Breastfeeding

Pedi wants me to supplement my 3 week old - advice please!

DD's birth weight was 9lbs 13 ozs and she dropped as low as 8 lbs 13 ozs and is now back up to 9lbs 11ozs. In the last week she has only gained 1oz. He was really concerned that my milk wasn't providing enough calories. Currently she is eating every 2-3 hours and I feed on demand. She does STTN. When i feed her it is usually 25 minutes on one side and about 10-15 on the next. Usually she isn't 'done' on the first side, she just falls asleep so I burp and switch sides.

Pedi agreed to give me one more week to see if I can get her to gain more weight (probably bc I started crying!)

I already plan on waking her at night to get in an extra feeding (I was pumping rather then waking her. Here are my questions:

1- how long did it take your EBF baby to get back to birth weight?

2- would it help to just keep feeding her on the first side so she gets more hindmilk and then use the other side at the next feeding?

3- if I do that should I pump the other side?

4 - what else can I do to get her to gain more weight? Or anything else you can add?

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Re: Pedi wants me to supplement my 3 week old - advice please!

  • what kind of delivery did you have- vag or c/s?

    we've been supplementing and it took DS 2.5wks to get to birth weight, but c/s babies often have artificially high birth weights due to the amount of fluids given. i had 4 bags of fluid, some of which he ended up with just because of nature.

    i can't help with much else, but i can offer support and sympathy. i know it's frustrating! 

    have you talked to a LC and thought about doing a before/after feeding weight check to see how much she's actually taking in? is it possible that she appears to be eating well but actually isn't (this is the problem we had)?

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  • First, relax!  You're doing great.  Stress does horrible things to your supply; I know you're worried but try to calm down and take it one feeding and day at a time.

     

    1- how long did it take your EBF baby to get back to birth weight?  It took a full 3 weeks; he was born 8lb 4oz, left the hospital at 7lb 5oz and I believe was at 8lb 5oz at a 3 week weigh in (at the pedi's office)

    2- would it help to just keep feeding her on the first side so she gets more hindmilk and then use the other side at the next feeding?  At this stage in the game I personally would feed both sides unless you have an oversupply.  Feed the first time, change her diaper to get her nice and riled up and alert and go to the other side.  Feed on demand, wake every 3 hours at night if she's not waking on her own.  Watch her diapers and make sure she's making enough wet/dirty per day.

    3- if I do that should I pump the other side? See my answer above

    4 - what else can I do to get her to gain more weight? Or anything else you can add?  All you can do is what you're doing, Relax, take care of yourself, get plenty to eat and drink and just go with the flow.  If absolute worst comes to worst you have to supplement I promise it's not the end of the world and it doesn't have to be forever.  Try not to get discouraged.  GL with everything!! 

  • I feel your pain!  We also went through the slow-to-regain thing, and our pedi also suggested supplementing, which was a no-go for me.  I sort of negotiated with him to nurse every 2 hours rather than every 3 and reevaluate in a week or two.

    When you burp and switch sides, does DD wake up to eat on the other side, or is she more comfort-sucking without getting much milk out?

    1) It took 3 weeks for DD to return to birth weight (6 lbs, 10 oz).  She was 5/14 at her lowest weight.

    2) If you think she's not getting to the hindmilk, I guess that might help.  For me one issue was that a different pedi had told me that DD would get everything she needed in the first 10-15 mins of nursing, which is obviously not true (but I didn't know it was bad advice then), so I was taking DD off after 15 mins and unknowingly depriving her of hindmilk myself.  Hellooooo, mommy guilt.

    3) If you're uncomfortably full on the other side, then yeah, sure, but IMO I wouldn't be messing with pumping at all this early.

    4) Like I said, I'd be feeding every 2 hours - or at most every 2.5 - instead of every 3.  And of course on demand where applicable.

    This - the struggle for DD to gain weight at the beginning - was one of the hardest things about being a new mom for me.  I hope my experience helps you a little bit.  Even though the doctor suggested it, I never did need to supplement, and DD is thriving on EBF now.

    GL.

