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Thread: 4m/o - Slow weight gain, fussy nursing, refuses bottle

  1. #1

    Default 4m/o - Slow weight gain, fussy nursing, refuses bottle

    Hi all,

    I'm really struggling right now with feeling guilty for breastfeeding as I watch my DS struggle to gain weight (my parter feels like none of this would be an issue if we had be mixed feeding from the get go). We started giving him the occasional bottle shortly after he was born but at 6 weeks he started to refuse the bottle. Now he has started to be a fussy breastfeeder - frequently pulling off even when letdown isn't strong and generally not seeming to want to eat very much and I feel like my supply is dropping because it doesnt sound or feel like he is getting as much from my letdownds. I try to feed him about 11x per day. He was diagnosed with mild tongue tie at 3 mo, but I resisted getting it clipped bc I felt like maybe it wouldn't help since he was so old.

    His weights have been as follows: birth 8lb11oz, 1mo ~10lb, 2mo 12lb1oz, 3mo 13lb11oz, nearly 4mo 14lb3oz.

    I have to go back to work in a month and I'm terrified he is going to refuse to eat and start loosing weight. I'm thinking of trying to start EPing and trying to force the bottle issue so that he is a) ready for when I go back to work and b) so that we can have a better idea of how much he is taking in. Do you think this could work, or am I just going to torture my baby by refusing to give him the breast and only offering pumped milk in a bottle?

    My parter is going to be home with him for 5 weeks when I go back (before he goes to child care) and I would rather him get through the fussiness with me and learn to take a bottle than get to that point and have him flip out when I'm gone.

  2. #2
    Join Date
    May 2006
    Posts
    24,794

    Default Re: 4m/o - Slow weight gain, fussy nursing, refuses bottle

    Can you start by giving us a complete weight history, including birth weight, lowest known weight, and weight at each checkup? It helps if you put things in the following format: baby's age in weeks or months - baby's weight in pounds and oz and/or kg.

    It would also be helpful to know some of your breastfeeding basics, including:
    - How often does baby nurse? (# of times per 24 hour period)
    - How does nursing feel?
    - Does the baby sleep long stretches at night?
    - Have you tried methods other than the bottle to feed the baby?
    - Who typically gives the bottles- back when the baby was taking them, that is- mom or partner?

    It's rarely a good idea for a mom to transition to exclusive pumping if her goal is to continue to breastfeed. EP is generally much harder and more time-consuming than nursing, typically does not maintain supply nearly so well as nursing or combining nursing with bottle-feeding, and offers none of the parenting benefits of breastfeeding. Let's see if we can find another way!

  3. #3

    Default Re: 4m/o - Slow weight gain, fussy nursing, refuses bottle

    Birth weight was 8lb11oz
    Lowest weight was 7lb15oz on day 3
    2 week weight 9lb3oz
    2 month weight 12lb1oz
    3 month weight 13lb11oz

    He nurses about 11 times a day about every 1.5 hours during the day and the 4 times between 8pm and 8am. Nursing doesn't hurt me but baby just doesn't seem relaxed at all and frequently pulls off when milk starts coming out. He won't let me nurse him in the cradle hold when he is awake and arches his back and tries to get upright but he won't let me nurse him in upright positions either - pretty much only sidelying during the day. At this point my letdowns feel a lot shorter/weaker so i feel like my supply is going down. If we are out and he is hungry enough he will nurse in the carrier. I was thinking it was distraction but now I'm starting to think it's reflux. I cut out dairy a day ago but it will take time to see if that helps.

    We have tried cup, syringe, and sippy cup feeding with pretty poor results - he spits most of it out onto his shirt. His daycare requires him to take a bottle though so it NEEDS to happen before Jan. We have both tried to feed him, including having me leave for 4 hours but he chose to just go to sleep rather than eat.

  4. #4
    Join Date
    May 2006
    Posts
    24,794

    Default Re: 4m/o - Slow weight gain, fussy nursing, refuses bottle

    Thanks for posting all of that!

    Based on the weights, I am scratching my head, wondering why anyone would say this kid is having trouble gaining weight. He seems to be doing beautifully, cruising up right around the 50th percentile, see http://cdn5.kellymom.com/images/growth/growthcharts.gif. Can you explain why you feel like he has trouble with weight gain? I feel like I must be missing something!

    It sounds like your baby is a fussy nurser, but that's pretty normal. Nursing doesn't hurt, the nursing frequency is good, and weight gain seems just fine, so fussiness isn't really a worrisome issue. I wouldn't worry about the shorter/weaker letdowns- most moms feel their letdowns more powerfully in the early weeks/months of breastfeeding, when supply often exceeds demand. When supply and demand are well matched, letdowns tend to be less detectable.

    Can you contact the daycare and discuss the bottle issue? I am pretty sure that your baby will eventually take a bottle- just keep trying. Try different bottles, milk temperatures, have dad or grandma try giving the bottle. But I'd be a little concerned if my daycare was adamant that a baby had totake a bottle- I'd see it as a sign that they weren't interested enough in working with parents and flexing to accommodate the needs of individual babies. Maybe they would be open to using a sippy cup if you explained that tour child is still working on using a bottle.

