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Thread: Ready to give up - 7 weeks and very slow gaining weight

  1. #1

    Default Ready to give up - 7 weeks and very slow gaining weight

    Losing faith and don't know what to do next. little one is gaining weight slowly and since our last weigh in (4oz in two weeks) things have gone from bad to worse. I've been feeding as much as possible (hourly sometimes), expressing every three to four hours and taking fenugreek to increase supply which seems to be working. I'm feeding our boy the expressed milk which he gulps down even after a feed - although he is often sick or bringing up milk afterwards. I still don't feel he's getting enough despite giving him an extra 3-400ml extra each day.
    Our breastfeeding technique seems to have gone out if the window - everyone tells me I have good positioning and he had a good latch, but he doesn't seem to be swallowing very often. (He'll happily suck on a Mandela Calma bottle taking 100+ml in 10-15minutes).

    Since starting this new feeding frenzy he's gone from a happy content baby to an unsettled, less smiley baby and I've gone from excited but anxious new mum to a nervous wreck who can't stop crying. He only sleeps when swaddled at night and takes a lot of settling. In the day he only sleeps on me or husband in the day which is exhausting when hubbie is at work, plus I have no opportunity to express...

    I can't see any solution bar switching to formula at the moment - expressing enough isn't happening and we have no life which is no good for him or me. I'm happy to adapt my life to suit him, but we haven't left the house (barely even the lounge) for over a week.

    I'm not sure what I'm after by posting this, I guess it would be good to hear from anyone who has anyone been through the same experience and come out the other side?! Also if we awitch to formula to build his weight up but continue the breastfeeding alongside each bottle feed, will we be able to get our technique back and return to exclusive breast feeding?! I feel like we're on the slippery slope and there will be no return from this if we switch now...

    Sorry for the long post. There's more to day but i should stop there!

  2. #2
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    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    I went through something sort of similar perhaps.

    You should probably try to get some hands on help from an IBCLC. Just because an LC says latch looks good, if baby isn't transferring milk well or if nursing hurts then things are not good and you need more help, an IBCLC should be able to help you.

    See if you can get a lactation aid so that you can supplement at the breast (Medela SNS or Lactaid), this should at least save you one step in that whole tripple feeding process (feed, supplement, pump) at least with an at the breast supplement you just Feed at the same time as supplementing hopefully giving you a little more time to possibly pump right after feeding. And with the lactation aid it is easier to transition back to breast from supplementing since baby is eating at the breast the whole time.

    Will baby occupy himself for ANY time when put down? Only way I was able to pump while DH was at work in the early days is because my son will spend somewhere between 5-10 minutes staring at the moving mobile with music. Once he is strong enough to push up on his arms he may be willing to spend a little tummy time before screaming too.

    do you have a baby carrier or wrap? If so, wear him whenever you are not nursing, pumping, feeding or changing. At least then you will be able to get up and move around a little bit (though that my only be a few minutes at a time since the tripple feeding schedule rarely leaves you much more than time to pee and if you are lucky wash pump parts and bottles.

    That is another thing, you might want to keep the pump parts in the fridge or a cooler so that you don't have to wash them every single time. Get an extra set so that you can have one to be using while the other gets washed. Of course make sure the pump parts fit you right and that pumping is comfortable.

    Next step is to figure out why your LO is having trouble with milk transfer.
    Here is a link to a thread I started back when I was finding resources to help my problems.
    http://forums.llli.org/showthread.ph...ransfer-Issues

  3. #3
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    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    Can you post a full weight history for your LO? Birth weight, lowest weight, weight at each check-up?

