Happy Mothers Breastfed Babies
Page 1 of 5 12345 LastLast
Results 1 to 10 of 45

Thread: Help! I have 48hrs to get my baby to start gaining weight

  1. #1
    Join Date
    Jul 2016
    Posts
    21

    Default Help! I have 48hrs to get my baby to start gaining weight

    My baby is now 9 days old and he has lost 10% of his birth weight. Because his stools have been mostly greenish the woman at the hospital suggested he wasn't getting enough of the fatty hind milk, they also looked at him sucking and noticed that he was sucking about 5 times for every swallow and they wanted to see him sucking 2 times for every swallow.

    They suggested I try and express milk for him and also do breast compressions while he is feeding. They will reweigh him in 48hrs and if he doesn't start gaining they're going to admit us to hospital and be much more aggressive.

    I feel like a total failure and I am so worried I am going to end up having to give him formula. He cries a lot because he is clearly hungry and I feel so bad for him suffering, we almost went and bought some formula today but we were told to watch his poos to see if they turn more yellow to see if things are working and if we supplemented now that would alter that.

    I have had really poor luck with expressing, it doesn't squirt out like in pictures, it just drips out, both with the pump and hand expressing.

    I am feeling really despairing that I can make this work, especially on such a tight deadline.

    I kind of think his nappies have been more yellow (it's been a few hours since I saw them) but it could be wishful thinking and there's still a greenness to them.

    Please someone tell me we can get through this?

    Edit: Since doing the breast compressions my baby has spit up some white chunks in saliva - does this mean I am managing to get lots of milk in him? That would be reassuring. On the other hand, he still wanted to go back on the breast after so was he still hungry? I feel like I am failing him and causing him to suffer by not being able to feed him properly
    Last edited by @llli*saw30; July 16th, 2016 at 04:01 PM. Reason: Additional developments

  2. #2
    Join Date
    Jun 2009
    Posts
    10,018

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    Ok. I know it is scary if baby is not gaining normally or you think baby might not be getting enough milk. But the last thing you need is to be threatened. That is absurd.

    Please let me reassure you, If your baby needs formula, that does not mean the end of breastfeeding or that you have failed in any way. It means you need more help with figuring out how to get more milk into baby at the breast. For that, you need to know what the problem is. Is it your milk production? How baby nurses? Something else? You need a partner in getting breastfeeding off to a good start.

    WHO is the "they?" talking about getting more 'aggressive" (whatever that means- how what a terrible thing to say...) - is it your baby's pediatrician? Or this person who is talking about hindmilk and green poops and sucks per swallow etc? I am sorry but there is absolutely no perfect specific sucks per swallow. All milk has fat, what a baby needs in order to gain is enough milk, not special magical hindmilk. and green is often a normal color for poop in an infant. Frankly this sounds like someone who knows just enough to be dangerous. Who are they, what is their training and experience, and what power do they actually have?

    How many different scales has baby been weighed on? Scale error happens A LOT especially in the early days. This may be why baby appears to not be gaining.

    Where do you live? Any chance you can see a board certified LC right away (IBCLC) who is not affiliated with the hospital? Here is an idea of what an appointment with an IBCLC would look like: http://www.cwgenna.com/lconsult.html

    Yes if baby is starting to spit up, it may well mean baby is getting more milk. But the real tell is how many times a day baby poops and ACCURATELY measured weight gain.
    After the first few days or first week, Newborn babies are pretty much hungry almost all the time and want to nurse almost all the time. Even right after they spit up. That is normal.

    More on scale error from Jack Newman (Breastfeeding expert) : https://www.facebook.com/DrJackNewma...45026312315087 and post partum weight loss in baby: http://www.canadianbreastfeedingfoun...ght_loss.shtml and https://www.facebook.com/DrJackNewma...43509742466746
    Last edited by @llli*maddieb; July 16th, 2016 at 05:54 PM.

  3. #3
    Join Date
    Jul 2016
    Posts
    21

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    Ah sorry, "they" are the breastfeeding midwife at the hospital and the community midwife who weighed my baby. I guess by aggressive they mean that they'll take me into hospital for a stricter process.
    This past week I've seen a tonne of different breastfeeding advisors, none of them did anything as thorough as that link though.

