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Thread: slow weight gain and many other questions...

  1. #1
    Join Date
    Feb 2006
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    Question slow weight gain and many other questions...

    I am new here and need som advice...
    My ds is 11 weeks old and has been gaining weight very slowly. He was 8.8 at birth and got down to 8.4 a week after birth. Since then he has been gaining two and a half ounces a week typically. I went on Domperidone for possible supply issues a month ago and he began to gain a bit more.At 8 weeks he was 9.13, nine weeks 10.2. He was 10.6 at 10 weeks and 10.6 agian this week.
    He is a bit stuffed up and has not been sleeping as well as he had been. By well I mean more than 20 minutes. Lately he has been eating every 1-1.5 hours and at times comes off the breast crying and upset. He scratches his face and head like he is in pain. I know the domperidone has increased the speed of my let downs which has been giving him gas so I have been using ovol to help him in that area. He also chews on his hand like crazy or on my finger knuckles...could he be teething? My dd did not get one tooth until 11 months.
    My dd (2 and a half years old) had a stomache bug that I think ds may have a bit of since his poops have changed from yellow and mild smelling to brown, watery, and stinky. He is still having plenty of wet dipes but all his poops are this yucky brown stuff.
    So...any ideas? I hate going in to the breastfeeding group to weigh him when all these chubby babies his age are there. The other mom's always look at me pitifully and say, "So, is he gaining? He is so tiny." I also dread his three month appt.
    Is there a bf baby weight chart out there?
    Denise

  2. #2
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    Jan 2006
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    Default Re: slow weight gain and many other questions...

    Hi Denise,
    I'm sorry you are having such struggles with your little nursling. I need to ask you a few questions in order to gain a better insight of the issues you are dealing with, so please bear with me

    When baby is weighed, is it on the exact same scale at the same time of day? Are you sure that the scale hasn't been calibrated since his last weight check? And is baby always dressed the same during his weight checks? If not then the weight checks cannot be considered accurate, unfortunately.

    From week 8 to 9, you baby gained 5 ounces which is right within the range of average (average being 4-7 ounces per week for a baby 0-4 months old). But he hasn't gained anything from last week to this week so I'm wondering if that's just a scale issue, as mentioned above.

    The stuffy nose, chewing on his hands and the possible tummy bug could be impacting how he's nursing as well as his weight gain. It wouldn't be unheard of for an 11 week old to start teething. Just as an example, my oldest son didn't get a tooth in his head until he was 12 months old. My 2nd one got his two bottom teeth at 7 months and my 3rd baby got her two bottom teeth at 5 months. So, there's a really wide range of what's normal when it comes to teething.

    Now, regarding his slow weight gain -- some babies simply gain less than the average just like some babies gain more than the average. Are you and/or dh small people? Did you breastfeed your daughter? If so, how did she gain? Try to consider the effect of genetics on baby's growth patterns. And it's always a good idea to look at the baby, not the scale.

    That said, how often is baby nursing? If he's gaining slowly and not nursing every 2-3 hours around the clock then you may want to consider offering more often. The more stimulation your breasts get the more milk you'll make. Plus if he's got a virus, the breastmilk will help him through it.

    What does baby's doctor say about his slow weight gain?

  3. #3
    Join Date
    Feb 2006
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    14

    Default Re: slow weight gain and many other questions...

    Thanks for your response- DS is always weighed on the same scale which is routinely calibrated since it is only used for a breastfeeding mothers support group. He is always weighed naked.( I zero out his cloth dipes) My dh is 6'5 and 200 lbs and I am 5'9. So I expect that my kids will be tall. BOth were over 22 inches at birth. My dd is two and a half and is 38 inches , 30 lbs. So I know that ds comes by his length naturally and his slender build but it is his nursing behaviour that concerns me. I would be fine with him gaining two ounces a week consistently if he was happy and content, sleeping well. But hi is NOT content or sleeping well. My doctor is less likely to pursue excleusive bf and will most likely at his three month appt. try to pusuade me to supplement.
    I did not bf successfully with my dd due to a severe tongue tie and a traumatic cesarean birth. My milk supply was very low and she was still not her birth weight at 11 weeks. We supplemented up until I stopped nursing with the SNS at 7 months. She continued to comfort nurse while being bottle fed up until 10 months.
    So, I think I am afraid that he is not getting enough calories. He nurses constantly. A short 40 minute nap in the am after nursing every hour through the night. And during the day he will only sleep if he is in the sling-which I can't nurse in. ( didymos )
    I honestly thought that a better birth experience would make all the difference this time.
    Denise

  4. #4
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    Jan 2006
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    683

    Default Re: slow weight gain and many other questions...

    Denise,
    I understand that you are struggling to figure out what is going on with your baby and that this is a tough situation for you. Let's talk more about what's going on and see if we can come up with some suggestions.

    Some babies just aren't very good sleepers and some babies will spend all day at the breast. Neither are indications that baby isn't getting enough. The only true indication of a milk supply issue in mom is if baby doesn't gain weight.

    It's a good idea to take a look at the big picture. In your baby's 11 weeks of life, he's gained 2.2 lbs. which equates to an average weight gain of about 3 ounces per week. This is slightly below average but it's been consistent.

    Do you feel as though baby has a good latch so that when he is nursing, he's nursing effectively? Can you hear him swallowing after every suck or every other suck? Do you notice baby taking in long, drawn out gulps for part of the nursing session (this would be when your milk let's down) or can you feel your milk letting down? You mentioned that he nurses constantly -- can you be more specific? Is he nursing every 15 minutes or every 3 hours? Does he nurse on both breasts per feeding? Baby doesn't get pacifiers, does he?

