Baby not gaining weight (at least not much)

[veggiemomto2]

I am devastated. And shocked. I just sat and bawled my eyes out when I saw his weight. He was 9.5 at birth. At 4 days after birth, he weighed 9.3. Diaper was on (dry) and it was NOT the same scale as today. Today. He weighted 9.11. I was absolutely SHOCKED. It has been a month since birth. Hubby and I were both thinking he'd be at least 11 lbs. He looks big, is so alert and happy, nursing well, poops 6-10 times a day, pees all the time. I am just shocked. I do no know what to think. I go from worrying that it's me to wondering if he has some disease causing him to not gain. I am also wondering if it's possible that he was actually losing weight still at that initial appointment at 4 days after birth. He was jaundiced then and VERY tired. I would say his poops and pees were not what I were comfortable with until 10 days. They increased then and have stayed good. I hear him gulp. I leak. What is going on? I'm so upset.

Ped said she was fine with giving it a week. She said he looked perfect. Healthy, alert, and just a picture of health. I am going to nurse and then get him weighed on Friday. She said if he doesn't gain at least an ounce a day then she will want to do labs and see gastroenterologist. Heartbreaking!

Oh. And his poops, especially towards the end of the day, have been a bit greenish. Last night he had one with mucus. Can oversupply (foremilk/hindmilk imbalance) cause low weight gain? What about food intolerance? He's very gassy and seems in pain a lot. No spit up though.

Please help me. We nurse on demand. We nurse all the time. I really don't want to have to supplement. I just don't know how to figure this out. I'm so stressed and so upset right now. My heart is breaking. I struggled with supply last time and I finally felt like my supply was good.... oh and I'm already on galactagogues. I really really do believe my supply is adequate and that's the frustrating thing.

Adding some more info - watched his poops a lot yesterday. They are starting out yellow and then getting more and more green at the end of the day. Last night he cried and kicked at the breast for quite a while. Seems in pain? No spit up - ever. cannot pump AT ALL. I have spent over an hour combined pumping and have gotten less than a half ounce all together so pumping and giving him extra is not an option. I really don't know if the poops has anything to do with low weight gain. Neither of my other two had green poops but they gained slow, just not as slow as this.

I'm struggling to figure out if this is really my supply or him or WHAT. The output is just clearly there and that's what's so confusing. Block feeding isn't an option as my left side doesn't produce very much.

[Megan73]

If I were you I'd give it a week and see how his weight his. It may be that he lost more than you thought earlier or it's the different scale.
That said, I've had two babies who had perfect output but didn't gain and it was a supply issue.
According to my LC and everything I've read, babies don't gain well because they don't get enough milk not because it's the "wrong" milk. Before starting a series of tests on your babe, I would try to boost supply. If you want to be sure it's a supply issue, you can do 24 hours of weighed feeds with a special Medela scale.
Are you taking domperidone? It would take a few days for pumping after feeds to increase your supply so I'd stick with it. Do you have a double-electric pump? If you can rent a hospital-grade pump, even better.
Hang in there, mama. I know exactly how stressful this is. With domperidone, pumping after feeds and using an at-the-breast supplementer I was able to get DS2 gaining well then weaned off the pumping. He's still EBF at 7 months.

[veggiemomto2]

Originally Posted by Megan73 

If I were you I'd give it a week and see how his weight his. It may be that he lost more than you thought earlier or it's the different scale.
That said, I've had two babies who had perfect output but didn't gain and it was a supply issue.
According to my LC and everything I've read, babies don't gain well because they don't get enough milk not because it's the "wrong" milk. Before starting a series of tests on your babe, I would try to boost supply. If you want to be sure it's a supply issue, you can do 24 hours of weighed feeds with a special Medela scale.
Are you taking domperidone? It would take a few days for pumping after feeds to increase your supply so I'd stick with it. Do you have a double-electric pump? If you can rent a hospital-grade pump, even better.
Hang in there, mama. I know exactly how stressful this is. With domperidone, pumping after feeds and using an at-the-breast supplementer I was able to get DS2 gaining well then weaned off the pumping. He's still EBF at 7 months.

How the heck do you explain perfect output and not gaining? I don't understand. It's what we look at to reassure us, you know?

So frustrating - all of it! I am on domperidone and fenugreek and more milk plus. The really frustrating thing is that my last child gained OK w/o domperidone even though it was more slow than we wanted. That's when I started taking it and it really upped his weight. My first baby gained slow but I didn't use anything other than fenugreek and within a few weeks her weight gain was normal. This time I started after a week just because I figured I'd have supply issues. I leak. I feel let down. baby gulps sometimes even sputters and chokes from the letdown.

It's just so frustrating. I have a medela PIS. I really am not getting anything when pumping. Not sure why. Any other ideas? I could drink mother's milk tea and eat some oatmeal - I don't know what else to do. I"ll also start blessed thistle and alfalfa I suppose. Fenugreek and Dom have always done the trick. I really wonder if starting zoloft has anything to do with this. If I wanted to do an SNS (like if his weight is really bad on Friday) how would I go about getting one? I'm just so upset. I know it's not the end of the world, but it sure is upsetting.

