bf baby not gaining enough weight

[2doggies]

My dd was born at 9 lbs 11oz, but dropped down to around 9 lbs. 5 oz before we left the hospital. DD was delivered C-section due to breech position and a too-short cord. One nurse said the water hadn't been "squeezed" out of her like a vaginally delivered baby and since I gained a lot of water weight, we were thinking dd did too...

She was down to 8 lbs. 4 oz at her week one check up, up to 8 lbs. 5 oz. the next week, and 8 lbs. 8 oz. the next. So, it's been a month now and she's 8 lbs. 11 oz.

I'm concerned, and I can't seem to get a clear picture on whether her "slow weight gain" is an actual problem or not. She grew an inch since birth and feeds on demand. I started pumping and was able to get 1 oz from each breast two hours after a big feeding session. Today, I pumped 2 oz from the one but she needed to eat, so I left the other for her...

Of course, the doc wants to supplement with formula. I wanted to exclusively bf, but more importantly I want to do what's best for my girl. Thoughts? Suggestions? Help?

[zipworth]

nak

I am by no means an expert, but I know that measuring how much milk you are making by pumping is not accurate. When I pump. the most I ever get is one ounce! But both my babies are great at gaining weight and they both have got waaay more than an ounce outta my boobs .

I am sure someone here will give you better advice.......

[sarahmck]

I'm also not an expert, but I wouldn't worry and I absolutely wouldn't supplement. You have a nice big baby. She's gaining weight nicely. Does she pee lots? Does she seem fine? Would you worry if you didn't have access to a scale and didn't visit a doctor? If not, then don't stress it.

I personally know of three 9.5 pound at birth babies who didn't stay that big for long. They all dropped down to around average size or even a bit less.

[sunnysideup]

Were the weight checks done with the same scale? Sometimes they are inaccurate if different scales are used.

Is baby nursing 8-12 times in 24 hours?

How long does baby nurse at each feeding?

How is baby's latch? Can you hear your baby swallow often while nursing? A poor latch can sometimes cause ineffective sucking. Would it be possible to have an LC or LLL Leader check the latch?

Do you use a pacifier?

[alegna]

IF you need to supplement, supplement with your own pumped milk in an sns or lact-aid.

-Angela

[madasmama]

Sorry if you've already thought about this, but I don't think you mentioned the foremilk vs hindmilk issue. You said that after nursing your little one you're still getting an oz or so. Maybe that is the fatty hindmilk that she is missing out on? I'm definetely not an expert, but you might want to try nursing from only one breast each feeding, or at least until you're sure that the first one is empty, to make sure she's getting enough of the fatty hindmilk she needs to gain weight.
And of course, as PP mentioned, going to a LLL meeting could be helpful.

[2doggies]

I've been feeding her 20 minutes on each side usually 10x/day, but I wait until she finishes to switch. On occasion, she'll stay with one for 30+ minutes and won't want the other. Her output is normal, her latch is good, and she seems to be happy and healthy otherwise.

The past two days she's been feeding every hour or hour and a half in clusters, then going 3-4 hours at other times. She doesn't sleep a whole heck of a lot compared to what other mothers report. Maybe she has a faster metabolism because she's awake so much?

We gave her an Adiri breastbottle full of expressed milk the other day, and she sucked it down like a champ. The flow was way too fast, so we'll have to try another bottle. I'm not entirely sure how switching one of my feedings with a bottle will help her gain, but we'll keep doing it if it will.

If we weren't "weighing in", I'd say she's perfectly fine. She eats until she's full, I feed her on demand, and she seems content. This is my first child, and I've never been around babies before this so it's hard to know whether it is my instinct that says she's fine or my wishful thinking...

There's no LLL meeting soon around my area, but my doula's (who's also a lactation consultant) coming over next week.

[alegna]

I would NOT NOT NOT use a bottle of any sort. No way. No how. If you need to supplement, do it at the breast with an sns or lact-aid. If there are any supply issues a bottle could kill your whole breastfeeding relationship.

-Angela

[mamaverdi]

Get a lactaid. IMO, sns is too hard for the baby to work.

What do you mean by normal output? And what type of diapers to do you use?

[lilsparrow]

Hi, I don't post here often. I just wanted to say that it doesn't sound like wishful thinking to me. You said everything else is fine if she wasn't "weighing in." Go with your gut. YOU know what's best for your baby. Mother's instinct is a gift.

Take care!

[2doggies]

I'm using cloth diapers. She pees after every feeding (sometimes more), poops every other one or so...

Any suggestions on where to get a Lact-Aid?

And thanks LilSparrow...it's hard to be confident in my mother's instinct right now.

[Ammaarah]

You are pumping a good amount. Could she be having a problem with milk transfer? It doesn't sound like a supply problem.

I would have her latch evaluated by someone who knows what she's doing. Ditch the non-creative ped.

