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Thread: Help: Inadequate weight gain + constant nursing

  1. #1

    Default Help: Inadequate weight gain + constant nursing

    My six week old daughter has, since birth, wanted to nurse constantly. She'll nurse for an hour or an hour and a half and then 15-45 minutes later want to eat again. At the breast her latch is good and she eats well, at first. But with time she tends to (understandably!) get tired and she starts nipping and napping, despite my best efforts to keep her alert and feeding.

    She just never seems satisfied after a feeding for very long. We can't get her to go down for anything more than a cat nap during the day or for a long sleep at night unless I express breast milk and give her some more breast milk by bottle (usually 70-100 additional ml). I started giving her several bottles of expressed milk each day when she was one month old because she remained at her birth weight of 3.4kg (7.5 pounds), despite near constant breastfeeding, and the doctor said we needed to get her weight up. Her urine and stool output, however, is and has always been good.

    In the last two weeks she has gained 350 grams (12.3 oz), which the doctor says is not enough. Meanwhile she's now 5 cm taller than she was at birth, so she's really long and skinny. The doctor has urged us to supplement with two bottles of formula a day.

    I can't figure out why she can't get more milk more effectively from my breasts. After she nurses I'm still able to express a good amount of milk, so the milk is there and if she's hungry (which she really is) why isn't she able to get it? (I've had two midwives and a lactation consultant say her latch is good.)

    I worry that I'm not making enough milk or there's something lacking in my milk or I'm doing something wrong. . . and I worry that if I give her formula it could exacerbate the problem. I really want to keep her on the breast, but even more important than that is that she gains some weight!

    Is there a way to give her some formula without diminishing my milk supply and making her even more lazy at the breast?

    I'm kind of at my wit's end.

  2. #2
    Join Date
    Jun 2006
    COUGARTOWN Baby! From here on in!

    Default Re: Help: Inadequate weight gain + constant nursing

    Don't give up and don't let your doctor intimidate you. If you child IS gaining AND growing AND you have good diaper output, you are doing fine. It takes time and practice for children to learn how to nurse effectively. And while they AND we are learning it's is best done in an environment where that is our only real focus. Most of us spent 6-12 weeks on the couch in our PJ's feeding. It's how we all learn. So expect that. PLAN for that. Don't feel trapped by that. Wake up and expect to spend your day just nursing. Doing that take the pressure off of you in terms of how "well" your child is nursing. It is normal for a child to want to nurse and be sleeping on her mother constantly. And when woken to want to go right back there. Remember that if you held and fed your child for 12hour a day, that is still a 50% reduction in what they are used to. They are used to being with you 24/7 and NOT having to work at all to get fed. Being born and learning to eat is a huge adjustment. It takes time. I think you are doing fine. I think within another 6 weeks you'll see a light at the end of the tunnel. Stay focused. The house work will wait. Have your DH bring home take out. The only job that matters this early in is feeding the baby.

    Way too lazy for formula

  3. #3
    Join Date
    Jun 2008
    Landof2toddlers, Oregon

    Default Re: Help: Inadequate weight gain + constant nursing

    if she is filling enough diaper then she is getting "enough". Has anyone done a weigh-feed-weigh on her to see how much she does get in a nursing session? But according to Kellymom the average weight gain in a breastfed newborn (0-17 wees) is 5-7oz so your LO is on track right now. It could have taken your baby a long time to get over birthweight for a number of reasons most common is that baby was "artificially heavy" due to mom getting IV fluids during labour.

    If you need to supplement d it with breast milk, if you are manging to pump a goodly amount after feeding you have plenty, there is no reason to give formula. Are you pumping after every nursing session, because that will result in you making enough milk for the pump session even if milk transfer is good.

    As the mom of an actually underweight baby and one who was a slow grower but just fine I can tell you those two things look different. A lean baby looks health and is happy. A skinny baby looks terrible (mine looked like gollum from lord of the rings) and does not act like a normal baby (mine did NOT sleep). You are mom, what is your instinct? Not what your Dr. has you worried about but your own instinct.

    Sorry this is rambly but I tried t hit on all the things you mentioned in your post.