Thank you for the advice.

[tashantx]

hugs to you mama. I can also sympathize. Mucus in poop is generally an irritation in the gut which can cause malabsorbtion of nutrients in some cases. So even if you have ample supply the baby may not be througly able to ''use'' all you are providing.   My ds took about a month or so to regain his birthweight, he had a tongue tie so my supply definately suffered. I was able to get him to gain an oz a day just by adding fenugreek and blessed thistle but after his tongue tie correction he developed a double whammy (thrush and reflux) He refused to nurse quite a bit. I will tell you I think my supply was suffering again due to those things and the healing from the procedure and him learning to use his tongue properly. The kicking at the breast REALLY reminds me of how my son was. I eliminated some things from my diet pumped after feeds ordered a scale on amazon (to avoid having to go somewhere to weigh my son all the time) started probiotics all at once b/c I didn't want to do the whole trial and error I figured we'd just try everything at once to get things better. nak so this is all over the place but around a month later my son is much happier poops are improving (still some mucus but much less and I'm still working towards figuring things out with a food diary) No more reflux very few hiccups no refusing to nurse gaining (still slowly but much better) . In retrospect I was definately having some supply issues b/c things are so much better now and honestly I thought my son's diapers were pretty adequate too seems like now they are a bit heavier. Don't expect to get anything when you pump it's really just extra stimulation to up your supply. And really 1/2 oz after nursing is pretty good....I saw an improvement in supply within 24 hours.

[tashantx]

also you may want to really work on doing breast compressions fully draining the breast is SO important! Have you done a test diaper? I think 3-4 tbsp in a diaper is how it's supposed to feel...I ended up starting to weigh diapers to see what my ds' output was like (yes I'm obsessive lol) I had b/f a slow gainer before this baby much like you and was able to get him to gain at least what I was satisfied with about a lb a month. I think you should also totally consider that if your l/o is satisfied and mostly content that you may just have a small child. I am starting to realize I do. Ds 1 and 2 are both toothpicks and I was only 17 lbs at a year old and was formula fed early solids cereal in an infant feeder....somebodies gotta be in the lower percentile!

[Adaline'sMama]

If you have a Medela PIS you may need a different size horns than what came with the pump. Check out their website for troubleshooting. Your nipple should be sucked all the way in, without it suctioning upwards or downwards against the horn. I didnt get anything for the first few months, got new horns, and all of the sudden the amount I was pumping tripled.

I have a skinny baby. She is 20 lbs at 18 months. The first month she only gained a 10 oz. from her drop weight. So, if your DS weighed 9.3 at his dropped weight, and 9.11 today then he has gained half a pound since his 4 days after birth weigh in. How old is he now? (how many days has it been?). On average babies typically gain .5 oz per day during the first month. So, at worst he is only gaining .25 oz per day if he is one month old. That really isnt that bad.

I doubt its your supply. Pooping 6-7 times a day?!?! It sounds like he is fine. I wouldnt worry about it, some babies just dont gain like others do.

[Megan73]

Originally Posted by veggiemomto2 


How the heck do you explain perfect output and not gaining? I don't understand. It's what we look at to reassure us, you know?

So frustrating - all of it! I am on domperidone and fenugreek and more milk plus. The really frustrating thing is that my last child gained OK w/o domperidone even though it was more slow than we wanted. That's when I started taking it and it really upped his weight. My first baby gained slow but I didn't use anything other than fenugreek and within a few weeks her weight gain was normal. This time I started after a week just because I figured I'd have supply issues. I leak. I feel let down. baby gulps sometimes even sputters and chokes from the letdown.

It's just so frustrating. I have a medela PIS. I really am not getting anything when pumping. Not sure why. Any other ideas? I could drink mother's milk tea and eat some oatmeal - I don't know what else to do. I"ll also start blessed thistle and alfalfa I suppose. Fenugreek and Dom have always done the trick. I really wonder if starting zoloft has anything to do with this. If I wanted to do an SNS (like if his weight is really bad on Friday) how would I go about getting one? I'm just so upset. I know it's not the end of the world, but it sure is upsetting.

Thank you for the advice.

It IS upsetting. I thought after having BTDT with DS1 I wouldn't be upset when I had supply trouble with DS2. It was still devastating despite the happy ending. My bottom line has been that my babies may not have been 100% breastmilk fed but they've been 100% breastfed - thanks to supplementing at the breast.
On the output, the way I figure it is that the average BF baby takes in 25 ounces. Let's say baby only takes in 20 ounces. There's plenty of milk for output but not QUITE enough to gain well. Poos are supposed to be a better indicator than pees of adequate milk intake but neither of my kids apparently got the memo. My first son - despite pumping, dom, etc. - always needed a bit of formula to gain well. I've been able to EBF DS2 (with a few days of formula supp near the beginning) with the same regimen.
How much dom are you taking? Some women are now taking up to 160 mg/day. I'm not sure about the zoloft... Do you have the book "The Nursing Mother's Guide to Making More Milk?"
For at-the-breast supplementers, you have two options. The Medela SNS is widely available through LCs and online but IME it's a fiddly PIA. The Lact-Aid is fabulous, especially for long-term supplementation. http://www.lact-aid.com/

[savithny]

My DD didn't return to birthweight until 3 weeks.    So a half-pound above that at 4 weeks would have been pretty good.  