[twinsarefun]

There are so many things that can cause this problem. You really need to get a good IBCLC (interview them first on the phone) who is very experienced. There are palate issues such as high palate, tonque tie, low thyroid, etc.. that can cause these problems. If you are pumping a lot of milk, most liikely the thryroid is not the issue. There is some kind of suckling problem that is going on. I would get a good LC asap. The Lact-Aid and SNS you have to be careful with. Only use this after first feeding at the breasst. Afterwards use the tube. You need to get this figured out though asap so that your little one does not get hooked on the tube like my guys. If I would have known what I am telling you now, my twins would not be stuck on the SNS/Lact-Aid with formula. You don't want to get in that place. With good LC help, you can most likely bf as you are desiring to do so. Let us know how it goes. I wish you well! P.S. I looked at your posts again. The diapers are good, so that is a good sign. I would skip any supplement and nurse as much as possible. Throw out any schedules, any certain number of minutes per side. Just nurse, nurse, nurse to get the baby fed a lot. The weight actually isn't that bad. My doctor was happy if my little ones were gaining 1/2 oz. per day! I know most doctors want 1 oz. per day, but my doctor was just happy with 1/2 oz. Only give supplements if your little ones seems still hungry after first nursing. You don't want to do anything to ruin your nursing relationship. Any bottles or over amount of formula, will just take away from your supply. If absolutely want the bottle for supplement (wouldn't recommend that though), use the Dr. Brown nipples size 1 (slow flow) from Target or wherever else they sell them. They are the best in terms on flow.

[kozmickreations05]

LOOK AT THE DIAPERS!!! MOST IMPORTANT!! All the DR charts are based on WHO formula fed babies...so they tend to FREAK we a bf baby looses weight. Granted your little one is loosing a little more than usual, if shes wetting and pooping enough she should be fine. I'd still recommend contacting a LLL leader that way you can talk to her along with your Dr.
All this info below is from Kellymom.com if you need more info.

WEIGHT GAIN:
If baby is gaining well on mom’s milk alone, then baby is getting enough. A 5-7% weight loss during the first 3-4 days after birth is normal. Baby should regain birth weight by 2 weeks. Once mom’s milk comes in, average weight gain is 6 oz/week. If these goals are not met, call your lactation consultant. More on weight gain.
WET DIAPERS: 5 - 6+ sopping wet diapers per day (after 1st week).
Expect one wet diaper on day one, increasing to 5-6 by one week. To feel what a sufficiently wet diaper is like, pour 3 tablespoons (45 mL) of water into a clean diaper (if baby wets more often, then the amount of urine per diaper may be less). Urine should be pale and mild smelling.
DIRTY DIAPERS: 3 – 4+ dirty diapers per day (after day 4).
Stools should be yellow (no meconium) by day 5 and the size of a US quarter (2.5 cm) or larger. The normal stool of a breastfed baby is usually yellow and is loose (soft to watery, may be seedy or curdy). More on infant stooling.
OTHER POSITIVE SIGNS: After a feeding, mom’s breast feels softer and baby seems reasonably content. Baby is alert, active and meeting developmental milestones.

[2doggies]

Her diaper count is definitely on track. In the beginning, my milk didn't come in until a couple of days later than average and her stools didn't turn yellow until the second week. So maybe we just need to catch up.

I went to kellymom.com (great site!) and followed the links to watch proper latching videos, etc. We do seem to be doing it correctly. I'll check again next week with the l.c./doula to be sure.

Yesterday, she was feeding almost non-stop all day. I was sure it was because I "ran out" of milk, but I checked and hand-expressed quite a squirt... I think I'll wait on the lact-aid/sns/supplementing until the next dr.'s appointment and just keep her feeding non-stop.

[sunnysideup]

So maybe we just need to catch up.

It sounds like that is defintely a possibility. C-section babies often have inflated birth weight because of the iv fluids--that and your milk coming in later than ususal could account for her low weight gain.

Her growth in length is good, and her diaper count is normal--both good signs.

Yesterday, she was feeding almost non-stop all day. I was sure it was because I "ran out" of milk, but I checked and hand-expressed quite a squirt... I think I'll wait on the lact-aid/sns/supplementing until the next dr.'s appointment and just keep her feeding non-stop.

I think that's what I would do, while keeping close track of her weight with the dr.

[Aridel]

It really doesn't sound like wishful thinking. A great thing to do if you're worried is to track your baby's growth on a chart yourself. These WHO charts are based on breastfed babies, so would be the right ones to use with your daughter. Don't know if you know statistics, but for a very quick explanation, the easier charts to use are the percentile ones. Percentile is how your dd compares to everyone else, so if she's in the 50th percentile she weighs about the same or more than half the children in the study. (Don't mean to be insulting if you know this already, I just remember being so lost when I first looked at all these numbers!)

The great thing with the WHO charts is that they're from a recognized group, and are recent, so they are easier to use to educate others (including peds) than trying to explain the different growth patterns for bf babies.

[Momtwice]

Originally Posted by 2doggies

Yesterday, she was feeding almost non-stop all day. I was sure it was because I "ran out" of milk, but I checked and hand-expressed quite a squirt... I think I'll wait on the lact-aid/sns/supplementing until the next dr.'s appointment and just keep her feeding non-stop.

That's a GOOD sign in most cases. She knows that the more she nurses, the more milk you will make. And often at around a month to 6 weeks they have a growth spurt where they will nurse constantly for days.

And again, the amount you can hand express or pump is NOT equivalent to the amount the baby can get. It is not a finite, limited amount in your breasts; instead, the more she nurses, the more she gets.

[2 in August]

One thing to have checked is if she is sucking hard enough. We found out that my ds was latching great and sucking but not hard enough. But it took me a couple weeks to find an lc to help figure that out. By that time my supply was dwindling. I would not supplement unless she is loosing weight. Formula can be hard on babies. It took 5 tries until we found one that my ds can tolerate. He didn't gain wt for weeks and the started going down. So I had to.

Good luck momma, it sounds like you are doing great.

[thepeach80]

It sounds like you have plenty of milk, maybe try having someone check suction and maybe see if she's tongue tied? Some babies are just slow starters though, Evan was like that and so is Ilana.