  4. #4
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    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    I'm not sure what I'm after by posting this, I guess it would be good to hear from anyone who has anyone been through the same experience and come out the other side?! Also if we awitch to formula to build his weight up but continue the breastfeeding alongside each bottle feed, will we be able to get our technique back and return to exclusive breast feeding?! I feel like we're on the slippery slope and there will be no return from this if we switch now...
    There is no need to "switch" to formula. If you are unable to pump enough, you can pump what you can, and supplement as needed.
    Or you can stop pumping entirely, encourage baby to nurse, and supplement with formula as needed.
    Or some combination that works for you.
    Yes, any time you reduce the amount a baby takes via the breast, or reduce pumping, that is going to harm milk production. OK. But you can only do what you can do. The slippery slope toward full in formula bottles is something to watch out for, definitely. But again, you can only do what you can do.
    Any time at the breast and/or any amount of breastmilk into baby is helpful in promoting normal health outcomes. Breastfeeding (or breastmilk feeding) need not be all or nothing.

    If you would like more help here, I would suggest giving us more info. As well as the weight history, What do you think is the primary issues? Low production, poor milk transfer, some combination? How many times each 24 hour day does your baby Nurse? How many bottles? How many times a day do you pump? What kind of pump? Are you using paced bottle feeding technique for bottles? Have you considered other ways to supplement? Who have you gotten help from? etc.
    what have you tried so far, etc.

    Since starting this new feeding frenzy he's gone from a happy content baby to an unsettled, less smiley baby and I've gone from excited but anxious new mum to a nervous wreck who can't stop crying. He only sleeps when swaddled at night and takes a lot of settling. In the day he only sleeps on me or husband in the day which is exhausting when hubbie is at work, plus I have no opportunity to express...
    You just described a normal baby. Poor weight gain is not normal and of course, not having enough to eat would be upsetting to a baby. I am not saying the behavior is not pointing to a problem. It might be. But what you describe here is the behavior of many entirely normal, healthy and gaining 7 weeks olds, breast of bottle fed.

  5. #5

    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    Hi all. Thanks for your responses so far. I'll add the weight details later, but a tough outline is:
    Birth weight 3360g
    Five days 3310g (lowest)
    Ten days 3610g
    15days 3550g (down)
    16days 3650g
    Home from hospital after 14 days of antibiotics for baby due to suspected meningitis
    3weeks: 3700g
    One month: 3850g
    6 weeks: 3970g
    Due to get him weighed today.

    I've seen a ibclc but we focused our session on getting his weight back up rather than the feeding issues. She suggested a feeding holiday, start expressing and feeding him the ebm and potentially introducing formula. I've done a week if virtually no stop feeding and pumping and my supply has definitely increased (taking fenugreek too) so don't think that's the issue.

    Since starting this, I'm managing to pump about six times a day an getting between 80ml and 120ml a session depending on time of day. In trying to feed him at he breast as often as he asks, which can be every two hours or so, and use breast compressions to help him, but he is struggling to latch in properly and get the milk. This seems to be getting worse (since introducing the bottle?). It looks like he isn't opening his mouth wide enough to me and I've got an osteopath appointment for him today to see if that helps.

    Also making a plan with HV today to look at introducing some formula. I would jut like to make sure that we don't lose the breast feed completely and feel like that's starting to happe with a lazy and/or a shallow latch (?)

    I've been shown many times how to improve the latch but however much I try we're just not getting it anymore...

    The only other thing to mention is that i went to a bf group locally this week and we discussed how building up his weight and strength (with formula where ebm has run out) will help him to regain his latch and bf ability in the longer term. Is this the case? Do they improve as they get bigger and stronger? Obviously along with more practice and perfecting technique from me???

    Thanks again for the help. I really want carry on breast feeding him- and while I feel much more positive than af we days ago, still have a horrible feeling that this is the beginning of the end unless we can sort or the transfer issues...

  6. #6

    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    Forgot to add that he had his tongue tie snipped at 5 and a half weeks... It seems to be since this that his weight gain has significantly slowed...

  7. #7
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    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    Quote Originally Posted by @llli*writingroad View Post
    Forgot to add that he had his tongue tie snipped at 5 and a half weeks... It seems to be since this that his weight gain has significantly slowed...
    http://forums.llli.org/showthread.ph...ransfer-Issues

    It took several weeks of oral motor therapy before my LO was able to improve his latch and milk transfer.

    Bottles also caused issues for us. I recommend using a lactation aid so you can do the supplementing right at the breast.

