March 2016 Moms

Weight/Feeding Concerns

My son is 17 days old. His birth weight was 8 lbs 2 oz. By his 1 week check up he was down to 7 lbs 5.5 oz, which the pediatrician was happy with. However, by his 2 week check last Friday, he was down to 7 lbs 2.2 oz. I was told to make sure I fed him every three hours and to wake him for feedings, if necessary. I was also advised to pump after feedings in order to build my supply and so we could see if there was any milk left. Well, after 5 days for following these instructions and getting anywhere from .5 oz-2oz at each pumping session, he was down to 7 lbs 1.5 oz today.
The pediatrician now wants us to supplement with 2 oz of formula after each feeding. We go Friday for another weight check. I am just so frustrated and confused. I see him swallowing when he nurses, I leak milk, I see milk on his chin after he eats, and I am still able to pump milk after I feed him, so it does not make sense to me that he is not gaining weight. I will do whatever I need to do so that he grows, but I would still like to make breastfeeding work. Does anyone have any suggestions?


Re: Weight/Feeding Concerns

  • Yes. I want to tell you that with my son I just went through the same thing. He had all the diaper counts and I knew he was swallowing and sucking and I didn't understand why he wasn't gaining. I was driving myself crazy. I was nursing all day and night and pumping. I was even giving him the pumped milk via supplemental nursing system (a total nightmare) 

    I had convinced myself that I was doing everything right and every time my baby would cry I would nurse. He seemed content and happy.

    BUT: he wasn't gaining and that means he was NOT getting enough food.
    I finally went to a lactation consultant who weighed him in grams during his feeding and realized that after an hour of nursing side to side he was only able to get 1.25 ounces. He was burning so many calories to get the milk that he was not gaining. 

    Give him the formula to supplement. I promise you both of you will be much happier. My son is now thriving and getting rid of the anxiety has helped me increase my supply. 

    Im still doing both and I'm happy knowing that we are gaining and he is growing.

    I feel for you. I truly was losing my mind.




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  • The same thing happened with us. The pediatrician wanted me to visually see him getting 2 ounces every feeding. So, I would pump and then top off with formula. What I did was let him nurse at the breast as long as he wanted. Then I would give him whatever I had pumped (0.5-2 ounces) then I would top off with formula. After all that, I would pump for the next session and wash my pump parts. It was exhausting, but let me encourage you to keep at it. It will be worth it in the end. Now we are back to EBF and he is gaining. 
  • I guess I'm confused why you have to give him formula and not the milk you've pumped?
    also try and do a weighed feeding somewhere like pp mentioned.  
    I know it's frustrating (ds3 was a slow gainer his whole first 6 months, turned out to be a reflux issue) and stressful but hang in there, you'll get it worked out soon!
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  • You could also try breast compressions while you nurse.  Can you get a baby scale for home?  They're about $40 and could really help with peace of mind for you.
  • Thank you for your responses! I am glad it is not just us. I was beginning to feel like I was crazy because everything lines up, except his weight. Honestly, I am not sure why she is not having me supplement with the breast mink. I am assuming it is because I do not have enough to give him 2 oz at every feeding. I will look into getting a baby scale. She weighed him at the office after I nursed and he was still 7 lbs 1.5 oz. I am hoping to meet with lactation today and get some answers.
  • @CalebsHabibi how long did you supplement for? How did it work out that you were able to go back to ebfing?
  • Have the LC check for lip or tongue tie too. I'd still add whatever bm you get in to the 2 ounces. Thee is no reason on earth for you to pump and dump
  • I will have her look at his latch at our appointment today. I gave him the pumped milk at his last feeding instead of formula. He took it down just as well, thank goodness! Also, I keep hearing about people feeling their milk let down. I have never noticed this. I am just wondering if it is normal to not feel it.
  • I never felt it with my first until I had been using the electric pump for a month at work.
  • katy0990 said:
    @CalebsHabibi how long did you supplement for? How did it work out that you were able to go back to ebfing?
    It wasn't very long- less than a week, like 5-6 days. I pumped for 15 minutes after every feed even when nothing was coming out. LO started pooping and gaining weight; we also visited the LC and weighed before and after and he was getting 80mL (a little less than 3 oz) so we quit pumping and FF and went back to EBF. While I was supplementing, I always offered the breast first, so I think that helped LO not to get "nipple confusion" or forget how to breastfeed. We did have trouble latching after supplementing with the bottle for so long, so the LC gave me a nipple shield. Now we don't even use that but on the rare occasion.
  • Someone gave me the great suggestion of expressing some milk into a glass and letting it sit out a few minutes until it seperates. Then you can see your water to cream ratio. Some people have low cream so the baby is getting a lot of milk volume, but not enough nutrients. 
  • Not true.  Don't let that freak you out or deter you OP from breastfeeding.
  • ecwkecwk member
    smushi said:
    Not true.  Don't let that freak you out or deter you OP from breastfeeding.
    https://breastfeedingusa.org/content/article/worries-about-foremilk-and-hindmilk

