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Thread: Slow weight gain help: 2 week old

  1. #1
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    Jun 2015
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    Default Slow weight gain help: 2 week old

    My 2 week old is not back to his birth weight of 9lbs 7oz. He is currently 8lbs 15oz and gained 3oz in the last week. He had a tongue tie snipped 5 days ago and he nurses 10-12 times a day and has 8-10 wet diapers and 6-7 dirty ones. He seems to be getting enough milk based on diapers but isn't gaining a ton of weight. The Lactation consultant suggested giving him 1oz of pumped milk a day until he's back to his birth weight. Any other suggestions on what's going on? I'm taking Fenugreek and Blessed Thistle as well.

  2. #2
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    Jun 2009
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    Default Re: Slow weight gain help: 2 week old

    Hi! Hopefully we can help you figure out what is going on.

    Can you describe the poop diapers in more detail? "size' and what the poop looks like?

    What was your child's birth like? Did you have IV fluids?

    Did you experience a clear sensation or sign when your milk "came in" (became more abundant) and when was that if you did?

    Do you every feel full between nursing sessions?

    What was 24 hour weight (if you know)

    Do you know the lowest known weight and what day of life was that?

    When you say baby gained 3 ounces in one week- do you mean from day 7 to day 14? Or other? Were those weight checks on the same scale?

    Does it appear to you that the frenotomy has helped baby with transferring milk?

    About how long is each nursing session and does baby usually take one or both sides? 10-12 times is the average amount of times a newborn will nurse in 24 hours. Some will need to nurse more often to get enough.

    The Lactation consultant suggested giving him 1oz of pumped milk a day until he's back to his birth weight.
    One ounce a day, or one ounce every feeding?

    What else did the LC do at your consultation? was there a before and after nursing weight check done? Nursing assessed, latch suggestions given, discussion of ideas for helping baby get more at the breast, like breast compressions or switch nursing, etc?
    Last edited by @llli*maddieb; June 26th, 2015 at 07:56 PM.

  3. #3
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    Default Re: Slow weight gain help: 2 week old

    The poops are yellow and look like seedy mustard. They range from small to medium sized.

    I had a csection and did have an IV.

    My milk came in on day 6. I was checking by expressing each day after birth.

    My breasts don't feel full. I think I have a decent supply going. The Lactation nurse weighed him before and after feedings and he was doing a good job extracting milk.

    I don't know a 24 hour weight unfortunately and the lowest weight I'm aware of is 8lbs 12oz on day 6.

    3 ounces were gained from day 6 to day day 14. Tongue tie was snipped during that time on day 10. The weight was done at the same office but different scale.

    Since the frenotomy his wet diapers are heavier and I'm not having any more pain. It does seem to have helped.

    He nurses anywhere from 20min to cluster feeding for 3+ hours. I switch him from side to side after ~10 minutes. I'm also putting pressure on my breasts to help milk come down per the Lactation nurse's suggestion during feedings.

    She suggested one ounce per day until he hits birth weight. Giving it during the cluster feeding.

    The Lactation nurse assessed the latch and suggested a tongue tie. She said the latch looks good since correction. She did pre and post nursing weights as well and he was taking good amounts ~40ml pre frenectomy and ~45 after. She suggested compressions while nursing and pumping 2x daily along with Fenugreek and Blessed Thistle.

    Thanks for helping. I'm really hoping it works out with my son. My earlier experience with my daughter was tough after an emergency csection and I ended up pumping with her for 8 months. Hoping things are smoother this time around.

  4. #4
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    Default Re: Slow weight gain help: 2 week old

    The poops are yellow and look like seedy mustard. They range from small to medium sized.
    Are at least 3-5 a day the size described here? http://www.llli.org/docs/00000000000...diaper_log.pdf
    I had a csection and did have an IV.

    My milk came in on day 6. I was checking by expressing each day after birth.
    So a C-section might lead to birth weight being "inflated." C-section would also lead to delayed lactogenesis, which would explain why milk took longer than average to "come in"

    The weight was done at the same office but different scale
    All checks must be done on the exact same scale, or they may be inaccurate, enough to make a real difference. Yes this really happens.

    Since the frenotomy his wet diapers are heavier and I'm not having any more pain. It does seem to have helped
    Great!

    He nurses anywhere from 20min to cluster feeding for 3+ hours. I switch him from side to side after ~10 minutes. I'm also putting pressure on my breasts to help milk come down per the Lactation nurse's suggestion during feedings.
    Do you think the breast compressions are helping? Also, are you deciding to switch breasts based on time or when baby starts slowing down or falling asleep? Switching sides in general is a good way keep a sleepy baby nursing longer, but if you switch sides too early, baby may not be getting enough of a complete feeding at the first side.
    The Lactation nurse assessed the latch and suggested a tongue tie. She said the latch looks good since correction. She did pre and post nursing weights as well and he was taking good amounts ~40ml pre frenectomy and ~45 after. She suggested compressions while nursing and pumping 2x daily along with Fenugreek and Blessed Thistle.
    Ok, great, this sounds good overall- but does she suspect low milk production, or are the galactaggues just sort of 'in case?" Sometimes if milk production is the problem, pumping or hand expressing after some nursing sessions to "empty' the breast more efficiently can help a lot. This expressed milk does not need to all go to baby that day, necessarily. If baby is getting enough at the breast, expressed milk can be stored for a later date or donated as you like.

