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Thread: newborn weight loss and supplementing

  1. #1

    Default newborn weight loss and supplementing

    A little background information before I get to my question. With my first son, I only breastfed for 5 weeks. We were advised by his pediatrician to supplement with formula after he lost too much weight after leaving the hospital. This led to my son preferring bottles to breastfeeding. After meeting with an LC multiple times and unsuccessfully trying an SNS, the stress and frustration got to be too much, and I just gave up.

    Fast forward to this year. On Monday the 21st, I gave birth to another wonderful boy at 38 weeks, 3 days. He weighed 7 pounds 11 ounces and appeared to take to breastfeeding beautifully while at the hospital. Wednesday, he weighed 6 pounds 13 ounces at the doctor's office. The doctor was concerned but didn't suggest supplementing since I said my milk had come in. I'm now completely worried that he's not getting enough milk and can't stop thinking about it. The LC I spoke with today suggested pumping after every feeding, and if I wasn't getting anything, to give him a little formula to get through the long weekend, at which point I can have him weighed on Monday.

    I'm basically freaking out that the same thing that happened with my oldest is about to happen again. I was really wanting to avoid formula this time around, but my first few pumping sessions have yielded nothing. His doctor's office says I can bring him in Saturday for a weight check. Now, I can't decide if I should hold off on supplementing until I find out his weight Saturday or if it would be better for his well being if I started supplementing now.

    Does anyone have any thoughts?

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

    Default Re: newborn weight loss and supplementing

    Welcome to the forum and congratulations on the new baby!

    I have some questions for you. First, your birth: anything of interest there? I'd be particularly curious about large volume blood loss, retained placenta, and long duration of IV fluids. Second, how is baby behaving- how many times per 24 hour period is he nursing? Is he sleepy at the breast, or is he feeding actively? Third, diaper output- can you tell us how many wets/poops you are seeing in a 24 hour period, and what the poops look like?

  3. #3

    Default Re: newborn weight loss and supplementing

    This birth was actually fairly easy all things considered. No major blood loss. I was on an IV but I was only hooked up to it for maybe 6 hours total. As far as I know, there's no retained placenta.

    I've been doing my best to nurse every 2 hours, although there have been a few times he's acted hungry within an hour so I've nursed him again. It's been very difficult to keep him awake while nursing. He's definitely more sleepy than actively participating.

    He's pooped about 5 times since early this morning (midnight until now - 4:30pm). It's been a very small amount each time though. Up until the last one, they were green in color. The last was more brownish. It's harder for me to remember wets, but I would wager he's had maybe 5 or 6 in the same time frame.

  4. #4
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: newborn weight loss and supplementing

    Hi since it is the holiday and I imagine you are stressing out, and I have 5 unexpected minutes of quiet I am going to hop in here, I am sure mommal will have more for you when she gets back online.

    I've been doing my best to nurse every 2 hours, although there have been a few times he's acted hungry within an hour so I've nursed him again.
    This sounds like someone has told you to not nurse any more often than every two hours. This is bad advice. It is perfectly normal for a newborn to want to nurse several times in a 2 hour span. "Every two hours" is a very general minimum recommendation that adds up to the general minimum you want to see a newborn baby nurse, which is (at least) 10-12 times in 24 hours. But if baby nurses more frequently part of the time, baby might nurse a little less frequently other times. This is normal and fine, as long as baby is nursing at least 10-12 times in 24 hours. In other words, nursing baby before 2 hours has elapsed since the last session as you are doing is entirely appropriate. Can you tell us about how many times in 24 hours baby nurses?

    I was on an IV but I was only hooked up to it for maybe 6 hours total.
    You would be amazed how much fluid went into you during those 6 hours. This may have resulted in baby's birth weight being "inflated." This is only one of several reasons why measuring gain from birth weight is problematic. From here on out, I suggest try to have all weight checks on the same scale and measure gain from the lowest known weight.

    Overall it is 100% normal for a baby to lose a little weight in the first few days after being born. IF the two weight checks are 100 percent correctly measuring how much baby lost, (and for several reasons they probably are not) But, if they are, then a loss of 14 ounces or slightly over 10% of birth weight is certainly something to be watchful about but not panicked about. I imagine your pediatrician saw an otherwise healthy baby and this is why he did not suggest supplements. He is talking a wait and see attitude, which I think is entirely appropriate as so much can change over the first week or two of life, usually for the better.

    He's pooped about 5 times since early this morning (midnight until now - 4:30pm). It's been a very small amount each time though. Up until the last one, they were green in color.
    Overall, This sounds entirely normal as far as frequency and color for a 3-4 day old baby. You would expect poops to keep getting lighter (more yellowish or mustardy looking) going forward now. Size- well, how small are you talking? Poops do not have to be huge to "count" but they have to be more than a little streak. Could you spoon what is in the diaper up in a teaspoon, or is it just a tiny streak? Also, has baby only just started pooping or was baby pooping at least once or twice a day before this?

    Basically to me this sounds like all could be 100 percent normal. It's just so early, there are several changes to be expecting soon- in the next day or two- maybe more poop overall, poop more yellow. And in the next week or so, baby more wakeful and wanting to nurse more.

    Meanwhile I would suggest encourage baby to nurse as much as baby will and keep watching the poop output. Even if supplements are required, there are many ways to approach giving supplements that are less disrupting to the breastfeeding relationship. At this age, any supplements can and probably should be given in very small amounts (an ounce or less) given via a syringe, just prior and/or just after baby nurses. Of course it is best if this can be your expressed milk, but if formula is needed that can also be done without harming the breastfeeding relationship.

    When you say you pump nothing, here is what I wonder. Because you know you are making something, or baby would not be pooping. So why would there be literally nothing when you pump?

    Do you mean you pump nothing at all, not even drops?
    Have you tried hand expressing instead of pumping? This works better in the early days for many moms.
    Are you sure the pump is working properly and fits you correctly?
    Also, never measure milk production by looking at pump output. It is not the right information.

    More info:

    What to expect in early days with a newborn: http://kellymom.com/hot-topics/newborn-nursing/

    Diaper log: http://www.llli.org/docs/00000000000...diaper_log.pdf

    waking sleepy baby: http://www.llli.org/docs/00000000000...py_newborn.pdf

    Alternative methods for supplements: https://www.youtube.com/watch?v=vrrrC5NyNnQ

  5. #5
    Join Date
    May 2006
    Posts
    24,794

    Default Re: newborn weight loss and supplementing

    with MaddieB's excellent advice above. IV fluids can go in very fast and may explain why your baby's weight loss is in the high side of normal; the baby gets bloated from the IV just as mom does, and then quickly excretes the excess fluids as urine.

    I absolutely agree that your best option right now is to nurse the baby as much as possible. If his cues are coming infrequently, try putting him to the breast every 1-1.5 hours and see if you can rouse him to latch on and nurse. Even a short session is better than no session. I know some well-intentioned people say that you should wait until the baby is really hungry because then he will eat a big "meal" instead of a small "snack", but newborn babies are natural smackers and frequent feeding tends to increase their total intake. Their tummies are too tiny for "meals".

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