Nursing 6 week old not gaining enough

amother

Mon, Apr 04 2011, 10:29 pm

I went to weigh my baby by the dr today. I was expecting to hear how she gained tons since she is so content, burps, spits up, smiles, etc. She also feels heavier. I mostly nurse her and give an occasional bottle of formula 1-2 times a week.

Dr said she is really below charts and I should supplement with formula if the weight gain doesn't pick up the next two weeks.she was 8 pounds 14 oz at birth, 9 pounds 1 ounce by 10 weeks, and now 9 pounds 9 ounces by 6 weeks.

Did anyone ever have this and they then needed to supplement? Did the nursing get less and less as more formula was given? Also, can it be that she is gaining at a healthy rate, just maybe it doesn't correspond with growth charts? Any info or advice appreciated.

Merrymom

Mon, Apr 04 2011, 10:52 pm

There are alot of old fashioned pediatricians out there who are only all too happy to get you to quit breastfeeding. Here's a chart from Dr. Sears telling you what to expect from a breast fed baby:

http://www.askdrsears.com/html/2/t023600.asp

Those charts were based on formula fed babies. Are you feeding your baby on demand or on schedule. If you're on a schedule I wouldn't do that nor would I try to get the baby to sleep through the night without feeding every few hours.

amother

Mon, Apr 04 2011, 11:07 pm

Op here

Thanks for the info. My dr is actually very pro nursing, he said I should nurse as much as possible not to stop, but that I may need to add formula to nursing if my baby doesn't gain more.

Thanks for the link, the info was very helpful. unfortunately, she is low according to breastfed charts. Sad

I feed her on demand, no scheduling, and she cosleeps with me. However, she on her own has a huge nap in the morning of 5 hours and in the night can go for 4-5 hours. The rest of the time I nurse every 2-3 hours. Dr suggested I feed more often in the day, even if I need to wake her up and well see how much she gains after that. I guess I will do that and hope she gains more.

Marion

Tue, Apr 05 2011, 12:37 am

DS#2 was never ON the charts. And I ignored it. At three and a half he's still tiny...wearing mostly 24mo/2T clothes...

The charts (and often the doctors) don't seem to remember that genetics play a part. If she's gaining on a curve (even if it's lower than the chart) and meeting milestones (sounds like she is), I would ignore the doctor.

Kayza

Tue, Apr 05 2011, 9:06 pm

Please see a GOOD lactation consultant ASAP.

Kayza

Tue, Apr 05 2011, 9:08 pm

Marion wrote:

If she's gaining on a curve (even if it's lower than the chart) and meeting milestones (sounds like she is), I would ignore the doctor.

The problem is that she really is not gaining on a reasonable curve. It does happen, and it's stupid (and irresponsible) to ignore it.

A good lactation consultant would be worth every penny in this kind of case - but someone with some sense!

acccdac

Tue, Apr 05 2011, 9:25 pm

Kayza wrote:

Please see a GOOD lactation consultant ASAP.

I agree.

I dealt with this one year ago (right before pesach) with my dd. I ended up having to stop nursing, but I hope it can be different for you.

what week in pregnancy was your dc born in?

feel free to PM me to discuss further

amother

Tue, Apr 05 2011, 10:15 pm

Op here

Spoke to LC she agrees with dr that weight gain is too little, which makes sense according to what I read on links above. She also recommended to nurse more frequently for shorter to get the most out of the nursing, I think since baby's suck is strongest then. After a week we can then see if baby is gaining better.

She also said I can supplement with my own milk instead of formula, just dd will get BM from bottle instead of me some of the time. Has anyone ever done that? I thought supplementing meant using formula.

Dd was born end of 41st week, was induced since overdue almost 2 weeks.

Marion

Wed, Apr 06 2011, 1:33 am

No, supplementing does NOT have to mean formula.

