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Thread: Gaining weight

  1. #1
    Join Date
    Aug 2010
    Location
    Texas, USA
    Posts
    59

    Default Gaining weight

    Hi,
    It has been a while since I visited, but I just had my 3rd child. We are in unknown territory for me as both of my other girls were full term 8lb babies. My new little one was diagnosed iugr at 20 weeks, and was born at 37 weeks weighing 4lbs 7oz. She spent 5 days in NICU. She was on a feeding tube with formula for 24 hours, but she kept vomiting up the feeds. I pumped every two three hours after she was born and manged a few MLS of coliseum by the end of the first full day. After 24 hours, they began letting me try nursing using the SNS to supplement. She was nursing ok about 10 to 15 minutes on one side, but she continued to vomit up the formula. By the end of the fourth day, I was finally able to pump between 15 and 30mls a pump and was able to supplement all feedings with breastilk through the SnS. She quit vomiting until she ate too much because my milk really started to come in. We were given the ok to stop SnS and feed strictly from the breast. She left the hospital at 3 lbs 15 oz, and at out first dr. Appointment she weighed 3lbs 13 oz. Dr. Asked me to supplement nursing by feeding from breast and then giving a bottle for the next feed. She is not taking the bottle well but she will take it if she is awake. I want her to gain and I am wondering if there is anything else I can do to help her.

  2. #2
    Join Date
    Jan 2016
    Posts
    74

    Default Re: Gaining weight

    Hi mama
    This story is close to my heart because my little guy was also iugr, born at 38 weeks and weighed 5lbs 1oz at birth, lowest weight was 4lbs 8oz. We were in NICU for 7 days due to very low blood sugars. I refused to give formula in the hospital. I did the best I could nursing, we had some issues but I tried hard to nurse regularly. I also pumped after almost every feeding while we were there for the week. I gave him what I could pump but it wasn't a lot. Mainly we just nursed. When we left the hospital he weighed 4.9, and at his first appointment 3 days later he was only 4.10. He started to gain pretty slowly, and then after several weeks weight gain really slowed down. I ended up supplementing too much and I stopped because I wasn't happy with doing that and I was afraid of ruining breastfeeding.

    I would say it is really important for you to nurse as much as you possibly can in order to maintain/increase your milk supply. If you are giving a bottle for every other feed, your breasts are not being stimulated to make the milk and your milk supply will suffer. For any supplement you give you will need to pump to make up for it. The SNS is better than the bottle for supplementing, since there is still breast stimulation happening, and there is no risk of nipple confusion. If you must supplement, I would say use the SNS and forget the bottle. I used to put 1-2 oz at a time in the SNS after nursing first without it.

    How does nursing feel? Any pain? It may be an issue with her ability to transfer milk if the latch is not good. In my experience, as my baby grew and his mouth got bigger, the latch improved and nursing became much easier. It was hard with his tiny little mouth in the beginning.
    Last edited by @llli*zachary.smommy; May 17th, 2016 at 06:47 AM.
    First time working mom to Zachary, 11/20/2015

    , , &

  3. #3
    Join Date
    Aug 2010
    Location
    Texas, USA
    Posts
    59

    Default Re: Gaining weight

    I think she is transferring well. I hear a lot of gulping and swallowing. The main issue is she is very sleepy. Sometimes no matter how hard I try to wake her, she either won't latch or will let the milk dribble out. However at that point she is not taking a bottle either. In fact most of the time with the bottle she only takes 1/2 an oz. I let her nurse as much as she wants, but it is so hard when she sleeps through feeding after feeding.

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

    Default Re: Gaining weight

    Sleeping through feedings is definitely a problem if baby is not gaining well. Is baby nursing less then 10 times in 24 hours? What have you tried for waking baby/encouraging baby to nurse more often, or keeping baby awake/active at the breast longer?