    ETA can you post weights so we can take a look at her growth, and the link above has a calculator that might make you feel a little better.
    Last edited by @llli*durhamgrrl; July 2nd, 2011 at 12:29 PM.
    proud but exhausted working mammy to two high needs babies

    • my surprise baby: the one and only D-Man born 3 weeks late (5/5/08) at 9 lbs 14 oz and 21.5 inches, and
    • the shock H-Girl born about a week late (10/7/09) at 8lbs 15oz and 20.75 inches.

    If I am here I am covered in baby (probably two) and fighting for control of the keyboard.

    Family beds are awesome

    Wondering if you have PPD? Take the screening and see your doctor. You deserve to feel better.

  4. #4
    Join Date
    Jun 2011

    Default Re: Help: Inadequate weight gain + constant nursing

    I'm so sorry to hear that you're having troubles. Here are just a few thoughts that I have from reading your message.

    If you can pump after her feedings (and I know it's so hard to find time to pump when she's constantly at the breast), you can use expressed breast milk to supplement her rather than formula. It's highly unlikely that there's anything about your milk that is making her not gain weight. She probably just isn't transferring effectively.

    Have you considered renting a high-quality scale from your LC to see how much she gets over the course of a day. My son had a "disorganized suck," and as time went on after birth it got worse rather than better. He would spend an hour to an hour and a half on the breast and get 0.0 ounces. We supplemented him via SNS (at breast and finger feeding), but he couldn't even suck well enough to get enough food that way (40 minutes to get one ounce). When we moved to bottles (even the LC insisted), he took two hours to get a few ounces. It doesn't sound like your daughter is in that kind of situation, but sometimes babies need a little help with their sucking.

    What really helped our son was (unbelievably enough) chiropractic adjustments. The LC said his problems were too big for them and referred us to a cranio-sacral therapist. My chiropractor works with children, though, and we went there instead. Even just one adjustment showed us marked improvement (he drained 4 ounces from a bottle in thirty minutes and was willing to come back to the breast after a period of refusal). It wasn't a miracle cure, but we got back to trying to breastfeed, and he made improvements over the next few weeks and months. We used a scale to verify that he was taking in enough each day (usually we had to wake him up in the late evening for an extra feeding to keep him at his minimum).

    The other very helpful tool as the Medela SNS. It allowed me to use my pumped milk to supplement my baby at the breast. It kept my supply up and gave him practice breastfeeding, which is what he needed. http://www.medelabreastfeedingus.com...ing-system-sns It can be a bit of pain to use at times, but the investment was so worth it for me to establish a successful nursing relationship with my son. (We had some weight gain issues, too, by the way, but thankfully our pediatrician is more committed to breastfeeding than he is to growth charts. He was reassured, though, by the fact that I was keeping such close tabs on how much my son took in.)

    Also, if you aren't familiar with www.drjacknewman.com, there's a lot of help there. He has an information sheet and a video about using breast compressions to help a little one get more milk from the breast faster. Those were really helpful to us, and I still use compressions with my son. (A faster flow helps keep a baby awake and alert at the breast, so it could be good for your little girl.)

    I hope this is some help to you.
    I breast milk fed my Blossom for fifteen months (after exclusively pumping for thirteen). My Bud (nineteen months) is still nursing directly (after a rough start that included a few months of pumping and supplementing with mommy's milk).

    TwoDewdrops: Nursing Dresses and Tops for Discreet Breastfeeding (and Pumping)

  5. #5

    Default Re: Help: Inadequate weight gain + constant nursing

    My first reaction is to wonder about milk transfer also. You mentioned an LC has checked your baby's latch... Could you contact her again and see if she can help you with weighing your baby before and after feedings to see how much milk she's actually getting?

    Whatever milk you can express, it makes sense to use that before turning to formula. It's extremely unlikely that there's anything wrong with it nutritionally. And pumping after feedings will help ensure that you don't see a drop in your supply because of supplementing.

