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Thread: Baby lost weight again...now what?

  1. #1
    Join Date
    Oct 2006
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    627

    Default Baby lost weight again...now what?

    A little background. DD was born at 8#7oz. 6 days later she had gotten herself down to 6#12oz on the same scale, ended up severely dehydrated and in the hospital. We were nursing every 2 hours, she appeared to be eating and everything, but obviously wasn't getting enough. She came home from the hospital at 11 days old with formula supplements. 2 weeks later we were down to 6-7 oz of formula a day and she had gained back up to 9#7oz. Well, today, 2 weeks after that, I had weaned her off supplements totally. She's now 6 weeks old. She was eating 8-10 times a day. She had 5-7 wet diapers a day. I can't always hear her gulping and swallowing, but I can see her little jaw working and see pauses. I took her to the doctor's today for a weight check and DD is down to 8# 15oz. So, in the last two weeks she lost 8 oz. The doctor wants me to supplement with formula every other feeding. I did pump about 2 oz out yesterday and then another 1 1/2 oz today so I'm planning on giving her that as one of the supplements. The problem is, pumping makes my nipples sore, even with a hospital grade pump, not for future pumpings, but for nursing.

    I'm wondering. Since at the last doctor's visit, I was supplementing with 6-7 oz of formula and she was gaining, if I should go back to giving her this much or if I should go to every other feeding, which is more like 12 oz of formula. I've started taking Fenugreek again, just in case it's a supply issue, which I doubt since I could pump out an ounce and a half in place of one feeding. My guess is DD has an inefficient suck. We are still using the nipple shields because she will not latch on without them. Unfortunately, the lactation consultant I spoke with at the hospital will only see patients in the hospital. She does not do outpatient consultations. The nearest LLL is 45 minutes away, but I am going to try to at least talk with them.

    OH, yeah, at first the doctor said that my breastmilk probably didn't have enough calories. Like she can tell that by magic? She did then say that maybe the baby was getting just enough to fill her up but not enough to grow. She said the baby should have 8-10 wet diapers a day. Is that right? She doesn't seem to know a whole lot about breastfeeding, and doesn't seem to advocate it unless it goes problem free because she offers me no advice on how to fix the breastfeeding issues. She just says I need to supplement.

    Anyways, I'm really frustrated and sad. The whole thing just makes me cry. I feel like I'm getting fired from my "job." Part of me wants to throw up my hands and give DD formula, because then she will gain weight without any trouble. But part of me is feeling injured because I really want to be able to nurse my baby and it's just not working.

  2. #2
    Join Date
    Aug 2006
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    1,987

    Default Re: Baby lost weight again...now what?

    What a difficult situation! Kudos to you for sticking with it and seaching out the answers that aren't easily accessible from your healthcare system.

    Are you feeding her on one breast or both during a feeding? I'm certainly no expert on this, but I wonder if getting her more fat rich hindmilk during a feeding might help.

  3. #3
    Join Date
    Nov 2006
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    6,959

    Default Re: Baby lost weight again...now what?

    What color are the poops? I hear that the greener ones mean that the baby is getting the fore-milk, and the yellow ones mean the baby is accessing the hind-milk...

  4. #4
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    Oct 2006
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    627

    Default Re: Baby lost weight again...now what?

    a yellowish brown poop.

  5. #5
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    Sep 2006
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    562

    Default Re: Baby lost weight again...now what?

    Goodness, what a rollercoaster you have been on! No wonder you are upset and worried. It can be VERY stressful when breastfeeding isn't working quite right, especially if your baby's weight gain is affected.

    The good news is that it is almost certainly possible to continue breastfeeding, and more than that, it is also quite possible that whatever is causing the problem with your daughter's weight gain can be corrected, if you can just get access to the appropriate resources and information.

    The other piece of good news is that, with supplemental feeds, your daughter gained weight well. That is actually a good sign, not a bad sign. Every once in a great while, a baby may have an underlying health problem that prevents good weight gain no matter how many calories she is getting. Since your baby grows when she gets more food in her tummy, then chances are she is perfectly healthy and just needs some more time and practice to get the hang of nursing well enough to sustain herself.

    Since she has actually lost 8 ounces in the past two weeks, I think that indicates that she has been pretty seriously short on calories and needs to do some catching up ASAP. So, for now, you probably should supplement as directed (every other feeding), get her weight gain back on track, and then you can work again on gradually reducing the amount of supplemental feeds. If a weak suck is the problem, just growing and getting stronger and more coordinated may help a lot. This is why rule #1 is always "Feed the baby!" by whatever means necessary.

    You mentioned that pumping makes your nipples sore when you nurse. What kind of sore? Do the nipples look raw or irritated? Some mothers find that lubricating the pump flanges with a bit of olive oil can make pumping more comfortable. Or you might try adjusting the suction DOWN, so that the pump works less vigorously on your breasts.

    And this brings us to the heart of the problem you face: your baby needs more food to grow, so of course you will give her supplemental feeds as necessary. But the conundrum is that every ounce of supplement she drinks sends your body the signal to make less milk for future feedings. By six weeks postpartum, your milk supply is completely demand-driven -- your breasts are only going to make as much milk as required, by either a baby or a pump.

    If you are going to have any hope of returning to exclusive breastfeeding some time in the future, you are going to have to figure out a way to pump frequently, preferably with a heavy-duty rental-type double-electric pump. If you are giving a supplement after every other feeding, then that means you need to pump after every other feeding. Of course, whatever milk you can express can be given as supplemental feeds, so that over time, as your pumping output increases, your EBM may replace the formula altogether. This approach will protect your milk supply, ensuring that when your baby does get better at nursing effectively, the milk she needs will be available straight from the source.

