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Thread: 8 week old suddenly not gaining weight

  1. #1

    Default 8 week old suddenly not gaining weight

    Hi all,

    I have been breastfeeding my second son since his birth 8 weeks ago today. Until now he has been gaining around 200g a week. He was 3.5kgs at birth and is now 5.3kgs.

    We have been battling thrush for over a month and have used gentian violet, canesten cream, daktarin cream, nystatin drops, daktarin oral gel and lots of washing, changing and sterilising (we use a nipple shield).

    On Sunday night I started taking Diflucan, a 400mg loading dose, followed by 200mg daily since then. My son had been going to sleep around 8pm and usually waking around midnight and 3am. Then from 4.30am he is awake and feeds every two hours, if not more and then feeds pretty much continually for three hours before bed.

    On Monday night he slept for 9 hours. I pumped 3ozs before i went to bed. I kept checking on him when he stirred thinking he'd be up in a minute but no. When he did wake up he was happy and alert but not feeding strongly the way you would expect after such a long sleep. I stopped worrying when he seemed happy after a slow feed of 1.5hrs. The rest of the day was as normal but I noticed he wasn't swallowing quite as much and I didn't have a second letdown during feeds.

    On Tuesday night he woke twice but again didn't feed as strongly as usual. I pumped one ounce after he fed. Wednesday I noticed I really didnt have enough milk so we nursed all morning, afternoon and evening and I pumped two more times after he fed. I got one ounce each time.

    Last night he slept from 8.30pm until 4am then fed again at 6am and that's where we are now. Five days ago he weighed 5.3kgs. This morning he weighs 5.27kgs.

    Output has been normal with the exception of a not too wet nappy this morning. Other than that, lots of wets and 3 big stools the past three days and one this morning.

    The doctors here know nothing about breast thrush, I have seen two. The baby's thrush is gone but I'm in agony. There is one board certified LC but she hasn't responded to me yet.

    Has the diflucan caused our problem? Could it be making my baby sleepy and lowering my milk supply at the same time? I was engorged the first night when milk wasn't removed for 6 or so hours but not this morning after 7.5hrs.

    I am worried to the point that I feel ill. There's nobody here who can advise.
    Last edited by @llli*celexel; March 20th, 2013 at 10:12 PM.

  2. #2
    Join Date
    Nov 2012
    Location
    Ontario
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    582

    Default Re: 8 week old suddenly not gaining weight

    Thrush sucks! As far as I'm aware, diflucan doesn't make babies sleepy or lower milk supply. I think it's more likely the fact that your LO is sleeping for such long stretches that is causing your supply to maybe take a bit of a hit. Can you try dreamfeeding him every couple of hours during the night, or getting up to pump (I know, who wants that...). I'm not really knowledgeable about nipple shields, but I have heard that they can lower milk transfer. I'm sure you're not anxious to wean off it while you're in so much pain though.

    As far as the thrush is concerned, have you tried diluted grapefruit seed extract? There's good info on both Dr. Jack Newman's candida protocol and Dr. Jay Gordon's thrush page (just google exactly that, should be the first ones that come up). I really didn't find that the diflucan made a big difference until closer to the end of the first week, and I needed to take a full two weeks of it to get rid of the thrush completely. The other thing that comes to mind is the possibility of a bacterial infection, rather than yeast. If you don't get any better after a week of the diflucan, I would definitely go back to see your doc about the possibility it's something else.

    If you're really concerned about the weights, can you rent an at-home scale to do some pre/post feeds? That might put your mind to ease about how much he's getting. Hang in there mama, you can do this

  3. #3
    Join Date
    May 2006
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    19,895

    Default Re: 8 week old suddenly not gaining weight

    To my knowledge, Diflucan doesn't make babies sleepy.

    How were those weights done, on a home scale? Was baby in the nude each time?
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  4. #4

    Default Re: 8 week old suddenly not gaining weight

    Wow sorry about the thrush and all. Ugh. That is enough to worry about without worrying about weight gain too!