    The scales have been crazy, the community midwives use different scales to each other, like different brands of scale and they're only calibrated once a year apparently. Two days ago they seemed to say he was beginning to gain finally at the hospital while the community ones said he'd lost even more. Today on the other hand they both agreed that he had lost a bit more than the first time they weighed him but not as much as the community ones thought two days ago. I do think he might look slightly thinner though, not sure. His poops have varied, a few days ago he had 13, yesterday more like 6 (although dunno if you count when he does it twice in quick succession s one or two). He's been having plenty of wees but I am not sure if the volume is sufficient.

  4. #4
    Join Date
    May 2006
    Posts
    24,870

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    Great advice from MaddieB. I just want to reiterate that if you have to supplement- which is still a big "if" because to my mind you can't properly evaluate weight gain when at least 2 different scales are being used- then it will be okay. It's not the end of breastfeeding- my first child is living proof.

    With urine output, volume matters less than color and odor. If the baby's wee is usually pale and mild-smelling, it's an indicator of him being well hydrated. Wee that is usually dark yellow or strong smelling is an indicator that baby isn't getting enough to drink.

  5. #5
    Join Date
    Jun 2009
    Posts
    10,018

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    This is sad and outrageous. If your baby is pooping between 6 and 13 times a day and really not gaining, (or even odder, losing weight!) then the problem may be something aside what or how much baby is fed. Something is clearly not adding up. So maybe it would be a good thing to have baby tested for some health issue. However, I fear all that will actually happen is you will be told to formula feed.
    If none of the "advisers" you have seen have done what is discussed in that article, then whether they are properly educated and trained or not, they are not doing what needs to be done to get to the bottom of what is going on. If you tell us what country you are in (I think I know but do not want to assume) I can see if there is a look up for IBCLCs you can use.

    Poops close together count. What makes a poop "count" is how much there is of it. You want to see at least an amount you could scoop up in a normal eating spoon should you want to do that. In other words, anything with an volume counts, but stains or streaks in the diaper do not. Really as long as baby is pooping enough (4-5 times a day or more, usually) you do not even have to worry about pees. A baby will not poop a normal amount if they are getting so little milk they are dehydrated. And the poops would be dryer looking than normal.

    Here is what I would suggest you consider doing if you are told to formula feed:
    Make sure you understand exactly how much formula they are telling you to give baby. How much each time, how much per day, and for how long. Formula is like medicine for a poorly gaining baby. They should be able to answer basic dosages questions.

    Typical recommendation when a breastfed baby needs supplemental feedings is that baby is given 1 to 2 ounces supplement "per feeding." But this is not enough info for you, because how do they (or you) know how many times baby might nurse that day? You need specifics.

    Ask them at what they expect in terms of weight gain and when baby will be weighed again. Lots of times the expectations for gain are not in line with reality.

    Ask them if you are able to pump or hand express any milk, if some or all of the supplemental feedings can be your expressed milk. If they say no, ask them WHY NOT. Breastmilk and regular formula are IDENTICAL in calories.

    Continue to nurse baby as often as baby will. Encourage baby to nurse at least 10 times in 24 hours if you can.

    Each time you supplement, which probably will NOT be at every feeding, you can nurse baby either before or after the supplement, or both. But try to avoid having supplemental feedings occur with no nursing at the same feeding.

    For every time you give baby any supplement, it is important that you try to pump. This will help prevent the supplementing from further harming milk production.

    So a day might look like this. Say you are told to supplement baby 6 ounces a day, one ounce at a time. Baby nurses 12 times, baby is supplemented one ounce at a time before or after 6 of those nursing sessions, and you pump 6 times overall, either between nursing sessions or directly after a session. Obviously you can adjust exactly how this is done as needed for you.