    What do you think about supplementing one ounce a day? It is a very mild intervention that is unlikely to cause any breastfeeding issues, but if that is all baby needs, I wonder if it might be much easier to try to nurse at least one more time a day? It seems like a lot of work to drag out a pump and wash bottles etc. for such a small amount of supplement.

  5. #5
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    Jun 2015
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    Default Re: Slow weight gain help: 2 week old

    Quote Originally Posted by @llli*maddieb View Post
    Are at least 3-5 a day the size described here? http://www.llli.org/docs/00000000000...diaper_log.pdf

    Yes the poops meet the sizes described.

    Do you think the breast compressions are helping? Also, are you deciding to switch breasts based on time or when baby starts slowing down or falling asleep? Switching sides in general is a good way keep a sleepy baby nursing longer, but if you switch sides too early, baby may not be getting enough of a complete feeding at the first side.
    Ok, great, this sounds good overall- but does she suspect low milk production, or are the galactaggues just sort of 'in case?" Sometimes if milk production is the problem, pumping or hand expressing after some nursing sessions to "empty' the breast more efficiently can help a lot. This expressed milk does not need to all go to baby that day, necessarily. If baby is getting enough at the breast, expressed milk can be stored for a later date or donated as you like.

    I do think they help. I can see him swallowing more when I do them and also keeps him awake. I've been switching if he gets sleepy but sometimes sooner which it sounds like I should stop.

    The supplements are a just in case. I think I have enough milk, I can pump a decent amount and I can see him swallowing a lot while eating, plus the 8-10 wet diapers a day seems like a good indicator. Also when she measured his milk intake it was fine at ~40-45 ml.

    What do you think about supplementing one ounce a day? It is a very mild intervention that is unlikely to cause any breastfeeding issues, but if that is all baby needs, I wonder if it might be much easier to try to nurse at least one more time a day? It seems like a lot of work to drag out a pump and wash bottles etc. for such a small amount of supplement.
    I can add another feeding but it seems like all he does is eat right now. Her main concern is getting him back to birth weight before my next peds check up next Thursday. She mentioned once babies get to their birth weight things seem to smooth out with feedings. I'm just frustrated because he is eating alot I think and peeing and pooping alot but weight gain is slow so it feels like I'm doing something wrong. The Lactation nurse felt since the frenectomy was only 6 days ago that he might take an extra week to get back to birth weight.

    Thanks for the help I really appreciate it.

  6. #6
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    Default Re: Slow weight gain help: 2 week old

    Ok, I do agree it is important to get baby gaining faster, because after about one week gain normally averages 5-8 ounces a week and that is what you would want to be seeing to be most sure all is going well. But I also think "back to birth weight' is just a fairly arbitrary number and not the holy grail. For one thing, your baby may have had an inflated birth weight in the first place, for another, weights taken immediately after birth are very likely to be incorrect just from human error, and for another, we have no idea how much baby actually lost total in the those first few days after being born. Weight may have gone lower than 8 lbs 12 ounces, in other words, and that weight check at 6 days may have been after some re-gain.

    I think whatever you can do that works for you is fine to try. Certainly supplementing a small amount of breastmilk each day is not going to harm breastfeeding and of course may help as long as the supplements are given in a breastfeeding supportive way. Did your LC discus how to give supplements? They can be given in a syringe, spoon, cup, or bottle, bottle being the most likely to cause problems, but ok as long as you let baby control the milk flow, I will link info on all this below.
    but it seems like all he does is eat right now.
    That's normal! The real problem is if a slowly gaining baby does NOT want to eat lots.

  7. #7
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    Jun 2009
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    Default Re: Slow weight gain help: 2 week old

    Paced bottle feeding: http://www.llli.org/docs/00000000000...astfedbaby.pdf and vids: https://www.youtube.com/watch?v=UH4T70OSzGs and https://www.youtube.com/watch?v=ykdFuEOIdeE (IGNORE comments this is a perfectly healthy and appropriate way to give a bottle.)

    Alternatives to bottles (not including cup) : https://www.youtube.com/watch?v=vrrrC5NyNnQ
    Cup feeding: http://www.breastfeedinginc.ca/conte...me=vid-cupfeed

  8. #8
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    Jun 2015
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    Default Re: Slow weight gain help: 2 week old

    Thanks so much for the support. I have a syringe and tube to use for supplementing bm. He is gaining and I think my pediatrician was just making me nervous but it sounds like we are on the right track as he probably lost more weight than we measured.

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