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  • Thanks! That article helped to clarify it for me.
  • Great article! Thanks for sharing! It helps to clear up a lot of misinformation that I fell for hook, line, and sinker, lol. 
  • katy0990katy0990 member
    edited April 2016
    I appreciate all of your helpful comments. LO is up to 7 lbs 6 oz, so he gained 5 oz in 48 hours, which I am very happy about. We are meeting weekly with the lactation consultant to work on his latch. At our appointment on Thurs he was only taking in .8 oz of milk from our nursing session so I am supplementing with 2 oz of breast milk (or formula if I do not have enough of my milk on hand) after each feeding. Hopefully, using this different latching technique and building my supply will allow him to take more in at each feeding and next Thursday at our lactation appointment we will find that I can supplement less or not at all.
    I am just wondering if anyone has any supply building  suggestions. I started drinking mothers milk tea today and I ordered some fenugreek. I drink over 100 oz of water each day. I am wondering if any of you ladies could offer any tried and true supply building methods. I am feeling a little overwhelmed by the 45 min nursing session followed by the 20 minute bottle feed and the 40 min of pumping/ pump cleaning. It is especially hard to care for the baby or get anything done when I spend hours each day tethered to this pump.
    ETA: I did not mean to sound so negative, I am so grateful for my healthy little boy and he is so worth all of this. I am just feeling a bit overwhelmed as I know once I take this pimp off I have 90 minutes until I have to start this whole feeding process over again.
  • The only things I have experience with are making sure I'm eating and drinking enough. When I was pumping at work with my first I always pumped more when I ate oatmeal and lactation cookies (there are tons of recipes online. Mine had oats and Brewers yeast, but I don't know if it was that or the extra calories). I also always pumped more when I had a doughnut in the morning! :)

    Hang in there! Pumping is hard and not fun. If you can get past it, breastfeeding alone will probably seem so easy! And if not, that's okay too. But props to you for trying so hard, it's not easy and you're doing an awesome job. Good luck! 
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  • We had the same issue.  LO lost about 7% in the hospital and then wasn't gaining by her next weekly checkup.  She wasn't getting enough milk (1.5oz) and was expending too much energy to get it, so we had to supplement 0.5 oz formula or pumped milk after each feeding.  Lactation consultant suggested breast massage to help with letdown (I don't feel letdown either) and pumping for about 2 to 5 min. 30 min after a feeding to build my supply. At our next visit we were gaining and we only supplement with BM occasionally. 

    Hang in there.  You're doing great.  

  • With pump parts, you could just put the parts in the fridge after each session then have your DH clean them at the end of the day for you (and wash bottles).  That way you've got one less thing on your plate (you're doing a lot of work!).  Skin to skin is really helpful at each nursing to ramp up supply; just strip you both down and hang out.  With a different latch/nursing position you might also see a difference in supply.  Put baby to breast as often as literally possible even when you aren't doing a usual feeding/bottle/pump session to encourage your supply.
  • I second the pump parts in the fridge.

    I felt the same way you do: tied to the pump all day. I felt I had no time to get things done or to just BE with baby. I got an infant carrier and that helped me a lot mentally! While I was cleaning pump parts or other things, I had LO right there next to me in the carrier. 

    Pumping for 5 minutes longer after you see the last drops of milk should increase your supply. Also, apply a warm compress for 5 minutes before you pump and massage during pumping.  

