Not gaining weight, help! Barb??

DD is 4.5 months now and at her 3 month check up, her weight gain started to drop off (which I know is normal). The CHN asked to bring her back at 4 months just for another weigh-in where we discovered she has lost 60grams. That was last Wednesday. CHN was less worried about it than I am, as DD is thriving in every other way, reaching all milestones, etc. She said it is most likely due to her being so active already (rolling over, kicking legs, batting toys, reaching out for things, constantly alert). As part of protocol she had to advise me to take DD to the GP, but not to hurry and see how it all goes.

So I decided to give it a week and weigh her again today. She has not put on any weight in the last week.

I'm at a loss as to why because she has about 6 wet nappies (sposies) in 24 hours, poops every 3-4 days, sometimes goes up to 6 days between poops.

She's been rolling from tummy to back since about 3 months, has always been alert and attentive since she was born. She moves around alot on her play mat. So very active.

She is growing well lengthwise and her head is growing normally as well.

She wakes for feeds and is content and happy after every one. She feeds 2 hourly during the day, bit of a cluster feed between 4 and 8pm of an evening, goes through to about midnight where she comes into bed with me and feeds whenever she wants (usually 2 hourly), wakes up about 7am. She has both sides most of the time, when she's in bed with me it's usually just the one. I've tried sitting up with her to feed and making her take both sides to get some extra milk in but she just falls fast asleep and I can't force her to have more.

Some of you may remember the trouble I had with DS and I now recognise the feeding problems there and DD is such a better feeder and the signs are so obvious to me.

She was born 3.25kg, left hospital on the 4th day at 3.07kg and is now currently 4.83kg. She was 4.89kg at 3 months. Can anyone suggest what can I do? I'm not sure how to squeeze in any more feeds as she feeds alot as it is. I expressed some milk the other day but she refused to take the bottle from me. However, she has taken a bottle of EBM from DH on the weekend.

I haven't taken her to the GP yet because I just think he will say start formula or start solids but my gut feeling is that she is fine, just little but I also don't want her weight to start dropping off.


Please help!

Listen to your gut :hug:
She's probably just a little (very active!) thing like your DS. All that output, growing well, reaching milestones... she sounds fine to this layperson.
Has she grown a lot just recently? I know DS used to shoot up, get skinnier, then put on some padding again when the growth rate slowed down again.

Can you go and see the LC who helped you with DS?
At least you would then have a second opinion from someone you trust.

Hi,
It doesn't sound like your little one is far off course, and it doesn't seem like your Maternal and child health nurse is very concerned.
I wonder, how much did your little one weigh at birth? What was the birth l ike? Usually babies gain 150 plus g per week in the first 12 weeks. But after that weightgain slows to *about* 100g per week - range being 70-120g per week. So there seems to be only 1 week that was a bit out of the ordinary - but then is there any particular reason you are weighing weekly? Usually at this age babies aren't weighed so much - you go on their general health and well being. Has she been well lately?
I wonder what you and her dad are like? Big people? At some point babies do have to grow to their genetic potential. It is normal for babies to cross percentiles - upwards and downwards. If your baby is anywhere on the growth charts she is normal. At some point we have to accept that they will be what they will be. I doubt your doctor will suggest formula. Just check that she is generally healthy. If he does, a useful question to ask is "why?" What would he be trying to achieve? And *why*?

You are right to listen to yourself. You can't force her to have more if she doesn't want it. You are so aware of her health and her overall well-being, i'm sure you'll know when/if you need to seek further medical help.
I would tend to agree about the GP telling you to start formula for no really good reason. Heck, I took DS2 to a GP for thrush and she told me that I should think about it and he weighs 6.5kgs!
:hug:

Thanks all. I know she is doing ok, it is just a bit deflating that the numbers on the scales are not moving. She feeds on demand and I feed her off to sleep, all the signs seem right.

Barb, the birth was great, VBAC, some gas during transition, 2nd degree tearing. She had a feed within minutes and my milk came in on day 2. Her weight gains have been:

Birth: 3250
3 days: 3070
10 days: 3140
2 weeks 5 days: 3490
6 weeks 4 days: 4120
14 weeks 3 days: 4890
18 weeks 5 days: 4830
19 weeks 6 days: 4830

She hasn't been weighed weekly, just at the usual checkups at 6 weeks and 3 months. CHN wanted to weigh her again at 4 months as her weight had slowed down at the 3 month checkup. So between 3 and 4 months she lost 60grams. I decided to weigh her again today (a week later) just to see how she was going after having lost weight. She hasn't put on any. She has been well, not even a sniffle. Coped with her 4 month needles ok. My DH & I are not big people and as such DS isn't either. Even after the weight issues with him, he caught back up to the "curve" he was born on.

