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Thread: Poor Weight Gain

  1. #1

    Default Poor Weight Gain

    This is probably going to be long.... Kudos to anyone who can stick with it!

    Okay... My daughter started out in the 13th percentile on the charts a week after she was born. I exclusively breast fed her for a month, and she wasn't gaining weight at a rate to suit the nurses in lactation, so they suggested I supplement... So I did. And then she gained enough to satisfy them, but then my supply dropped. Those same nurses in lactation then raked me over the coals for supplementing. So, I busted my butt with supplements and got my supply back and now my daughter is exclusively breastfed again.

    The problem is, if I don't supplement she doesn't gain enough weight to satisfy the pediatrician or the lactation nurses. But if I do supplement they jump on me for supplementing! The thing is, it's not a low supply issue, when I pump I typically get around 4-6 ounces per pumping session now. She has a pretty good latch most of the time, however sometimes she's lazy and doesn't want to latch properly. She never seems hungry after nursing, and spends anywhere from 5-10 minutes on each side. If I pump afterward I am lucky to maybe get a half an ounce. So I would guess she's draining me pretty good.

    I've noticed some issues that my pediatrician ignores when I bring up my concerns. My daughter spits up a lot... And when I say a lot, I'm talking a couple hours after a feeding, she's still spitting up. Sometimes, when she burps it sounds like spit up is coming up with it, but never does. Not sure if she's swallowing it or what. She gets the hiccups after nearly every feeding. After some feedings she will pull off and go into a full blown screaming fit, but won't re-latch or take a bottle....so I'm not sure if she's still hungry, gassy, or what?

    I'm concerned that maybe I don't make enough hind milk? Should I try and get her to nurse on one side per feeding to make sure she gets enough hind milk? I just don't know what to do, and why she isn't gaining weight like she should. She nurses/takes a bottle about 8 times a day. We're lucky to get her to take more than 2 oz of BM out of a bottle, too.

  2. #2
    Join Date
    May 2006
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    19,905

    Default Re: Poor Weight Gain

    Welcome and congratulations on making it this far, considering the negativity you've gotten from the docs and nurses. Would you consider giving us a full weight history on your little lady? That would help us figure out whether your baby's weight is likely to be problematic on not. So, birth weight, weight at 2 weeks, weight at 1 month, etc.

    Based on what you've posted, it sounds like you have a lot going for you. You're pumping a very large amount when you do pump. Your baby is happy to eat and does't seem fussy after eating. And you don't have to worry that you "don't make enough hind milk" because there's really no such thing as hindmilk and foremilk. You just make milk. At the beginning of a feeding, the mi is relatively low and fat, high in lactose, and refreshing. As the feeding progresses and the breast empties out, the milk gradually becomes higher in fat. But there's no abrupt switch from low-fat to high-fat milk. It's a gradual change. If your baby empties the breast well and mostly has yellow poops, then she's getting plenty of fat.

    Some more questions for you:
    - How often does the baby feed in a 24 hour period?
    - What color are her diapers, in general?
    - Has she ever been checked for reflux? http://kellymom.com/babyconcerns/reflux.html
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3

    Default Re: Poor Weight Gain

    Birth weight was 7 lbs 5 oz... Dropped to 6 lb 11 oz before we left the hospital. I'm not sure what she was at 2 weeks... But at 1 month she was around 8 lbs 6 oz... And then at the 2 month appt she was 9 lbs 5 oz. At her 4 month appt she was 11 lbs 5 oz, at a weight check two weeks after that she was only up to like 11 lbs 9 oz.

    In a 24 hour period she typically eats around 4 AM, 6 AM, 9 AM, 12 PM, 3 PM, 5 PM, 7 PM, 9 PM, 11 PM, and usually sleeps till 4 AM, otherwise she wakes up around 2 AM. She typically goes 3 hours between feedings, sometimes it's only 2 hours between them if she's having trouble focusing and is too interested in things going on around her.

    She has plenty of wet diapers, and then when she does have a dirty diaper it's usually a yellow/brownish color, never really solid or thick though.

    I really suspect she has reflux, but her former pediatrician wouldn't check for it for some reason. When I brought up my concerns she seemed to ignore me... Instead she wanted us to go do an echocardiagram...which came back normal. And then instead of investigating the excessive spit up issue, she gave me milk fortifier to put in her BM bottles... I just don't see how that's going to help if she keeps spitting up a lot!

    Thanks for the help!

  4. #4

    Default Re: Poor Weight Gain

    Check out refluxrebels.com. There is a quiz that might help see if your LO has classic symptoms of reflux or silent reflux

  5. #5
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    May 2006
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    Default Re: Poor Weight Gain

    Thanks for psting the weight history! It's good to see that your LO is consistently gaining weight, albeit at a somewhat slow rate. It could just be that your LO is destined to be a smaller person, and is therefore a smaller baby. But I think it makes sense to really investigate reflux- with the frequent spit-up and slow gain it seems like a strong possibility.

    One thing that can really help with weight gain is to feed the baby more often. If your baby typically eats every 3 hours or so, that's on the lower end for feeding frequency. So trying to offer a little more than baby seems interested could really boost her weight, if her issue is just that she's a polite little lady who prefers not to kick up a ruckus, or a baby who just has more interesting things to do than eat.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  6. #6

    Default Re: Poor Weight Gain

    I really think it's reflux. Which really upsets me that my pediatrician wanted to run an echo and give her vials of milk fortifier instead of investigating the reflux issue. =( I've attempted to feed her more often, offering every two hours, but she turns away and gets mad (also a sign of reflux from what I understand). And then there are times where I try to offer her and she just turns away and refuses. It's like she's just not hungry. I think she's just a petite little thing. I was that way, as was my husband. Hopefully, we'll get more answers come Nov. 30 when we have an appt with the new pediatrician.

    I guess my biggest concern was that it had to do with my milk. Obviously I don't have a supply issue, but I wasn't sure if maybe I somehow produced the equivalent of skim milk rather than whole milk.

  7. #7
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    May 2006
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    Default Re: Poor Weight Gain

    Quote Originally Posted by @llli*kymbirleigh View Post
    I guess my biggest concern was that it had to do with my milk. Obviously I don't have a supply issue, but I wasn't sure if maybe I somehow produced the equivalent of skim milk rather than whole milk.
    I can totally understand your concern. I think the whole idea of foremilk and hindmilk makes a lot of moms worry- if their baby isn't gaining weight at the "right" pace, it's logical to surmise that perhaps you somehow only make one type of milk. Skinny baby? Maybe you only make foremilk. Fat baby? Maybe you only make hindmilk. It's too bad because foremilk and hindmilk can be useful terms, as long as moms understand that they have to think of the two as intermixed. You can't make only low fat or only high fat milk. So, really, don't worry about this part of the puzzle! And please let us know how things go with the new pediatrician.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  8. #8

    Default Re: Poor Weight Gain

    Thanks! Appointment is November 30! Last night was rough, I'm considering cutting back on the milk fortifier that the former pediatrician asked us to use, because I don't think it's helping DD's digestive issues! Last night she was a screaming mess, and she hasn't done that since before we started her on this! This pediatrician is becoming more harm than help, thank God we are switching.

    Also, I managed to get my hands on a scale that I'll hopefully be able to keep track of how much she's taking in after feedings. Here's to hoping over the next couple of weeks things improve!

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