Health is a Virture

Wed, Apr 06 2011, 2:20 am

especially because your baby is so big you might want to nurse him more often to make sure he is getting enough. he needs to eat more just to maintain his body weight!
what color are his diapers, as that might give us a cleareer picture of what type of milk he is taking in.
do you switch sides during a feeding?
basically, the first milk that comes out of the breast is less fattening and as the baby nurses from that side, the milk becomes fattier and fattier, think WEIGHT GAIN. so, it is very important that you make sure to "empty the breast" before giving the other side. This might mean giving the same breast for a whole feed without ever offering the other breast, until the next feed.
if baby's diapers are green then that would be a clear sign that he is getting too much foremilk (skim milk) and that you need to have him empty each side more to get the hind'smilk.
You should look on kellymom.com for more info. Sears also writes about "emptying the breast". I would suggest to nurse every two hours (to 2 1/2 hours) during the day and then let the baby go a stretch at night. wake the baby up to nurse. This is not forever, but just until baby starts gaining weight properly.
Try making sure he gets enough hinds milk for a few days and nursing more frequently. take him to get reweighed every few days. If his weight does not improve then you should go to a lactation specialist...it could be his latch or suck is not good so he has difficulty drawing out enough fatty milk.

Good luck!

spinkles

Wed, Apr 06 2011, 2:53 am

Breastfed babies in the early months should be gaining AT LEAST half an ounce a day, but more typically they gain an ounce or more a day. So, yes, your baby is not gaining enough. The question is, why not?

Is it just that, as the doc suggested, she needs to nurse more frequently? Or is it because her latch is not optimal? Is it because you aren't producing enough milk? Is the milk flow too slow? Is it because she has some sort of anatomical issue, such as being tongue-tied, which is making it hard for her to suck effectively? Etc. etc. etc. There are so many possibilities here. And I'm feeling frustrated by the advice you've been given by both the doc and the LC, because it seems as if (correct me if I'm misunderstanding) no one has thoroughly evaluated your baby's feeding skills and your milk supply.

You need an IBCLC (international board-certified lactation consultant) who has great references, and you need to meet her in person, rather than over the phone. You need her to weigh your baby before the feed; you need her to carefully watch you and the baby throughout the feed; and then you need her to weigh the baby again after the feed. (Ideally, you have her stay for several feeds, because the amount of milk that baby transfers varies from feed to feed.)

SIDENOTE:

About the weight: to figure out how much milk your baby needs, take your baby's weight in pounds and multiply by 2.7. So, in your case, we have:

9 lbs. 9 oz. x 2.7 = 25.13 ounces

Your baby needs a daily intake of 25.13 ounces. How often do you feed her? You said she sleeps about 10 hours a day, and nurses every 2-3 hours during the rest of the time. So let's say she's nursing 6 or 7 times a day??? Is that right? Because that's not enough for a nursing baby her age. She should be nursing 10-12 times a day, in general. Now, back to the daily intake: if she's nursing 7 times a day, and needs 25.13 ounces per day, that means she needs to get around 3.59 ounces per feed. (Again, keeping in mind that it's normal for amounts to vary from feed to feed.) So this gives you a ballpark figure. So, after the LC weighs the baby post-feed, you have info to work with: did the baby get approximately that amount of milk?
----------------------------

Anyway, back to what I was saying before the weight segue: basically what I'm trying to say is that your doctor may be right, and the problem may be solved simply by waking baby up to feed more often. This is a definite possibility. But you don't know for sure. There may be a problem with your milk supply, which can usually be fixed...but it can't be fixed if you don't know about it. Or there may be a problem with the way your baby's latching on and/or sucking...again, usually correctable IF YOU KNOW ABOUT IT.

Both the doc and the LC you spoke with had a wait-and-see attitude, but IMO this is something that needs to get thoroughly evaluated by someone excellent NOW. You said your baby is a content baby, and you said that she sleeps for long stretches. I don't want to worry you, but I think it's important to know that sometimes a baby who sleeps a lot and seems content is actually a baby who isn't getting enough calories and is conserving energy.

