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Thread: Weight gain issues

  1. #1

    Default Weight gain issues

    Hi, on our last visit to the health visitor she said they were worried about my LO's weight gain and that if she didn't improve next week we would need to do something.
    This has worried me for the last few days and I'm now questioning everything I'm doing which means I'm stressing with every feed, which isn't helping.

    I'd like to know if her weight gain is low and what I can do to help?

    Birth weight - 7lb
    3 days - 6lb 9
    10 days - 7lb 2
    2 weeks + 6 - 7lb 9

    Feeding wise we are probably not textbook but she latches easily on a cradle hold and lying side by side without causing me discomfort or sore nipples. She feeds for between 20 minutes and 1 hour, but falls asleep easily during feeds. She also loses milk from which ever side of her mouth is facing downwards which makes me think she's not latching properly, but I'm not sure what to do about it.

    I appreciate any advice.

    Thanks
    A&A

  2. #2
    Join Date
    Jun 2009
    Posts
    10,739

    Default Re: Weight gain issues

    Hi, I am sorry you are having this concern!

    So since birth weight is often inflated and not truly relevant anymore anyway, and it is normal for baby to lose some weight at first, let's just look at weight gain since day 3.
    in the 7 days between day 3 and day 10, baby gained 9 ounces, surpassing birth weight, which is actually a little above average gain rate.
    So then what happened? I am unclear what "+ 6" means. Was the last (most recent) weight check on day of life 14 or day of life 20? How old is baby now?

    Anyway, in either case, It appears baby lost weight. This is very strange. First I would suggest consider scale error. It is possible that any of those weights is off, causing a highly unusual pattern to emerge. Scale error happens due to either the scale being off or using the wrong kind of scale for weighing newborns, or from human error when doing the measure. Weight checks are so tricky that even using a different scale can easily throw off a check by many ounces.

    It would help to know:
    -What kind of scale was used for every check was it the same scale each time, and was baby naked or in a dry disposable diaper only? Was the check done on a digital medical grade infant scale, and was there any unit conversions done where a math mistake may have occurred? Did whoever weighed baby zero out the scale first, and seem to be taking their time to get a good measure? If the scale was brought to your home, on what kind of surface was it placed?
    -How many times total in 24 hours does baby nurse?
    -Does baby ever go more then 4 hours between any nursing sessions?
    -Is nursing uncomfortable for you at all? Sometimes the nipples are fine, but the back aches, for example.
    -How many times in 24 hours does baby poop and can you estimate volume (for example, if you had to pick it up in a spoon, would you use a teaspoon or a ladle?) and tell us what it looks like (color, consistency.)
    -Are you on any type of hormone-based birth control and if so, what?
    -Is baby using a pacifier more than just a few minutes a day?
    -Is or was baby supplemented with your milk in bottles or formula at any point?

    In the meantime, rather than stressing when baby nurses, here are some suggestions that may help when baby is getting sleepy and not nursing with normal vigor
    1) Breast compressions: http://breastfeeding.support/what-is...t-compression/
    2) Switching sides
    3) stroking baby, verbally encouraging baby, "pumping" (rhythmically gently squeezing) baby's hand or foot, jiggling baby's chin, etc.
    4) Try leaning your body back a little (or a lot, just not totally flat on your back) when you nurse in such a way that you are comfortable and well supported. (For example, lean back on mound of pillows.) You can adjust baby's position if needed, as baby can be nursed while in pretty much any position. Nursing "laid back" like this may help you be more relaxed and may help with baby getting a deeper latch and with the milk escaping out the side of baby's mouth, although I doubt that last is much of a problem as this is fairly common.
    5) take deep breaths and use visualization to relax. When my oldest was not nursing well and not gaining well, I found it helped me to picture my milk going into my baby, but you can use anything that relaxes you.
    Last edited by @llli*maddieb; April 1st, 2017 at 11:53 AM.

  3. #3

    Default Re: Weight gain issues

    Sorry, I've confused things

    At day 20 she weighed 7lb 9 so has gained but not enough for the professionals.
    Today she is day 24 and is due to be weighed again at 1 month.

    Answering your questions
    She nurses 8- 10 times a day (She's been cluster feeding for 2 days so every 20 minutes at the moment. Which I suspect might be due to my stress)

    Overnight she goes for 4.5 hrs between feeds and her morning feed is usually about 4.5 hrs. (Since the weight issues I've been waking her at 3 hrs to feed)

    I get back ache when I'm sat up to feed.