    Consider alternative feeding methods for the supplements. Bottles are probably the most problematic choice as they might lead to eventual breast refusal over time. But, if you keep the amounts small at a time and pace the feeding as much as possible, they can be ok. There is a special method to use that makes the feeding a normal pace called paced bottle feeding and this is important for avoiding nipple or "slow" confusion from bottles that leads to breast refusal. However if baby has truly not been getting enough to eat, you may want to hold off on that method until baby starts gaining, and instead just keep the bottle feeding quick and simple for baby and you.
    At the breast supplementer (aka lactation aid) is probably the least problematic method in terms of preventing nipple confusion, but does not work well in all cases.
    A syringe, open cup or a spoon can all work well.
    There are videos and articles on the net that explain these alternatives. Please let me know if you would like links.
    Last edited by @llli*maddieb; July 17th, 2016 at 01:45 PM.

  6. #6
    Join Date
    Jul 2016
    Posts
    21

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    I am feeling really crushed. My son has lost more weight (though again, depends on the scale, when he last fed, pooed etc). I have been told I *must* give him 30ml of formula every 3 hours and I was told by the midwife I have to give his next feed as all formula to "let your breasts fill up" - does it actually work like that?

    The health visitor thinks that I am still anaemic from the birth (had a postpartum haemorrhage and my haemoglobin went down to 8.6) and this could be effecting my milk supply. She made me a doctors appointment and he's booked me for some blood tests tomorrow to see if that is the case. He also prescribed me 30 10mg tablets of domperidone to take 3 times a day.

    I was feeding any supplements with a cup but that was taking so long that we were unable to get any sleep so they want me to use the bottle. I got slow flow nipples for it, but I am still pretty scared it's going to ruin my baby's suck. He is latching painlessly now so it would be really frustrating.

    I feel a great deal of despair about this, that I have pretty much set things in motion to doom breastfeeding - I was just starting to really enjoy it, I was crying most of the day just thinking about it. Yesterday the health visitor was ok with me just giving him expressed milk but now he lost more weight she has changed her tune.

    They said if he loses any more weight I *will* go to hospital, not just as a threat (although at first it sounded that way) but because if he doesn't gain weight on the formula they will have to investigate for absorption issues. I wish they could have checked how much he is getting some other way. How can he poo so much if he's not getting milk?

    I am only managing to pump small amounts though. 15ml over 20min on a good go. I think it probably is related to the blood loss, but I wish they could have treated that more aggressively early on and maybe none of this would have happened

    Oh and Maddieb - I am in the UK.

  7. #7
    Join Date
    May 2006
    Posts
    24,870

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    Quote Originally Posted by @llli*saw30 View Post
    I am feeling really crushed. My son has lost more weight (though again, depends on the scale, when he last fed, pooed etc). I have been told I *must* give him 30ml of formula every 3 hours
    Of course you are feeling crushed. You are trying so hard and not getting the results you deserve. I felt the same way when my firstborn wasn't gaining weight despite all my efforts. Just take a deep breath and remember that problems with breastfeeding don't make you a lesser mom or a lesser woman. It's not a "failure". It's just a problem that you will deal with, and most likely you will get it sorted in time.

    and I was told by the midwife I have to give his next feed as all formula to "let your breasts fill up" - does it actually work like that?
    NO!!! It does NOT work like that. Letting your breasts "fill up" is how you damage supply. Milk supply is created and maintained by frequent removal of milk from the breast. The more often you nurse or pump, the more often your body gets this message: "Hingry baby! Make more!" Leaving milk in the breast for a long period signals your body that there's not much demand, and your body interprets that as a cue to produce less.

    The health visitor thinks that I am still anaemic from the birth (had a postpartum haemorrhage and my haemoglobin went down to 8.6) and this could be effecting my milk supply. She made me a doctors appointment and he's booked me for some blood tests tomorrow to see if that is the case. He also prescribed me 30 10mg tablets of domperidone to take 3 times a day.
    Let's hear it for the HV! She is correct that postpartum hemorrhage can affect milk supply. I forget exactly how it works, but high blood loss can interfere with the hormonal message that goes to the brain and triggers the onset of milk production. If you haven't already been to the doctor, make sure you get your prolactin level checked. If it's low, the hypothesis about blood loss may be the correct one. Regardless, a scrip for Domperidone is probably a good idea at this point.

