Baby not eating when breastfeed

[@llli*anapaula]

Hello everybody, I have just joined this forum that i have found very interesting and I am writing because I am desperately looking for help.
My baby has just turned 1 month yesterday and when i tought we were doing well on breastfeeding I realised she wasnt gaining any weight. I will shortly describe the situation.

Since the hospital I had problems with breastfeeding, she just couldnt leach and cried a lot, i tried different possitions and a nipple shield because i have flat nipples. After days of frustration i began pumping my milk and giving her bottles after hours of trying to breastfeed. After a very frustrating day, i just gave up and gave her bottles with my milk, days later she just began breastfeeding and it seemed like improved everyday. Then she would fall asleep after sucking 2 times and it took for ever to feed her. After couple days she began to cry a lot and couldnt let her down, she was calm only in my arms. Then i realised she was loosing weight and discovered that after 2 or 4 hrs at the breast she would get 50 grs or nothing.
I am back to pumping and bottles, have less milk and have to give her formula, i am trying to get my milk supply back by pumping, and i would really love to be able to breastfeed but dont know how to do it, now she just doesnt get the breast and cries when i try to breastfeed.
hope you can guide me, thanks a lot

[@llli*krystine]

I'm sorry for the troubles you're having! It is not too late for things to turn around and for things to work out, I don't want you to give up hope.

Will she latch on now? Do you have a scale you are weighing her before and after nursing so you know how much she's getting? 50 ccs is not nothing, it's not a huge feeding but it's not nothing.

What kind of pump are you using? How often are you pumping?

We will all try our best to give you good advice, I know it's a lot of work, but I do believe it's worth it. Hang in there.

[@llli*maddieb]

Your situation could have been caused by many factors-It would take to long to list all the possibilities. Also I am not sure that your situation is all that dire, from a milk supply standpoint, it’s difficult to tell after the fact what was happening there. But typically, milk supply issues are not organic but rather are caused by issues that occur after baby is born-baby not nursing effectively, baby not nursing frequently enough, the use of pacifiers, supplementing (especially if mom is not pumping as well to make up for the supplementing) and the use of a nipple shield without pumping as well, because shields, while a very useful tool if that is the only way baby can latch, can at times cause milk supply issues and moms are typically cautioned to pump as well when using them.

The good news is low supply is very often reversible, and certainly even if you had to keep supplementing there are ways to do so while also nursing baby.

IN such situations you have to do three things: 1) make sure baby is being fed (you are already doing that, but you might want to consider feeding baby in a more breastfeeding supportive way than bottles if possible) 2) Encourage baby back to the breast and 3) Increase your milk supply.

It would be really great if you could find local breastfeeding support to talk over your situation and help you monitor your progress. You could hire a lactation consultant or contact your local LLL or other breastfeeding support group.

Here is a good article on encouraging baby back to the breast: http://www.kellymom.com/bf/concerns/...to-breast.html

And here is a good one on low supply: http://www.kellymom.com/bf/supply/low-supply.html

Pumping log (for when baby is not nursing at all): http://www.llli.org/docs/00000000000...umpigchart.pdf

Feeding the non-latching baby: http://www.llli.org/docs/00000000000...ching_baby.pdf

When supplementing, you could consider a lacation aid like the Medela sns or the Lact-Aid, or cup feeding, or at least, bottle feeding in a more breastfeeding supportive way. See videos on this page for tips on cup feeding and using a lactation aid: http://www.nbci.ca/index.php?option=...id=6&Itemid=13

And here for bottle feeding tips: http://www.llli.org/docs/00000000000...astfedbaby.pdf

[@llli*anapaula]

Thanks a lot for your answers you give me some hope back. I believe milk supply is increasing now, i am pumping every 3 or 4 hours and sometimes I even get 3.5 oz. I wasnt trying to nurse these days until today, and it is a bit frustrating the only way i can do it is with a shield, but she wont stay more than 2 mins then cry and fall asleep, i dont know if it is best to try when she is really hungry or before, but i will keep trying. I have been to support groups but they just tell me to keep trying, I will check the links you sent me and keep me updated.
By the way i got a digital scale, and also took her to the pediatrician and she has gained 300 grs since thursday.
thanks a lot for this forum and for your support

[@llli*anapaula]

hello gain, today while trying i realised that the problem could be that my babe doesnt open her mouth wide enough to latch properly, also the slow milk supply compared to bottle frustrates her, can these be the issues?

[@llli*maddieb]

hello gain, today while trying i realised that the problem could be that my babe doesnt open her mouth wide enough to latch properly, also the slow milk supply compared to bottle frustrates her, can these be the issues?

