We need help, baby is loosing too much weight - Page 2

[Triniity]

Hi, 

she is bf quite shortly, like 5 - 15 min before she fells asleep. i do feel the letdown (quite uncomfortable actually), i am leaking quite a lot esp at night. Milk is spraying :) 

I pump around two ounces per day, but i only pump after feeding her and not at night  I feed the bm as the last feeding after bf her (how come actually that she takes it just after a feeding?) 

I started the dom two days ago. and i spend a lot of time holding and bf. 

and SHE GAINED! she gained 100 g since tuesday 

@cookamh: no chocolate? honestly? i live on chocolate at the moment...do i honestly have to stop that? 

[Megan73]

Originally Posted by CookAMH 

Reduce acidic foods in your diet like OJ, chocolate, tomatoes, sausage. Can alleviate reflux for her.

I don't see how that could work. Breastmilk is made from what's in mom's blood - not her stomach. The exception is proteins like milk and egg that can turn up in milk.

Originally Posted by Triniity 

Hi, 
she is bf quite shortly, like 5 - 15 min before she fells asleep. i do feel the letdown (quite uncomfortable actually), i am leaking quite a lot esp at night. Milk is spraying  
I pump around two ounces per day, but i only pump after feeding her and not at night   I feed the bm as the last feeding after bf her (how come actually that she takes it just after a feeding?) 

I started the dom two days ago. and i spend a lot of time holding and bf. 

and SHE GAINED! she gained 100 g since tuesday 

That's great that she's gaining! It's great that you started the dom and you can boost the amount of milk she gets without pumping by doing breast compressions and switch nursing to keep her awake and get more letdowns. Typical weight gain for a BF newborn in metric units is here: http://www.kellymom.com/babyconcerns/growth/weight-gain-metric.html

[CookAMH]

It worked in 24 hours for us. I cut it out completely for about a week then could have those things periodically just fine.  Just speaking from our experience.
 

Originally Posted by Megan73 

Originally Posted by CookAMH 

Reduce acidic foods in your diet like OJ, chocolate, tomatoes, sausage. Can alleviate reflux for her.

I don't see how that could work. Breastmilk is made from what's in mom's blood - not her stomach. The exception is proteins like milk and egg that can turn up in milk.

[CookAMH]

How's it going?

[Triniity]

didn't gain in the last two weeks :( still holding on, she is bf fine, but not gaining. 

otherwise she appears to be just fine, smiling, sleeping as long as i hold her, having plenty of wet diapers ... we will see the doctor wednesday... 

[GoddessKristie]

Originally Posted by Triniity 

I pump around two ounces per day, but i only pump after feeding her and not at night  I feed the bm as the last feeding after bf her (how come actually that she takes it just after a feeding?) 

This was going to be my suggestion. When my DS was born he was long and weighed a good amount but was skinny. He lost a lot of weight after birth, too, so when my milk came in I pumped right after feeding him (every time) and immediately gave that to him with a syringe. It did the trick and he gained beautifully after that. 

I wonder if something that might enrich your milk would be beneficial. I know there are herbs that can increase supply, I wonder if there's something that could make your milk more fatty, like alfalfa (that works for livestock, don't know about humans). 

I hope you find some answers! Are you talking with a lactation consultant or LLL?

[GoddessKristie]

OK, I just pulled out my copy of Nursing Mother's Companion and here's what it says about weight loss:

"An initial loss of 10 percent or more of a baby's birth weight suggests the baby is underfed."

Here are the guidelines for newborn breastfeeding it gives (the ones that apply)

"Your baby is probably getting enough milk if-

...

Your baby is nursing at least eight times in a 24-hour period.

If your baby is not nursing enough you may have to wake her for feedings.

Your baby is nursing 10 to 45 minutes at each feeding and seems content after feedings.

Your baby has several periods of swallowing during each feeding.

Your breasts feel softer or lighter after the baby has nursed.

Your baby is having bowel movements ever day, and by the fifth day they have turned yellow.

Your baby is wetting more diapers by the fifth day after birth." (In a later chapter is says that during the first two months 8 or more wet diapers a day are a sign that baby is getting enough milk)

There is a long section of treatment measures for underfeeding. I would be happy to send you an email with that info if you want it. It includes estimating your supply, checking your baby's milk requirement, how to stimulate more milk and what to do if that all fails. 

Send me a PM with your email address if you'd like that info.

I hope you can find something that works!

[Megan73]

How are you doing? What did the doctor say?