    Last night he slept from 8.30pm until 4am then fed again at 6am and that's where we are now. Five days ago he weighed 5.3kgs. This morning he weighs 5.27kgs.
    is this the weight gain (or lack of) you are concerned about? Are you weighing baby yourself or having frequent weight checks done due to using nipple sheild?

    A single 5 day period of no weight gain may mean nothing at this age. or it could mean a temporary illness or sleepiness etc. Or a scale error. Baby has been gaining well previous-500 gm a week= 7.5 ounces, right? that is good gain. and output over the same period of concern sounds normal.

    Are you pumping due to using the shields, but otherwise, exclusively nursing? Don't let pump output scare you, that can mean nothing. Your milk production is not going to disappear in a week of baby nursing slightly less often.

    if you think baby is sleeping too long, no reason at all to not wake him up or to lie down with baby (or pick him up) and dream feed. Try not to get engorged that puts you at risk of more issues. The adage to never wake a sleeping baby goes out the window if you need baby to nurse. Also if you are using pacifier or swaddling you can try not doing so. if baby sleeps separately try having baby sleep in your room.
    Last edited by @llli*lllmeg; March 21st, 2013 at 07:50 PM.

  5. #5

    Default Re: 8 week old suddenly not gaining weight

    Thank you all for the replies. What concerns me most is that his feeding has changed. Up until this week, if I put him to the breast asleep or awake he would suck and suck strongly. Since I started the Diflucan his suck is lazy and he is sleepy while feeding which is very unlike him. I have a home scale that I bought almost two weeks ago when he got too big for the kitchen scales. I weigh him because where I live there are no routine check ups for baby and paediatric visits are costly do do often. I usually weigh him once a week for my own information and only weighed him twice this week because of the way he is feeding and because I noticed he was swallowing less. Also I only started pumping this week because he wasn't draining the breast as usual.

    We sleep in the same room, his bassinet is right next to me. He doesn't take a pacifier. I had to wake him for one feed last night but he woke by himself for the other two. Again though he isn't sucking very strongly and just doesn't seem hungry. Otherwise he is in excellent form, very alert and smiling.

    It just seems so coincidental that the problems only began when I took the diflucan.

    We use a shield because I have an asymmetrical point on one flat nipple that makes him gag and have a very shallow latch if he can latch at all. My milk supply increased when we began using the shield and we will keep trying without it until he can latch comfortably.

    The previous week he gained 300g. After his six week growth spurt I suppose. I weigh him in a vest and sleep suit with a fresh nappy, only because that is how he is weighed at the paediatrician and I wanted to be consistent with that. I know it's incorrect.

    When should I weigh him again? I am nursing him every two hours or more during the day, continually for three hours in the evening and three/four hourly at night. Is this enough? My breasts did not enlarge with pregnancy or feeding this time and I know I don't have much storage space.

    I read about the grapeseed extract but don't know where to find any. The only options in this country are supermarkets or pharmacies. There are no health stores.

    I am pretty sure it's thrush as baby had quite a lot of white patches in his mouth and the nasty nappy rash, confirmed by the doctor to be thrush. I am keeping in mind the possibility of a bacterial infection if I see no improvement.

    I don't know. It just feels as though he doesn't care much for the taste of Munmy's milk at the moment when he is normally very enthusiastic and loves, loves, loves his milk.

    Sorry for the essay, I am just confused. Thank you again. x

  6. #6

    Default Re: 8 week old suddenly not gaining weight

    So, in the US, where we tend to have lots of pediatric visits, healthy babies generally are weighed at birth, at 24 hours, then maybe a few days after birth, at two weeks, and then not again until two months, then four, then 6, nine, and 12. Babies are not weighed weekly or anything like that unless there is some reason for concern. Moms can keep a pretty good idea baby is doing ok from output.

    Statistically, there is some increased risk of baby not gaining well and/or low production due to using nipple shields. But sometimes it is no problem at all. That is the only reason I can see for maybe doing weight checks more often, but probably not weekly.