    She poops every other day but 3-4 times in that day. 1 laddle and 2-3 serving spoons. Yellow and very runny with some blobs.

    No birth control, no pacifiers and no formula.

    Many thanks for your advice I'll try that.

    A&A

  4. #4
    Join Date
    Jun 2009
    Posts
    10,739

    Default Re: Weight gain issues

    Ok great, thanks for the more info!
    At day 20 she weighed 7lb 9 so has gained but not enough for the professionals
    Ok more math- so baby gained 6 ounces in the 10 days between day 10 and 20- do I have that right?

    So, while that appears to be a slow down in gain, I am not at all sure it signifies a problem, and certainly not a problem that warrants "doing something" if "doing something" means putting baby on formula supplements.

    To look at it another way, what if baby was not weighed on day 10? What if baby was weighed only on day 3 and then on day 20? The gain would have been 1 pound (16 ounces) in 17 days. So, pretty much text-book normal gain. When we say we expect a baby to gain one ounce per day, that does NOT mean we can expect a baby to gain exactly one ounce each day. It means that when babies have been weighed at 3 months, the average gain among all the babies studied has averaged out to one ounce per day over that period.

    Yes of course any slow down in gain rate is something to take note of during the early newborn period. But that alone is not enough to assume anything is wrong.

    If baby's weight is not satisfying the hv or doctor at the next weight check, I suggest for your own info crunch the numbers taking into account the whole story as I did above. I would also suggest that if gain is still recording as slow, it is very important to see a board certified lactation consultant (IBCLC) at that point, if you have not been able to do so before then. If you would like info on how to find an IBCLC where you live let us know. Health visitors as I understand it are NOT trained in how to assist moms with breastfeeding issues. Nor are doctors in most cases. If a baby cannot gain normally when exclusively breastfeeding, that is a breastfeeding problem. Formula, whether needed or not, will not solve the actual problem.


    She nurses 8- 10 times a day
    This would be on the low average for this age. Newborns often nurse 10-12 times or more in 24 hours.
    (She's been cluster feeding for 2 days so every 20 minutes at the moment. Which I suspect might be due to my stress)
    This is an entirely normal nursing pattern for this age. It is normal for a baby to cluster nurse (nurse several times close together, even several times in an hour) and then take a break of 1-3 hours.

    I get back ache when I'm sat up to feed.
    So of course because babies nurse so much, and so long, it is vitally important that nursing be overall entirely comfortable for mom. Research has shown that sitting straight up (typist position) to nurse is very hard on mom's back, neck and shoulders. This is why this type of positioning has fallen out of favor, and "laid back" or leaning back nursing position for mom is now the rage. Sidelying nursing is also a favorite for many moms. There is no one perfect position for nursing, each mom needs to listen to her own body and figure out what works best for her and her baby. Of course usually there are several positions that work, but it takes time to figure that all out and that is ok.

    Overnight she goes for 4.5 hrs between feeds and her morning feed is usually about 4.5 hrs. (Since the weight issues I've been waking her at 3 hrs to feed)
    As long as baby is nursing at least 10 times in 24 hours and gaining ok, a sleep stretch ONCE per day (or hopefully night instead) of 4-6 hours is probably fine. This is why cluster feeding rather than every 2-3 hour scedules works to help mom get more sleep. Of course I would agree, such a long stretch might not be the best idea right now, but if it happens naturally and baby has nursed 10-12 times that day previously, it might be fine. Of course some moms find themselves getting uncomfortably full if baby is taking a longer break. In that case it is always a good idea to encourage baby to nurse to relieve that discomfort. Feeling full tells the body to make less milk, just as frequent nursing tells the body to make more.

    She poops every other day but 3-4 times in that day. 1 laddle and 2-3 serving spoons. Yellow and very runny with some blobs.
    Ha, your baby really likes to confuse every one! That poop pattern sounds great, except it "should" be every day not every other! Poops look normal, volume normal - all very good. As far as the every other day pooping, maybe that will change, but for now just be on the lookout for any reduction in that output and concentrate on gain as the poops are not cooperating to assure us all is entirely well.
    Last edited by @llli*maddieb; April 1st, 2017 at 05:39 PM. Reason: added bolded 'not' to fix meaning

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