Where do you live? If you're in NY, I would highly recommend Catherine Watson Genna (cwgenna.com). She's excellent, and travels all over teaching continuing education classes for lactation consultants and nurses.

Anyway, you sound like a wonderful mommy doing the very best for her baby! I hope this little bump in the road gets resolved quickly and easily! I know it can be overwhelming, but iy"H it will all be okay very soon. Hug

Pizza

Wed, Apr 06 2011, 5:08 am

sounds like a combination of a less-than optimal latch and a growth spurt. See a lactation consultant ASAP - you may still need to supplement, but she will teach you how to simultaneously increase your supply, so that you can get off the supplement within a few weeks, instead of having it sabotage your nursing.

best of luck!

LiLIsraeli

Wed, Apr 06 2011, 11:20 pm

amother wrote:

When my DD was that age, she also was not gaining enough from nursing. I pumped and fed her breast milk from a bottle. She gained very nicely like that! Now at 8 months she is in the 50th percentile for weight BH.

YALT

Wed, Apr 06 2011, 11:28 pm

DD was burning more calories from nursing than she was actually taking in. As soon as I gave her bottles more frequently she started gaining beautifully.
But the LC, who is known to be "the best" insisted that I shouldn't change to bottle since she's doing just fine. What made me change to mostly bottles was my son's therapist who saw her and said she was so scrawny looking. I hadn't noticed since I saw her daily.

amother

Thu, Apr 07 2011, 1:51 pm

chana_f wrote:

this is a great post!!!
listen to the advice here, and you will be fine.
I had a baby who wasnt getting enough milk, he was content, happy, seemed satisfied after every feeding. I never had a clue he didnt get enough milk.
When my ped commented that he hadnt gained much since the last visit, I asked him if its possible I didnt have enough milk, and he said sure its possible. I stayed in the office to weigh the baby before and after a feeding and found he got only 2 oz. (he was already 6 months old then) and was so happy after you'd never guess he was hungry.
when I fed him his first formula bottle that night, he gulped down 6 oz, and I felt like the worst failure as a mom. I was pregnant and my milk supply dropped completely without my realizing.

the first thing you need to do is find out how much milk your baby is getting. take it from there.

anon, cuz many know my story.

amother

Thu, Apr 07 2011, 2:52 pm

Op here

I am working with an LC since birth since my baby had latching issues from day 1. Baby now nurses with a shield however dr and LC don't think that is preventing her from getting enough milk. Till she latched regularly, I pumped and gave bottles.

sv9506

Thu, Apr 07 2011, 3:02 pm

If your baby is sleeping a 5 hour stretch for a nap why don't you try to pump once or twice during that time and feed that to your baby later. Then you can be supplementing with your own milk and it might even help to increase your supply.

RachaelLeah

Thu, Apr 07 2011, 5:11 pm

OP, if your baby had latch issues from day one, please tell me you ruled out tongue-tie? I had to go to 3 different lactation consultants before I found one who knew what my dd's problem was, baruch hashem we got it clipped early on. It ruined a good friend of mine's breastfeeding relationship. Please look into it!!
Another idea I had - try nursing in a sling. My new baby was very lazy and not so interested in nursing, his weight gain was slow, also. I would nurse him in the sling once or twice a day, and he sucked MUCH more that way, which stimulated my milk production more, and helped him get more. It's a great way to relax them and focus them on nursing.

amother

Thu, Apr 07 2011, 7:57 pm

Op here

Tongue tie was ruled out right away.
I don't let her nap 4-5 hours anymore during daytime as per dr orders, I wake her to eat.

Her pampers are like olive green liquidy, (sorry if TMI). Could that be an indication that she isn't getting the fatty content of the milk? Maybe I will try alternate sides by each feeding

Hashem_Yaazor

Thu, Apr 07 2011, 9:00 pm

Yes, it can be an indication of that. Is it possible to pump after nursing for about 10 minutes to 1)get the hindmilk out which can be fed to the baby via supplementation temporarily 2)increase your supply?