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Thread: Overactive Let Down, Reflux or Allergies - low weight gain

  1. #1

    Default Overactive Let Down, Reflux or Allergies - low weight gain

    So I've been on here for advice before by reading posts, but this is my first time posting. The biggest issues is my daughter is gaining weight real slowly, average 2-4oz a week. She was 7lb11oz at birth and at 3 mos just barely hit 11oz (with clothes and diaper). I go to a breastfeeding support group once a week to weigh her, so each week she has gained about 2-4oz. She doesn't cry much, seems to be full and content, meeting milestons, just so tiny still. My first daughter was much bigger at this point.

    Here is the basic info:
    - We started off with low supply (did pre/post feed weights)
    - started taking domperidone to increase my supply (also used with first daughter 3 years ago)
    - for the two weeks I was building my supply, we supplemented with formula and she did seem to spit up and be uncomfortable during that time (diary issue?)
    - I've since been able to EBF with 1 bottle of BM a day - during the middle of the night feeding since she was always falling asleep at the breast then
    - When I pump to replace a feed I get 4-6oz. When I pump in the MOTN feed after 4-6hrs I can get 8-10oz - so supply seems good

    Current Issues:
    - spits up a ton! On meds to help with reflux, but not sure really helping
    - doesn't spit up much after a bottle, just after bfing
    - often spits up an hour or two after bfing and it is then partially digested milk
    - when bfing and sometimes with bottle, a lot of milk spills out of her mouth - often
    - gulping during letdown - sometimes
    - clicking noise - sometimes
    - pulls on and off - often
    - gassy, cries, straightens legs - often
    - eats 6-7 times in 24hrs
    - 1-2 major poops a day
    - poop is yellow but often mucousy and sometimes very watery

    Her 4 month dr appt is in 3 weeks and I'd like to find out as much as I can before then and hopefully either fix what is wrong or be able to ask the right questions of the dr.

    What can this be? Seems like I have symptons of a lot of these - overactive letdown, refux, and maybe tied to allergies? Doesn't look like a tounge tie from what I can see. Possible lip tie.

    Any advice is so greatly appreciated.

  2. #2
    Join Date
    May 2006

    Default Re: Overactive Let Down, Reflux or Allergies - low weight ga

    Much of what you describe sounds like oversupply and fast letdowns. You are pumping extremely large amounts of milk. 2-4 oz when pumping instead of feeding would be more typical. 4-6 oz is very much on the high side, and 8-10 oz is absolutely oversupply. Also, the baby's behavior matches fast letdowns very well- the gulping, the spit-ups, the clicking, the pulling on and off, the infrequent feedings (most 3 month olds nurse a minimum of 8 times a day, and many nurse more frequently than that, in the 10-12 range, or even more often).

    But there are things in your list that could match tongue tie, as well- the clicking, the dribbling even when being bottle-fed. I'd want someone to take a very careful look in baby's mouth and see if there's an issue there. How does nursing feel?

    Nothing on your list really makes me think allergy except perhaps the gas and mucous. But gas is very normal for babies and when a mom has oversupply, it can make the poops look pretty odd.

    If you want baby to gain more weight, the first thing to try is nursing more often. Again, 6-7 nursing sessions is on the very low end, even with one additional bottle. It sounds like baby isn't nursing much at night, so you might want to try waking her for a dream-feed right before bedtime, and maybe once more during the night. Also, if you're using any sleep-extending techniques- swaddling, pacifier- you might want to take those away and see if that results in increased night-waking and night-nursing.

    I'd also encourage you not to focus on the week-to-week weight gain. Pediatricians don't weigh babies every week because they know that growth isn't perfectly smooth, and that if you zoom in too closely on a baby's growth, you can miss the broad patterns. I'd also make sure that proper weighing procedure is followed each time. Use the same scale, and make sure that baby is always weighed nude. When there's any concern about weight gain, ounces matter, and you don't want to weigh baby in a diaper one time and nude the next time.

  3. #3
    Join Date
    Jun 2009

    Default Re: Overactive Let Down, Reflux or Allergies - low weight ga

    I agree with mommal. The only thing that stands out in your post to me (aside from the slow gain rate) is the low number of nursing sessions per day. Did baby ever nurse with more frequency?

  4. #4

    Default Re: Overactive Let Down, Reflux or Allergies - low weight ga

    Thank you both for your responses. I can see now how her dropping a feed can make a difference in weight gain. She has just been sleeping a good 6-7 hrs at night. For the past few nights when she has started to stir around 1, instead of letting her fall back asleep on her own (as she had been), I'm feeding her. Not sure she gets much then as she falls asleep soon after and only eats on one side. During the day, I've been trying to feed her more often, if she will nurse. Somedays, like now, she will take a long nap and go 3.5-4hrs. lllmeg, to answer your questions for the first 2 months she would eat 8-9 times a day.

    mommal - I agree week to week gain isn't the best thing to look at. I'm doing it myself, luckly dr was okay with her weight at 2mos, and we go back for 4mo appt in a few weeks. After having issues bfing my first, I've just been more on top of it this time. My first was supplemented with forumula and grew just fine, so I never worried about weight. With this DD she has gained about 1lb a month, so hoping dr is okay with that.

    In the meantime, I'm seeing a LC this week to talk to about all of this and have her check for ties. It does look like she has a lip tie and not sure about tongue.

    Thanks again for the advise!

  5. #5
    Join Date
    May 2006

    Default Re: Overactive Let Down, Reflux or Allergies - low weight ga

    Sounds like you've implemented a really common-sense approach for getting more a lories into your LO! A few more feedings per day- they can make a big difference. Let us know how it goes at the doctor's appointment.

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