    Infant scales are made for infants and really, no other kind of scale should ever be used for gauging weight gain in a baby. I assume this is a digital infant scale you bought and you are being careful to use it correctly?

    You can weigh your baby as much as you like, just remember we are talking mere ounces. An ounce a day is very good weight gain. (sorry I just can’t talk metric) Anyway, so, A large poop makes a difference. Type of clothing, diaper being wet...this is why babies should always be weighed totally naked. If you lay baby on a blanket, weigh the blanket and subtract that, or always use the same blanket. That is how precise this is. plus since your scale may not be calibrated the same as your doctors scale, different scales matter.

    Is it possible your thrush treatment is finally working, so the latch feels less intense? Normally Nursing is very comfortable for mom, not so with thrush.

  7. #7

    Default Re: 8 week old suddenly not gaining weight

    i just want to add quick that when i have time i will research if thrush treatment has been shown to adversely affect baby nursing. But usually with thrush the issue would be the thrush itself causing baby oral discomfort. The diflucan it's oral right>? no change in nipple care? Different soap to wash sheild, (do you use soap? or boil?)

  8. #8

    Default Re: 8 week old suddenly not gaining weight

    Thank you Meg. When baby was 10 days old we saw a board certified LC (the only one in this country) and she said to have him weighed each week. I suspect this was because of his shallow latch.

    I wash the shield with soap and sterilise in an electric steriliser after each use.

    The pain is still excruciating so the meds haven't started taking affect just yet.

    However, we may have had a revelation... I checked the shield soon after latching and my nipple was being sucked through it leaving four raised dots. He was only swallowing after every five sucks despite let down. My nipple was compressed as it was with the shallow latch. So I latched without the shield. Still very shallow with the line across my nipple but he drank more, not too well though as he fussed so much. I don't know why this is happening after 6 weeks of easy nursing with the shield.

    At this point I can't tell what is latch pain and what is thrush pain. It is all just agony. I will have to see the LC to try and go from here. She wanted me to use cross cradle hold and sandwich the nipple but his head is just too heavy for me this way. Just now I have laid back and nursed him. The latch was still very shallow though.

    We gave baby 3oz of expressed milk at lunchtime (I can't freeze it while I have thrush and i had been nursing all morning non stop) and he drank like he was starving, as expected with the bottle, but was extremely crampy after (which he never is after nursing). At least the memory of those cramps is keeping me away from the formula but I don't know how long that will last, knowing that he's not transferring enough milk to grow or to keep up my milk supply coupled with the extreme pain. This is the hardest thing I have ever done in my life.

  9. #9
    Join Date
    May 2006
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    19,895

    Default Re: 8 week old suddenly not gaining weight

    It could be that your baby is growing into a deeper latch, and is now pulling the nipple so deep into the shield that it's getting compressed against the end of the shield.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  10. #10

    Default Re: 8 week old suddenly not gaining weight

    ok I am really sorry that I missed that you are under the care of a lactation consultant and that the frequent weight checks were part of her plan. That being the case I would say the appropriate action is to see her or at least talk to her again about this sudden change. I just did not want you deciding based only on the one weight gain stall that something is seriously wrong withmilk production or milk transfer. There may or may not be, more info is needed.

    I agree with mommal about the nipple sheild. I have also seen this when the sheild is too small for mom, but if you have been using the same sheild all along that would be unlikely. I also wonder id all the washing and steralizing is somehow compromising the sheild. I understand you need to do that due to the thrush, but when I used a sheild I recall being told to just rinse it between uses. Also probably an outside possibility, jusy musing.

    Here is what I think-if the last time you saw the LC was 6 weeks ago, and you are still in pain, definitely time to see her again if that is possible. Your baby has grown so much since then. Thrush should respond to treatment once you are getting the right treatment. If pain continues so long, either you are being re-colonized somehow or there is something else going on. Bacterial infection, tongue tie?

    If you were not able to incorporate her latch and positioning advice, explain that to her. There are many ways to tweak positioning of both mom and baby so it is comfortable for mom.

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