10 week old just won't nurse enough? How do I convince her?

[mckittre]

My 10 week old is an extremely happy baby most of the time, alert, active, strong, etc...  But I can't get her to eat enough.  When awake, she'll happily lay and look at her mirror, bat at her toys, smile at me, be held, etc...  When I try to nurse her, she often gets upset and won't eat.  When she does decide to nurse, her latch is fine, and she can get milk.

This has been especially true the last few days, which may be because the whole family has had the flu (even though it doesn't seem to have hit her much).  But she's been a slow gainer her whole life (after regaining her birthweight just fine) at about 3.5-4oz per week.  Which I've been trying super hard to increase, which is why it's so frustrating that she won't nurse enough.  She even sleeps too well for me to feed her extra at night!  She was a huge newborn so she's still well above average for weight, but I need her to eat more.

What do I do?

[jksmith]

It sounds like you baby is doing fine. 0.5-1 oz a day is normal growth. And she's happy and sleeping at night. If I were you, I would stop worrying and enjoy your baby (and your sleep!)

[mckittre]

Hmmm.  When I look it up, I read that the normal range is 5-7oz/week or 6-8oz/week.  Which is also what the doc told me.  So 3.5 or 4oz/week is below that range.

[PlayaMama]

you could poke around kellymom.com a little bit.

have you talked to a lactation consultant or anyone at la leche league?

[Llyra]

The best ways that I know of to encourage a young infant to nurse more often are:

1. to spend lots of time skin-to-skin, or to wear baby in a position where baby has easy access to the breast
2. to try nursing in a variety of positions and circumstance-- like in a warm bath, or while walking around, or in the car
3. to "wake up" baby before you begin with a warm sponge bath and a diaper change
4. to take baby to bed with you at night, and sleep topless, with baby nestled against the breast-- in a side-lying position
5. offering while baby is sleepy, or even while baby is sleeping-- some babies will "dream feed."

You're right-- 3 to 4 ounces a week is not considered normal weight gain. Kellymom states that 4 to 5 ounces may be acceptable in certain cases. My DS was a very slow gainer in his early months. He did a lot of catch-up growth in the fifth and sixth months, and is now average-sized, but we worried a lot in those early months. However, he was also extremely fussy and miserable-- it sounds like your baby is content and happy and alert.

How is baby's output? Is baby wetting diapers, and pooping regularly? That would be reassuring to me. Have you had baby's latch evaluated? It might be helpful to see a lactation consultant to check on that.

I think what I'm thinking is that it might be a bit concerning, but there's no need to panic-- somebody has to be on the slow side of average, after all. It's possible that despite being large at birth, that she's not genetically destined to be a heavier-than-average kid, and that her low gain is what's normal for her. Maybe watch, and wait, and in the meantime try encouraging more nursing?

[jksmith]

Originally Posted by Llyra 

It's possible that despite being large at birth, that she's not genetically destined to be a heavier-than-average kid, and that her low gain is what's normal for her.

Exactly. My LO was born big, and my midwife warned me that big babies can gain slower as they get into the normal range for their age, and that as long as they are happy, and poops and pees are normal, not to worry.
 

[mckittre]

Thanks for the input.  I'm sure at least some dropping down in percentiles is expected - she was born an ounce short of 10 pounds, but does not come from large people.  I have a 2 year old who's been happily clicking along somewhere near the 3rd or 5th percentile for a year now, so it would be unlikely that my second kid should be a giant.  But he grew faster than this when he was very young, and the doc thought that even if she did need to slow down, it shouldn't be starting so young?  My other thought is that she's losing too much of what she eats by spitting up - she spits up a lot more than my son did. 

She does seem to have plenty of wet and poopy diapers (though often fairly small amounts of poop each time), so I guess that's a good sign.

I will try some of the ideas you suggested, but it's rather hard to get this one to eat when she doesn't feel like it.  And of course, I won't make enough milk if she doesn't eat enough, right?

I haven't talked to a lactation consultant.  I thought that after having no trouble at all nursing my 2 year old, that I'd do fine the second time around, but now I'm just confused.

[Heba]

Various things can affect weight gain, and it may well be that this weight gain is fine for this particular baby, but If you're at all concerned, a check with an IBCLC should put your mind at rest, or they would be able to suggest ways to tackle the problem if there turned out to be one.

You mentioned that the doctor had commented on expected weight gain - I assume your daughter has been given a clean bill of health?  Minor illnesses such as a UTI can affect weight gain. 

In the meantime, breast compressions might encourage her to stay active at the breast for longer?

xx