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Thread: 3 month old not feeding efficiently and losing weight

  1. #1

    Default 3 month old not feeding efficiently and losing weight

    My 3 month old nurses for a very long time (30-40 min per breast). She doesn't nurse efficiently - she sucks a little rests sucks a little and she seems to have no energy when sucking. Many times she just falls asleep on breast then she is hungry 20 min later again because she didn't get all the milk out. So she doesn't even empty the breasts. She had her tongue tie clipped. She is not gaining weight as fast as pedi wants her to and they are about to put her on formula but I keep fighting it because I want to exclusively breastfeed her. I saw 3 LCs and none of them could solve this. I saw a pediatric GI. No one can help me. Please help!!!

  2. #2
    Join Date
    May 2006
    Posts
    21,097

    Default Re: 3 month old not feeding efficiently and losing weight

    Welcome to the forum!

    Can you tell us a bit more about nursing and about your baby? For example:
    - How does nursing feel?
    - How many times per day day baby nurse?
    - Does the baby take both breasts at most feedings?
    - Can you post baby's complete weight history for us?
    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!"

  3. #3

    Default Re: 3 month old not feeding efficiently and losing weight

    Nursing feels fine - no pain or unusual feeling. Baby nurses every 2-3 hours a day (usually every 2 or even more often since she is not transferring enough milk at a feeding). She doesn't stay content very long after a feeding because she is still hungry (she stays content longer and sleeps longer after a bottle of EBM). I know I have enough milk because I can still see it coming out or squeeze some out after the feeding. She takes both breasts at a feeding. Main pedi concern is that she is not gaining weight fast enough (went down from 30th to 6th percentile in 3 months). She started at 7 lbs 8 oz when she was born and right now she is 10 lbs 11 oz. She is not gaining 1 oz a day as recommended. One LC told me to supplement with a bottle of milk after a feeding but now after doing that for a week I am running low on expressed breast milk (I sometimes don't have time to pump after each feeding as she recommended to do). I am trying to get into a feeding clinic but the wait times are ridiculous and I don't have that much time. Basically I am lost because I have no idea who can help me.

  4. #4
    Join Date
    May 2006
    Posts
    21,097

    Default Re: 3 month old not feeding efficiently and losing weight

    Thanks for providing more information.

    Okay, so nursing feels good- that's excellent, since it suggests that baby can latch on deeply enough. It sounds like the problem might be more that she is a pretty sleepy baby who isn't a particularly efficient feeder, for whatever reason. If she had a tongue tie, she may still not be perfect at using her tongue even though the tie was released. So I think it's very good that you're trying to get into a feeding clinic, though I would encourage you to see the LCs again- hopefully they can pick something up this time.

    Sleepy babies can sometimes be encouraged to eat more at a feeding with the following strategies:
    - Keep the baby cool while nursing; a cool baby is more alert. When it's time to nurse, strip her down to a single light layer or even just a diaper if you're somewhere warm, and keep a fan blowing in the room where you're nursing (just not directly on the baby).
    - Annoy the baby when she seems to be drifting off. Rub against the grain of her hair or tickle the soles of her feet using your hand or even a cool damp washcloth.
    - Do breast compressions to speed milk flow to the baby.
    - Try switch nursing. When baby transitions to shallow, erratic, sleepy sucking, take her off the breast, change her diaper, and switch her to the other breast. Repeat this process until the baby will no longer wake.

    I agree that your baby's weight gain is a little slow. But it's not necessarily abnormal; see http://kellymom.com/bf/normal/weight-gain/ for normal weight gain in breastfed infants, and please note that it is acceptable for some babies to gain just 4-5 oz per week, which is less than 1 oz per day. It would be interesting to know what you and your baby's dad were like as babies, and what you're like now: were you smaller, more slender babies? Are you smaller, more slender people today?

    It's also going to be interesting to see if supplementing makes a big difference here. If baby's weight jumps right up, then maybe that is an indication that she hasn't been able to get her needs met while nursing. If it stays pretty much the same, maybe she's just genetically destined to be a smaller, lighter baby.

    As you are supplementing, you definitely want to be pumping, as well. Try to stay even with the supplement amounts and you'll have an easier time going back to exclusive nursing in the future, because your supply will stay equivalent to baby's needs. What sort of pump do you have? In this sort of situation, you want to be using a good double electric pump (think Medela Pump in Style, Hygeia are Enjoye, or even a hospital-grade rental).

    When you supplement, try to do it in a breastfeeding-supportive manner. Ideally, you would nurse, offer a couple of oz of expressed milk, and then nurse again before pumping- this technique is called "finish at the breast" and it helps the baby associate feelings of satiation and relaxation with the breast rather than the bottle. You also want to make sure you feed baby the bottle in a breastfeeding-supportive way- cuddle her close to your bare chest, switch her from side to side about halfway through, and pause the bottle after every oz or so of milk.

    Does the baby sleep long stretches at night, or is she up a lot nursing?
    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!"

  5. #5

    Default Re: 3 month old not feeding efficiently and losing weight

    Thank you this is very helpful advice. I haven't done bottle feeding where she finishes at the breast yet but just recently I got a supplemental nursing system (medela) where one end of the fund goes into her mouth so she sucks the milk from bottle and breast at the same time. I used it a few times and it seems to be working. Except few days ago she started pulling off my left breast only a few minutes into nursing without finishing (breast still feels full) and not being content. I not sure what's up with my left breast. Of course it could be anything but I don't know how to keep her going. I relatch her but she pulls off again. To answer your other questions - both my husband and I are slender people. It makes me feel a little better that it's ok to have a little slender baby although I feel pressure from pedi to have her in higher percentile for weight. At night her sleep varies - she slept 7 hour stretches a few times and I think that's when my supply dropped but now she is up every 3-4 hours.

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