I may just take her to the GP for a checkup next week and give the LC a call. I'm figuring if I just keep an eye on her over the next few weeks and then it won't be long before we can give solids ago and that might help boost things up if she's still a bit on the slow side.

I don't really expect her to be a chubba bubba but I'm just at a loss as to why she has lost some weight when everything else seems to be going so well.

:hug: :hug: :hug: Oh hun, I know how important this is to you.

I think youa re doing an awesome job, and it sounds like you DD is just on the move so much, and based on your, your DH and DS's size I would say that she is going to be similar to you.

The smaller they get moving about the battle to get them to put on weight can be really difficult as they are just burning up so much energy exploring the new world.

I would keep going how you are going, if there is a chance for an extra feed pop it in, but if she doesn't want to feed it can't be forced either. She is probably finding her spot ont he graph, we know that some babies are meant to me at the lower ends and others on the higher ends of the charts and the birth weight doesn't determine where that chart position actually is.

I am so proud of you after all that you went through with your DS, I can only hope that my journey this time is close to yours :hug:
Take care xxoo

Give it a few weeks and see - numbers aren't everything :hug:

*sigh* Took DD to the GP this morning and she weighs 4.79kg so not really any change in a month. GP said she very healthy, alert, great skin tone and that she might just be a baby who does not get hungry screaming for food type hungry. He suggested my supply could have dropped off a bit and to top her up with some formula this week and bring her back on Thursday.

I just nodded my head but inside I was thinking 'no I don't want to give formula' Couldnt bring myself to buy some either. Bought some fenugreek instead. Got some EBM which I will give first. DH will have to do it because she refuses bottle/cup from me.

Argh...maybe I just resign myself to the fact my boobies are useless. Nothing has changed at all yet in the first 3 months she was having gains of up to 200g a week. So I don't know what's happened. Maybe I just don't make enough.

If in the first few months you made heaps of milk and bub grew rapidly and now things have decreased then I wonder if the issue lies with sucking and skin-to-skin (or lack thereof). Can you try more frequent emptying (either by bub or by pump), and lots of cuddles??
And maybe some high-calorie solids (e.g. avocado) rather than the formula?? Or there is a high-calorie powder that you can add to ebm....

Hang in there - there may not be as much milk as you would like, but what's there is still very good for bub!

Thanks kmn, we are feeding 2-3 hourly, more closer to 2 and we cosleep so she has free access overnight. My boobs do feel empty after feeds. I've been expressing about 8:30 of an evening when both kids are asleep, after DD's 7pm feed and get around 30mls in 20 min (manual avent pump).

:hug: :hug: :hug:

Hun your boobies are not useless they are amazing and they have kept your DD sustained for 5 months 1 week and 6 days :)

I would do as you said get DH to give her some EBM from the bottle or cup which ever works best for her. Have you tried Motilium? It may that you just need an extra boost, it was at 10 weeks that my supply started to dwindle and we boosted the Motilium (after F top ups and waiting for the appointment), I would give that a shot before going to the F as it is what you want. Can you see another GP to get some Motilium if you don't think your GP will, because ti would have been my suggestion to try that first, but a lot of GP's do just go the Formula line first.

I completely understand you not wanting to use the F, perhaps also try Aktavite or Milo, they are both great at boosting your supply, Blessed Thistle I think needs to be used in conjunction with something else.

Here for you if you want to chat xxoo

Thanks beema :) Haven't tried motilium yet, I didn't even think to ask GP today. I'm sure he will be happy to prescribe it. I used it when I hads trouble with DS and it worked very well. I get the feeling GP wants to get the extra calories in her via formula top ups just to see if it is a supply problem. That's probably all it is, I'm not making enough. Why would my supply drop off especially if she is still feeding frequently and sucking for a good amount of time? I drink heaps of milo ;) and have got fenugreek now but not Blessed Thistle as chemist didn't have any.

No worries hun :hug: As you saw the GP today, give his office a call, he may just be able to write a script and you pop in and get it, or have a prescription only appointment usually less than 5 minutes, seeing as it is realted to what you saw him about and have only just seen him.

