Should I wake him up?

[@llli*eb.mom]

I have a 2 week old who isn't gaining as well as the pediatrician hoped. His birth weight was 8lb,8oz and at his 2 week appointment today is only up to 8lb,5oz. (He lost some weight in the hospital - his lowest was 7lb,11oz I believe - but went up to 7lbs,13oz when we left.) He is exclusively breastfed and has lots of wet and dirty diapers. He sleeps a lot and I feed him whenever he wakes, which happens every 1-3 hours. At night, he can go longer. He eats for maybe 10 minutes before falling back asleep. I usually just have him feed off one side, then do the other side on the next feeding. The pediatrician suggested that I pump after he feeds so that I keep my supply up - just in case.

I'm not sure if I should be waking him to feed more often or wake him up for a second feeding off the other side after he falls asleep while nursing. When I do try to feed him off the other side in the same feeding, he eats a little bit more but not that much before falling asleep again. I don't want to diminish my supply but I'm not sure if constantly waking him to eat is what I should be doing either. I'm trying to feed on demand instead of a schedule since that is what seems best but I don't want to jeopardize my supply or a healthy weight gain.

Any input is much appreciated. He is a happy baby and things are going well, I just want to make sure we can continue to breastfeed successfully and that he is getting what he needs. Thanks!

[@llli*djs.mom]

Whether or not you need to wake him depends on how many times TOTAL you are getting in in a 24hour period of time. IF your baby does some cluster feeding in the evening and you are getting AT LEAST 10-12 feedings in a 24hour period of time then NO you don't need to wake him and you can let him sleep a little longer at night. A little longer being 3-4 hours. IF your 2 week old IS sleeping LONGER than 4 hour than YES you need to feed him. However, you don't actually have to wake him to do it. YOU need to be awake. But you can dream feed your child. They will instinctively suck in their sleep. You don't want to go more than 4hours without feeding this early in the game because your supply is still being established and going that long between feeds WILL damage your supply. AND if you find that you are nursing LESS than 10-12 times in a 24hour period of time you need to up the amount of nursing your are doing. It doesn't matter WHERE you add them in, but you need AT LEAST 10-12 feedings in a 24huor period to get the weight gain your doctor is looking for.

[@llli*maddieb]

Yes the really important number is how many times total baby is nursing per day, and also at this early age with weight gain concerns, it is probably best to never go more than one 4 or at most 5 hour stretch at night. Here is something else to think about...Why not wake baby? It does not mean you have to be constantly waking baby. If you are able to wake baby and feed baby even two more times a day, assuming baby is nursing well, that could increase baby's daily intake by approximately 3-6 ounces. This would make a difference! I am not convinced this is a true slow weight gain issue, as I don't have enough info-but clearly your pediatrician is concerned enough that s/he is suggesting you pump. What if the next suggestion is formula supplements? Waking baby to nurse is a more benign intervention that pumping and way more benign than supplementing. Presumably this is temporary and you will not need to keep waking baby to nurse.

It is not always easy to actually wake a baby, so if that is not working for you, you can try dream feeding baby by bringing baby to the breast when baby is sleeping. Many Babies can and do latch and nurse in their sleep, given the opportunity.

[@llli*mommy2lilah]

Did your pediatrician say why he was concerned? I thought that the goal was to get back to birth-weight by 2 weeks, which you've done. There is a difference between the scale at the hospital and the one at the doctor's office, so I wouldn't be bothered by that 2 ounce difference.

[@llli*djs.mom]

Did your pediatrician say why he was concerned? I thought that the goal was to get back to birth-weight by 2 weeks, which you've done. There is a difference between the scale at the hospital and the one at the doctor's office, so I wouldn't be bothered by that 2 ounce difference.

It's a 3oz difference and I am sure that is the doctors concern.

[@llli*mommy2lilah]

It's a 3oz difference and I am sure that is the doctors concern.

Sorry, my math was wrong. But even a 3 ounce difference is easy to attribute to a scale difference. However, newborns need to be nursing 10 to 12 times a day. Weird that the pediatrician didn't point that out and instead pointed to pumping.

[@llli*maddieb]

However, newborns need to be nursing 10 to 12 times a day. Weird that the pediatrician didn't point that out and instead pointed to pumping.

From my conversations with moms, I have the impression that doctors and even lactation consultants often neglect to inquire about nursing frequency or stress it's importance. I admit it makes me a tad batty.

[@llli*eb.mom]

The pediatrician did ask a few questions about nursing but didn't ask how many times per day he does - which you say is the most important number. Since posting I have been actively feeding more (from both sides in a single feeding) and more often. He still doesn't spend much time nursing but the frequency has gone up. We're going in again for a weight check in a few days and I'm sure he'll be at a place that the pediatrician is happy with since nursing really hasn't been problematic. I haven't been pumping and am hoping that just the increase in frequency is enough. Based on reading other threads, it seems that it should be. Thanks for the input and hopefully everything continues to go well.

[@llli*maddieb]

Yes nursing frequency is so important. And pumping should not be needed in the normal course of things, because as long as baby is getting enough milk at the breast, your production is getting stimulated enough. Newborns have teensy tummies and are still learning to nurse in the early days, and for the first 4-6 weeks a mothers milk production increases, and normal production depends on baby nursing frequently. As they get bigger and can take in more milk at a time, the need for this high frequency begins to lessen a bit.

Let us know how it goes at the weigh in!

[@llli*eb.mom]

The weigh in was great. He came in at 8lbs,14.5oz - which means in this past week he's gained 9.5 oz and is far past his birth weight. The pediatrician was impressed and happy and is no longer concerned. I think just being aware that he wasn't gaining at a good rate and that he should be eating more was enough to get me to step up my game. Also, breastfeeding in general has been easier and that has helped a lot. Thanks for the advice and support!