    I was feeding any supplements with a cup but that was taking so long that we were unable to get any sleep so they want me to use the bottle. I got slow flow nipples for it, but I am still pretty scared it's going to ruin my baby's suck. He is latching painlessly now so it would be really frustrating.
    I understand completely. Cup feeding can be very time-consuming, and if the baby is having real trouble gaining I think it might be a good idea to try a different method. Bottles can be made more compatible with breastfeeding if you do things like continuing to nurse before and/or after a bottle, and using paced feeding techniques.

    I feel a great deal of despair about this, that I have pretty much set things in motion to doom breastfeeding - I was just starting to really enjoy it, I was crying most of the day just thinking about it.
    Steady on, mama! As I said above, this is not "doom". This is a bump in the road, and you are going to get over it.

    Yesterday the health visitor was ok with me just giving him expressed milk but now he lost more weight she has changed her tune.
    So they are insisting that baby get formula via bottle instead of the same volume of breastmilk via bottle? If so, that's silly; breastmilk and formula have the same amount of calories. Formula is designed to copy breastmilk in this vital respect. I would push back on this front.

    They said if he loses any more weight I *will* go to hospital, not just as a threat (although at first it sounded that way) but because if he doesn't gain weight on the formula they will have to investigate for absorption issues. I wish they could have checked how much he is getting some other way. How can he poo so much if he's not getting milk?
    There is another way to check a baby's milk intake, which is to get your hands on a professional digital baby scale, one that is good to the 1/10th of an oz or metric equivalent- you didn't give up on metric with Brexit, right? With this sort of scale, you can weigh the baby at every feeding, subtract the baby's weight before nursing from the baby's weight after nursing, and come up with how many oz or ml of milk he took in while nursing. Given that scale error may be in play here, I would encourage you to look into getting a scale for a while. Keeping your own accurate weight records seems like a good idea.

    I am only managing to pump small amounts though. 15ml over 20min on a good go. I think it probably is related to the blood loss, but I wish they could have treated that more aggressively early on and maybe none of this would have happened
    Non-metric moms, 15 ml = 0.5 oz.

    What sort of pump are you using? Are you combining pumping with hand expression? And are you pumping after nursing- in which case 15 ml is decent output- or instead of nursing, in which case it is low?

  8. #8
    Join Date
    Jul 2016
    Posts
    21

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    Hey again, well they weighed him again today and he gained but not enough to satisfy them. They now want us to give him unlimited formula until he is satisfied. They said it's not forever but it seems like things are just getting worse and worse, I am worried that the baby won't take anything from my breasts being all stuffed with formula.

    I have a philips event single electric pump. However today we decided to rent a hospital one because I am feeling like I need to try a lot harder at pumping from now on since the baby is not going to be drinking as much from the breast. When I hand express it is coming out faster than before the pills (already) and I am really panicking that it's going to dry up for not being used.

    Baby is sleeping on my lap, totally uninterested in feeding and they want me to give him another formula feed (every 3 hrs) in 10 min.

    So they are insisting that baby get formula via bottle instead of the same volume of breastmilk via bottle? If so, that's silly; breastmilk and formula have the same amount of calories. Formula is designed to copy breastmilk in this vital respect. I would push back on this front.
    Oh no, she was ok with the smaller volumes before.

    There is another way to check a baby's milk intake, which is to get your hands on a professional digital baby scale, one that is good to the 1/10th of an oz or metric equivalent- you didn't give up on metric with Brexit, right? With this sort of scale, you can weigh the baby at every feeding, subtract the baby's weight before nursing from the baby's weight after nursing, and come up with how many oz or ml of milk he took in while nursing. Given that scale error may be in play here, I would encourage you to look into getting a scale for a while. Keeping your own accurate weight records seems like a good idea.
    Do you know how I could go about doing that?


    Are you combining pumping with hand expression? And are you pumping after nursing- in which case 15 ml is decent output- or instead of nursing, in which case it is low?
    After for the most part. I found trying to hand express just left me with milky boobs and not much in the cup.