[Triniity]

Hi,

sorry for my sluggish responses, I am in a different room-time-continuum than everybody else :) It is still tuesday in my week, it appears to be friday in your world

My doctor does not think that it is a milk supply problem. She is nursing fine, sleeping long hours at night, nursing every two to three hours otherwise, my breasts are bursting after about 4 hours (if I carry her all the times she can oversleep) and they start leaking ... I am leaking all the time anyway, I know women who call that oversupply ... I don´t actually know if leaking and bursting feeling and this things are actually a sign of good supply. I think I could fill a whole bottle of milk with the let-down-reflex-milk from the non-nursing side - I am using half a package of breast pads every day, at least two every feeding ... (I am going to sew a couple as soon as this time problem get right again - by than she will probably eat burgers ... :) )

Little one is nursing just fine, just not really gaining weight. We went to a cardiologist today to rule out structural problems with the heart, and her ductus botalli appears to have closed up just recently, maybe that is a reason for the sluggish weight gain, but I totally don´t know.

We have another appointment with our ped next week, but the ped does not see a reason to offer formula, since it is less calory dense and in his opinion not making any difference. I mean, I think you can kind of "overfeed" them much more easily, which is probably totally not possible with breastfeeding.

He thinks she is still within the normal range, so no reason to panic (just yet ;) ) 

I am still wondering about cow milks intolerance, she still has signs of reflux and is pretty gassy. The crying is less now, though.

I´ll keep you updated!

[Megan73]

I have to disagree with your doctor: a newborn not gaining for two weeks - unless they were ill - is not within the range of normal.
The bottom line is that she's either not getting enough to eat - either because of low supply or a problem transferring milk, which will eventually result in low supply - or she can't make use of the milk she is getting because of some medical condition, which would be rare.
Breast milk is 22 calories an ounce. Formula has 20 calories.
But there's no need to use formula. If your supply is so good, you can pump (or even just catch the letdown) and supplement with the pumped milk.
I would suggest seeing an International Board Certified Lactation Consultant who can do an assessment for a tongue tie and rent you a specialized scale so you can do 24 hours of test feeds to figure out how much she's actually getting at the breast.
Edited by Megan73 - 1/20/12 at 1:32pm

[PatioGardener]

Originally Posted by Megan73 

I have to disagree with your doctor: a newborn not gaining for two weeks - unless they were ill - is not within the range of normal.
The bottom line is that she's either not getting enough to eat - either because of low supply or a problem transferring milk, which will eventually result in low supply - or she can't make use of the milk she is getting because of some medical condition, which would be rare.
Breast milk is 22 calories an ounce. Formula has 20 calories.
But there's no need to use formula. If your supply is so good, you can pump (or even just catch the letdown) and supplement with the pumped milk.
I would suggest seeing an International Board Certified Lactation Consultant who can do an assessment for a tongue tie and rent you a specialized scale so you can do 24 hours of test feeds to figure out how much she's actually getting at the breast.

I agree. Sleeping long hours at night would also worry me - newborns who are not getting enough calories often sleep more to conserve energy. Lack of weight gain in a newborn is a huge concern for me.

[GoddessKristie]

I'm with Megan and PatioGardener. Something just doesn't add up here. You mentioned a few things from the list in The Nursing Mother's Companion, can you confidently say that your baby is meeting all of those? 

I second the suggestion to see a certified lactation consultant. I would not trust a Dr's opinion on breastfeeding. I would see a specialist.

[Triniity]

i did see a lll leader, and i consulted with an lactation consultant. both did not see anything wrong latchwise or tonguewise. they advised me to block-feed to get good hindmilk supply.

i did pumping and supplementing, but for one thing she slept for about seven hours after the feeds, so she just missed at least one feeding. sh does not really feed if a wake her up, so that does not help either. the other is that she just refused the bottles ( i used the calma bottle) after a couple of days and i am to dumb to use the other systems, the breast system does not work as well ( for us)

dd is drinking quite shortly, one feeding is much shorter than with both the others. they just kept on feeding and feeding for hours, she does not do that. she is feeding for 5 - 10 minutes mostly and than just licks on the breastt without actually feeding. the icblc consultant advised to pump before feeding to get more hindmilk, but it did not seem to make a difference.

i personally think she's got reflux and does not really like to feed. 

weight wise, she does gain, just very sluggishly, she is now 3700g, did gain just 100 g in two weeks though. from her lowest weight she gained around 10g/day, which is not too bad, is it? she appears to be skinnier now though. i can see her ribs and i am not sure if you are supposed to see them. dd1 was 1 kg heavier at the same age, and she was tiny.

i´ll try the 24 hr input chart. i am not sure if i can actually manage to do that, i would have to stay near the scale for 24 hrs, and that is really difficult with the other two kids ...

i don´t think that she sleeps to conserve energy since she is not sleepy at daytime, just at night. she is meeting all her milestones and is not below the 3rd centile weightwise (yet)

[Megan73]

Originally Posted by Triniity 

i did see a lll leader, and i consulted with an lactation consultant. both did not see anything wrong latchwise or tonguewise. they advised me to block-feed to get good hindmilk supply.