Yes of course. This is why using an alternative to bottles as I suggested above, or at the very least, paced bottle feeding, if you need to supplement, may help. Bottles can cause latch issues, and also "flow confusion." Of course, the best thing would be to eliminate supplementing at all if possible and just nurse at the breast, remember that that is what you are working towards.

Are you trying the ideas for encouraging nursing in this article? http://www.kellymom.com/bf/concerns/...to-breast.html

You do not want to try to starve baby into nursing. A frantic baby has a very difficult time latching. Offer the breast when baby is calm and content as much as possible. Offer at baby’s earliest cues or just whenever you like, comfort nursing often comes first and that is fine. If baby is already fussy, offer a small amount of expressed milk or formula-maybe an ounce?- to take the edge off, and then offer the breast. Also you could try offering the breast after every supplemental feeding. It's a hard balance, because if you offer the breast only when baby is totally tanked up, it is unlikely baby will nurse much. Overfeeding with a bottle will cause baby to be overly sleepy. This is another reason bottle alternatives are helpful IF you need to supplement.

Here is info on feeding cues: http://www.llli.org/docs/00000000000...eding_cues.pdf

For latch, try the ideas here, especially breast sandwich technique- http://www.lowmilksupply.org/latching.shtml

or laid back positioning or any different positioning that helps: http://www.llli.org/docs/00000000000...astfeeding.pdf and http://www.biologicalnurturing.com/

btw, above you said you can pump 3 ounces or more. That is a very good sign re: milk supply.

[@llli*anapaula]

Hello again, I wanted to thank you for all your good advice and give you an update on our situation, i didn´t try to nurse for a couple days, until last thursday when i decided to dedicate the whole day to it, we got some few moments of latching when she would eat 30, 40 0r 50 grams ( i got a scale and i am weighting her before and after feeds). After I always gave her a bottle with my milk.
It went like that, where sometimes she wouldnt take the breast, others she would take it for a few minutes and others longer. Saturday, she finally stayed latched for almost 30 min and ate around 90 grs, then we tried with the other breast and she did great, at the end she had eaten 130 grs. She was happy and awake, a while after she seemed to be hungry bbut I waited a bit to offer her again, because then i dont really know how many times a day she eats, it just seem a long feed. She slept around 4 hours and when we tried again we didnt succeed much, she would latch and suck but get 10 grs. We stayed trying for 3 houirs and at the end I expressed some milk and gave her a bottle.
Today I feel we have gone back to the beginning, she cries, then takes the breast sucks for a bit and falls a sleep, then wakes up crying and the same thing goes on and on..I am afraid of doing the same mistake i did before that once she latched i stoped giving her bottles and she lost weight. Today she hastn been happy awake much, she is either sleeping or crying, On our last attempt she latched for 15 min eating only 40 grs, then i expressed my milk and gave her another 70 grs. She is more awake but suddenly cries, dont know if it is hunger or stomachache. I really dont know how to go on, and for how long should I try each time or if i shouldnt give her any bottles and just offer the breast anytime she cries. thanks again for your help

[@llli*maddieb]

Hi, sorry but- I am not used to measuring in grams and not sure how to figure that out. So keep that in mind as you read my reply.

How is baby’s overall weight gain? what is output daily-Pees, poops? And how old is baby again- five weeks now?

OK, so from what I can understand, it sounds like your baby is capable of latching and nursing pretty well. So I don’t know that bottles/supplementing continue to be necessary. I think the issue at this point may be primarily that you have lost confidence (typical in such situations) and also baby is experiencing some nipple/flow confusion from the bottles, making nursing more difficult. The cure for both of these would be to nurse frequently and avoid bottles unless they become truly necessary. I also think the frequent before/after nursing weight checks can become counterproductive at a certain point, if they undermine a mom's confidence. You can tell if a baby is getting enough from output.

A baby is normally NOT going to nurse the same length of time each time, not go the same amount of time between each session, and the amount of milk a baby takes in each time will vary as well. So all that sounds normal.

For more I need weight history again-not how much baby takes in each time he nurses, but weight gain overall. In ounces, if possible. (Sorry) Also, what is the average baby takes in per session when you do before after weight checks?

[@llli*anapaula]

Good day, thanks again for your reply. Yes you are right I have lost confidence, and after that week when i decide not to give her any bottles that she cried a lot and lost weight, I am very worried to do it again.

She was born 11 feb, so she is now 5 weeks. when i pump my milk and she takes almost 2 oz, equals 50 grs on the scale more or less. The pediatrician told me she should eat at least 4.5 oz 6 times a day.

About latching, sometines she latches and i hear she is swalloing, others she is sucking but it doesnt seem she is getting anything in. From what I have read and what i see, it seem her mouth is not open enough, i dont see her lips folded out, instead it seem as if she was biting with her lips, specially the lower one is always inwards. It works better when i pump for a bit before offering her the breast.

