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Thread: 4 wk old not swallowing when nursing, poor wt gain

  1. #1

    Default 4 wk old not swallowing when nursing, poor wt gain

    My 4 wo had a tongue tie which was clipped just over a wk ago. She's always had a strong suck but she's constantly feeding, coming off the breast after just a short period of time and also falling asleep on the breast. She was weighed this past Friday and she still is quite a bit under her birth weight but good wet/dirty diapers, alert and skin looks good. We've been to a LC who looked at her latch and thought it looked good but noted that she didn't seem to be swallowing hardly at all. I'm worried about my milk supply as well as she seems desperately hungry at times. Yesterday we caved and gave her a bottle of expressed bm as well as a bottle of goat milk formula, which was really upsetting but also made me realize that she was starving. My LC is away until the end of the wk and there's no one else locally to help. I think this is an issue of not swallowing and milk supply as I'm getting very little with pumping. Any ideas as to how can I encourage her to actually take in the milk? Thanks

  2. #2
    Join Date
    Mar 2014
    Location
    Central FL
    Posts
    1,575

    Default Re: 4 wk old not swallowing when nursing, poor wt gain

    My son now over 8 weeks just had his tongue tie/lip tie treated last week, I'm still working on improving his latch which still hurts a lot on my Rt side. Anyway, I've always had a fairly under active let down so my son spends a long time eating and only getting a very slow flow. I joke that he is being drip irrigated. And it is often hard for me to see/hear him swallow but I know that he has been getting quite a bit of milk out of me since he does drain the breasts and I've only been supplementing a small amount and he does gain weight.

    If you want to avoid the nipple confusion/flow preference situation you might get a lactation air or supplemental nursing system where you can put the expressed breast milk or formula in and feed it right at the breast (getting the stimulation at the same time as feeding the baby.)

    Hopefully your pump is a high quality one (double electric and able to adjust both speed and suction), if not, can you get a hospital grade rental for a time to help increase your supply?

  3. #3
    Join Date
    Jun 2009
    Posts
    9,652

    Default Re: 4 wk old not swallowing when nursing, poor wt gain

    I doubt your baby is starving. Certainly, a 4 week old who has not yet regained back to birth weight is concerning, and supplementing with your expressed milk, donated milk, or formula may well be indicated. But a baby who is pooping is unlikely to be starving. A baby taking a bottle is not, on its own, indicative that the baby needed a supplemental feeding. It is important to know this. How much a baby takes when given a bottle depends as much or more on how the bottle is given than if baby is actually hungry.

    Besides watching your baby nurse, what else did your LC do? A before and after nursing weight check? Did she work with you on latch? Did she show you how to do breast compressions? Did she discuss ways to increase milk production? Did she discuss using a lactation aid as tclynx suggests? Did she show you how to do paced bottle feeding? There is information on these things online, so you can research them yourself or we can provide links for anything you are not aware of. But I am just wondering what else happened at this appt.

    Now here is another barrage of questions. Sorry but your answers will help us understand more about what is going on.

    Is nursing comfortable for you? Painful? any nipple injury?

    Is pumping comfortable for you? how often are you able to pump each day (about?) What kind of a pump are you using and is it new or used? How much are you actually 'getting' when you pump? Pump output is not reliably indicative of milk production, however, it will tell us something.

    How many times a day is baby nursing? How long does baby nurse for typically? Does baby typically take both sides? Switching sides once or more each feeding is a fairly reliable method of increasing milk production.

    How many times a day does baby poop and what do the poops look like (size, look, consistency)

    Has baby been seen by a doctor and what is their opinion about baby's health, gain, and supplementing?

    Can you give us a complete weight check history?

    Even if you have to supplement, breastfeeding can continue while you figure this out, and at this point there is no reason to think you will not be able to exclusively nurse at some point. The general way to make sure breastfeeding is not undermined by supplementing is to keep nursing as much as you can, pump as much as you can, and supplement as needed using either a lactation aid or paced bottle feeding or cup feeding. Please let us know which things you need more info about.

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