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Thread: Poor weight gain after tongue tie

  1. #1

    Default Poor weight gain after tongue tie

    Morning all,

    Where to start! I'd love any help or advice.

    Son was born 6lb6 - 2940g on 7th November with obvious tongue tie (second son with tongue tie). Due to hospital backlog tongue tie wasn't snipped till day 5. SON LOST 8% body weight by day 3 then managed to gain 20g or so before TT snip. Before tongue tie was done he was feeding pretty well from my right breast my left breast was becoming really engorged however.

    After tongue tie snip baby drained both breasts really well and I was feeling encouraged.

    In following days however baby was not gaining well and feeding becoming less structured (falling asleep at breast, not seeming 'full'), 10g or no gain every couple of days and at two weeks baby not back to birth weight. Weight at day 14 was 2730g.

    Met with a brilliant lll consultant on day 11 who advised on positioning, latch and prescribed as much time at the breast as possible, switch nursing, breast compressions, pumping where possible (medela symphony hire) and giving expressed milk to baby to perk up feeds. I've basically been in bed doing this for 6 days. Getting abou 10ml max from both breasts after pumping.

    After meeting lll consultant, it has felt like the feeding has improved. I use beast compressions whilst listening to him swallow, then switch breasts as swallowing stops and repeat. I'll then pump when he seems satisfies so I was really hoping this would be draining the breasts and generating more milk.

    At a health visitor appt yesterday, day 16, baby was 2770, so out of the lower 2700's finally but ultimately only a gain of 40g in a week.

    Health visitors have advised a formula top up by tomorrow if baby hasn't gained an additional 40g.

    What's going on? I'm doing everything I can to generate more milk but it doesn't seem to be enough. Have I missed the window for generating an abundant milk supply?
    Should I pump more and remove baby from the equation?
    His tongue seems to be working better now, he can stick it out and I can see it 'reaching' for the breast. My first son had a tongue tie and I never thought I'd be in this situation again! First son wasn't diagnosed as TT till week five and we spent 5 long months breastfeeding, supplementing (sns, cup, spoon, bottle), pumping etc until we were able to exclusively breastfeed(we fed then for 2 years).

    I really wanted to ebf. It's driving me mad! Any ideas, hope or shared experience?

  2. #2
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: Poor weight gain after tongue tie

    First, is it possible we are seeing scale error here? Have all weights been on the same scale, digital infant scale, baby wearing nothing or only dry diaper? Birth weights are often inflated, especially if you had IV fluids. Also, lowest known weight is not the same as the actual lowest weight- if baby initially lost more weight than you think before starting to gain, that would make it harder for baby to regain it all by 2 weeks.

    You are an experienced mom. Does baby appear to not be getting enough to eat to you, based on behavior, how baby looks, etc? You say baby appears satisfied after some sessions, for example? Very importantly, How many times a day is baby pooping and what does it look like? (size, consistency, color)

    Can you see the consultant again and talk to her about doing some weighted feeds to measure intake? Just so you know, intake of 2 ounces per session AFTER age 2 weeks is considered a reassuring intake. It may be less before that. And of course, some sessions baby will eat less just naturally so a feed that does not result in a two ounce or more transfer is not necessarily bad news. But a weighted feed - or several, even better- can offer some more info. Just do not live or die on the results.

    Sometimes a tongue tie correction has to be repeated.

    NO it is not too late to have an abundant milk production. For one thing, it is a myth that there is some absolute cut date of for increasing milk production. Yes it is harder after 6 weeks or so, but certainly not impossible. But your baby is not even 3 weeks old! This is early days.

    If you like, can you provide exact daily numbers of how many times a day baby nurses, how many times you pump, and what the daily pump result is? Also, what kind of pump is it and are you sure it is working perfectly and the right size for you?
    Last edited by @llli*maddieb; November 24th, 2015 at 10:33 AM.

