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Thread: Baby not gaining weight! please help!

  1. #1

    Default Baby not gaining weight! please help!

    Hi-
    My baby was born at 7 lbs 2 oz, and now at 3 mo. is only 9 lb 11 oz. Doctor telling me to just give formula to increase his weight. It all doesnt make sense to me, I know that he is getting milk from me, he even sometimes spits up a little after a feeding,, burps, pees and poops adequately and sleeps the same amt of hours at night after being breastfed or formula fed. I am currently pumping now for 2 days and freezing my milk while my husband feeds him formula. Could it really just be that even though I have the proper volume of milk, the fat content is just not high enough for him?
    -Should i mix it with formula or just do formula exclusively???
    please help, im in dire need.
    Thanks so much in advance.

  2. #2
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    Default Re: Baby not gaining weight! please help!

    I do not think it is an issue of fat content. Where is this idea coming from? Formula has a similar fat content as breastmilk-by design, as of course formula makers want to make formula as much like breastmilk as possible. And a mother’s milk will normally vary quite a bit in fat content over the course of the day, this is by natures design. Usually when a breastfed baby is not gaining as expected, it is due to baby not getting ENOUGH breastmilk, which could mean mom has low supply but also could meant baby is simply not nursing often enough or efficiently enough. Sometimes, there are other health issues that have noting to do with what baby is eating. And sometimes, there really is not a problem after all.

    Do you have a complete weight history? I am wondering if baby gained more or less rapidly etc. at any point, or has steadily gained but just slowly, or what? Also, what was babies LOWEST weight was, rather than birth weight, many babies lose several ounces after birth.
    Also-how many times in a 24 hour day does baby nurse, is it on cue, and does baby typically finish the session or do you end it?
    how long does baby go without nursing at night (or any other longish stretch?) and how long has that been going on?
    how much do you/did you supplement before this last weight check?
    have all weight checks been done on the same scale with baby naked or in a dry diaper?
    Are you or your husband small or have a history of being small as babies?
    how are other growth indicators (head circ, length) and milestones?
    Last edited by @llli*lllmeg; July 20th, 2012 at 07:37 PM.

  3. #3
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    Default Re: Baby not gaining weight! please help!

    oh and did you see this recent thread? http://forums.llli.org/showthread.ph...ch-to-Formula-!

  4. #4
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    Default Re: Baby not gaining weight! please help!

    with LLLMeg. Formula does not have more calories than breast milk. In fact, it has slightly fewer calories (on average). Its only advantage is that it makes it easier to measure how much baby gets. So please don't worry that your milk doesn't have enough fat or calories. When a baby is having trouble growing on a breastmilk diet, the problem is almost always inadequate QUANTITY of breastmilk, not inadequate QUALITY.

    In your shoes, I would do the following:
    - See another doctor for a second opinion
    - See a lactation consultant, preferably an IBCLC
    - Have baby checked very carefully for any physical issues that could be impeding his nursing- especially tongue tie and reflux
    - Nurse baby more frequently (10-12 times per day if possible)
    - If you determine that you must supplement, do so with your own milk

    LLLMeg asked some terrific questions, and the answers to those questions may help us figure out how best to help you.

    Don't give up, mama!

  5. #5
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    Default Re: Baby not gaining weight! please help!

    How is it going shans984?

    I still have my previous questions about if supplementation was needed or how much is needed, but in the meantime I wanted to address this question which I missed before:
    Should i mix it with formula or just do formula exclusively???
    Number 1, I am glad you are pumping. Even If you chose to supplement baby with formula rather than your expressed milk, you will lose your milk supply if you do not pump!

    What did the pediatrician advise, exactly-to keep nursing but give additional feedings with expressed milk, to give formula only, what? Typically the advice with a poorly gaining baby would be for mom to keep nursing but add additional feedings of expressed breast milk, and only giving formula if mom is unable to pump enough additional breastmilk. From a breastfeeding duration standpoint, If you are supplementing, it is very important to not only keep up your milk supply by pumping but also to keep baby nursing as much as possible. All too often the recommendation to supplement, needed or not, leads to early cessation of breastfeeding due to many factors and this is very harmful, health wise.

    Also you do not mention how much you pump or how much you get when you pump. Please remember that pumps are not as effective as a baby at extracting milk so if you are not making much for the pump, that means NOTHING about your milk production capability.

    Also it is typically not recommended to mix formula and breastmilk in the same bottle as breastmilk is much sturdier and has a longer fridge and/or shelf life than formula, In fact an unfinished bottle of breastmilk can be put in the fridge until the next feeding while leftover formula must be discarded. So mixing the two leads to waste of breastmilk. On the other hand, if that is not a concern, it is fine to mix premixed formula with breastmilk, just do not use breastmilk as a substitute for water when mixing powdered formula. Formula must always be mixed precisely according to instructions.
    Here is more about safe milk handling and bottle feeding the breastfed baby: http://www.llli.org/docs/00000000000...fyour_milk.pdf

  6. #6

    Default Re: Baby not gaining weight! please help!