  5. #5
    Join Date
    Jun 2009
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    10,754

    Default Re: 4m/o - Slow weight gain, fussy nursing, refuses bottle

    This whole situation has me feeling sad for you.

    You are blaming yourself for breastfeeding...so sad. Your baby is being fed normally. Biologically, nursing at the breast is the only normal way to feed a baby.
    Baby is gaining fine if those numbers are correct. So there is no need for supplements or worry or "mixed feeding." There rarely is.
    If your child really does need to take supplements due to poor gain, those can be given at the breast with an at the breast supplementer. (Lactation aid.) If the concern is truly one of poor gain, and baby will not take nourishment in any way except at the breast, wouldn't supplementing at the breast be the thing to try, rather than taking the very risky step taking away baby's only currently successful way of eating?


    Baby is refusing taking a bottle. OK. There are lots of ways to get milk into a baby and yes, none of them are as simple and non-messy as the breast is (once nursing is going well.) Even bottles can drip, spill, or cause baby to spit out milk. Feeding a baby takes patience and there will be some spills and mess. So what? That is life with a baby. Your child will probably be starting solids in a couple months. Now, that is a MESS!

    Here you are, a whole month from facing any separation, and more than 2 months from sending baby to daycare, yet you are considering ending the breastfeeding relationship in the hope this will make baby take the bottle. I understand why this seems like a good idea, but I am so sad that you feel that desperate. This idea makes the wrong thing the problem. The problem is not that your baby is breastfed. The problem is that we live in a world that does not understand what is normal when it comes to babies, mothers, weight gain, and feeding practices. A world where moms and babies are supposed to seamlessly and effortlessly abandon what is normal biologically- nursing at the breast- for what is not normal- pumping and bottles. No matter how necessary financially such a transition is, no matter what wonderful tools pumps and bottles are, the fact is that this transition is not natural and so will not always be smooth and easy! Sometimes it is really hard! But that is not the fault of breastfeeding. That is the fault of the circumstances that routinely part very young babies from their natural source of both food and comfort.

    Here is what I suggest.
    Keep nursing baby. If you are concerned about weight gain or milk production, encourage baby to nurse more often. If we are wrong and there really is a danger that baby is gaining abnormally slowly, look into using a lactation aid to provide needed supplements.
    Forget bottles for the time being. Work on cup feeding, because this is an excellent fall back if bottles are not working, but it takes practice and patience. But even with cups, practice with no more than a tiny amount once a day- at most.
    For a week of so, let baby hold an empty bottle once in a while.
    When baby appears comfortable with the empty bottle, maybe is even mouthing it, put a tiny amount of expressed milk in it. No more than a half ounce.
    Try offering it to baby using the same positioning you have to use to safely cup feed- baby upright, bottle horizontal or tilted down, not up. See paced bottle feeding info below. This is how all bottles should always be given, allowing baby to control the flow.
    If at any point baby resists, back off and go back to the previous step.
    Get the book The Womanly Art of Breastfeeding (8th edition) read as much as you like but start with section on the "Four month fussies."

    Here is what I also suggest. Get some breastfeeding supportive friends fast. If there is a breastfeeding support group anywhere around, go. And ask baby's dad to go too.

    Think very hard about it before you destroy your breastfeeding relationship with your child trying to get baby to take bottles. This is something you may live to very much regret. It is exceedingly unlikely that your child will totally refuse to eat while you are at work. Even the most determined bottle refusers usually take a bottle eventually. He may not eat as much as you think he "should" while you are at work, but in fact that may be fine, as normal intake varies quite a bit child to child, and many babies make up for eating less while mom is at work by nursing lots when she is home. Also, by the time he is staring daycare, he may be eating solids and daycare can give him that as well. As far as daycare "requiring" bottles, that is a absurd. Plenty of babies go to daycare the first day having never had a bottle, ever, and the parents have no idea if baby will "take" a bottle or not. And plenty of babies who do take bottles refuse to eat when they are in a new care situation. In other words, it is impossible for any parent to guarantee to the daycare that the child will take a bottle.

    For the fussy feedings, it sounds like different positions work. Many babies as they get longer do not like the cradle hold or nursing curled in moms arms. They like to stretch out, get some room, chin stretched out, not tucked. Sidelying position, laid back position, playing- around -you- make- it- up -position may help. I think it is possibly premature to suspect painful reflux or dairy sensitivity based only on fussy nursing.

    Bottle feeding the breastfed baby: http://www.llli.org/docs/00000000000...astfedbaby.pdf
    Paced bottle feeding Video: https://www.youtube.com/watch?v=UH4T70OSzGs
    cup feeding video: https://www.youtube.com/watch?v=R95FUa7_s84
    Dad cup feeding: cute video but the cup is too far tilted up as commenters note. You can see baby can almost not keep up with the flow. Nevertheless, milk went into baby, and that is the point.
    Last edited by @llli*maddieb; October 23rd, 2015 at 01:28 AM.

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