Because I'd nursed a baby before, and because she was clearly alert and thriving, the ped didn't worry about it at all when at the 3-week visit she was just back to her 10#3 birthweight. 

Basically, because oyu don't know his lowest weight accurately, you don't really know if he's not gaining.   Many babies lose up to 10% of their birthweight before they begin to gain.   It could be that he bottomed out relatively late and is actually gaining steadily from that low point.

[ErikaS57]

My 3rd child is 2 weeks old now.  We have also struggled with slow weight gain - he was born at 9lb 9.8oz, down to 8lb, 15oz 4 days later, and still was the same weight 4 days after that.  He seemed to be nursing well, and the doctor wanted me to go dairy free, supplement, etc.  He was having 12+ wet diapers a day, 10+ poopy diapers... I couldn't understand it.

Instead, I got an LC to come over.  She helped us with his latch (which, while not terrible, wasn't great), and also noticed that he was slightly tongue-tied.  Not too serious, but enough to require him to have a great latch to compensate.  As a result, he was getting just enough to maintain his weight, but not gain.  I'm now renting a scale from her doing pre/post feed weights (a pain, but reassuring).  The first few days, it took a ton of effort to get him up to 24oz/day, but now (6 days later), we're up to 28-29oz/day easy.  In those 6 days, he has gained 9oz which I'm thrilled with.

[savithny]

I want to add -- my baby who didn't even return to birthweight until 3 weeks?   

Doubled her 10 pound birthweight by 6 months.    The pictures tell the tale -- I took a bunch at 3 weeks, and then over the next 2 weeks she suddenly turned into Buddha Baby.  In her case, it was clearly not latch problems, or something I was eating.  She just was a little slow getting going.

I"m not saying not to keep an eye on it -- but it's a bit early to start panicking and drastically reducing your diet.

[veggiemomto2]

nak - lost 2 ounces. tongue tie and really uncoordinated suck. using sns. so upset. trying to get in next week for clipping. really worried about wt check at ped tmrw

[tashantx]

 Huge hugs. My son has a recessed chin (lower jaw) and had a posterior tongue tie. Everything will be ok. We had it lasered along with an upper lip tie at 5 weeks. If it's posterior you may want to seriously consider laser over scissor clipping and also check for an upper labial tie the dentist told me that he felt that was impacting ds' latch more than the tongue tie and lower jaw issues. (as he's grown that has improved anyways). Before you know it you will be  breastfeeding a toddler and this will all be behind you guys.

[marywingerden]

I know how heartbreaking this can be as my 3 year old was a significantly slow gainer. She was actually diagnosed failure to thrive as her weight was below the chart. Usually she would hover around the 5th percentile. I did everything on earth to improve my supply. (are you night nursing a lot? that is one of the most important things to do for supply). I used a SNS, and bought my own scale. I fought supplementing and pumped after every feed to give her a grand total of 3 extra oz. a day by bottle/sns. I did give her one bottle of formula, once, and that's all she needed- for some reason after that she gained all right. prob. a combination of everything. i had early intervention look at her and work with her a bit. Now, for hindsight- she just turned 3 and she is tiny. She eats like a horse, nursed until she was 2.5 (and my milk dried up w/preg for #2). She can wear an 18 month onesie lol. But she's very healthy and dr said she's the most verbally advanced toddler she has ever seen. She was just petite, that's all. I went w/my intuition and KNEW she was ok, even if VERY slow to gain.. always alert and active with good output. I was always pumping JUST enough when I returned to work- never as much as I wanted. 

Now I have a 4 month old who weighs only 2 lbs less than what my daughter weighed at a year. He is at the 75th percentile. He's huge (5 lbs heavier and 3 inches longer than she was at his age, and he was smaller than her at birth), and it shows me that each baby is diff. and usually they do get just what they need for their own body type. 

Try to relax and know that your baby will be ok no matter what.. I know it can take a hit to your self-esteem and you worry so much. But as Tashantx said, soon you'll be nursing a toddler and it will be behind you. address whatever issues you can, and then go from there, one day at a time. 

[PatioGardener]

Originally Posted by veggiemomto2 

nak - lost 2 ounces. tongue tie and really uncoordinated suck. using sns. so upset. trying to get in next week for clipping. really worried about wt check at ped tmrw

Tongue-tie is SO difficult! hang in there - clipping can make the world of difference.

Good luck!

[Adaline'sMama]

Oh, Im so sorry. At least the problem has been identified and you are not having to worry about a supply issue. Hopefully as soon as the clipping happens the babe will latch well and start gaining. Hugs to you! I know this is a hard time. Let us know when the clipping is scheduled.