The problem, when i use bottles or formula, is when whe arrive to the point where she is either crying or sleeping, but not a relaxed sleep, she just falls asleep as soon as she sees the breast,but she doesnt seem relaxed, she is tense and breathing really fast, then as soon as i put her down she starts crying and seems really hungry all red, desperate and sucking her hand, i hold her, and the same story goes on an on, then i feel she hasnt eaten the whole day, that is to weak for nursing, I get al stressed and frustrated and bottles come in.

Another thing that worries me, is not knowing how many times a day she eats, if it turns to be 1 day long feeding. I dont mind nursing anytime she wants it, it is just frustrating wwhen she doesnt eat and she is not happy.

For what I have seen, when she is not hungry she sleeps relaxed or she can be happy awake, altert and moving a lot even if she is alone in her crib.

As for diapers, she does wet more than six a day, as for poo it is one a day, it seems ok is yellow. Sometimes the diaper is really full, others is just stained yellow but seems poo was liquid.

Here is her weight history:
born 2990 kgs - 105.469146 o
left hospital 2690- 94.8869576 ounces
29 feb 3190
7 march i didnt go to the mums group, and i weighted her with the pediatrician her weight was 3,090 - 112.523939 ounces(there i tought it was a difference between scales, but i believe she had lost weight, because she was only nursing with nipple shield, and she just didnt seem right) here is when i began giving her formula, because the pediatrician told me her weight gain wasnt right, from march 8 to march 13 she gained almost 300 grs.
14 march 124 517.086 ounces, here using formula to complement my milk supply.

Hope this gives you a better idea, what i was thinking to do but no tknow if it is a good idea is after nursing, express my milk and always offer it to her, just to be sure she is ok. By the way these days i havent used much formula, since my milk supply seems to be enough
thanks, have a nice day

[@llli*maddieb]

She was born 11 feb, so she is now 5 weeks. when i pump my milk and she takes almost 2 oz, equals 50 grs on the scale more or less. The pediatrician told me she should eat at least 4.5 oz 6 times a day.

This is incorrect. So- 6 X 4.5 = 27 ounces. This is about the average a baby needs in a day-the average is actually 25 ounces I think-some take less, some more. BUT-A baby at this age would typically nurse a minimum of 10 times per day. So a baby nursing 10 X a day would only need to take in about 2.5 ounces per day to = 27 ounces per day total milk, and if the baby nursed MORE frequently (as many do) then amount per nursing session would be less and still be fine.

I know that after 2 weeks of age, lactation consultants want to see intake of an average of 2 ounces (at least) when doing before/after nursing weigh-ins.

About latching, sometines she latches and i hear she is swalloing, others she is sucking but it doesnt seem she is getting anything in. From what I have read and what i see, it seem her mouth is not open enough, i dont see her lips folded out, instead it seem as if she was biting with her lips, specially the lower one is always inwards. It works better when i pump for a bit before offering her the breast.

Well, it would be nice to hear some swallowing, but that can be very subtle. Sometiems its more something you see rather than hear. As far as how latch looks, if it does not hurt you it is probably fine. Not all baby's do that perfect flanged lip thingy. Not all babies make a nice 'gape' when latching. Some babies can even nipple nurse and do fine, unless it hurts mom.

Everything else you describe is normal for a baby who is exp. nipple confusion. You baby needs to nurse frequently at the breast in order to learn to nurse at the breast.

I am not saying do not supplement, that is up to you, you never want to allow baby to get weak with hunger! But meanwhile, maybe try to nurse MORE OFTEN. And if/when you do supplement, maybe try to have baby begin and finish feedings at the breast, or at least, finish at the breast. Resist the urge to top off with a bottle, top off at the breast instead.

How long are you going between feedings? Too long will surely make baby frantic and desperate. 6 feedings a day is entirely too few at this age. Nurse every two hours or MORE frequently if baby cues. (You can take a longer stretch at night if baby has been nursing well the rest of the day) Even if baby cues 15 minutes after a nursing session, that is NORMAL. Just nurse again.

Poops can naturally begin to become less frequent at about this age, so that is no longer going to be the best indicator. (unless there is lots of poop, which would be reassuring.) Look at wets and overall weight gain. If weight is now good, maybe weigh baby once a week? Daily weights can normally fluctuates. You want to see an overall weight gain of *about* an ounce a day at this point.

Is there any way you can see a lacation consultant? It would be really great if you can get hands on help weaning off the supplements and, if neccesary, working on latch.

Feeding cues: Try to offer the breast at the earliest cues! http://www.llli.org/docs/00000000000...eding_cues.pdf