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  • imageuncharch7:

    what kind of delivery did you have- vag or c/s?

    we've been supplementing and it took DS 2.5wks to get to birth weight, but c/s babies often have artificially high birth weights due to the amount of fluids given. i had 4 bags of fluid, some of which he ended up with just because of nature.

    i can't help with much else, but i can offer support and sympathy. i know it's frustrating! 

    have you talked to a LC and thought about doing a before/after feeding weight check to see how much she's actually taking in? is it possible that she appears to be eating well but actually isn't (this is the problem we had)?

    This is a great suggestion that might put your mind at ease; does your hospital provide a breastfeeding support group?  Have you looked into going to Le Leche League meetings?

     

  • If weight gain is a problem, I'd wake her to feed once overnight. That's the easiest way to get more calories in the baby without resorting to formula.

    It only took us about a week to get back to birthweight. We had a lucky good start.

    I would continue feeding on both sides - if you're feeding frequently, the whole fore/hind milk thing isn't really an issue. It keeps the fat mixed in when you're drawing milk out often.

    Really, the best thing would be to add in more feeds per 24 hours. Aim to feed every 2 hours during the day and every 3-4 overnight.

  • 1- how long did it take your EBF baby to get back to birth weight?   5 weeks and he is still slow to gain weight.  8 lbs. at birth (7 lbs 5 oz at his lowest) and 12 lbs 9 oz now at 4.5 months.

    2- would it help to just keep feeding her on the first side so she gets more hindmilk and then use the other side at the next feeding?  Yes.  Wake her up and try to finish the one side before moving on to the other side. 

    3- if I do that should I pump the other side? I would so you won't be uncomfortable.  It may also reduce the amount of foremilk in the next feeding.

    4 - what else can I do to get her to gain more weight? Or anything else you can add? As much as it sucks, wake her up at night to eat.  My pedi suggested feeding no more than 3 hours apart during the day and 5 hours at night until LO got back to birth weight.

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  • DD did that too, falling asleep, not gaining, nursing longer than other babies.  I had the same conversation with my ped.  I do not want to give formula and wouldn't even consider it unless she was losing weight.  The best thing I ever did was pump and bottle feed.  I started pumping and DD started gaining - 11.5 oz in 10 days for the next appt.  The two appts prior to that she had gained 4 oz in 14 days and 0 oz in 7 days. 

    Ultimately it's your baby and your decision.  Most of us do want professional advice but you can choose how to feed her regardless of what the ped says.  Just like some ob/gyns push inductions for example, some peds push formula.  Not saying yours did but you didn't mention him/her giving you any other options.  Mine asked about her eating habits, my diet, how BF was going in general, etc. trying to figure out what to do.  There are alternatives to straight up formula too.  In the NICU DD lost 11 oz and they gave her this little tube of caloric supplement mixed into her BM for a few days. 

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  •  

    1- how long did it take your EBF baby to get back to birth weight?

    It took us about a week to get up to birthweight - BUT we were told we had to wake him through the night until then.  Which we did.  And we really had to work on waking him.  He would have STTN if we'd let him.  Instead it would take about an hour to wake him up using stripping, diaper changes wet washcloths, feet tickles - every trick in the book.  

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  • Supplementing with formula will affect your supply. I know because I was given this advice early on. This is a good resource:

     https://www.kellymom.com/babyconcerns/growth/weight-gain_increase.html

     I think you'll feel better if you talk with a lactation consultant. 

    tinaraye
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  • To build your supply  you need to eat well, drink a ton of water, and breast feed more frequently.  The more you breast feed the more milk you will get. 

  • I had a pediatrician tell me to supplement too, and I agree with one of the PP's that he was probably just trying to push formula. My baby was born at 6 lbs 7 oz and had no trouble with getting it back (6 lbz 8 oz at his third-day appointment!), showed consistent weight gain and plenty of wet/dirty diapers, but as you see was smaller than average. At the 2 month appointment, I told the Dr that he spent a couple of days feeding every 1.5-2 hours (must have been a growth spurt), and he immediately jumpeds to the conclusion that he's not getting enough.

    I nodded, went home, and continued EBF. By his 3-month appointment he was a healthy 13 lbs, and the Dr we got that time (different one) said we were absolutely right in that we did not need to supplement!

    That said, if you do the weight test or count diapers and see an issue, then maybe, but otherwise I wouldn't worry. Babies develop at different speeds. Ours gained four lbs before he added any length at all, for example. Maybe yours is working on something else first. Good luck!

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