  3. #3

    Default Re: Poor weight gain after tongue tie

    Hi & thank you,

    I did have an I've drip. His weigh ins have been done on different scales but always naked.

    The little chap looks a tiny bit slender but healthy, he's really bright and apparently has good muscle tone. Some feeds, I can hear him swallowing rhythmically and he feeds from both breasts at least once and he'll drop off the nipple and look very relaxed and have s sleep. Other times he'll feed and there won't be much milk there as his swallows are few and far between and he'll just fall asleep.


    2-3 poo nappies in 24hrs. Was more last week. Loads of wet nappies.

    I'll speak to the consultant about weighing intake.

    My first son had to have tongue tie correction at 4 months so I'm keeping an eye on that.

    Great to hear it isn't curtains for my supply after 2 weeks, I was worried.

    Feeding schedule has been pretty constant for the last week, I've just been sitting in bed feeding, I haven't really been monitoring individual feeds as they're all blending into one but roughly..... He feeds from both breasts in any one sitting, I used breast compressions to keep the milk flow when swallows slow and swap him over when the swallows stop, I keep that up until he dozes off, usually after 35-40mins I suppose but will carry on if he wants to. I usually give him 10ml of expressed milk (finger feed) during a feed to perk him up after the first breast swap. I then punp if he's got as much as I think he can (no more swallows) using medela symphony hospital grade rental. The machine itself looks new, or I assume well maintained and I think the flanges are a good size. I don't pump every single time but this must happen 10+ times a day.
    Pump output is prob only 60ml over the day (1.5oz) I always pump straight after he's finished feeding and the pump output doesn't seem to be increasing mucH.

    Xx

  4. #4

    Default Re: Poor weight gain after tongue tie

    Also to add.....we co sleep and baby has been waking every 3hrs for a feed from 11-5 ish then back to the 'constant' cycle, I reckon I never go more than 1 hour in the day without the baby or pump on my boobs!

  5. #5

    Default Re: Poor weight gain after tongue tie

    And one more thing!.......while he doesn't look dehydrated or too thin, I think it's my feeling that there just isn't enough milk, he often just keeps suckling and I know he'd be drinking if there were milk available. I just wish my supply would show signs of having risen after I'm working so hard, either in pump output or improved weight gain. Aggggh so frustrating!

  6. #6
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: Poor weight gain after tongue tie

    OK you are pumping and nursing with very high frequency it sounds like, so that is great.

    It is good baby is pooping every day. You do not mention the look or size of them, so it is hard to say what they are indicating since that number (2-3) is kind of borderline. Poops are what indicate whether baby is getting enough milk to grow normally and are consequently more important to measure than pees. A baby who is getting enough milk to gain at all is unlikely to be dehydrated.

    I cannot stress how vitally important it is that all future weight checks be on the same exact scale. Scales, even the exact some make and model, cannot be trusted to match each other no matter how well or often they are calibrated.

    When you pump, make sure your nipple moves pretty freely in and out of the tunnel (no or little rubbing) but at the same time, if too much areola is coming into the tunnel, that might indicate a too large flange. This will make the pump not extract milk well. Also, check membranes and all connections. Some moms need a different size flange on each breast.

    Since you are pumping after baby nurses, you may not see in increase in pump volume even if you are making more milk. So try not to be discouraged by how much volume you pump. You are pumping to give your milk production an overall boost, and while of course it would be satisfying to get more milk out when you pump, that is only a secondary reason for pumping.

    An excellent read is the book Making More Milk and I strongly recommend it.

  7. #7

    Default Re: Poor weight gain after tongue tie

    I've ordered the book and look forward to reading it.

    I had the weigh-in this afternoon and he'd increased by 60g so current weight is 2830, I'm so pleased with this as it must mean he's accessing more milk (?)

    Although he's not yet back at birth weight -110g to go I'm thinking that a temporary formula top up is not necessary? I'll see how his weight is over the next couple of days.

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