    Hi!! Thanks so much for all your responses-- I was trying so hard to write back but for some reason it wouldnt let me log in and kept signing me out...now I'm on so let me answer and again, your answers so far have helped me.
    Do you have a complete weight history? --- 7/2 at birth, 6/13 when we left hospital, 8/6 at 6 wks old, and then 9/11 at 9 wks old, and 9/11 again at 11 wks old.
    .
    Also-how many times in a 24 hour day does baby nurse, is it on cue, and does baby typically finish the session or do you end it?---I have been trying to FOD but it is obviously hard with 2 other kids around ( I have a 6 yr old and a 3 yr old too), ususally every 2 1/2 hrs during the day and then usually a good 7 hr stretch at night that hes been doing for a while
    how much do you/did you supplement before this last weight check? i didnt supplement much because for the first few days I was nursing and then giving him like an ounce or 2 of formula like an hr after the nursing but then after day 4 of that he didnt want to latch on to me anymore so i kind of cut it out, but he really was not content in between feedings like he used to be
    have all weight checks been done on the same scale with baby naked or in a dry diaper? --same scale with same size dry diaper
    Are you or your husband small or have a history of being small as babies? both have no h/o being small as babies and are both tall now
    how are other growth indicators (head circ, length) and milestones? --head circ and length are great

    It is very disappointing to me because I thought this time around my breastfeeding was going better than ever, I had stalked all the nicu lact. consultants at work (im an NP) to help me before the baby came with advice, and then he was jaundice so we actually ended up in the hospital i work in with him as a newborn and they all watched him latch on and watched him feed and told me we were doing everything right. The first month of life went great and now i just cant seem to get his weight up.. I thought it was very helpful that you said that formula is not higher in calories than breastmilk. I have been breaking my head over the concept that my breastmilk is just not fattening enough, and it just hasn't made one bit of sense to me. So, now I am definitely leaning towards what you said that he prob. is not getting enough volume from me.
    Since Thurs night Ive been bf him and then giving him whatever he'll take of formula after sometimes he'll drink 4 oz. and then I substituted a couple feedings and pumped while he drank 6 oz and i produced about 4-5. Since I have to return to work tomorrow anyway my question now is if its ok to have my babysitter give the pumped bottles i have (i am leaning towards yes since you said the calories should be the same if not higher than formula).
    Let me know if you have any further advice for me...I greatly appreciate all your help thanks so much!!!

  7. #7
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    Default Re: Baby not gaining weight! please help!

    Definitely give baby the bottles you have pumped. They are superior to formula.

    The one thing that jumps out at me from your post is that your baby gives you a 7 hour sleep stretch, and has been for some time. At 3 months old, sleeping through the night is still defined as one 5 hour stretch. I'd try waking him in the night and nursing him, which I am sure is not what the tired mommy of 3 wants to hear! But cramming in 1-2 extra feedings at night can make a big difference to baby's calorie intake.

  8. #8
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    Default Re: Baby not gaining weight! please help!

    --- 7/2 at birth, 6/13 when we left hospital, 8/6 at 6 wks old, and then 9/11 at 9 wks old, and 9/11 again at 11 wks old.
    So this sounds like weight gain was fine until some time in the two weeks between 9 weeks and 11 weeks. Right? Here is my quick and dirty math so tel me what I am missing-normal amount of weight loss in first few days, then, 25 ounces gained from lowest weight until 6 weeks, which could be low but could be normal as well, depending on when the gain started and how it went- typlically babies do not start regaining weight until several days in, and then it is often slowly at first and getting faster-rule of thumb is want to see baby back to birth weight by 2 weeks-did baby not have a two week check up? Anyway, and then 21 ounces gained in the next 3 weeks which is right on target-an ounce a day. So, the question is, what happened in those two weeks from 9 to 11? I agree with mommal, if there is an issue, (and its not just a scale thing or temp illness or something) this could be a case of baby simply not nursing frequently enough-did pacifier use start or ramp up? Longer sleep stretch, busyness at home, etc, start around 9 weeks? in any case, it cannot possibly hurt to nurse more often.

    But how is nursing? Is it comfortable for you? Can you nurse in a variety of positions, even standing, and/or with baby in a sling or front carrier, etc? Or do you find you always have to sit and focus exclusively on nursing when baby eats? Have you tried dream feeding/offering when baby is very sleepy or even asleep? Are feedings always very long, drawn out, still? I am asking all this because typically, if there are no big nursing issues, by this age, nursing has become pretty easy for both mom and baby and basically second nature, so even busy moms can fit plenty nursing in-so if that is NOT happening, something may need tweaking so nursing is easier for you...

