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Thread: Not gaining weight

  1. #1

    Default Not gaining weight

    My daughter is 16 days old and only gained 2oz in 6 days according to her doctors scales. She was weighed once on a digital and then 6 days later on the regular scale. We go for another weight check this coming Wednesday.

    I am so fearful that she won't gain enough weight and they will want me to supplement formula or pumped milk. My first daughter had latch issues and didn't gain weight either- so I pumped and bottle fed for 6 months. It was a miserable experience and I vowed never to have to do that again. I didn't want to give a bottle for a good month+ this time. I was so looking forward to breast feeding the "right way" this time around.

    This baby loves to nurse. She gives signs every 1-3 hours (hands in mouth, trying to latch on to anything near her face, sticking tongue out, etc).

    She doesn't really open wide enough and can be painful. I have a hard time getting her to open wide enough. She either nurses for 30 mins straight-- or most of the time- she eats for 5 and falls asleep. But when I unlatch her, she acts like she's starving and wants to go back on. Even if she is just holding my nipple in her mouth (not sucking).
    I'm afraid she's only getting the fore milk and not the good, fatty hind milk because of her frequent, short sessions.

    She also spits up a lot. I don't remember what's "normal" for new babies to spit up and what's not normal.
    I'm just a born worrier, I guess.

    Any suggestions on how to get her to nurse longer or to help with her latch?
    And what is "normal" for EBF weight gain for newborns?

  2. #2
    Join Date
    May 2006
    Posts
    23,813

    Default Re: Not gaining weight

    Welcome to the forum and congratulations on the new baby!

    My first thought is that there is a good chance of scale error here. Proper weighing procedure calls for a baby to always be weighed in the nude and on the same scale, because differences in calibration between scales are common. So if your doctor's office is sloppy about the scales, make sure you demand that proper procedures be followed.

    Now, if there really is a problem and supplementation is required, please don't panic. Temporary supplementation will not doom your nursing experience. Lots of moms have been through it- myself included- and we'll help you through if it becomes necessary!!!

    This baby loves to nurse. She gives signs every 1-3 hours (hands in mouth, trying to latch on to anything near her face, sticking tongue out, etc).
    Excellent! You want a newborn to nurse at least 10-12 times a day, and if she's asking to nurse every 1-3 hours you're probably at that level.

    She doesn't really open wide enough and can be painful. I have a hard time getting her to open wide enough.
    Okay, so this could be a problem. Perhaps the painful latch stems from the baby just being very small and new at this point. But I would like to have her checked carefully for tongue and lip ties, which can cause a painful, shallow latch and can also impact the baby's ability to transfer sufficient milk. So have the pediatrician take a careful look, and look in her mouth yourself. If she can't stick her tongue out past her lower gums, or her tongue seems to have a "heart-shaped" divot in the top (do a google image search on this on), or the baby routinely curls her top lip in while nursing, those things could all suggest ties. I would also want to have her seen by a lactation consultant, preferably an IBCLC. You would probably benefit from hands-on help with the baby's latch and with positioning, and of course the IBCLC can check baby for a tongue/lip tie as well.

    Some things that may help:
    - Experiment with different nursing positions, particularly reclined ones.
    - Try to latch the baby on early, before early hunger cues escalate into frantic hunger.
    - If the baby is opening and closing her mouth too fast for you to get the breast in, try having her suck on your pinky finger, nail held down towards the tongue, for a few seconds. This may calm her enough to enable a repeat latch attempt.

    She either nurses for 30 mins straight-- or most of the time- she eats for 5 and falls asleep. But when I unlatch her, she acts like she's starving and wants to go back on.
    This sounds like a baby who sometimes may be falling asleep too quickly, which is a common problem with newborns. Here are some things you can do to keep your baby alert and active when nursing:
    - Keep her cool. When it's time to nurse, strip baby down to a single light layer, and keep a fan blowing in the room where you nurse (not directly on baby).
    - Annoy her. When she seems to be getting sleepy, tickle her feet or rub agains the grain of her hair using your hand or a cool damp washcloth.
    - Use breast compressions to speed milk to the baby.
    - Switch nursing. When you observe baby going from rhythmic, active suckling to shallow, erratic "comfort" sucking, take her off the breast, burp her or change her diaper, and put her on the other side. If she starts falling asleep in the second breast, repeat the process and switch her back to the first breast. Switch nursing is excellent for increasing milk transfer.

    I'm afraid she's only getting the fore milk and not the good, fatty hind milk because of her frequent, short sessions
    One of the most common misconceptions about breastfeeding is that there are 2 types of milk: bad, fat-free foremilk and good, creamy hindmilk. But the thruth is that we only make one kind of milk, and all milk is good milk. Foremilk and hindmilk are convenient terms for describing the continuum of milk composition, starting out refreshing and relatively low-fat, high-carb when the breast is full and gradually becoming fattier as the breast becomes increasingly empty, but there aren't 2 discrete types of milk.

    Both foremilk and hindmilk have all the nutrients needed to ensure proper growth and development, and a baby will grow well-sometimes exceedingly well- on the so-called foremilk alone. What matters, when it comes to weight gain, is the volume of milk that the baby is getting, not the type of milk.

    Frequent feedings are actually excellent for increasing the baby's intake of fat, so I would encourage you to continue to feed the baby frequently.

    Now, very short sessions can be problematic for some babies because they result in baby not taking in enough milk. So keep baby awake and active at the breast as much as possible- use breast compressions and switch nursing, etc.- and keep a careful eye on her poops. You want to see 3-4 or more "scoopable" poops per day, the size of a US quarter or larger. Keep track of poop color, too- yellow tones are great. If the baby's stool is consistently green, let us know.

    She also spits up a lot. I don't remember what's "normal" for new babies to spit up and what's not normal.
    Spit-up is a totally normal part of infancy, and many babies will spit right after eating. Spit-up can be watery or curdy. What's important is that the baby not appear to be in pain when she spits. If she is arching her back and seems very distressed when spitting, you might want to consider the possibility of reflux.

    I'm just a born worrier, I guess
    Must be because you're a mom.

    And what is "normal" for EBF weight gain for newborns?
    This is a handy reference: http://kellymom.com/bf/got-milk/supp...s/enough-milk/

  3. #3
    Join Date
    Mar 2014
    Location
    Central FL
    Posts
    1,576

    Default Re: Not gaining weight

    Here is a thread with helpful links for milk transfer issues
    http://forums.llli.org/showthread.ph...ransfer-Issues

    Here is a link for helping you find an IBCLC
    http://www.ilca.org/i4a/pages/index.cfm?pageid=3901

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