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Thread: Another slow weight gain thread - and a zillion questions

  1. #1
    Join Date
    Mar 2011
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    Default Another slow weight gain thread - and a zillion questions

    Hi everyone

    I realize there are other threads like this around, but every baby and situation is unique, so here goes... (and this is long, I'm sorry!! I've tried to keep my questions close to the end of each paragraph)

    DS2 is 12 weeks old. His birth weight was 7lbs2. He was down to 6lbs11 at day 5, and then at 2.5 weeks he was 8lbs6! We thought we were off to a great start and continued as normal for another 5 weeks, when we went for another weigh-in. At that point (7.5 weeks) he had only gained 2 ounces - in 5 weeks! Yikes. At 9.5 weeks he had gained another 8 ounces, which, though a bit on the low side for 2 weeks, we were really happy with considering the poor weight gain before that. At 11.5 weeks he had gained another 6 ounces, making his weight now 9lbs6.

    We aren't happy with the 6 ounces. We had hoped that the 8 ounce gain was a step in the right direction and that his weight gain would continue to increase. (I keep 5-7 ounces a week in mind for a good weight gain.) Going down is not the right direction! I'm worried that my supply is dwindling. I would say his diaper output is mostly OK though he's certainly not a heavy wetter. He poops usually once or twice a day. He's a happy, strong, alert, active baby. So that's all good.

    During those 5 weeks of almost no gain everyone else in the family had been sick - me, dh, ds1. Ds2 had some green poops during this time, which we thought might be a foremilk/hindmilk thing at the time so I did a bit of block feeding but never figured out if it was related or not and went back to normal feeding. His poops went back to normal a bit before the two week period that he gained 8 ounces, so we think now that maybe he was sick during that time too and that's why he didn't gain much. But I also worry that during that time my supply suffered.

    His latch has never been textbook. Ds1's latch was the same, and after struggling to improve it with him I gave up and decided it was 'good enough' - and it was good enough for over four years of nursing! So with ds2 I decided it was 'good enough' quite early on. Now of course I'm thinking it is not good enough! It's a shallow latch. When he comes off the right side my nipple is white and lipstick shaped. My left nipple is sometimes lipstick shaped, but never white. It doesn't hurt though, which is why I never tried too hard to fix it. Is it too late to fix it now? I don't really know why one side is pretty much fine and the other isn't. On Monday a public health nurse who specializes in breastfeeding is coming to see me and I'll be asking her to check what I'm doing. Any suggestions though on how to fix this?

    Another issue with his latch is that it's pretty easy to break it, whereas when he was a newborn it was HARD to get him to unlatch! So now I'm worried his suck is getting weak. A doula I saw a few weeks ago suggested I fix his upper lip (it doesn't roll out like it's technically supposed to) after he latches on and often when I do that it breaks the latch (so I stopped doing it). I can pull his bottom lip down usually without it breaking the latch, though sometimes it does. Is there any way to get him to suck harder and stay latched on better?

    He is at the breast a lot, but a lot of it isn't active feeding. He comfort nurses a lot, which I understand still stimulates milk production but isn't getting the calories in him. He also falls asleep during feeds very easily. We get into a cycle of him nursing a bit, falling asleep, jerking away, nursing a bit more, sleeping a bit more, and repeat. It results in not a great sleep and not a great feed. I've been trying switch nursing this past week to keep him awake which is helping, but I never quite know when to switch sides. When he goes into comfort sucking mode, or just lays there with boob in mouth looking around, or starts to fall asleep, I do breast compressions. I try that a few times and then also normally wait a bit to just see if another letdown will come on its own. If nothing happens after a few minutes, then I switch sides. Should I switch though as soon as he isn't actively sucking? Also I'm worried that this way he isn't getting the hindmilk. We usually end with comfort nursing on one side after it seems like he's had a good feed, so maybe he's getting hindmilk then? This all takes a long time and feeds are normally about an hour.

    He also latches on and off quite a lot, in frustration, mostly on the right but sometimes on the left. I figure it's him wanting a faster letdown or more milk. The last week he doesn't latch on and off so much as moans and grumbles at the breast instead. I started doing breast compression after we realized he wasn't gaining well and *sometimes* doing compressions will stop the moaning. When he starts to grumble should I switch him to the other side straight away? I haven't been straight away - instead doing compressions, massage, burp him - and after a while if it isn't helping I'll switch him. My thought was if that breast is having trouble making milk I want to have him nursing there as much as possible, but I'm wondering if at the grumble stage if I shouldn't just switch the poor lad to a better breast right away so he at least gets milk and is happy, and then try the other breast after.