    You may want to try doing breast compressions while baby is nursing if you notice that his sucks are shorter (meaning he's not actively "drinking") in order to encourage him to take more milk in.

    Is your baby alert and active? Is he meeting his developmental milestones? How is is muscle tone and skin elasticity? You mentioned that his weight gains have been consistent and continuous albeit lower than average -- some babies simply gain less than average, as we already discussed.

    How many wet diapers per day is baby having? He should be having at least 6 wet cloth diapers per day. How many bowel movements per day is he having? Once a baby hits the 6 week mark, bowel movements may become less frequent. However, in a baby who's gaining poorly, fewer than 3-4 bowel movements per day can indicate that baby isn't receiving enough milk.

    I'm really wondering if your baby may not be sucking effectively. You may want to try using the SNS too and supplement with expressed breastmilk (it has more fat & calories than formula).

    Are you working with a IBCLC? If not, I would highly encourage you to do so. She'll be able to assess baby's latch better than any of us here can.

    I'll wait for your response and hopefully have some more ideas for you then

  5. #5
    Join Date
    Feb 2006
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    14

    Default Re: slow weight gain and many other questions...

    Carol, Thank you for your prompt responses. YOu are right I would love to figure out if this is even an issue or not or if he is just a slow gainer and a fussy baby.
    You wrote that he should have 3-4 bowel movements a day right now well he definetely DOES NOT . He has one or two every few days but there is quite a bit then. This has changed since about 7 weeks when he had a bm after ever feed. He is in cloth dipes so I know they are fairly wet when I change him 6-8 times a day.
    I don't feel my let down but I do hear a time in the feeding when he swallows with every suck...almost to the point that he can't keep up. This lasts for less than a minute but may happen up to three times. His latch is not painful when he is aactually drinking but it gets painful when he wants to non-nutritive suck for hours on end.
    He eats every 45 min -60 minutes in the late after noon, and almost constantly in the evening. (Cluster feeding) But I would then assume he is getting ready for a big sleep but he doesn't. He eats at the allnight buffet all night. He sleeps best in the early morning, or if we go out and he is in the car seat.
    Breast compreesssions havent' seemed to do much but I will continue to do them. I am seeing an IBCLC ( over the phone) and she only works two days a week and is VERY hard to get a hold of.
    No pacifiers here...he does suck his thumb though in the carseat only. He feeds from the right side better than the left so often he only needs that side in a feeding. If I start on the left he often still needs to have more and feeds on the right for awhile. I use the left as a pacifier to try and increase the supply in that breast...if it seems like the nursing session is going to be a marathon I put him on the left.
    He is alert and active...rarely sleeps in the day time and is smiling...cooing...etc. Everyone just comments on how tiny he looks.
    I have an SNS but have only 5 ounces of pumped milk. I have NO time to pump with the way he eats and a two year old at home. IT took me two weeks to get that 5 ounces. It is like gold in the freezer. I used a hospital grade rental pump to get that 5 ounces but have since had to return the pump. I hoped the domperidone would increase my supply and make it so I coudl pump more or at least have time to pump more but no.
    Any ideas are appreciated. Thanks again.
    Denise

  6. #6
    Join Date
    Jan 2006
    Location
    Charleston SC
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    Default Re: slow weight gain and many other questions...

    Silver, I am sorry that you are having so many troubles I am a bit confused, is he not thriving or just a fussy, frequent nursing, small baby? I ask bc I have one of those too Just now at 9 months he is 16lbs 14ounces. He was also a frequent nurser and a fussy baby, seemed to be very "high need" The book, The Happiest Baby On The Block, By Dr. Karp really seemed to help us. Def could be teeth, allergies? Or just high need like my son, the good news at 9 months he is very much the perfect angel, minus sleeping through the night, which is ok bc he is so little that he needs to eat anyway LOL Blessings! Brittan

  7. #7
    Join Date
    Jan 2006
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    683

    Default Re: slow weight gain and many other questions...

    You wrote that he should have 3-4 bowel movements a day right now well he definetely DOES NOT . He has one or two every few days but there is quite a bit then. This has changed since about 7 weeks when he had a bm after ever feed. He is in cloth dipes so I know they are fairly wet when I change him 6-8 times a day.
    Since baby was having very frequent bowel movements up until around 7 weeks of age then his having infrequent bowel movements now (at 11 weeks) does not concern me. Like I mentioned, at about the 6 week mark breastfed babies often start having bm's more infrequently. Also, he's having 6-8 wet diapers per day so this is encouraging.

    I don't feel my let down but I do hear a time in the feeding when he swallows with every suck...almost to the point that he can't keep up. This lasts for less than a minute but may happen up to three times.
    This is great!

    He eats every 45 min -60 minutes in the late after noon, and almost constantly in the evening. (Cluster feeding) But I would then assume he is getting ready for a big sleep but he doesn't. He eats at the allnight buffet all night.
    Most babies will cluster feed in the late afternoon and/or evening. For some, it can help them "tank up" to go a bit longer between feedings. But for a lot of babies (including all 3 of mine!), it means nothing more than that they're simply cluster feeding. Also, keep in mind that some babies simply have a higher sucking need than others. It sounds like your baby has a very high need to suck!

    I hoped the domperidone would increase my supply and make it so I coudl pump more or at least have time to pump more but no.
    Keep in mind that something like Domperidone is really only effective if it's coupled with frequent pumping or nursing. Since your baby nurses almost non-stop, there's no reason to pump. It very well could be that your supply is just fine. Also, Domperidone doesn't work for everyone Perhaps you might want to explore different galactogogues?

    Have you tried getting a different sling and learning to nurse in it?

    I think that you probably need to track baby's weight weekly for a few more weeks. He sounds like he's thriving and doing great. One more question for you -- how is he growing in length and head circumference?

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