My DD was born 4/2 at 7lb 3oz and discharged at 6lb 6oz. Weighted a week later, 6lb 4oz and two weeks later at 6lb 6oz. I've been working with a LC and at that point we rented a high precision scale to track LO's progress.
She seems to eat well - at least 2oz per feeding, every 3.5 hours or so. We also supplement with expressed breastmilk to get her to at least 2.5oz with each feeding. Plenty of wet diapers and very few BMs - maybe a BM every 3 or 4 days. This isn't uncommon for us as our last two children often stooled just once a week while they were ebf.
The problem is that her weight gain is almost non-existant. For every 2.5 oz increase in weight, there is a 2.2oz wet diaper. We will very slowly gain over the course of days, then a BM will bring her right back down.
Brought DD in to get weighed on 5/7 (5 weeks) and she was 6lb 15oz which our ped wasn't thrilled with but at least we were seeing a little progress. Weighed again this saturday (7 weeks) and she was at 7lb 3oz. We started her on alternating breastmilk and formula that day, and have moved up to at least 3.5oz of breastmilk or formula every feeding (every 3.5 - 4 hrs). Seemed to gain well for the last 48 hours, then had a large BM and we're back to a hair over 7lb 3oz.
I don't understand how, with herculean efforts to get her to gain weight including ensuring she's getting enough from breast, then using a syringe to give her additional milk beyond what she would normally nurse, and now stuffing her with up to 4oz of formula multiple times per day, we're only seeing a fraction of an oz in gain per day. Where does it all go??
We are having my milk tested to ensure it is nutritionally sufficient - aside from that we're lost. What else can we try?
DD seems to be perfectly healthy apart from being very small and skinny. When awake, she is alert, has started smiling a little, cooing. She really seems very happy and healthy. If we didn't have a scale in our lives we would probably be stress-free parents. But, we have an almost 2 month old that is eating a tremendous amount and is just barely over her birth weight. We're so desperate for answers, if anyone can offer any ideas we'd be very grateful.
You may find this article informative - especially with few stools and little weight gain: http://www.llli.org/llleaderweb/lv/lvdec97jan98p123.html
The other thing I would look into is tongue-tie.
If milk supply and transfer are good, I'd ask my doctor to start to look for other reasons - sensitivities to foods, and other medical issues.
Good luck, this must be frustrating for you!
Just a quick update - we are now seeing a much higher rate of growth, thanks in part to feeding more often and supplementing even more, including at night. It turns out we have a lazy nurser on our hands - she will stop at 2oz at breast when she will take over 4oz with supplementing. At night, when we didn't weigh her, we discovered she only nursed a max of 1oz, which is where we saw a lot of weight loss which we then would be trying to counter during the day with supplementing.
We also throw in the occasional bottle of thick formula - we use 1 1/4 scoops for every 2oz of water instead of the 1 scoop the directions call for. These additional calories per volume, in addition to supplementing with breastmilk at every feeding including (especially) at night, have resulted in 2 to 2.5 oz per day gains. She is finally growing faster than the projections call for, and in 3 weeks or so will have caught up to where our ped would like her, at which point we can back off slightly on stuffing her at every opportunity.
So very relieved it's nothing more serious than volume issues......
Just remember that if baby is being supplimented you need to pump each time to maintain supply, also remember that babies will take more from the bottle than the boob, because it (usually) comes out quicker and they do not have time to realize they are full.
Yes, I am pumping each time we give a bottle - including in the middle of the night which is oh so fun...
I realize we may be shooting ourselves in the foot by giving our LO a bottle after each nursing attempt, but I felt like we didn't have much choice considering the dramatic weight problem we were facing. The first priority is to get her up to a reasonable weight for her age, then we can try a few things to get her to be more EBF. I'm loving that she's gained almost a pound in one week - seems like she's making up for lost time.
Great news about the weight gain! Hopefully you can drop the formula soon and then slowly back off the extra bottle feeds. Before long you two will be nursing up a storm and all this will be behind you!
Did you find someone to assess baby for tongue-tie? They are a cause of poor milk transfer.
MY baby had a tongue tie and we had to suppliment with bottle also...so no condemnation there, I understand :-) a pound in the week is amazing! We've been about a pound a month! We fortify the suppliment too. My DD can transfer much better sicne getting her tongue tie fixed - we are still supplimenting the high calorie formula a few times a day though just because she is so so small.
If baby is sucking well you can also try an at breast supplimenter (SNS or Lactaid) which will help stimulate your supply...it usually only works well if baby is sucking and latching well though - w were never able to use it effectively.
Glad to hear you are pumping - I know how hard it is to breastfeed, pump and bottlefeed - you are doing great!
I'm also pumping/supplementing and trying to get our daughter back to the breast so I know how exhausting it is especially pumping at night! But it is so rewarding to see your babe gaining weight, sleeping better and just being so much happier, good job! :)
I think our problems lie with my flow being too slow, which you can't do a lot about so I might be pumping for a really long time, yay that your baby is gaining so much weight!
I hope this doesn't come across as nosy but I just wanted to make sure you cleared the "thickened forumula" with your doctor. Not something that someone should do on their own. But great news about the weight gain!
4 years and 5 IVF cycles in the making, Elliott was born at home in water on 2/2/11.
Please read this!!! http://drjaygordon.com/pediatricks/newborns/scales.html I've been having very slow gain with my LO however everything else about her is perfect. She is happy, content, hitting ALL milestones extremely early, etc...I found this very helpful!
Student mama to four big kids and one brand new baby girl Lennon (04/17/12)