I'm so sorry you're still struggling with this. It must be so tough with two other kids to look after.
I have to say that IMO block feeding is really bad advice for a baby who's not gaining - it's usually a technique for reducing over supply. Babies who aren't gaining aren't getting enough milk not the "wrong" milk. You don't need to worry about foremilk vs hindmilk as long as you're letting baby finish the first breast before offering the other. Babies who aren't gaining should definitely be offered both breasts at a feeding along with using breast compressions. In fact, switch nursing - feeding off each breast twice per nursing session - can be a great strategy for getting more milk into baby.
And 10 g a day isn't adequate weight gain. Average weight gain for BF babies her age would be between double and triple that.
I think you should try pumping after feeds and giving her the milk. If you don't want to use the SNS, why not try a cup, syringe or dropper? Or you can use the SNS on your finger.
Babies should not be allowed to sleep long periods without feeding until they're gaining well. I've had two sleepy babes. It sucks but I did whatever it took to wake them to feed.
Edited by Megan73 - 1/21/12 at 5:51am

[Triniity]

even at nigt?

[Megan73]

If they're not gaining, yes.

[Mom2M]

Sorry to hear you are having a hard time, I know it can be so frustrating and worrying. Just to give you my experience, DD1 was a very sleepy baby and lost about 10% of birth weight also. She ended up being about 5 lbs 4 oz at her lowest! I had to wake her up every few hours and the dr. said to set an alarm and wake her up at night. During a feeding, she would doze off and I had to constantly wake her up. I tickled her feet, under her chin, took her clothes off, etc...She would end up on the breast for about 45 min total for both sides. I pumped after every feeding, even during the night and we gave her the milk in a bottle. Our dr said when she got up to about 8 pounds, it would be easier and she would stay awake better and he was absolutely right, it was a world of difference. But it took a long time till she got there. I did have some trouble with her not wanting to latch as well because of the bottle nipples but a few days of no bottle and nursing all day took care of it (with a lot of work and some crying from both of us!)
She nursed until she was 3 and it really didn't affect our bf'ing relationship after those few days of getting her solely on the breast. She never had to have formula.
You need to pump and feed her in whatever way you can, I wish I had thought of syringes or something!
Good luck and take care!

[GoddessKristie]

Have you tried an elimination diet? If you think something about feeding is making her avoid it perhaps you're right. 5-10 min is not enough time nursing to get enough milk. My DS had milk and soy allergies when he was nursing and I had to put us both on an elimination diet to figure out what it was (he was 1 yr old when it developed). We went to an allergist and had him tested and he tested negative for any allergies, but he still has a bad reaction to soy, he can tolerate cow milk now (after about a year of goat milk only). I asked the allergist if an elimination diet would be a good idea to figure out what is going on and he said no, that I should just keep him on Benedryl all the time because figuring out what was causing it would be too much work (!). When it came to my baby there was no such thing for me and I was not about to drug him 24 hrs/day to save myself some work. It was WELL worth it and avoiding soy is now just second nature to us. He was sensitive enough to soy that he couldn't even have grocery store meat. We had to buy freezer beef that was grassfed and when he went back on cow milk we bought grassfed milk as well. After he turned 4 his tolerance had increased and he can now have meat and milk from animals that have been fed soy, but still can't have any soy directly. 

Also, when he was nursing he LOVED my milk after I had eaten a lot of garlic.

I wouldn't let a babe that young sleep for that long, either. DS was early and had bad jaundice, so he was really sleepy. It was difficult to keep him awake to nurse long enough, but it had to be done. My girlfriend kept a cold wet wash cloth nearby for her preemie and would strip her down to her diaper and rub her feet with that cold cloth when she started to drift off. That worked like a charm.

It sounds like you're doing all you can and working hard for your LO! Keep at it and I'm sure you'll get it figured out!

[Triniity]

thanks for all the support.

the thing is, she is not actually falling asleep whilr nursing, just not really nursing anymore. she is not sleepy at daytime, only sleeping for long stretches if she is in the sling, otherwise she is being awake quite a lot.

we are monitoring her intake today, dp is taking care of the other two so that i´ll have time to stay close to the scale :) 

[Megan73]

Originally Posted by Triniity 

thanks for all the support.

the thing is, she is not actually falling asleep whilr nursing, just not really nursing anymore. she is not sleepy at daytime, only sleeping for long stretches if she is in the sling, otherwise she is being awake quite a lot.

we are monitoring her intake today, dp is taking care of the other two so that i´ll have time to stay close to the scale  

You rented a specialized scale, right? A standard scale won't be sensitive enough. The most common one for pre and post-feed weights is the Medela BabyWeigh. The way I was told to do it was to put baby in a clean diaper then weigh them, zero the scale, feed and - without changing the diaper or clothing - weigh again. Average intake for a breastfed baby is 25 ounces (750 ml) a day with a typical range of 19-30 ounces (570-900 ml) per day.