Increase intake

[@llli*bens.mommy]

My little guy will be 3 weeks old on Wednesday. We've had all kinds of feeding issues with him...he wasn't gaining weight as much as the Pediatrician wanted so they had us put him on a schedule and do supplemental feeding. That didn't work out well, so I went back to how we 1st started and doing on demand feeding. Things have been much better since but his intake isn't very high. He's a slow sucker. We rented a scale from the hospital because of all the issues, we still have i so we check to see how much he gets from breastfeeding. I know they're supposed to get 1.5 to 2 ounces per feed. He rarely gets 1.5 ounces in 1 feed in an hours time. A couple times he has oversuceeded and got over 2 ounces. So he's all over the board. He never complains and is very content but we've supplemented a couple times after several low feedings and he inhales pumped milk in a bottle after breastfeeding for an hour. He's not a strong sucker and he takes forever to eat. Any suggestions on how he can increase his intake?

[@llli*phi]

As your son been checked for tongue tie? I really don't have first hand experience with tongue tie, but I understand that it can lead to poor milk transfer. Hopefully someone with more experience can tell you more about that.

You can also try breast compressions to help get more milk into him while he nurses. You can offer to nurse frequently, even if he isn't showing hunger cues. It's okay if he refuses, but you can always offer.

If he is having adequate diapers, then he is probably doing fine and may just need some time to get more efficient at the breast. Pediatricians sometimes have unrealistic expectations of what weight gain should look like.

[@llli*mommal]

I'm so glad you followed your instincts and took your baby off the schedule! Schedules feedings don't increase weight gain unless baby is so sleepy that he normally wakes to eat less frequently than the schedule.

Can you describe your baby's feeding frequency for us? How many times does he eatin a 24 hour period? Also, can you give us a complete weight history, and let us know if he has always been weighed nude, on the same scale? And can you tell us if he is sleepy at the breast- does he drift off after just a few minutes?

I am with the PP that a trip to the LC, preferably one who is an IBCLC, is a good idea. I'd want to have your little guy checked for tongue tie, and to have help with his latch and with positioning.

[@llli*kass.love]

If you must supplement, use an SNS. This way the supplement is given at the breast. My DD had the same issue and the SNS worked for us. She is still a little slow at eating nutshell sucks just fine now. Good luck!

[@llli*bens.mommy]

thanks ladies! Sorry, this is a long reply. It's been a long battle. I fear the future of breastfeeding my little guy...I'm trying to fight through it but I need to make sure he eats!

He's been checked for tongue-tied a couple times I'm pretty sure. We thought about triple checking though.

I have often done a warm wash cloth pre breastfeeding and have used a nipple shield when latching is really difficult for him.

Diapers have been good.

Yeah it's been a rollercoaster ride for his 1st 3 weeks. Here's the skinny....sorry it's a bit long....

He was born 4/25 (a Wednesday) weighing 7 pounds 12 ounces. He weighed 7 pounds 6 ounces on Friday when we left.

That next Monday we had my post-pardum check up and he weighed 7 pounds 8 ounces. At this visit the Lactation specialist told me to start limiting my feedings as my nipples were sore and baby would nurse anywhere from 15 minutes to over an hour. She said to do 20 minutes on each side...total of 40 minutes and call it a day...know that he's not hungry if he fusses more.

Wednesday afternoon our baby boy would not take to the nipple at all. He screamed and screamed. He was unconsolable. He ended up throwing himself into such a fit that he fell asleep. When he woke up he immediately started screaming again. We went to the Pediatricians office that evening and they weighed him and he weighed I think 7 pounds 8 ounces. They were a bit concerned about his weight gain and thinking that was why he was fussy. The on-call Pediatrician had me pump that night to see what my milk intake was like. Baby did fine that night and I pumped basically an ounce on each breast using a hand pump.

We had our already scheduled appointment the next morning (Thursday) with our normal Pediatrician. Baby had gained .5 ounces over night. Our Pediatrician looked at the whole picture and was a bit concerned of the lack of weight gain and also was trying to help us figure out why baby wasn't nursing well anymore...to rule out acid reflux or whatnot he told me to pump and add breastmilk to feedings to see how he'd do and see if he'd gain weight.