  6. #6
    Join Date
    Apr 2011

    Default Re: Help: Inadequate weight gain + constant nursing

    my lo was gaining weight but slower than his dr was happy with. I felt a lot of pressure. my son nursed constantly. I decided i would use compressions and work to keep him awake for the first part of his nursing sessions ( he fell asleep very quickly which is natural). I also really kept an eye on the latch.

    I used these videos:


    I would get set up in our chair with supplies for the day, get him latched well, compress my breasts, switch back and forth between breasts constantly, repeat all day.

    A week after this "marathon" his weight increased significantly. I think we both needed to find a groove and he really needed some time. It helped me to put my whole self into it, think of nothing else! I nursed, peed, read the womanly art of breastfeeding, read this website. I immersed myself in breastfeeding. My dh took care of my older son, the cooking, everything other than the nursing. My older son didnt see me much and ate chicken nuggets every night. Even started getting himself ready for school (he's 8). My DH even slept on the couch so the baby and I had plenty of room in the bed to work it all out through the night too. It took all of us doing our part in different ways to help our baby get a good start.

    You can do it. Your baby is gaining and growing. Be committed and trust yourself. You are a strong mama.

  7. #7

    Default Re: Help: Inadequate weight gain + constant nursing

    Thanks for the encouragement. I read all these breastfeeding books and talk to moms and most people talk about nursing for 20 minutes at a time. And I'm like I wish. I love being with my baby, but sometimes I like to shower too. And it just makes me feel like there's something wrong nursing so long at a time...The doctor says it's not fair to the baby, it's too much work for the LO, to make her suck all day.

  8. #8

    Default Re: Help: Inadequate weight gain + constant nursing

    Thanks. I watched the Dr. Jack Newman videos too and found them really helpful. After your marathon week, what happened? What kind of feeding pattern did you establish? And how did you get your baby to stop nibbling and sleeping and spend more time sucking better? That's my real challenge. . .

  9. #9

    Default Re: Help: Inadequate weight gain + constant nursing

    Gollum?! Oh dear, that sound rather bad. No, our LO has not achieved Lord of the Rings status, thankfully, but she is skinny, even by breast milk fed baby growth charts. (Thanks for the Kellymom chart, that was really helpful, but she's still gained only 2.2 oz per week average since birth, which is not enough.) She is alert and playful, but I really think she does need to gain weight. I think she may have stopped gaining because of a skin infection she picked up at the hospital (details below) and after that cleared up her weight gain has been within the recommended range. But I do think there is a problem with milk transfer from my breast and part of the reason she's gained better in the last two weeks is because I've been pumping and giving her expressed milk by bottle. I'd really like to do two things: (1) help her catch up on her weight...she's only gained about a third of the "ideal" since birth; (2) improve the transfer of milk directly from my breast so she's getting fewer bottles and nursing more efficiently.

    What I'm trying to do now to get her weight up is give her a bottle of expressed milk after each feeding and then pump for the next feeding. I just nursed her for an hour and then was able to pump 90mL of milk, which makes me worry that she's not getting the milk out of my breasts efficiently. I thought babies were better than pumps!

    She was born a healthy 3.38 kg (7.4 pounds), 50 cm (19.7 in). She lost 4 percent of her body weight after birth, which she regained by day 10. But at our one month weigh in she was still at her birth weight. (Her length was 53cm). She had a skin infection (impetigo), for which she had to take antibiotics, around week 2 to 4, so maybe that's why her weight flatlined (?). By week six, her weight was 3.75kg (8.3 pounds) and her length 55 cm (21.7 in).

    Thanks again.

  10. #10

    Default Re: Help: Inadequate weight gain + constant nursing

    Thanks. Dr. Jack Newman was a great help. I'm pumping after every feed and giving that milk to her after the next feed to help her get her weight up. So far I've had enough milk to do this. (I'm using this new Calma teat from Medela, which is supposed to better mimic the breast. The milk doesn't come out unless the baby actually sucks. I think it's better than a normal teat, but still makes it way easier for the baby to get the milk . . .)
    I live in India and haven't found a lactation consultant with a high quality scale. But I'm going home to the states in a few weeks and will look for one there. Do you know how to locate a good lactation consultant?

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