    The other issue that we need to look at is how you are giving her supplements, and if it is with a bottle, then how that might affect her suck. But I don't want to overwhelm you with a novel-length post, so let's set that matter aside for the time being.

    I strongly encourage you to find a local source of in-person skilled lactation support. If you can't work with the hospital lactation consultant, check out http://gotwww.net/ilca/ to see if there are other IBCLC-credentialed lactation consultants in your area, either in private practice or in a clinic that does outpatient work. There are ways to evaluate your daughter's suck strength and coordination that are not really feasible over the internet. Some IBCLCs also do pre- and post-feed weighs, to estimate how much milk a baby is actually taking in -- or one might be able to send you home with the right kind of super-sensitive rental scale so you can do your own pre- and post-feed weighs (several measurements will give you a more reliable picture than just one done in a clinic visit, for example). A LLL Leader might also offer wonderful in-person support and information, but you might start with a phone call and then see if you feel like driving the 45 minutes to see her ... or she might even be able to direct you to a closer Leader.

    I will post this now and try to come back later to see if you have any thoughts to add or questions to ask. I hope others will chime in with encouragement as well!

  6. #6
    Join Date
    Oct 2006
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    1,512

    Smile Re: Baby lost weight again...now what?

    Zoemwu,

    I know how you feel and I offer you support and encouragement. My LO (now weeks too) also had a period where she lost a good bit of weight and was not eating enough. We had to supplement with formula and fed EBM so we could track how much she was eating. The good thing (like LLL Rebecca said) is that your LO is gaining weight so it can be corrected. Just hang in there and keep pumping. You can do it!

    I know how awful you feel and it is ok to cry when you need to do so. Just please know, it is not your fault and it will work out. You are doing your job and you are a great mom for sticking to it. The encouragement and advice of posters on this board helped me through some very rough times and continue to do so. Please feel free to let out your questions, feelings and frustrations here and allow these wise women to help you!

    Be strong and keep at it! It will all work out with time. Your LO knows you are doing all you can and she knows you love her very much!
    I wish you the best!
    Samantha: born 3 1/2 weeks early on Sept 2006 6lbs 4 oz 18 inches long with situs inversus totalis. Now a strong healthy little girl that wants to be a NICU doctor, loves her little sister and breastfeeds her dolls!
    Milk donated with while nursing first LO: 2,200 oz
    Alexandra: born 3 weeks early on July 2010 7lbs 8 oz 19.5 inches long.
    Milk donated with while nursing first LO: 1,200


    For information on becoming a Breastmilk Donor http://hmbana.org/index/donatemilk

  7. #7
    Join Date
    Oct 2006
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    627

    Default Re: Baby lost weight again...now what?

    To update:
    I took her to the doctor again today and DD is now back up to 9 lbs 6 oz...so in the past 2 days she gained 7 oz! I started taking fenugreek to see in case it was a supply issue and that seems to be really helping. I've also started really paying attention to DD's latch and suck, and when she stops being an active nurser, doing compressions and then switching sides. DD got a whole 8 oz of formula yesterday, and about 3 1/2 oz of EBM in addition to the 8 times I nursed her. I have to take her back in on Monday to be reweighed, so we'll see how things go.

  8. #8
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    Sep 2006
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    562

    Default Re: Baby lost weight again...now what?

    Quote Originally Posted by zoewmu View Post
    To update:
    I took her to the doctor again today and DD is now back up to 9 lbs 6 oz...so in the past 2 days she gained 7 oz! I started taking fenugreek to see in case it was a supply issue and that seems to be really helping. I've also started really paying attention to DD's latch and suck, and when she stops being an active nurser, doing compressions and then switching sides. DD got a whole 8 oz of formula yesterday, and about 3 1/2 oz of EBM in addition to the 8 times I nursed her. I have to take her back in on Monday to be reweighed, so we'll see how things go.

    This is a great update! You sound in much better spirits; I'm so glad to hear that your daughter showed a good weight gain once you began supplementing again. Breast compressions and frequently switching breasts is a great approach to make the most of each nursing session; pumping frequently and using any EBM you get that way to reduce the amount of formula she needs is also definitely a strategy for success. Way to go Momma and Way to grow little girl! Keep us posted!

  9. #9
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    Oct 2006
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    627

    Default Re: Baby lost weight again...now what?

    Thank you so much, Rebecca. If I had to rely on what I heard "in real life" I would have given up in despair a long time ago. I've learned so much from coming here, but most importantly, I've learned not to give up, that there are things I can do to make it better and that, if I hang in there, things do improve. I appreciate the support.

  10. #10
    Join Date
    Oct 2006
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    627

    Default Re: Baby lost weight again...now what?

    Today DD's weight was 9.74, up 1.74 oz from Friday. The doctor was happy she didn't lose, but didn't think that was enough weight gain. When you factor in the 8 oz she gained the two days before that, she has gained almost 10 oz in a week, which seems pretty good to me. I asked the doctor if I could use EBM inplace of the formula when my pumping output increased and she said no. She said she didn't think there was enough fat and protein in my breastmilk. Without testing it, I'm not sure how she could know that, and, from my reading, that doesn't seem like a common reason for babies to lose weight. I'm thinking about getting a second opinion because this doctor just doesn't seem to understand breastfeeding and I'm getting the impression that she would rather that I just give formula. I really don't want to do that so, rather than feeling bad every time I take DD to the doctor, I think I'm going to find someone who shares my view.

    One other thing I did do is buy a more accurate home scale so I can weigh DD myself and know whether or not she is gaining before we get to the doctor. These doctor visits are stressing me out.

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