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

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#31 of 55 Old 01-20-2012, 05:06 PM
 
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Originally Posted by Megan73 View Post

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.

 

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#32 of 55 Old 01-20-2012, 09:35 PM
 
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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.

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#33 of 55 Old 01-21-2012, 03:01 AM - Thread Starter
 
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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)


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#34 of 55 Old 01-21-2012, 05:39 AM
 
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Originally Posted by Triniity View Post

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.

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#35 of 55 Old 01-21-2012, 06:48 AM - Thread Starter
 
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even at nigt?


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#36 of 55 Old 01-21-2012, 06:58 AM
 
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If they're not gaining, yes.
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Megan, loving her sweet rainbow1284.gif boys, born Aug. 2008 and Feb. 2011, and their sister, born still March 2007 candle.gif
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#37 of 55 Old 01-21-2012, 07:32 AM
 
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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!

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#38 of 55 Old 01-21-2012, 03:33 PM
 
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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!

hug2.gif

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#39 of 55 Old 01-22-2012, 12:55 AM - Thread Starter
 
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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 :) 


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#40 of 55 Old 01-22-2012, 05:44 AM
 
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Originally Posted by Triniity View Post

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 smile.gif 

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.

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#41 of 55 Old 01-22-2012, 06:28 AM
 
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Quote:
Originally Posted by Triniity View Post

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 may like to try breast compressions and / or "switch nursing" when she stops actively sucking. Switch nursing is that you give her the other breast once active sucking stops, and just keep switching breasts for the whole feed. Breast compressions can be seen here: http://www.breastfeedinginc.ca/content.php?pagename=vid-4dayold

 

Hope the weight gain goes well!

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#42 of 55 Old 01-22-2012, 01:08 PM
 
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Quote:
Originally Posted by Triniity View Post

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 :) 



I'm so interested so see how her intake is coming out!

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#43 of 55 Old 01-23-2012, 03:52 AM - Thread Starter
 
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It´s acutally quite shocking, she is not even taking 500g/day. No wonder that she is gaining so slowly. huh.gif

 

I am a bit worried now, it's not surprising, really, but now the question is, why she is not taking enough milk. I honestly don't think it's a supply problem.

 

I don't know if I can manage to pump enough milk to supplement her, I am gonna try ... but last try she just took less on the breast, anyway, I'll try again, I am going to use this breastsystem from medela again (I always forget the name...)

 

we'll discuss with the doc on thursday.


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#44 of 55 Old 01-23-2012, 05:57 AM
 
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Hang in there, Trin. You can do this. hug.gif
The good news is that you can increase her intake. If she was drinking plenty of milk and wasn't growing it could have been caused by a potentially serious medical problem.
The bad news is that if you didn't have a supply problem before you may well have one now because she's not removing milk from your breasts well.
Here's what I would do: switch nursing and compressions at each feed then pump with a good double electric. Use the milk you pump to supplement at the next feed via the SNS. I would start with 30 ml per feed - you may need to seek out donor milk or use formula if you can't pump enough within a few days - then see where you are in a week.
While you're doing that, search out a good International Board Certified Lactation Consultant to double check her latch and whether she has a tongue tie. You could also talk to your MW about whether there's anything that could be sabotaging your supply, like hormonal birth control or retained placenta from the birth.
Also, how much domperidone are you taking? The current starting dose is 90 mg a day but some women take 120 mg.
My second son wasn't gaining well at the beginning but within a few days of dedicated pumping and dom I was able to supplement only with pumped milk then eliminate the supplementing and pumping altogether. Sometimes things get better just because they get bigger, stronger and better at nursing.

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#45 of 55 Old 01-23-2012, 07:49 AM - Thread Starter
 
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actually there is something wrong with my uterus, doc calls it retained blood, would not look like placenta, could that be doing something? she prescribed an ergotamine which would be causing low milk supply, so we opted for oxytocin instead.

 

after a couple of doses nothung happened, will see her on wednesday to discuss surgery bigeyes.gif


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#46 of 55 Old 01-23-2012, 07:51 AM
 
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Was going to post, but Megan has already said it!

 

Hang in there!
 

