breast milk not satisfying baby

[purple dali]

hi, i would appreciate some advice about expressing breast milk. My 6 week old son was low birth weight 5 4oz and recently because of concerns of him not putting on enough weight, generally unsettled after a feed and bringing up large amounts of milk back, i have been expressing and giving him my breast milk via bottle. However despite having good quantities of milk, he is not putting on appropriate weight and he is unsettled and hungry after feeds. I feel that the expressed milk milk is not satisfying him and wondered wether he wasnt getting enough of the hind milk. my milk appears thin and there doesnt seem to be much creamy milk. My sister suggested trying him with a bottle of formula and this seemed to settle him and satisy him. I want to continue breast feeding but as he is on the lowest growth centile I'm worried that he is not receiving adequate nutrition. The coliky type, symptoms and discomfort he experiences seem to disapear when he is given formula. Any advice would be welcome, thanks!

[@llli*number4]

That is a lot to be concerned about.. and you have come to the right place to get the help and support you need.


One thing I'll mention right off is babies are much more 'effective' at getting milk out than the pump

Can you tell us more about your sons growth pattern since birth, including his lowest/discharge weight?
Was he a premie?

(here's some info on those growth charts)

Here' s a link for you to peek at in the interim, to help you determine if he is getting enough.

[purple dali]

Hi thanks for your welcome and prompt reply.
here is some more info:
Born at 37 weeks. 5 4 oz by c section. 6 week ago
I had pre-ecalmpsia and placenta previa
lost more than 10 percent weight in hospital and re gained birth weight 11/3/08
weighed 1/4/08 3kg and the last time he was weighed 9/4/08 he was 6 9.5 oz

I had been expressing and documenting how much milk he was receiving to show health vis, which has varied from 16-25 oz a day. She said this was considerable amount and she would have expected more weight gain.

I was concerned that in addition to only small weight gain, he is posseting quite a lot after feeds, spurting out at times and for some time after. WE need to keep him upright after feeds, change nappy before feeds etc. I thought it may have been reflux. I went to GP, but as he looks well, good colour, breathing ok, they told me not to worry-and carry on doing what i've been doing. But I'm not happy and he is due his 6 week check next week so I will be raising my concerns again.

[@llli*number4]

Well he is right on that line of preterm/term. So *I'd* treat it like a premie situation and work with the guidlines / info on that link.

But he is gaining and gaining a good amount. How fast did he regain birth weight?

Not all babies receive the memo of how much they "should" be gaining and the HV's don't always get that either But it seems he's gained about 4 oz a week on average and that is well within reasonable. (see link here)

Reflux can indeed be handled the way you're describing and as long as their diaper output is good, then there's no need to be concerned with the amount they are sending back up, because they're keeping enough down


So I wonder if you get a chance to read the links I gave you, if youd let us know what you think after that.