    Other things I've heard: eat oatmeal, drink red Gatorade, avoid peppermint. 
  • amyidamyid member
    I had no idea that breast feeding was going to be so difficult. I spent the first 3 weeks of my babes life a nervous wreck that she wasn't gaining enough and would burst into tears literally, when she was weighed. She was 8lb10.5 at birth and almost instantly dropped to 7.11 in the hospital. By week 2 wasn't back at birth weight. I couldn't understand why some days she would be averaging a 5g gain and then others 30! We are at about 21g average daily gain right now. I agree that trying to supplement via the SNS is a total pain and I couldn't do it. I currently bf whenever babe wants too ( veryyyyy time consuming ) and use one of the plastic collection cups whilst nursing. She feeds what I have collected in the o call ette cup after the feeding and as of this week I'm giving her supplemental formula 1oz to top her off. The lactation specialist I saw seemed to think she was feeding about 2.5oz per bf session but until my baby starts to gain more like 25g a day, I'll keep on topping her off with the formula too. 
    Big hugs to you all that have gone through this, it's so stressful and worrying. 
  • Same here!  His weight was down at 2 weeks, so we got told to supplement.  He had his four week appointment last Monday and is now gaining appropriately (he gained two pounds in two weeks once we started supplementing!) 

    We visited the LC twice after the appointment where the Dr. wanted him supplemented with formula because I had hoped that maybe we could figure out what was wrong and get off the formula supplements.  Even though he was sucking, we could hear him swallowing, and the frequency and duration of nursing was appropriate on two separate weighed feeds with the LC, we found that he was only transferring 1-2 oz nursing for 40 minutes.  Just not nearly as much as he needed.  And we didn't really figure out why - tried some things the LC suggested and on the weighed feed re-check, still no luck.

    But, when I pumped, there was plenty of milk for him - he's just not able to get it out of me.  So, I pump before his feeding times and we give him a bottle that has both breastmilk and formula in it now (yes, I know that most people don't do this for fear of baby not finishing the bottle and having to throw out precious breastmilk, but Dr. says its okay to mix as long as you follow safe handling guidelines, and I've found that "the mix" is best for his stomach and keeping him "full").  

    We still nurse occasionally because it comforts him and he likes it - but I don't count nursing sessions in for his total oz consumed per day because I just assume that what he's getting is negligible.  I have had a pretty "whatever will be will be" attitude about feeding and am comfortable with the content of the formula I've selected so I've tried not to be too upset about this - and remind myself that he's gaining now and was not gaining before.  He needed a little something extra.
  • I just wanted to update this in case anyone else is having the same issue. We have still been meeting weekly with a lactation consultant and I have been pumping after each feeding. I noticed that I was still getting plenty of milk whether I pumped before or after nursing him which made me realize it was most likely not a supply issue. At our appointment yesterday the lactation consultant brought in an OT who examined him and watched me nurse. It turns out because LO  was caught on my pelvic bone during delivery which resulted in a C-section the sutures in his head were formed incorrectly. Through some neck massage and manipulation in the back of his head she was able to correct this and he sucks now! He could not get enough suction, which was the problem the whole time!  I feel so relieved that there was nothing I did wrong. I have spent the past few weeks blaming myself and feeling guilty that I couldn't just breast-feed him. I have been so frustrated and stressed, but I am so glad I hung in there. So if you are struggling with breastfeeding issues stay strong! Sometimes when you least expect it there is a light at the end of the tunnel.
  • That is so wonderful you were able to pinpoint the issue to correct it!  So happy for you and your LO with your bfing journey!
  • We had the same thing (coming over from Aug 15 board to check on you new mommies!)- and here is what I WISH we had done at the time. 

    What we did do: 
    Ended up giving daughter bottles after breastfeeding until 3 months when she refused the breast because it wasn't happening as easily as the bottle.

    Purchased a Lactaid Supplemental Nursing system at this point, and am still using it with my 8 month old, 5 times a day. No bottles! 

    The great thing about this system is: 
    * You can put the tube up to your breast and cut off milk from the bag until baby empties your breast, then unclinch the tube and the milk begins to flow from the bag. So, your breast is emptied and baby gets plenty of food
    * You don't need to pump anymore if you use this exclusively
    * Easy to use out in the world (I put it in a mason jar with ice)
    * No bottles=no breast rejection
    * supply goes UP UP UP with this! 

    Also, take Mother Love's More Milk Supplement "Special Blend". This worked really well for us. 

    Wished we had done:
    Bought Lactaid system at 2 weeks when we realized little one wasn't gaining enough. Would have saved me so much worry about "is she going to reject breastfeeding today?" or "is she getting too much from the bottle and won't be hungry later?". Use this system! You can put up to 7 oz of milk into the bag that hangs around your neck, and it's super easy. Easier than bottles, in my opinion, and you get that breastfeeding relationship for so much longer. 

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