Quote:
Originally Posted by Megan73 View Post

Hang in there, Trin. You can do this. hug.gif
The good news is that you can increase her intake. If she was drinking plenty of milk and wasn't growing it could have been caused by a potentially serious medical problem.
The bad news is that if you didn't have a supply problem before you may well have one now because she's not removing milk from your breasts well.
Here's what I would do: switch nursing and compressions at each feed then pump with a good double electric. Use the milk you pump to supplement at the next feed via the SNS. I would start with 30 ml per feed - you may need to seek out donor milk or use formula if you can't pump enough within a few days - then see where you are in a week.
While you're doing that, search out a good International Board Certified Lactation Consultant to double check her latch and whether she has a tongue tie. You could also talk to your MW about whether there's anything that could be sabotaging your supply, like hormonal birth control or retained placenta from the birth.
Also, how much domperidone are you taking? The current starting dose is 90 mg a day but some women take 120 mg.
My second son wasn't gaining well at the beginning but within a few days of dedicated pumping and dom I was able to supplement only with pumped milk then eliminate the supplementing and pumping altogether. Sometimes things get better just because they get bigger, stronger and better at nursing.


 

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#47 of 55 Old 01-23-2012, 07:52 AM
 
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actually there is something wrong with my uterus, doc calls it retained blood, would not look like placenta, could that be doing something? she prescribed an ergotamine which would be causing low milk supply, so we opted for oxytocin instead.

 

after a couple of doses nothung happened, will see her on wednesday to discuss surgery bigeyes.gif



Any retained placenta (including membranes) can result in a lower milk supply - so this is definitely something to consider.

 

It sounds like you have a lot to deal with right now - good luck with it all hug2.gif

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#48 of 55 Old 01-23-2012, 08:13 AM - Thread Starter
 
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what kind of schedule for pumping do you suggest? I am always unsure, since she is not very regular in her feeding.


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#49 of 55 Old 01-23-2012, 08:14 AM
 
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Quote:
Originally Posted by Triniity View Post

actually there is something wrong with my uterus, doc calls it retained blood, would not look like placenta, could that be doing something? she prescribed an ergotamine which would be causing low milk supply, so we opted for oxytocin instead.

after a couple of doses nothung happened, will see her on wednesday to discuss surgery bigeyes.gif

It absolutely could be reducing your milk supply. From what I've read, you'll be able to nurse as soon as you feel up to it after a D&C. Good luck, mama.

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#50 of 55 Old 01-24-2012, 12:21 PM
 
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what kind of schedule for pumping do you suggest? I am always unsure, since she is not very regular in her feeding.



I had HUGE success by pumping 45 minutes after each nursing session for at least 15 minutes total. I was a SAHM to only my baby so I had time to sit and pump ten minutes on each breast. I never worried if he needed to eat again before 45 minutes were up (my LC said it takes 45 min between for your body to see it as a separate feeding), I just fed him, then waited another 45 and pumped again.. I used a manual pump and after a day or two I started pumping first thing, before the first feeding I would pump and I easily got 12oz from each breast before I let my LO nurse. That first feeding was the biggest because he was sleeping well, but I kept nursing throughout the day and then waiting 45 minutes and pumping. I was just building freezer supply, so after a couple days I stopped and just let him go back to his regular nursing schedule. I was seriously impressed at the ability of breasts to make that much milk. 

 

ETA: Here's a link to KellyMom.com with some more ideas for helping baby gain.

http://www.kellymom.com/babyconcerns/growth/weight-gain_increase.html

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#51 of 55 Old 01-24-2012, 01:20 PM
 
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I don't know if anyone has suggested it yet, but I could cut out all sources of dairy and/or soy. My son was allergic to milk from birth and as soon as I cut that stuff out the spitting up stopped. This can affect his gut and absorption.

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#52 of 55 Old 01-29-2012, 06:34 AM
 
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How's it going, Trin? hug.gif

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#53 of 55 Old 02-03-2012, 11:42 PM - Thread Starter
 
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It´s going okay beastfeedingwise. she reached 4 kg now, ped is happy, and i am not pumping anymore, just bfing.

 

i am really grateful for all your support! i feel my mw did not help at all...

 

thanks!


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#54 of 55 Old 02-05-2012, 02:22 PM
 
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It´s going okay beastfeedingwise. she reached 4 kg now, ped is happy, and i am not pumping anymore, just bfing.

 


Awesome news! Well done! joy.gif

 

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#55 of 55 Old 02-13-2012, 12:21 PM - Thread Starter
 
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unfortunately she lost weight, had a bit of a runny nose, but nothing major, but is now below the weight she had two weeks ago (slightly) 

 

She is well below the third centile now, and that is WHO centiles for bf babies :( 

 

I am exhausted...


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