    His weights to me actually look (with fluctuation) to be stable rather than constantly going down, but he did look very thin yesterday (less so today because he's bloated from all the formula).

    in Kg:

    10/7/16 - 3.18
    11/7/16 - 3.20
    12/7/16 - 3.18
    14/7/16 - 3.16
    14/7/16 - 3.21 [at hospital]
    18/7/16 - 3.14
    19/7/16 - 3.17
    20/7/16 - 3.12
    20/7/16 - 3.18 [health visitor scale]
    21/7/16 - 3.18

    However since the formula his pees are a lot heavier it's true.
    Last edited by @llli*saw30; July 21st, 2016 at 09:10 AM.

  9. #9
    Join Date
    Jun 2009
    Posts
    10,018

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    EDIT: FYI wrote following post before seeing your last post: Here is a directory to look for IBCLCs in many countries, including UK: http://www.ilca.org/why-ibclc/falc

    There are lots of filters. That is new and I am not sure why ILCA is doing that but whatever. I suggest, ignore most of those. Just find a few closest to you who will see private patients (not sure how it will work in UK with national health) and get the LC on the phone and talk to them and find one who will do a consult similar to what CW Genna describes in the article and who sounds like someone you would feel comfortable with. Most LCs are lovely people and will be happy to talk to you about their experience and training. You do not need an IBCLC who is also a nurse, midwife, doctor or anything else. Speaking generally, probably the best IBCLCs do NOT come from the medical profession. Because they are required to have more training and clinical hours in breastfeeding issues specifically.

    I agree with mommal about the bottles. If cups are taking too long, even if paced bottle feeding is taking too long, you do not have to do those things. What is important is to feed baby. But you do want to be careful to not overfeed baby and to continue to nurse as much as you can. Keep baby aware that the breast is a wonderful place for comfort as well as food. That will help to counteract any tendency for baby to refuse to nurse due to getting bottles.

    You may want to ask your midwife if there is something IN the formula that she thinks would help baby gain faster than your milk. If you are anemic, your milk possibly is as well, and maybe she is thinking baby needs Iron. Formula is, of course, fortified with Iron because that is the only way it has iron in it. Babies are born with good levels of Iron UNLESS, maybe, the cord was cut very prematurely. But if baby is low in iron, baby can get iron directly from a vitamin supplement rather than formula- at least I think baby could, not sure of the safety of that for brand newborn? Just not sure, since baby is so young and this issue (possible low iron) usually only comes up a bit later.

    This is early days! Very early days! You are certainly not doomed in any way...

    I will not repeat mommal more- I agree with her entire post. Hang in there. If your baby is not gaining there is a problem and breastfeeding problems are USUALLY SOLVABLE. I still do not like the threats, but again, if baby needs testing it is best to get that done! If a newborn in the States was losing weight at this point they would have been back in the hospital already in many cases. It sounds to me as if overall, you are at least getting breastfeeding supportive if not entirely breastfeeding knowledgeable support from your health care providers. Many moms in the US with low milk production would kill for a script for domperidone which is impossible to get here. If you want to read more about this medication, Dr. Jack Newman is probably a good online source. He is Canadian.

  10. #10
    Join Date
    May 2006
    Posts
    24,870

    Default Re: Help! I have 48hrs to get my baby to start gaining weigh

    The way I got a scale was by renting it from my IBCLC. I have also heard of people renting them through medical supply places- do they have those in the UK?

    With the Domperidone and the hospital-grade pump, I think you should start to see an increase in output. I also encourage you to keep trying hand expression as you pump with the rental- I found it measurably increased the amount I saw in the bottle as I got better at it. And I know this sounds bonkers, but don't cry over spilt milk. If hand expression wrings more milk out of the breast than pumping, it's okay if the milk just ends up in a puddle. I mean, obviously you want to get the milk to feed the baby. But the act of removing milk from the breast is good for supply even when the milk ends up wasted. That was hard for me to accept when I was pumping and desperate to increase supply, but it's really true.

    You're doing wonderfully well, just keep at it!

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •