3 weeks tomorrow
So this is my first post and we've been having real difficulties. Leo was born with 2 teeth which were extracted when he was 2 days old. He also had a tongue tie that was cut last week. He is also in double naps due to bung hips from being breech, and has a hernia that requires surgery later this week. Leo was breech due to bicornuate uterus and thus an elective c-section at 39 weeks & 2 days.
At birth Leo weighed 2.86KGs and now weighs 2.91KGs. His nappies are changed at each breast feed (as below) and are always wet & dirty.
My husband and I are at our wits end as to what to do and have had conflicting advice from the midwifes & pediatricians. One midwife said to only express 100mls-120mls and top him up with formula. Another midwife said to breast feed him to the max, set an alarm and wake overnight and feed him every 4 hours. The peads have said to breast feed for 15 mins, and do 40 mls EBM at each feed as well in the hope that he'll wake for the night feeds. We're just lost.
I'm using a medium nipple shield as previously he wasn't latching on. I had a go today without it with success! We are waking Leo for the feeds in the night which is why they are a little long between feeds. The day feeds he sometimes can be unsettled afterwards as well.
Any advice would be greatly appreciated.
Date Time Breast/EBM Time between feeds
12/07/2012 15:00 Breast
16:00 90 mls 1:00
19:15 Breast 3:15
20:30 Breast 1:15
21:30 85 mls 1:00
13/07/2012 2:50 Breast 5:20
6:30 Breast 3:40
8:10 50 mls 1:40
9:00 Breast 0:50
10:00 Breast 1:00
13:40 Breast 3:40
17:30 Breast 3:50
18:00 60 mls 0:30
22:30 Breast 4:30
14/07/2012 3:00 Breast 4:30
4:00 60 mls 1:00
9:00 Breast 5:00
11:45 110 mls 2:45
15:30 100 mls 3:45
19:45 110 mls 4:15
23:30 Breast 3:45
15/07/2012 0:30 80 mls 1:00
5:45 Breast 5:15
10:20 Breast 4:35
10:40 50 mls 0:20
13:30 Breast 2:50
13:50 50 mls 0:20
16:40 Breast 2:50
17:00 50 mls 0:20
19:50 Breast 2:50
20:10 50 mls 0:20
16/07/2012 2:00 Breast 5:50
2:15 50 mls 0:15
5:30 Breast 3:15
5:45 30 mls 0:15
10:30 Breast 4:45
10:45 60 mls 0:15
13:30 Breast 2:45
13:45 40 mls 0:15
Re: 3 weeks tomorrow
Welcome to the forum!
By 2 weeks, a baby is supposed to have regained his/her birthweight. Your baby is just barely over that at 3 weeks. There are some possible explanations for that which exclude nursing issues, including:
- long period of IV fluids given to mom during birth (fluid from mom's IV can bloat baby, making his birthweight appear higher than it really was, and making neonatal weight loss appear more severe than it really was)
- baby being weighed on different scales
- baby not always weighed in the nude
If none of those seem likely to have been a problem for you, then we can move on to nursing issues. When a newborn isn't gaining weight, or is gaining but very slowly, here are some possible causes:
- sleepy, jaundiced, or extremely mellow baby who does not nurse often enough (often enough generally being 10-12 nursing sessions per day)
- baby who does not nurse effectively due to a physical issue like a tongue-tie or a poor latch
- baby who is impeded from getting enough milk due to rigorous scheduling
- baby who is prevented from getting enough milk due to a improperly used shield
I think in your shoes, I would do the following:
- Try to ditch the shield- but if baby will only latch with the shield, use it! It's more important to have him at the breast than to get breastfeeding "perfect" at this point.
- Wake him very frequently to nurse. You want to nurse at least every 2-3 hours during the day and every 3-4 at night.
- See a lactation consultant, preferably an IBCLC, for hands-on help with latching and positioning And a reevaluation of the tongue tie (sometimes they need to be re-clipped).
- Keep baby alert and active at the breast by keeping him cool while nursing (strip him down to a nappy, keep a fan blowing in the room you nurse in), annoying him (rub against the grain of his hair or tickle the soles of his feet using your hand or a cool washrag), doing breast compressions to speed the milk flow when he slows down, and switch nursing (when he seems to be dozing off at the breast, take him off the breast, change his diaper, burp him, and put him onto the other breast, and repeat the process until he will no longer wake).
- Watch his nappy output very carefully- if he has decent output you know he's getting enough milk.
- Supplement with breastmilk (not formula, which actually has slightly fewer calories!) if necessary.
- Consider getting a professional grade baby scale, and weigh baby before and after feedings. By subtracting the before from the after, you can gain a highly accurate picture of how much milk baby takes in over a feeding, and you will know if a supplement is actually necessary.