    One thing I learned the hard way is that it is not always best to try to always nurse every such and such hours. Since you nursed your other children you know this is not how babies typically nurse, and the most common pattern is for baby to nurse in clusters. At this point waking baby to nurse may definitely be needed, but as much as possible, when appropriate, it can help to let baby find her own "rhythm" when it comes to eating as long as she is eating often enough overall.

    Sometimes giving baby a small amount of supplement prior to nursing can help wake baby up and provide the shot of energy they need so they can actually nurse better. Since the bottle is not working, Have you tried a syringe for supplements instead?

    Research shows that lots and lots of skin to skin contact is incredibly important for very small/poorly gaining babies. And it is something other trusted adults can offer your baby as well as you.

    Are you able to see/have you seen a board certified lactation consultant since you and baby left the hospital? Since your baby is so small due to the iugr, that makes your situation a bit out of the ordinary and that is the time getting in person professional help may be needed.

    To ensure accuracy, scales must always be digital infant scales, the same exact scale every time, and baby naked or in dry diaper. I wonder if some of this weigh fluctuation is actually scale error due to different scales being used? How is poop output?

  5. #5
    Join Date
    Jan 2016
    Posts
    74

    Default Re: Gaining weight

    When we were leaving the hospital, the doctor told me that at LO's 1st ped appt the weight may not be what we expect since a different scale is used, and explained that it will be important to get a base weight from the ped and then compare from that weight forward at the ped office.

    As PP suggested, skin to skin is important and helpful. I had the same problem with a sleepy baby and I would have to keep rubbing his palms, tickling his feet, rubbing under his chin to try to get him to keep eating.
    First time working mom to Zachary, 11/20/2015

    , , &

  6. #6
    Join Date
    Aug 2010
    Location
    Texas, USA
    Posts
    59

    Default Re: Gaining weight

    Saw the doctor again yesterday for a weight check. No loss no gain. Tried to do a feed and weigh with the lactation department at the hospital, but she was so sleepy when she was nursing, she only transferred 8mls. I was given a bottle with a preemie nipple and finally yesterday afternoon and evening was able to get her to take an oz from the bottle every 1.5 to 2 hours. She then latched every 2 to 3 hours overnight. I am supposed to go tomorrow for another feed and weigh attempt at the doctor's office, but if she is sleepy, I know she will not nurse well again. I want my baby to eat but I don't want to hear I can't nurse her. I love that bond that it creates between the baby and I. It was such a special time with my other two babies that I hate to lose it with the last one. If I have to switch over to bottles exclusively and pumping, what are the odds of getting her back on the breast when she is older and stronger?

  7. #7
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: Gaining weight

    It is very unlikely you would have to switch to bottles and pumping exclusively. There is usually no reason a baby cannot continue to nurse while being supplemented whatever else they need. If your baby lost no weight then baby must have been getting something when nursing so this is something to build on. If anyone tells you this is needed, question them why, exactly, and how long you would have to not nurse, etc. It may be that nursing sessions need to be reduced somewhat, but it would be very unusual for them to need to be eliminated entirely.

    I would also suggest talking to the LC about using a lactation aid so baby may be supplemented at the breast for at least some meals.

    If YOU decide it is too exhausting for YOU to "triple feed" (Nurse, pump, supplement) and so you switch to bottles and pumping exclusively due to that, then you can increase your chances of bringing baby back to the breast later by keeping milk production in good shape with frequent pumping, keeping the time you exclusively pump (with no nursing) as short as possible, and start bringing baby to the breast at least once or twice a day as soon as you can handle that.

  8. #8
    Join Date
    Aug 2010
    Location
    Texas, USA
    Posts
    59

    Default Re: Gaining weight

    Well she gained a little over an ounce in 2 days. That is with feeding her 1 oz through a bottle during the day and nursing on demand or no more than. 2 hours between feedings overnight. Now they want me to add neosure to her bottles and get her mostly bottles overnight too. Doc only wants her on the breast after she takes a bottle. I am a little disappointed, that I won't be able to nurse more but bottom line is feed the baby.

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