    Also I am sorry but I am not sure what this means:
    how much do you/did you supplement before this last weight check? i didnt supplement much because for the first few days I was nursing and then giving him like an ounce or 2 of formula like an hr after the nursing but then after day 4 of that he didnt want to latch on to me anymore so i kind of cut it out, but he really was not content in between feedings like he used to be
    So you stopped supplementing with formula after day 4 and baby was exclusively breastfed from that point?
    Last edited by @llli*lllmeg; July 23rd, 2012 at 10:51 AM.

  9. #9

    Default Re: Baby not gaining weight! please help!

    But how is nursing? Is it comfortable for you? Can you nurse in a variety of positions, even standing, and/or with baby in a sling or front carrier, etc? Or do you find you always have to sit and focus exclusively on nursing when baby eats?-- Never been able to really do anything else while nursing with this one, if i do he unlatches, with my other 2 i think i definitely had more of the ability to get things done at same time. Only one position--I think cross cradle is what its called
    Have you tried dream feeding/offering when baby is very sleepy or even asleep? Yes, he really doesnt take much when he is too sleepy or not due for a feeding.
    Are feedings always very long, drawn out, still? Yes, still can be like 20-25 min per side and then hes still not completely satisfied and can finish a whole 4 oz bottle right after? BUt i know he is ingesting milk bc it will sometimes drip out of his mouth, or he'll burp and spit some up afterwards.
    I am asking all this because typically, if there are no big nursing issues, by this age, nursing has become pretty easy for both mom and baby and basically second nature, so even busy moms can fit plenty nursing in-so if that is NOT happening, something may need tweaking so nursing is easier for you...

    Also I am sorry but I am not sure what this means:
    how much do you/did you supplement before this last weight check? i didnt supplement much because for the first few days I was nursing and then giving him like an ounce or 2 of formula like an hr after the nursing but then after day 4 of that he didnt want to latch on to me anymore so i kind of cut it out, but he really was not content in between feedings like he used to be
    So you stopped supplementing with formula after day 4 and baby was exclusively breastfed from that point?---Yes since the last weight check from wk 9 to 11 I stopped supplementing after about day 4 or 5 bc nursing really seemed to satisfy him,

    Last night was my first nt back at work and my babysitter fed him 6 oz of my BM and she said he was still hungry and had 2 more ozs of formula...that is so much for him, the most hes ever taken from a bottle is 6 oz of formula so again this is leading me to believe that my milk is not satisfying for him??? I am so confused, thanks for your help again!!!

  10. #10
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    Default Re: Baby not gaining weight! please help!

    Just real quick-baby taking more, even a lot more, from a bottle after nursing often means nothing. Babies need to suckle lots and some babies are compelled to suckle much more than others-And if they are given a bottle to suckle, they cannot help but take everything that is in the bottle, because it is impossible for them to control the flow unless special steps are taken to slow the bottle session down. (More on how to do this below.)

    Ditto being topped off after a bottle. 6-8 ounces at once would be a tremendous amount for a baby to drink all at once. 4 ounces at a time or less would be the typical amount. The fact is, babies are routinely overfed via bottles.

    I still am not understanding why your baby is not gaining well on breast milk alone, or even if that is truly the case. I strongly urge you, if it is at all possible, to meet with a IBCLC and try to get to the bottom of this. A before and after nursing weight check, (or several, if possible) to measure intake, and someone experienced and clinically trained to watch baby nurse and gather info & give you a plan for addressing any issues could really help with this. To find an IBCLC see this website, www.ilca.org if possible I always suggest moms call two or three or more, you want to find someone who has experience with what you are dealing with and who you feel confident in/comfortable with.

    Some insurers cover IBCLC visits, the US govt. mother/kid nutrition program WIC offers them (not all local WICS do but some do) and there may be other lower cost options, call your local LLL or breastfeeding coalition for more info and you can also call and simply ask the IBCLC if they can give you a better price if needed. Even at full price, the cost of an IBCLC appt. will be far, far less than having to buy formula for the duration.

    I suggest you share the following info with your sitter so she will slow down feedings, these techniques can be used any time baby is supplemented as well. http://www.llli.org/docs/00000000000...astfedbaby.pdf and http://kellymom.com/bf/pumpingmoms/f...ottle-feeding/ and here is an expressed milk calculator for you to know how much generally you need to leave with your sitter: http://kellymom.com/bf/pumpingmoms/pumping/milkcalc/

    Also, the general recommendation if supplements are needed is to give a small amount of supplement (1-2 ounces, for example, PRIOR to nursing at the breast.

    You could also try breast compressions for speeding up feedings: http://www.nbci.ca/index.php?option=...tion&Itemid=17

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