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Thread: Not sure what to do...

  1. #1
    Join Date
    Sep 2006
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    Default Not sure what to do...

    My dd was born on 8-23-06, she weighed 7 lbs. 4 oz. and lost about 3/4 lb the first week. She then got jaundice and we had to use a biliblanket for 8 days at home. She is now a little over a month old and only weighs 7lbs. 6 oz. Our pedi is supportive of exclusive bf-ing, but dd needs to gain weight, we have to take her in for weight checks every week. I'm afraid that when we go in on Friday, we will get the news that she again hasn't gained any weight. There are times everyday that after a feeding (on both sides) she is content for only 5-10 minutes, then fussy and the only thing that calms her is eating again. She has at least 6-7 wet diapers every day, and eats about every 1.5-2 hours, and cluster feeds in the evening. By midnight, she has drained me and still acts very hungry. On two occasions we have supplemented with formula after at least an hour of her crying from what we thought was hunger (and she drank the oz of formula in no-time!). I have pumped just to see how much milk I am making, and in the early a.m. I get about 1-1.5 ozs. on one side but as the day goes on it gets less and less. I drink Mother's Milk tea 3-5 times a day and today went a got fenugreek. I am planning on attending a LLL mtg tomorrow in my area...I am afraid I'm getting close to giving up - she just seems hungry all the time, I am feeding her on demand, but it doesn't seem like my supply is increasing and her weight isn't increasing either.
    Any advice or insight would be greatly appreciated.

  2. #2
    Join Date
    Apr 2006
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    869

    Default Re: Not sure what to do...

    It sounds like you are doing all the right things (most importantly frequently removing milk from the breasts). If the fenugreek doesn't make enough of a difference, you may wish to consider Reglan or Domperidone. They would require a prescription from your midwife or OB.

    You are doing a great job. I know how tough it can be. My son was in the 10% for weight for the first six months of his life.

  3. #3
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    Jan 2006
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    Default Re: Not sure what to do...

    Hi there,
    I am so sorry things are stressful for you and it is great that you are going to a meeting tomorrow! I hope it proves fruitful for you.

    In the meantime, I wanted to suggest a couple of things to you. First, fussy or high-need babies often want to nurse ALL of the time. This doesn't mean you don't have enough milk. It just means she wants you.

    The other thing, is that when offered a bottle, many babies will just "drink it down". This is the "drink or drown" reflex they have. The milk comes out so fast that they have no choice.

    Also, as you probably have heard before, a pump is not a good indicator of what your baby takes. But maybe in this case it is. If dd is nursing every hour and a half, she may only be taking a small amount. This is normal for babies like her.

    I would be interested to know more about her weight gain issue. You said she was 7-4 and lost less than one ounce. So her lowest weight was about 7-3? And now at 4 weeks she is 7-6, so she has gained 3 oz. in 4 weeks. Is this correct? I just wanted to clarify.

    Another clarification I need: you mentioned 6-7 wet diapers per day. What about poopy ones?

    Have you tried breast compressions? Somes moms in your situation find they help. You can find a good explanation (and video) of them at Dr. Jack Newman's website. (not LLL, but he is on our Advisory Board)

    http://www.thebirthden.com/Newman.html#Video%20Clips

    Also, you may want to check this out:
    http://www.lalecheleague.org/FAQ/enough.html

    Let us know how you make out at the meeting, if you don't check back before tomorrow.

  4. #4
    Join Date
    Sep 2006
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    11

    Default Re: Not sure what to do...

    Kate,
    Thanks for your message. She lost almost a pound, not an ounce...so she really has gained about a pound altogether. I have read that pumping isn't an indicator of how much she's getting and that is reassuring.
    The hardest part about all of this is that I worry and would feel awful if the sole reason she isn't gaining weight is because of me. The pediatrician said that 10% of babies have trouble gaining and she is that 1 in 10 - I'm thankful I have the pedi's support.
    I learned about breast compressions from LLL and have been doing it a little, and will continue to do that.
    I had no idea how hard this was going to be....but also didn't know how rewarding and amazing it is too...
    Thanks again!

