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Thread: Doc concerned with LO weight gain

  1. #1

    Default Doc concerned with LO weight gain

    My son was born on 4/7/14 weighing 9 lb, 4 oz. He dropped to 8-4 before we left the hospital 4 days later, but was back to 9-5 at his 2 week appointment. At his 2 month appointment this past Tuesday, he was 11-12, but had a touch of a stomach bug (as noted by diarrhea - not seedy, watery stools). His vaccinations were pushed out a few days. We went back Friday for shots and a weight check, and he was down to 11-6 (same scale as previous visit).
    In the days between visits, I met with our LC twice and did a before/after weight feeding. At that feeding, Jake didn't eat as good as he usually does but managed to gain 3.4 ounces. LC suggested fish oil 3x/day and a couple of diet changes. She also suggested compression feeding in an attempt to shorten Jake's usual 45-55 minute feeding sessions. Now the ped wants me to supplement with BM, does this mean adding a feeding or 2 or replacing a current session at the breast with an expressed feeding? Any other suggestions??? I see the LC again Monday for a weight check.

  2. #2
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    Default Re: Doc concerned with LO weight gain

    How many times a day is he eating?
    I wouldn't "replace" any feedings with supplement, rather add feedings or add supplement to any feedings that he doesn't seem satisfied with. (this is of course my opinion and totally not a professional one.)

    Do you have a stockpile of expressed breast milk?

  3. #3

    Default Re: Doc concerned with LO weight gain

    He's eating 7-8 times a day - once over night and every 3 hours while awake (around naps, usually one 1 long one a day and 2-3 shorter ones). I pump twice a day - during his long nap and after he's in bed for the night. We have a decent supply of frozen BM (about 90 oz). Since the LC visit, I've been pumping around 4 oz per session. The bottles we have given him are 3.5 oz as of this week.

  4. #4
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    Default Re: Doc concerned with LO weight gain

    Quote Originally Posted by @llli*liljake.mom View Post
    He's eating 7-8 times a day - once over night and every 3 hours while awake (around naps, usually one 1 long one a day and 2-3 shorter ones). I pump twice a day - during his long nap and after he's in bed for the night. We have a decent supply of frozen BM (about 90 oz). Since the LC visit, I've been pumping around 4 oz per session. The bottles we have given him are 3.5 oz as of this week.

    Sounds like you have plenty of supply, I would say just feed a little more often if you can. Most breastfed babies will nurse at least 8-12 times during 24 hours. Will he dream feed if you try to nurse before going to bed?

  5. #5
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    Default Re: Doc concerned with LO weight gain

    Was the doctor concerned about the 2 month weight check, or the apparent loss of weight between the two most recent appts? Or both? I guess I am confused what is so worrying that supplements are needed-unless my math is off, always a possibility, gain between 2 weeks and 2 months seems pretty close to normal, and the sudden drop in weight could be from the illness or scale error or both. (Good that scale was the same, but that does not rule out human error.) Another way to look at this is, if baby was not weighed at two months, and you only came to the apt after the illness, gain would have been recorded as 2 pounds in 6 weeks, or about 3/4 ounce per day. That is a little slow, but many doctors would not suggest supplementing based on that type of gain.

    Anyway, I agree with tclynx, try to nurse more often. 7-8 times a day is on the low side of normal frequency and simply is not often enough for some babies. Supplementing with your own milk in bottles is fine if needed of course, but will tend to further interfere with baby's ability to nurse effectively and frequently enough. Plus is a lot more work than just nursing more often. If you are supplementing, this means 'in addition' so it is important the supplements do not lessen how much baby nurses at all. This can be tricky, which is why supplements even of moms own milk can be problematic fro breastfeeding. Try to supplement only small amounts at a time, before and after nursing sessions as you like, using paced bottle feeding technique. And again, I would suggest getting clarity on what the concern is and what type of gain is expected, so you do not end up supplementing forever.

    For the long feedings-Are the breast compressions helping? Another way to help baby get more milk more quickly is to switch sides during a nursing session, more than once if you like.



    I hope the fish oil was for you, not baby. But why? Does she suspect you are nutritioinally deficient? It sounds as if you make lots of milk. So I don't understand that concern there.

  6. #6

    Default Re: Doc concerned with LO weight gain

    I have never tried dream feeding - or heard of it. We are trying to get in 1-2 extra feedings this weekend before I go back to LC on Monday.
    Doc was concerned about the 2 month weight and then a further drop in 3 days. Doc is concerned because he isn't following the curve. I agree that much of a drop seems like an error somewhere but it is an electronic scale. LC actually did the counting and Jake gained 37 ounces in 50 days. And from what I have seen this is an acceptable weight gain but towards the lower end.
    Compressions are helping a bit with the length but not much of a difference. My breasts definitely feel more empty and baby seems fuller as well.
    Fish oil is for me to try to increase the calories/fat in my milk, but supply does seem to have increased. Just in the couple of days I've taken it I'm noticing more fullness between feedings.

  7. #7
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    Default Re: Doc concerned with LO weight gain

    I expect adding feedings and doing compressions are what has actually had a bigger effect on your milk supply since anything that empties your breast more or more often is what triggers the body to make more milk.

    Dream feed is what I've seen some ladies on here call it when you get the baby up to nurse but basically don't try to wake him up but let him nurse in his sleep.

    Baby taking a really long time to nurse might simply be that he likes to take his time eating but it could also be a sign of a disorganized suck/swallow which might benefit from some type of physical therapy or suck re-training. Does your LC know anything about that or can she help you find some one to help you with that? We just started seeing a speech therapist with our LO to help with our nursing issues. Just make sure to find a therapist that is experienced and trained in the proper ways to work with infants with such problems.

  8. #8

    Default Re: Doc concerned with LO weight gain

    We tried to fit in another feeding today but with LO taking an extra long nap recovering from vaccinations yesterday, it didn't happen. We did make sure to get at least the same number by cramming them together - closer to every 2 hours than every 3. He did ok, but was unable to finish his usual bottle in early evening.
    There is no problem with LO's suck; both ped and LC have commented on how strong and steady it is.
    We'll keep pushing tomorrow and will keep you updated, especially after the weight check on Monday. Thanks for the support ladies!

  9. #9

    Default Re: Doc concerned with LO weight gain

    So we went to see the LC for a weight check Monday afternoon. She agreed that something must be off with the dic's scale. Anyway her goal was that Jake would be at 11-10.8 as he had weighed 11-8.8 before our weighed feeding. Jake weighed in at 12-1.8, a 9-ounce gain in 4 days!! LC was going to call the doc for me. We go back on Thursday for another weight check just to satisfy the powers that be.
    Thanks again for your support!!

  10. #10
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    Default Re: Doc concerned with LO weight gain

    Good news! And thanks so much for the update. Your experience shows how important it is to keep on top of a situation when weight gain is in question so you don't end up supplementing baby more than is needed or longer than needed.

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