Please help - baby who won't drink enough!

[babymiracles]

Hi there

My gorgeous daughter is 3 and a half months old and we have been having big issues with feeding.

I was breast feeding but after baby started not gaining weight and was very unsettled we realised she had problems with a poor suck - as a result my supplies dropped. We ended up having to feed expressed milk (I am on domperidone three times a day to keep up my supplies) with a bottle and a fast flow teat. This improved things and better weight gain for a while but her weight gain is still not ideal and the last few days things have got worse again.

At the moment she will only take between 70 and 90 ml (5-6 times a day) - and she is meant to be having about 750 ml in total each day given her current weight of about 5 kg. I have tried lots of different bottles and teats. It seems after the 70-90 ml she is just not hungry and she cries and pushes bottle away. If I try to feed her more frequently she will take in even less. I try topping her up after a play following a feed but this doesn't seem to work either. We are adding polyjoule to her feeds to increase calorie content.

I have not given her any formula - all expressed breast milk - but am wondering if I should try formula - maybe she doesn't like taste of breast milk?

would love any ideas as finding I am getting pretty stressed, and feeding is becoming unpleasant for us both . She has had blood tests and ultrasound of head and paediatrician visits and nothing except poor suck has been picked up.

Many thanks

[Eluned]

My DS had a poor suck too. It's really hard work to get them to feed properly. I ended up topping him up with EBM via a supply line or a newborn slow flow teat. This meant he had to suck strongly to get his milk. A fast let down or fast flow teats make it easy for them to not have to suck as hard. Talk to the ABA and a good LC for advice on suck training and using a supply line.

The supply line was great because it kept up the breast stimulation needed to increase my supply. I also took Motilium and fenugreek.

I was crap at expressing though and soon my EBM ran out and I had to top up with formula but after a few months we were back fully breastfeeding.

[marcellus]

Hi babymiracles,
A few questions
Are you still breastfeeding or only feeding ebm?
What have the weight gains been like? You mentinoed improvement then not so good again - it's normal for gains to slow down after the 12-week mark.
Plenty of wet & dirty nappies?
I doubt she'd dislike the taste of breastmilk. (What's the polyjoule stuff? maybe that tastes bad)

I'm no expert, but hopefully someone who knows more can give you some advice. I guess you've seen an LC? Have you called the ABA for support?

It must be very stressful for you. It sounds like you're working really hard to do your best by our little girl. Hope things improve for you guys soon

[babymiracles]

Thanks Elund and Marcellus for replying so quickly.

We have seen LC and haven't found ABA helpful with this problem. We actually spent 4 days at a place called Torren's house which is in adelaide for babies with sleep or feeding issue. Supply line was considered but not thought to be an option in our case. I have a fast let down and we all decided on fast flow teat just to ensure she doesn't get too tired and is able to get a decent amount of feed.

For your questions Marcellus - I am almost completely doing bottle with Expressed breast milk - only occaisonally on the breast now (for comfort really - but rarely) - mainly because with bottle we can see what she is actually taking wherease with breast we don't know and given her poor weight gain this seemed important. Am doing well with expressing and now with domperidone making more milk than she is taking so freezing quite a bit too (although it is a pain to have to express 6 times a day!)

Last time she was weighed she had gained 230 g in two weeks. Paediatrician said this wasn't enough but I didn't know about the smaller weight gains after 12 weeks so thanks for that info. In her early weeks she averaged only 125 g per week until we ran into trouble when she was 10 weeks old and then had practically no weight gain.

Since bottle feeding she has a lot more wet nappies and a dirty nappy once every one to two days.

The polyjoule is supposedly tasteless - it is just a carbohydrate to add in more calories - recommended by paediatrician.

Thanks again ladies for your quick replies and support

[Barb Glare]

Hi Babymiracles,
You are having a tough time of it. Truth is, your little one is doing pretty well - just about a tablespoon a week below what you would expect (usually aroud 150 + in the first weeks) and then she's doing "fine" in the last couple of weeks. After 12 wkd it is normal for babies to gain 80 -130g per wk.
The secret is in feeding her (ideally from the breast) more often. Imagine having to get 750 ml into a jug -but you've got to do it by filling a port glass (the size of baby's stomach) and then tipping it into a jug. You are going to have to fill that port glass a lot of times. She needs to feed at least 8 -up to 12 times per day. Even though she takes less at each feed she will take more over a 24hr period.

[babymiracles]

Thanks so much Barb - that is reasurring re the amount of weight gain after 12 weeks - I didn't know that.
I think I might give the feeding on the breast another go (especially now I know my supplies are okay again) - and will feed her more often. One problem is that she doesn't seem to demand food very often anymore - do you think I should just feed her 3 hourly if she isn't asking for food?