    I started taking fenugreek and blessed thistle on Wednesday. I totally smell like maple syrup! I noticed an increase in supply last night, which is fab. We stayed in bed, skin to skin, for most of today and will do the same tomorrow, with lots of nursing! I'm wondering if I should also start taking domperidone? My supply has def increased - I feel more full and I can see more swallowing (normally four sucks and then swallow is the most we get, but today we got two or three sucks and then swallow!) - but I still don't feel like I'm bursting or anything. (Not that I want to burst!) My feeling is that because of sickness, sleepy baby and poor latch my milk supply started to go down, which resulted in more of a sleepy baby at breast and more poor latch, which decreased my milk more, etc etc. I'm hoping if I can get my supply up, get him used to being awake at the breast and actively feeding, and ideally fix his latch, then he will start gaining more weight and his nursing will then maintain my supply. So with that in mind maybe I should throw domperidone at this as well? I'm worried about weaning off it though and it hurting my supply in the end!

    Also, is there a difference between slow letdown and low supply? Even with the increase in supply today, we've still had plenty of grumbling at the breast. I'm not quite sure what's going on with that.

    Well if you've read to the end of this I applaud you!! I'm sorry it's such a novel. On the WHO growth charts he is way below the 3rd percentile. I know that's just one measurement and really he is a happy, strong baby, but I'm still worried. Thanks so much for reading and any advice/support you can offer!

  2. #2
    Join Date
    Feb 2011
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    Texas
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    375

    Default Re: Another slow weight gain thread - and a zillion questions

    I'm going to let someone else take the switch nursing questions, because quite honestly, I struggled with something similar myself, tried a thousand different variations, and never really felt like I came up with the magic bullet

    I can understand your dismay over your baby's weight - I'm obsessed with my daughter's weight gain, and she's basically average. When you say he's not a heavy wetter, what sort of diaper counts are you getting?

    One suggestion popped into my head while I was reading your story: have you thought about trying to nurse while walking around or in a sling? It may possibly help with the dozing off. Pumpkin never falls asleep at the breast, but she's a super fussy and distractible nurser - occasionally I find this helps keep her focused on the task at hand (even though it's not so fun for me )

    Another thought I had was about his upper lip. My baby's lip used to ALWAYS be tucked in, and she'd also frequently lose her latch when I flipped it out. I noticed at some stage during one of her on/off/on/off/on/off marathons that her upper lip was usually better positioned once my nipple was already slick with saliva...less friction, I guess, hahaha! From that point on, I occasionally used my own or her saliva to help out during her initial latch. Even if she still tucked in, the extra slickness made it easier to flip her lip out without messing everything else up. Unorthodox, maybe, but worked for us

  3. #3
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    Mar 2011
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    39

    Default Re: Another slow weight gain thread - and a zillion questions

    Quote Originally Posted by @llli*firefly View Post
    When you say he's not a heavy wetter, what sort of diaper counts are you getting?
    We change his nappy usually every 2-3 hours during the day. We use cloth, and they are not usually drenched. Though he does have a tendency to pee WHILE we are changing his diaper!! Anyhow, so that's about 6-7 a day, I think.
    Quote Originally Posted by @llli*firefly View Post
    One suggestion popped into my head while I was reading your story: have you thought about trying to nurse while walking around or in a sling? It may possibly help with the dozing off.
    I wish I could nurse in the sling, but I find i have to hold my breast so this is quite difficult. Plus I mainly use the Moby and am not sure how to nurse in that! I do have a Maya ring sling also though he doesn't really like it as much as the Moby.

    Quote Originally Posted by @llli*firefly View Post
    From that point on, I occasionally used my own or her saliva to help out during her initial latch. Even if she still tucked in, the extra slickness made it easier to flip her lip out without messing everything else up. Unorthodox, maybe, but worked for us
    Haha - love this suggestion! I will definitely try it, thanks!!

    Had the breastfeeding support person from public health come by today and she thinks his latch is pretty good. She def thought my supply was low, judging by the lack of swallowing and the amount I could hand express. He was also acting like a very hungry baby when she was here, with all sorts of grumbling. This has been happening more and more over the past week. I wouldn't have said he seemed hungry until recently!

  4. #4
    Join Date
    Feb 2011
    Location
    Texas
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    375

    Default Re: Another slow weight gain thread - and a zillion questions

    Forgot in initial reply to mention that, yes, there's a difference between low supply and slow let down...although one could technically have both, yikes! Low supply is a lack of adequate milk production, slow let down is simply that: the force of your milk ejection reflex might not be very strong, so the flow of milk isn't very fast. Either can cause baby to be agitated.

    I'm not completely up on what's a good wet count for cloth diapers, although it should generally be a bit higher than disposables since they're less absorbent. That said, different resources often have different estimates. What color is his urine?

    Another thought I had: what sort of environment do you nurse him in? If it's quiet and peaceful, maybe you could turn up the lights and have the television running. Conversely, if there's a lot of stimulation already present, maybe you could try toning it down to see if it helps him concentrate.

    Lastly, two things: have you thought about pumping to help increase supply? Re herbs, from what I know about herbal supplementation, some work as galactagogues (increase milk supply) and some work to facilitate your let down. It might be worth looking into those that facilitate let down if you feel like you've had an increase in supply but not a noticeably happier/heavier baby.

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