  5. #5
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    Jan 2006
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    Default Re: Not sure what to do...

    Hi again,
    Sorry I misread what you said in the beginning.

    So, just to clarify one more time:

    Birthweight: 7 lbs. 4 oz.
    Lowest wt: 6 lbs. 8 oz. (is this right?)
    (at 1 wk)
    4 weeks: 7 lbs. 6 oz.



    If this is correct, she has gained approximately 14 oz. in three weeks. That equals out to be 4 1/2 oz. per week. That is well within the range of normal for what LLLI suggests for weight gain at dd's age. The average weight gain is 5-7 oz. per week. That is what most babies gain. Some gain more and do fine. Some can gain less (4-5 oz. per week) and that is fine for them. ( This info taken from the BAB, 3rd edition)

    I am glad you are happy with you ped. That is a huge help for you right now! I encourage you to explain dd's growth pattern to the ped and discuss that this may be just fine for dd. Not everyone is in the bell curve, and dd might not actually be "having trouble gaining". She might be normal for her. Are you or dh small people?

    Finally, here is a link to the new WHO growth charts. You may wish to print and share these with the ped as well. These new numbers are based on BF babies as the biological norm. Typically doctors use growth charts produced by formula companies based on formula-fed babies. (You can just look for the name or logo at the top of the chart!)

    http://www.who.int/childgrowth/standards/en/

    Under "Indicators" you can click on any of the charts. Then download and print. You can see where dd falls here as well.

    But the bottom line is that she IS gaining. Look how much she has gained in the past 3 weeks! And it is all from you! I commend you on your will to BF! You are doing great and I see no reason to be concerned.

    Let me know what the ped. says. Take care and keep up all the great work!
    Last edited by LLLKate; September 26th, 2006 at 06:25 PM.

  6. #6
    Join Date
    Apr 2006
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    Default Re: Not sure what to do...

    My son averaged a 4 ounce gain per week. My doctor considered him to be a slow-gainer, but still acceptable. He did not recommend that I suppliment.

    His weight really started to take off when he was six months old and I began introducing solids. He's now 8 months and up to the 35% for weight.

  7. #7
    Join Date
    Sep 2006
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    11

    Default Re: Not sure what to do...

    I took her in for a weight check yesterday...the GREAT news is that she gained 4 oz this week, this is the most that she's gained in a week. The bad news is that my ped wasn't there and the other ped I saw was "very concerned" that she has only gained 4 oz and commented on how skinny my dd is (ugh ). She stated that I needed to supplement everyday over the weekend and then come back in Monday for another weight check. I finally feel that I was giving her enough b/c of the weight gain and all of your support and now I feel that I need to supplement - as does my husband (who is supportive, but he wants to follow the ped's recc).
    This is so much harder than I thought it would be....

  8. #8
    Join Date
    Sep 2006
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    66

    Default Re: Not sure what to do...

    i feel the same way you do.. mine LO wasn't breast feeding until 2 wks old and after she had been doing so for 3 wks, wasn't gaining well at all. the ped was trying to be supportive but recommended i come in for a weight ck the following week after which she had only gained 1.5 oz !! i was panicked for fear i had been starving my child.. and this is when supplementing was recommended. i didn't want to, but felt it was necessary. after a week of supplementing she gained 18 oz.! i've been hoping my supply would build up since i've been giving the formula via a SNS... i honestly don't know how to tell if its been working aside from more weight cks... but this has been really hard for me too, something i thought was going to be so natural and effortless. i'm just about at the point of giving up, but figured i've come this far and can't do that just yet. a 4 oz gain in a wk is excellent as far as i'm concerned for a slow gainer and i would keep with it. my dd wasn't gaining enough to keep her strength and wasn't sucking hard enough to empty me so my supply diminished. i think ur doing great.. don't give up!!!

