Two month check up did not go as planned (long)

jaykay627 · January 2014

Hallie had her two month check up yesterday and I'm really disappointed to say her weight gain is not where it needs to be. She's only gained 16 ounces in 6 weeks. (Although she has grown about 2.5 inches). She's EBF, so of course I can't help feeling like it's my fault. I really thought everything was fine since she always has plenty of wet and poopy diapers.

She does take a long time to eat; about 40-45 minutes on average, but I just figured that was normal for her and could have been because she was born late-preterm (36w3d). The pediatrician thinks the problem is that she's burning up too much energy nursing and suggested supplementing with an ounce of formula after each feeding. But after discussing it, we agreed to a plan of nursing on 15 minutes each side (I was doing primarily one side then offering side 2 to top her off) so she gets the fast letdown sooner and doesn't have to work as hard. Plus I'm using warm compresses to encourage letdown. I also started fenugreek to increase supply, which I don't think is an issue now but I want to pump more so if we do have to supplement it can be breastmilk instead of formula. I know formula supplementing isn't the end of the world, but as soon as I start, my supply will decrease and I'm afraid it will be a slippery slope to EFFing. Of course I want the very best for her and I will do whatever I need to do for her to be as healthy as she can be.

I have an appointment with a LC and we'll go back Friday to recheck her weight and go from there. I'm hoping to get a weighted feeding. I know the scales they use to do them are very accurate, but they did weigh Hallie again yesterday after eating just one side (she ate more after) and she was up 3 oz, which translates to 85 grams = 85 ml, so just shy of 3 oz volume, so it seems like she's getting enough. She is very active and very strong (has been rolling from tummy to back since 3.5 weeks, is constantly wiggling, and even the pedi commented that it felt like she was about to walk off the exam table when she was holding/standing her up), but I'm taking this very seriously, since I know this is the most critical time for weight gain.

Does anyone have any other suggestions for how to get this under control? It's so discouraging to feel like I'm not taking the best care of my baby.

tattooedtragedy · January 2014

I'm sorry your check up didn't go as you had expected. I've been struggling with low supply issues since my daughter was born and have been supplementing with either bm or formula to get her weight up for several weeks and our gain is back on track. I'm glad your seeing an LC I find mine incredibly helpful. If you don't want to use formula I suggest getting on a pumping routine but you should talk to your LC about that. Also I don't necessarily agree that supplementing with formula is a slippery slope to EFFING I think it is what you make it. If you want to know about my experiences please feel free to message me.

notthecheat · January 2014

Just wanted to say I'm sorry you are dealing with this and hope you find something that works. *hugs*

jaykay627 · January 2014

@Cashingn2 said:
The LC will do a weighted feed and be able to tell you how much she's getting in. She will probably suggest pumping. I was told to pump then nurse so baby gets more hind milk which is fattier. We ended up finding out that she has a lazy suck. Basically, she has some issue with muscle coordination of her tongue because she gets fatigued quickly. I'd have the LC thoroughly check her suck reflex. When you nurse. See if you can count how many sucks she gets in before resting and starting again. Pay attention to whether her mouth quivers too. This is what the OT told us today.

Okay, that's good advice. I'm really interested in what your OT said. I wonder if Hallie has something similar because of the rolling/scooting/holding her head up very early on. Plus she's just so active ALL the time. She's never still. So I wonder if it's something with her suck that makes her nurse inefficiently along with her muscles/activity just burning off a lot of calories.

jaykay627 · January 2014

cepayseur said:
This happened to me, but much earlier on. She wasn't gaining the weight she needed from EBFing (lost way more than 10% initially, and wasn't gaining back) so I started pumping immediately. I am now EPing and she is a little chunker!! I know some people feel bad when people say their baby is big/fat/chunky... I love it! It makes me feel very accomplished! EPing was very hard at first and felt like double the work... Now at 10 weeks we have a routine, and my supply continually has increased with her!

Hugs momma! You may be able to avoid EFF (not that there is anything wrong with it...just for me, it's a great HEALTHY way for us to save money on our baby!)

Thanks. That makes me hopeful!

mightymousy · January 2014

No suggestions, just love *HUGS* sorry things weren't as positive as you'd like, but it sounds like you're doing everything you can and that's all anyone can ask.

jaykay627 · January 2014

@AmyG*, thanks for weighing in! LO was one ounce over birthweight at her two week checkup. She only lost down to 4 oz below, so she didn't have a ton to gain back.

She did have a pretty big poopy right before her appointment and when they weighed her after eating, it wasn't a full meal.

The recommendation to switch sides earlier did concern me about not getting enough hindmilk, therefore not enough calories which would defeat the purpose. I'll try what you suggested and make sure the LC checks for ties as well. Maybe I can relax a teensy bit now.

jaykay627 · January 2014

@Cashingn2, that would be great if you can. Regardless, I hope your appt was helpful today and that things will begin to improve soon for you and Anja.

lijah · January 2014

Cashingn2 said:
@jkrauss627, that's was pretty much what the ot said. She has an uncoordinated suck. She's only sucking 3-6 times before resting her jaw. She suggested we lightly place a hand beneath her jaw for support. You don't really put pressure on the jaw though. I have papers that I will try to scan and upload for you.

How many times is the average amount of sucks before resting the jaw. I often wonder whether my LO is doing too much sucking and not much swallowing...

azmama20 · January 2014

No suggestions, really. Just some love and encouragement, since my LO had weight gain issues and I have had to supplement with formula. It is a slippery slope and I'm likely on my way to EFFing, unfortunately. But that is mostly due to BFing causing a lot of stress and depression and contributing to my PPD, so I have chosen to not seek out help from a LC since BFing has been driving me mad basically. But I just wanted to say I've been where you are and I wish you the best of luck! Hopefully you get some help from your LC!

jaykay627 · January 2014

@rfred20, thank you, and I really hope you start feeling better after your upcoming appointment. Thinking of you, too! *hugs*

BootsOrHearts · January 2014

We supplemented baby boots with pumped milk that had been fortified with a small scoop of formula, just to add more calories. That's one idea instead of using just formula. Your baby may not even like the taste of formula if she's not used to it. Baby boots hates formula.

I think continuing to work with the LC is a good idea.

jaykay627 · January 2014

Good ideas. Thanks.

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