I could tell he wasn't getting anything. I even tried to express some by hand and barely any came out. He kept pulling away and screaming like he was starving so I gave him pumped milk from a bottle and he gulped down 2 oz. Am I running out of milk at the end of the day? Will pumping more help this situation? I am starting to go insane with these long, unproductive feeds that take up most of the day. Spending the rest of my night pumping sounds just awful. But I will do it if it will keep my from completely drying up. I feel like I'm trapped in some sort of breastfeeding hell.

[RedOakMomma]

They're not unproductive feeds! When he sucks more, even if he's not getting much, he's giving your breasts the message they need to make more milk. During growth spurts, even with babies who have tons of interest and appetite, that happens too...it's totally normal.

I would definitely increase the water intake. Try to drink several full pint glasses a day. The general guideline is to drink a glass of water every time you nurse.

From the LLL book "Womanly Art of Breastfeeding", it says in the "Increasing your Milk Supply" section to:

1. Nurse Frequently (as long as baby will nurse. Plan a "nurse-in" when you spend 24 to 48 hours doing almost nothing else but nursing and resting (sidenote: I've had this work well! with my babies). If your baby is sleepy wake them up (cold washcloth, rubbing, changing diaper) and encourage them to nurse more frequently.

2. Offer Both Breasts at each feeding...then your baby gets all the milk available and it stimulates both breasts frequently (increases supply)

3. Try Switch Nursing..if you switch breasts two or three times in each feeding, it may keep a sleepy baby awake and interested. Switch breasts as soon as your baby's sucking slows down...could be 10 min, could be 2 or 3. Switch breasts at least twice each.

4. All your Baby's Sucking should be at the breast

5. Stay hydrated

6. Get plenty of rest and relaxation. I think that's why the nurse-ins work so well. Your body can up its supply more easily if you're relaxed and rested.

One more thing...regarding weights, the LLL book says that normal weight gain for a breastfed newborn is 4-8 oz. a week in the first three to four months. It sounds like you *almost* made that in the week that you stopped supplementing. I think you can do this!! Call up the LLL leader, get some extra help, maybe ask the amazing ladies in the bf forums, and maybe try a nurse-in, but do try to take some deep breaths. Your baby is gaining weight.

[jenrett]

Originally Posted by RedOakMomma

From the LLL book "Womanly Art of Breastfeeding", it says in the "Increasing your Milk Supply" section to:

1. Nurse Frequently (as long as baby will nurse. Plan a "nurse-in" when you spend 24 to 48 hours doing almost nothing else but nursing and resting (sidenote: I've had this work well! with my babies). If your baby is sleepy wake them up (cold washcloth, rubbing, changing diaper) and encourage them to nurse more frequently.

hang out with skin to skin contact. get your baby in diaper only and you go topless or with t-shirt pulled up so baby is on your belly/chest. that really gets the milk going. that's what i am doing now and the milk is literally dripping from me, and i just read about that concept somewhere yesterday.

good luck!

[Carma]

Our girl was also a bit early (induced at 38 weeks) and very sleepy. When she was awake and nursing I compressed my breast during nursing to get more milk in her faster before she fell asleep again. Drinking lot's of water also helped in my case.

Don't give up, you are doing great!

Carma

[khaoskat]

This is where DS3 and I are right now..

At birth 11 lbs 1 oz. (5/14)
On 5/17 he was 9 lbs 15 oz (no negativity from the Ped)
On 5/28 he was 10 lbs 10 oz (got negativity because not back to birth weight)
On 6/4 he was 11 lbs again (still some negativity)

Plus I am dealing with a severe tongue tie that took two different people, two times, to get properly clipped, and will now have to go back to the LC's for a 4th time, to get nursing going again.

I am in so much physical pain when he latches on that I cry and I bite my arm so something else hurts it is that bad. I am not nursing on my left side because it is so raw that I scream in pain and nothing helps.

I dread every feeding session and

[Gemini529]

Oh I'm not ready to give up. At least not yet. I will suffer through it til it works or until I lose my mind. Another issue I'm having is that even when we do supplement him by giving him an extra .5 to 1 oz of pumped milk, he usually will end up spitting it up. I'm not sure if it's from the bottle or if it's that he is getting too full. Maybe he just isn't really that hungry? The lactaction consultant at the hospital told me to force him to drink after he feeds but I feel bad doing this cause he doesn't seem to want it, and then often throws it up. But when I stopped doing this, he gained too slowly! Ugh!!!

I did the skin to skin thing today and it did seem to help.

[khaoskat]

Ok, stupid question here...

When you pump...how much do you get out? Is that on the same side you are feeding him from ... different side ... are you feeding both sides...

With DS2, we realized I had an OSS (Over Supply Syndrome), which because of the issues with DS1 we never realized....

But you may want to try what I do.. Block feedings...basically he is not getting my hind milk, so I have to do 2-3 nursing sessions per side, then switch sides...I have had to do this with all my DCs subsequent to #1. The issue is that he maintains..gets enough to feel full, meet his needs, but he is not getting the hind milk enough. So, with the block feedings, he will get more of the hind milk in the second feeding, and thus more calories.

He would put out enough wet/poop diapers...maintain his weight or slight weight gain....but not really gain anything...

[Gemini529]

That would make sense actually. Because part of why I wasn't that worried during the week I wasn't supplementing was that he was peeing and pooping constantly. So I knew he was getting milk. That's why I was so depressed when I found out he had only gained 3 oz. I didn't understand what I was doing wrong.

I will try doing the block feeding. My friend who is an LC actually mentioned to me that he might not be getting enough of the hind milk. The LC at the hospital keeps stressing to me that I need to increase my supply and pump constantly.

Whenever I pump after feeding him, I don't get very much. Maybe .5 to 1 oz at the most combined. I usually don't pump until I've at least tried to feed him for awhile. When he was a week old, he wasn't latching very well at all, and I would pump out probably 2-3 oz combined but that was 2 weeks ago.

[khaoskat]

If I would do it regularly, I could pump out about 3-4 ounces on the side he did not eat on.

How long are you pumping for? It takes me about 20 minutes using a hand pump to get that out. I get about 5-6 let downs during that time.

Also, don't let pumping be a dictate about getting enough or not, even though I have over supply syndrome, my ability to pump sucks...I was using a hospital grade double electric rental type pump and was lucky to get out 3-4 ounces total in 30-35 minutes of pumping.

If you want to do some of the "natural" supply increasing things - alphalpha capsules, fenugreek, etc.

Look into a book called Mother's Milk, it is an interesting read all about lactation and different cultural things on increasing supply through the ages --- it includes a list of foods to avoid as they are considered supply busters (or at least avoid excessive amounts of) and foods that are considered lactogenic (that means good for your supply).

[buckeye_bebe]

Update!

[HonkyTonka]

I notice that my baby gets fussy at the breast halfway through a feeding when I'm occupied in some other way (like chatting to ILs). When I paid more attention, and really thought about my baby when she nursed, she seems more content... might signify the importance of really relaxing during nursing sessions in a quiet place.

Also, it is very normal for your supply to decrease throughout the day. My LO cluster feeds in the evening when I have less milk.