  9. #9
    Join Date
    Jun 2006
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    Default Re: Not sure what to do...

    DO NOT FEEL LIKE YOU HAVE TO LISTEN TO A PEDI!!! Especially if it's not your regular doctor that you trust. Pedi's in all their years of schooling only get 8HOURS of education on BFing and it's OPTIONAL. Another thing to consider, often the charts that they use regarding where your baby is in percentiles are provided by the formula companies. Supplemeting this early in the game is a slippery slope. You are still establishing your supply based on the baby's demand to eat. Everytime you supplement, your body doesn't get the signal to make more milk. Plus formula generally takes 4hrs to digest instead of 2hrs like BM. This is because formula is harder for their little bodies to break down and not nearly as much is absorbed. So that will be a 2nd signal that your body misses to make milk!!!
    I hear self doubt in your posts. I would hate for you to begin to supplement, feel inferior to formula because the baby goes longer between feeds and then begin to have supply issues. Which by the way happens to A LOT of women!!! Your are absolutely doing exactly what your child needs!!! Believe that. Don't doubt it. Your baby's eating patterns are totally normal!!! They are hungry all the time. Your milk is increasing and You ARE meeting her needs. Just know that doing that, means feeding around the clock. Your are very close to a 6week growth spurt if your not already involved in one.
    A couple of things that I found helpful in the beginning....A nursing island during the day. Set up a spot on the bed or couch where you know your going to be all day and just plant it. You, the baby, a nursing pillow, remotes, phones if your up to it, a HUGE glass of water and snacks. Accepting that your only going to get up to go to the bathrooom, get more food and change diapers. Other than that, your feeding the baby.
    My husband giving me a two hour break to nap beofre the nocturnal clusrer feeding begins. Taking the baby to bed w/ me so the cluster feedings just involved sitting up instead of getting up.
    I would suggest over this weekend instead of supplementing, just take the baby to bed and stay there. It's the weekend. Just stay in bed for 24hrs and become one w/ the child and have your husband support you by doing diaper changes and bringing you food. Please please don't doubt yourself. Your body was made to do this!!! Good Luck!

  10. #10
    Join Date
    Jan 2006
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    Default Re: Not sure what to do...

    Lillia'smom,

    I'm glad you let us know how things went yesterday.

    It sounds like you were very happy with her weight gain, until the other Ped. told you that it was not enough.

    While we can certainly not tell you what to do in this situation, we can give you the support and info needed to make the best decision for you. I have already given you references to LLLI's Breastfeeding Answer Book which states that it can be normal for some babies to gain 4 oz. per week. I have also given you the link to the WHO's new growth charts.

    The one thing that I do want you to be aware of is that formula supplements can reduce the time that dd spends at the breast, thereby reducing your milk supply. I know this is something you do not want. There is something else you could try. I am not saying that you need to do this, because I can't say that. But if it would make you and dh more comfortable, you could try supplementing with *your own* milk. You would continue to nurse dd as much as she needs/wants. And add to that a couple of pumping/hand expression sessions. This would only add to the stimulation your breasts are receiving. You could then give her that milk. (Although I should tell you, she may only drink it because it is put in her mouth, not necessarily because she is hungry.) At any rate, this is something between not supplementing at all, and supplementing with formula.

    By the way, I don't think I mentioned this before, but if you are still worried about her weight gain it is not suggested that she spend any time sucking on a pacifier. This can also decrease your supply.

    Now, I can also tell you that YOU are the mother. If you have instincts on this, it is ok that you follow them. You could wait on the supplementing until you get back to see your regular ped. You could explain this to your dh that you have this instinct and that you just want to follow it. Let him know that you really respect your normal ped. and you will see him as soon as you can.

    I hope this helps! Keep us posted.

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