Breastfeeding

weight issue

i thought i was done worrying about her weight when she gained all of her birthweight back (at 2 weeks), but now we again seem to be stuck in a rut with regards to weight gain. She had been gaining 1/2 a pound a week, up until the end of May. That also coincides with her beginning to STTN. Between the end of May and today, she's only gained 1 pound. She is now 15 weeks old; we EBF and I don't know what to do. She spits up a lot. A whole lot (my mom, who had 4 kids, even commented that it was more than what's normal when she watched her the other day). I've cut out a whole bunch of foods in an attempt to figure out what's causing her to spit up; it may have cut the spitting up down a little bit but not completely.

I've been going to lactation support classes up until last week (now that I've started back at work I can't attend them) and our weighted feedings were about 3 ounces. I'm wondering if it has to do with her STTN. She sleeps almost 12 hours. We get in about 5-6 feedings a day; that's only 15-18 ounces. Sometimes she'll want to cluster feed in the evening (not all the time), so maybe she gets a little bit more but not much. I don't know what to do at this point; does anyone have suggestions? I'm really afraid to talk to the pediatrician; i'm afraid they will just tell me to put her on formula.  

Re: weight issue

  • We had weight issues at our four month appointment. He was gaining but it was slow. With the support of an LC, we continued to EBF. I offered more often, and did tons of breast massage on one breast to get more fatty hindmilk in before switching to the other breast.

    It meant I offered every 2.5 hours for a while...but it worked.

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  • I agree with pp. you're going to need to offer more often during the day. LO needs closer to 25 oz per day.
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  • oh, no wonder she's not gaining. 

    but i am kind of not getting it, sorry. with her sleeping almost 12 hours, that only leaves 12 hours of awake time. 25 ounces would be 8-9 feedings...that would mean i would have to feed her about every 1.5 hours? Or is she supposed to be taking in more than 3 ounces a feeding?

  • May 30-July 7, 16 ounces... is a bit on the low side but not really that low.  8 ounces a week is on the high side for a BF baby, so maybe your LO is just leveling out her weight gain this month to make up for her fast weight gain as a younger baby.

    I agree that feeding more often during the day is going to be the best recommendation.

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  • image boosn:
    oh, no wonder she's not gaining.nbsp;but i am kind of not getting it, sorry. with her sleeping almost 12 hours, that only leaves 12 hours of awake time. 25 ounces would be 89 feedings...that would mean i would have to feed her about every 1.5 hours? Or is she supposed to be taking in more than 3 ounces a feeding?


    At that age, DS1 was STTN and was taking at least 7oz at every feeding.
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  • image boosn:
    oh, no wonder she's not gaining.nbsp;but i am kind of not getting it, sorry. with her sleeping almost 12 hours, that only leaves 12 hours of awake time. 25 ounces would be 89 feedings...that would mean i would have to feed her about every 1.5 hours? Or is she supposed to be taking in more than 3 ounces a feeding?


    Since your supply naturally fluctuates during the day, she probably does take in more at certain feedings. If I do a weighted feeding in the afternoon, he gets three ounces. I bet if I did one at the first morning feed, it would be about 6 ounces.

    For example, if you are feeding 6 times a day now, I'd work on getting in a seventh feeding, and upping the massage to get more hindmilk out.

    Do you feed on one breast per feeding or both? I'd also try to lengthen feedings. When baby is done, I'd reoffer the first breast and see if baby will take more hindmilk in.

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  • the lc didn't say anything about fluctuating amounts during the day. I usually feed from both breasts during a feeding. So i'm wondering if my supply is low, too. Since I've just started working PT last week (just 3 days a week) i've been pumping in the morning around 5:30. I get anywhere between 4-6 ounces then. Then I wake LO at 7:00 to feed (if i don't go to work then I wake her at 8:00 to feed). But I wonder now if i'm 'stealing' milk from her by pumping before she eats. When i pump at work, i don't get much at all...only 2-3 ounces all day (i work a 8 hour day, so i pump twice). I think I'm just not that responsive to the pump.

    So i'll add in another feeding when i'm at home (not working). I've noticed also that our feedings have been getting a bit longer (they went from 1 hour as a newborn to about 15 minutes and now they are at about 30 minutes).  i'll make sure they stay at 30 minutes. 

    I was having the babysitter give her a 3 oz bottle every 2.5 hours while i'm at work...should i have her increase the bottle size, then? (fortunately i have some milk frozen)

    This stinks. I have a feeling i'm going to have a hard time getting to 6 months with EBF. I didn't think it would be so difficult to figure out. Eventually my freezer store is going to run out. When I'm not working I only pump first thing in the morning. I don't know when else to do it; I was trying to do at night after her last feeding but I only get about 1/2 ounce then. During the day it's too hard because I have LO. 

     

  • Weight gain will usually slow down normally a little bit at 6 months, but I see you aren't quite there yet.

    You need to feed baby more often...which simply means offering the breast or bottle more often. 18 ounces is not enough. 

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  • image boosn:

    When i pump at work, i don't get much at all...only 2-3 ounces all day (i work a 8 hour day, so i pump twice). I think I'm just not that responsive to the pump.

    It sounds like you aren't responding well to it during the day. You might want to try a few little things to make those pumping sessions more productive.

    Check your flanges to make sure they fit correctly

    If you have a Medela, switch the membranes to new ones or trim the tubing where it connects to the pump.

    Use heating pads (Lansinoh has some therapy bead purple ones that wrap around flanges) when pumping

    Up massage when pumping

    Play around with the pumping settings. Some people respond better when playing with the speed or stopping and then trying the letdown cycle part again.

    Good luck!  


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  • It is probably not a supply issue, but it definitely could be that you don't respond well to your pump. Try the pump maintenance and tips recommended above and see how that goes. How long do you pump per session? have to pump at least 20 min to get enough milk, and sometimes that's with breast massage the whole time. Also I get more when I stay really well hydrated (I drink a 24 oz jug of water while I pump) and eat oatmeal for breakfast every day.

    Baby might not be ready to STTN. I've read on Kellymom that hungry babies often sleep to conserve energy, so baby might still need a MOTN feeding or two! If you don't feel you can do feedings that often during the day, try a dream feed at night. Or if you don't want to interrupt your own sleep, maybe try to rouse baby right before you go to bed.

    Also don't increase the size of baby's bottles. No more than 4 oz, you don't want baby to develop a bottle preference. Baby's tummy would stretch out and eventually you would create a supply issue because you wouldn't be able to keep up.

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