  8. #8
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    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    Ok I cannot convert grams in my head and don't have time to convert at the moment so I am winging this. If I stumble with the math, please forgive me.
    If birth weight was 3360 grams and baby was above that by 16 days, that is within normal expectation. The expectation is that baby be back to bw by 2 weeks give or take. The blip with weight going sharply down then sharply up down just prior to 16 day check makes me wonder if checks were always on the same scale.

    After the two week (16 day) check, that first week home, gain was very slow. 2.5 ounces, or about a third what you would expect for that amount of time. But between 3 weeks and one month, it was 5.5 - normal gain
    IN the next two weeks, gain was again as slow as the previous slow week.
    This is odd. Gain is not usually exactly the same each week, of course, but this much of a difference raises questions in my mind.
    What were these checks all being done on? What kind of scale(s) and were they different scales?
    How was/is babies output-how many poops a day, how big about and what do they look like?

    I've seen a ibclc but we focused our session on getting his weight back up rather than the feeding issues.
    Unfortunately this is typical. Obviously working on getting baby gaining is important. but the reason you see an IBCLC - a lactation specialist with specialized education and training on solving breastfeeding issues- is to figure out what is going wrong so that issue can be solved. A baby "should" be able to gain normally exclusively breastfed. So figuring out why baby is not. and solving those issues is the problem that you need help solving and what an IBCLC should be doing when seeing a mom and baby. Was this an independent IBCLC or with your hcp? Did you like him or her? Can you see them again?

    Since starting this, I'm managing to pump about six times a day an getting between 80ml and 120ml a session depending on time of day.
    That is good frequency when baby is nursing often as well, very good!

    In trying to feed him at he breast as often as he asks, which can be every two hours or so, and use breast compressions to help him, but he is struggling to latch in properly and get the milk.
    This is the problem that needs solving. Formula will not solve a latch or sucking problem. Also, do you mean baby nurses about 12 times in 24 hours? That would be normal nursing frequency at this age.

    This seems to be getting worse (since introducing the bottle?). It looks like he isn't opening his mouth wide enough to me and I've got an osteopath appointment for him today to see if that helps.
    absolutely bottles can make baby not nurse as well.
    as tclynx suggests, if baby is able to latch and nurse, an at the breast supplementer may be a better choice for supplementing.
    But if bottles are needed, it is important how they are given and how much at a time. small amounts at a time-no more than an ounce or two- is where you would want to start. and given with paced bottle feeding method-. Nursing baby either before or after the bottle, or both, can also help.

    If you are pumping 2-4 ounces each time you pump, which is very good per session output, I would wonder why your baby needs formula. There must be something very wrong with your baby's ability to transfer milk at the breast, as a normal feed at this age would be about 2 ounces, 3 at most. And pumps are typically less effective at getting milk out than a baby.

    The only other thing to mention is that i went to a bf group locally this week and we discussed how building up his weight and strength (with formula where ebm has run out) will help him to regain his latch and bf ability in the longer term. Is this the case? Do they improve as they get bigger and stronger?
    Yes, IF a baby is exceedingly weak due to lack of nutrition, that can certainly adversely effect babies ability to suckle. But your baby IS gaining weight, even though slowly, and so that indicates baby is getting at least enough milk to have the strength to eat enough. And yes, typically babies in general do get more efficient at the breast as they get older and stronger ASSUMING THERE IS NO UNDERLYING ISSUES PREVENTING NORMAL LATCH OR SUCKLING ABILITY. With your history, I think you have to assume there probably IS some underlying issues affecting your babies ability to latch and suckle effectively. These can be hard to figure out and solve, but not impossible by a long shot. Also, you are doing great because you are pumping as well which is keeping your milk production in good shape or at least in much better shape, even though baby is having difficulty getting enough milk at the breast.

    Obviously along with more practice and perfecting technique from me???
    Yes, this of course necessary and will help. But again, you need help figuring out what the problem is so you can work on fixing that specific issue. This is what your hcp should be providing you. I am guessing you are in the UK. The info on this thread may help you?http://forums.llli.org/showthread.ph...=#post1340428c look for the posts from bsua65
    Last edited by @llli*lllmeg; August 5th, 2014 at 09:27 AM.