[marcellus]

Hi again,
Well, those weight gains actually sound pretty good to me!
I asked about bf just because if she is still having some from the breast, that might partly account for why she doesn't seem to have much from a bottle (ie, maybe she gets a lot during those feeds).

I would aim for 2-3 hourly during the day and (hopefully) longer breaks overnight. But I guess it just depends what works for the both of you.

Good luck with trying breastfeeds again.

All the best

[Barb Glare]

Yes,I think feeding every 3 hours would be a great idea. Many mothers are surprised to find that while their baby seems uninterested initially - the more they get the
ore they really want. Things just get better and better.

[babymiracles]

Thanks again all

Feeling very frustrated at the moment as last two days she has only been taking about 450 ml. Last feed (3.5 hours since previous feed) she only took 50 ml from the bottle (under duress) - then offered her breast which she just bounced on and off again continually - did a bit of smiling and licking and did manage to get a let down -seemed to enjoy herself but just proceeded to get us both soaked with breast milk and really wasn't interested in drinking it!). Re-offered bottle 45 minutes later and she took about 5 ml - some of that 55 ml in total she managed to spit up as well. This feeding pattern seems to be more the norm over last couple of days (minus offering breast in the past). Before last few days we were getting closer to 700 ml via the bottle which is more what she needs. I guess something I am worrying about with breast feeding again is I wont know how much she is getting - and when we were in Torrens house they did test weighs and she would only take about 40 mls usually off the breast each feed (which is why we changed to bottle)- so even if she had 12 feeds a day (which I don't think I would have stamina for!) she still wouldn't be getting anywhere near enough.
Maybe she is just having a bad week and things will improve again soon.

[MantaRay]

It is frustrating and can be very worrying. However it is pretty normal at that age. I hope it settles down soon for you. In the meantime, you are doing a fantastic job hun.

[nicjay]

Hi hun

You poor thing! I just wanted to say I hope you can get Molly back on the breast soon! Sounds like she is doing great with the weight gains to me but one thing I'd be doing is offering the breast before the bottle if I were you.

Does she feed much at night? I know E does and I think she gets most of her daily intake then too, as she feeds like you say Molly does during the day too. Really quick feeds and doesn't really demand them unless she is starving LOL I try to feed her even though she doesn't ask about every 2 hours or so, especially when I'm at home.

I did the expressing and comp feeding thing with DD1 so I know how hard it is on you And re the weight gains, I will say that a lot of health professionals only look at the weight and don't look at the whole picture - wees, poos, skin tone, bright and alert baby etc etc. They are so hung up on "how much" the baby is getting It drove me (and DH) nuts and you should see DD1 now LOL You're the Mum and if your instincts tell you she is right then I'm sure she is! Trust yourself and Molly OK? It is so hard being a first time Mum isn't it?

xo

[marcellus]

I remember at that same age DS started getting fussy at the breast and feeding very quickly (max of 2-3 minutes during the day). I was worried and kept tryign to force him on more, and he ended up refusing altogether for a while.
Don't underestimate just how much she can get from the breast even in a very short time - it'll be a lot more than you get out via the pump.

It is very hard to trust ourselves and our babies when we're trying so hard to get everything right! And it's extra hard when things don't seem to be going quite right.
You are going to get there

[babymiracles]

Thanks MantaRay, Megsmum and Marcellus - your support and advice has helped enormously

Megsmum - thanks for sharing your experiences. I can totally relate to what you say about the emphasis on weight gain and not looking at whole picture. I guess after my experience when she was 8-10 weeks when she was not getting enough to eat and was very unhappy and unsettled (ie before we started expressing and using bottle) i have been on tenderhooks but really since then she has been happier and looks healthy to me - so I think I need to trust she knows how much she needs - especially using the bottle which her sucking problems are not a real issue (going back on breast could be a problem with her poor suck though so reluctant again to do this after giving it more thought over night - also only planning to use breast milk till she is 6 months as want to go IVF again and from my understanding I need my cycle back and that is going to be more possible to achieve if I stop breast feeding) Like E Molly does tend to feed better at night overall - so I will think of you feeding E when I am awake at night in future

[nicjay]

Sounds like a plan to me you have to do what you think is right. I just wondered if you were looking to get her back onto the breast to avoid the expressing KWIM? I must admit I hated it after a while LOL and couldn't wait to ditch the pump! So I assume everyone else is the same But yes, think of me at night - the way she has been the last 2 nights I'll almost certainly be awake when you do!!

And yep you will need your cycle back for IVF, not much use doing it without it I guess LOL My cycles took quite a while to become regualr again after DD1 too, but hopefully you'll get back to normal quick