Baby was still struggling with nursing and not latching. On Friday I called the Lactation people again at the Hospital and they suggested getting a nipple shield. I picked one up and baby fed great with the nipple shield...for 2 feedings anyways. Then he fussed with that just like nursing.

Over the weekend he did pretty good. We were trying to feed him every 3-4 hours (having to wake him up, etc) and still adding pumped breastmilk to help get his weight up. We rented a scale from the hospital to see how much milk he was getting from me so we knew if and how much we needed to supplement his feedings with. We understand he needs 1.5 to 2 ounces of milk per feedings - we were trying to get him to eat about 3 oz if possible to help get his weight up (especially since our Pediatrician originally suggested we supplement with an additional 3-4 oz after nursing for a max of 10-15 min.). Our little guy is a very slow eater and not a very powerful sucker. Two times over the weekend we had to add a little formula to his feeding as he wasn't eating enough. Sunday and Monday were fine. Last night he went crazy for breastfeeding, which he hasn't done in a long time. He was struggling with latching and not eating as much as he has in the past. At 2 weeks old the lactation gal told us since the weight gain on Monday 5/7 (7 pounds 10 ounces) was good to slowly start weaning him off supplementing by doing it every other feed. So we did that for 24 hours.

Things were going fine but still not the same as in the beginning. So we decided to go back to on demand feeding. He did pretty good for several days. On this past Monday he weight 8 pounds. So it is some gain but only about a half an ounce a day and our Pediatrician would like to see more. He's giving us another week of feeding on demand to see how things go and then we'll talk about supplementing. However, we have been weighing our little guy before and after every feed (we still have the rented scale from the hospital) and over the past 2 days it's been tough getting him to eat even an ounce. So we had to supplement last night and today. He's a very calm kid and doesn't complain. He should be starving but he doesn't complain and he falls asleep all of the time during feedings.

I have no experience with La Leche league...so I'm just now trying this avenue after my other avenues I feel have let me down. We've missed the monthly meetings for this month in our area so hopefully I can make it next month. Any help here would be GREATLY appreciated.

[@llli*auderey]

bump

[@llli*phi]

It does sound like he is having a difficult time nursing. You should try to find an IBCLC. While I'm certain that some are wonderful, hospital LCs can be pretty incompetent (at least from my experience - and I was in an excellent hospital - but my nurse was far more helpful than any of the LCs that stopped by). There may be a legitimate reason for it, but the suggestion to limit time at the breast for such a young baby seems a little off to me.

You can have and ENT doctor check for tongue tie too. I tend to trust specialists over GPs when it comes to specific conditions.

Try breast compressions in the mean time to help your baby get extra milk without extra effort on his part.

I don't have much experience with this sort of thing myself, so I'm going to leave it at that. I'm sure some other mamas here will chime in if they have any additional ideas. Breast compressions will only help your situation, so there is no harm in trying. I really do think an IBCLC and/or ENT will be more qualified to identify any anatomical issues affecting nursing than the general pediatrics staff, and in your shoes I would find one before taking any other actions on this.

[@llli*allmykids]

Your situation sounds exactly like mine. You may want to find the post Persistence Pays that I started on May 8th...it described my situation which sounds very similar to yours. You may go see a pediatric ENT to have your daughter evaluated for a tongue tie (mine had a posterior tongue tie which wasnt readily apparent to all the LC's I looked at). The procedure was less than 5min, they clipped it. She cried briefly and was a little aggrated that day but that was it.

[@llli*auderey]

i've been mulling this too ... it sounds like he's not getting enough. but most little babies nurse for long periods of time - it's not abnormal for him to nurse for a whole hour, for example ...

i second the experience of the hospital lactation consultant being the least helpful person for nursing while i was there. get an IBCLC involved.

when you supplement, how are you doing that? maybe a SNS or lactaid would keep him at the breast better?

other mamas on here have made "double cream" bottles by skimming off the top of a settled bottle, and adding it to the ohter. since he's taking so little at a time anyway, this might be a really good thng for you to do for a week to try to get him back on track. then you can use the "skim" milk in baking, as a bottle when he's older and gaining well, etc.

[@llli*phi]

breast compressions info

breast compressions video