  9. #9

    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    Thanks for the replies. It's been a tough week but we got there and his weight was much better putting on 7oz in seven days. However the week we've just had isn't sustainable... I'm feelin too close to the edge, so think we'll have to introduce a bottle of formula just to take the pressure off as the pumping just can't keep up with his demand now that he is in catch up to get back to the 25th centile (he's dropped to about 5th).

    In answer to the questions posed, he is filling lots of nappies, they had been very green , but have now returned to a yellow seedy colour. He is having 5 or 6 dirty nappies of considerable amounts each day. Plenty of wet nappies too so no concerns about dehydration. We've been giving him 400ml at least a day and he's feeding around ten times in 24?hours.

    I've seen an ibclc who gave me the feeding plan to improve his weight gain, and I spoke to her again today - she suggested giving it over the weekend and if nothing has changed between now and then meeting again to look at our technique. However I'm not sure I can last that long and am worried little one is going to carry on dropping percentiles if we dont supplement.

    I was starting to feel much more positive yesterday after weight gain, and a successful Half hour at the breast but today his nappies have gone back to the dreaded green for the first time in a week and his latch seems non-existent. So disheartening after such a good week. He's still smiling though, and does seem a bit more settled again, so the smiles are what is getting me through...

    This is so tough but I jut can't see how to get of this downward cycle without cracking what caused the issue in the first place?! And i can't work out who will be able to help me with this.

  10. #10
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    Default Re: Ready to give up - 7 weeks and very slow gaining weight

    So weight gain was normal when you were nursing 10 times a day and supplementing about 400 mils or about 14 ounces a day, of your expressed milk? Hmmm.

    This has got to be about baby having an issue with transfer. If you are pumping that much or anything like it, while your baby is nursing 10 times a day and gaining normally, your milk production is surely fine. If you cannot hold out until the weekend, then can you try to see IBCLC again sooner?

    Look that is a lot of supplement. Almost half of normal average daily intake. If you are able to pump that much, this is not about milk production, OR, perhaps, you have solved the milk production part of whatever has been going on with your dedicated pumping.

    Here is what I suggest. If you cannot sustain that much pumping, and giving your baby a little formula is going to keep you holding on to keep trying, for goodness sakes, give the formula. Because if a mom makes enough for her baby, that is half the battle won already. So I would suggest, don't give up now. If a little formula now, and a couple less pumping sessions is what will allow you to keep going, then do it. Yes this may impact your milk production but not too badly unless it goes on too long. Sometimes you have to lose a battle to win the war.

    But get help with whatever is going on with baby that he cannot nurse efficiently. That is the key.
    and his latch seems non-existent
    if a baby is getting lots of supplement, they may not be hungry enough to nurse efficiently. So look out for that too.

    What I do not understand is 1) Why green poops are "dreaded." Generally, You want to see lots of poops. At least 3-5 a day. Not little streaks, they are normal but do not 'count.' what counts is a poop that you could scoop up in a spoon if you wanted. That is how you know baby is getting enough. If there is lots of poop, the color is probably not an issue.
    2) Why you think you are on a downward spiral. Baby has gone from gaining 2 ounces a week to 7, entirely due to your efforts. That sounds like very much upward mobility to me.
    3) If anyone is suggesting your child now has to "catch up" to some number on a chart, no wonder you feel hopeless. Please understand this is not true. Percentiles are not lines no baby may cross, babies actually fluctuate around percentiles all the time. If 25 was the birth percentile, that is probably almost entirely irrelevant at this point.

    Weight charts that track gain rate are guides to let a hcp know something may be up with a baby, healthwise. Well, you knew that already, right? Gain was certainly slow. And you have taken steps to correct the issue, and those steps appear successful. Now, you want baby gaining normally. And 7 ounces in a week is normal weight gain. It is irrational to expect a baby to start gaining loads more than what is normal gain so that they can get back to some number on chart.
    Last edited by @llli*lllmeg; August 7th, 2014 at 01:10 AM.

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