no weight gain at 1 month check-up

whensongbirdsing

backstory: at my 20 wk ultrasound, they found that my son had a renal cyst (kidney).  they monitored me for the rest of my pregnancy, and the cyst did get larger, but only in proportion to my son's growth.  he was born at around 38.5 weeks, weighing in at 8lb 3oz, and measuring 20.5 in.  after he was born, they did another ultrasound on just him, and the the 1 renal cyst they had found in utero, was actually 1 large, and 4 small cysts.

now, i'm not sure if the backstory has anything to do with this, but at my son's 1 month check-up today, he weighed 1 oz LESS than his discharge weight from the hospital (today he weighed 7lbs 11oz, and measured 22in).  he also appears very thin, and he doesn't look like he has any baby fat on him.  he has been this way since birth.  starting 30 minutes after he was born, he's been EBF, on demand...and OFTEN!  in fact, when we are out or with family, they comment "you're feeding him AGAIN?  you just fed him an hour ago!"  in addition to being fed constantly, he also soils his diapers...OFTEN!  his first day in the hospital he peed AND pooped 8 times!!  so, this leads me to believe that i must be producing milk.  but, even still, his pediatrician recommended that i nurse him for 15 minutes, then follow up with 2oz of formula.  (i have another appt at the end of the week to see if he's had any gain with the addition of formula)  

at his first bottle feed today, i admit that i was crying.  for one, at the thought that maybe there was something wrong with me or my milk, for two because i am, and have always been an EBF as well as an EBF advocate...but mostly i cried at the thought that there could be something wrong with him that is causing his failure to thrive.  his pediatrician has referred me to a pediatric nephrologist for his kidney issues.  and, i'm wondering if the cysts and his zero weight gain are in any way connected.  if that's the case, then my hope is that we can treat the cysts, and then he can go back to being EBF and finally start to thrive.

if anyone has or is having a similar experience, or has any first-hand knowledge, it would be really helpful to hear!

AmyRI

It is a lot of work, but pump after you feed him. See how much you can get so you know if it is a supply problem on your part. See if your pedi would be ok with you using pumped milk to supplement.

When DS wasn't gaining weight like the pedi wanted, we were told to give him an ounce after each feeding - breastmilk if I could pump it, or formula if I couldn't. (For us, latch was an issue because he was tongue tied and we had not gotten him to an ENT yet.) The first time we supplemented he had an ounce of formula, and after that it was only breastmilk supplementation until we were back to exclusively nursing. This also helped keep my supply up. So even if your pedi says not to supplement with the breastmilk, I would still pump so your body knows to make more (since your LO is eating more).

Good luck, I hope you get answers soon!

BostonMama2011

I am so sorry!  I don't have advice about the renal issues, but my LO wasn't gaining weight the first couple weeks, and I had to supplement with formula too which was extremely hard mentally and emotionally for me.  She was also peeing/pooping a lot but not gaining weight, which I thought was strange too.  Just remember his health is #1 and you are being the best parent you can right now by giving him formula.  What helped me was realizing I did not have a choice anymore.  I HAD to give her formula.  Do you think he could have latch issues?  I had a second opinion lactation consultant do a home visit and that's when things turned around for me and I was able to stop supplementing.  

larrysdarling

Not an expert but my thought would be to NOT follow the clock. Let him finish at the breast THEN supplement.

If you pull him off too soon, he's missing out out on the fat rich hind milk which aides in weight gain.

 Good luck.

whensongbirdsing

thank you everyone.  so far, i've been nursing until he pulls away, follow up with 2oz of formula, then, while he's passed out from fullness, i pump as much as i can from each breast, then i just repeat the cycle.  i did notice that when i pumped i wasn't getting as much as i thought i was.  i was only able to pump about 2oz at each sitting.  so, after 2 sittings, i had 4oz, so i fed that to him, and he finished it pretty quick, actually.  

i only started formula yesterday afternoon, but i've already noticed a decrease in poopy diapers, and an increase in gas.  and when his diaper is pooped, it's thicker and smellier.  (i really hate that about formula).

but i'm making sure he is constantly eating, so if he still hasn't gained anything by the end of the week, then we know that something is really wrong.  unfortunately, he doesn't see the pediatric nephrologist until next month.  

thanks, again, ladies.  it's been a little rough, but your advice has been really helpful.