I agree you are doing all the right things with the feeding frequently and sucking effectively, is the skin up near her eye moving as she sucks, I was told to look for that for effective sucking, but I would think it is less likely that she is ineffective at this stage. She is also not that far off from 6 months and may be ready in a few weeks to give solids a go, so I would hesitate at introducing formula now and go for the Motilium and when she is showing signs of being ready for solids to give them a shot, she can get the extra calories in that way.
Take care xxoo

Will give them a call but am going back on Thursday anyway so if not can get one then. Yep her skin moves and her ears wiggle and I can hear her swallowing too. At the start of some feeds she even gulps. We actually started solids on the weekend as she has been showing signs. So far she's had baby porridge with EBM, roast pumpkin and pumkin soup. Will try her on some fattier foods like you said kmn, avocado this week too. She actually seemed to enjoy the solids after an initial "screw the face up that's not milk mum" look.

It's so frustrating. I just want a normal breastfeeding experience!

Have you tried hand expressing (even briefly down the sink) after each feed?? It may be more effective at getting the last bits out than a pump!

Well I dont' know what's going on, but clearly your breasts have done a fabulous job.
Sounds like everything else is ok, it's just the numbers on the scale - is that right? Have you spoken to the ABA or an LC yet? If you want to get advice that doesn't start with 'Try formula' that might be a better place to go.
All the best~~

Oh hun, I'm sorry you're having this stress :hug:

Is she generally a settled baby? Any reflux?

Eluned, you are doing a great job hun :hug: Babies grow faster in the first 3 months than at any other time. It is totally normal for weight gains to drop a lot after that. Think about it this way - most babies double their birth weight in the first 6 months. If they kept doing that they'd weigh than us within 2 years!!

I know it is very stressful to not see the numbers on the scale going up as much as you would like. But there are so many more signs of "getting enough". The doctor isn't worried, and doctors usually are worry-warts about numbers, so that should give you some reassurance. Perhaps your little one is just going to be a slow grower. Or maybe she's saving her growth spurts for a little later! Honestly, everything you have said sounds to me like your DD is doing really well, and that you are doing a great job of nourishing her. If you want to give her top ups to be sure, you could try putting her back on the breast 20 - 30 minutes after a feed - that way she will take more if she wants it, and you don't have to give her formula if you don't want to. That will also help your supply.

I hope that she has a good gain next time so that you can relax a little. In the meantime, try to trust your body in its ability to feed your DD. It seems to be doing well.

Also, a little note on solids. Solids displace breastmilk, and can actually lower weight gains, particularly if they are low calorie foods like vegetables. As kmn said, if you are feeding her solids, it might be better to stick to high calorie foods - dairy and meat are good for that.

Sweetheart - YOUR BOOBIES ARE NOT USELESS - yes I am shouting at you LOL

Your baby is well padded, healthy, alert, happy, content, wetting/dirtying nappies - remember as well that weight is adjusted when kids have growth spurts - and you are in a prime time for it (first 6 months)

Both my kids are the exact same - really. Very fine kiddos that are really light. My 26 month old is only 13kgs - but as healthy as they come.

Don't let their weights stress you - look for the more practical tells such as nappies, demeanor, appetite and overall condition.

You are doing a fantastic job - keep going!

Thank you so much everyone for the encouragement and support.

But is it really ok that she has not gained ANY weight in the last month? I know she's not going to be a chubby baby for sure, but I would have expected at least a little bit of weight gain? Is it normal for them to not gain any weight for a short period and then have a spurt maybe?

MR, I offer the breast whenever she is unsettled, sometimes she'll have more to drink, sometimes she'll nod off to sleep, sometimes she just needs to get some bottom wind out. The only thing I can think is to offer both breasts over night. She sleeps and feeds in bed with me and will have one side and fall asleep.

Janie, yep she is really quite a "good" baby, settled most of the time, has her cranky moments. Reflux not that I'm aware of. She does possett (sp?) a couple of times a day, usually with a big burp after a feed.

You're right, she should have gained some weight, even if it wasn't a lot of weight. I know it's hard not to worry, but maybe try all the different things to boost your supply - maybe even some lactation cookies as well and see if you can get her to have longer/more feeds and see if that helps. If there has been little or no change, then it may be time to look at reasons why.

Just checking is your DD being weighed by the same scales each time?

It sounds like you are feeding often enough. Does your DD seem satisfied at the end of the feed?

gtg

Thanks Trillian, have started expressing more and started fenugreek and DH is finding some blessed thistle for me. Will make some cookies, any excuse to bake :)

Kate, was a different set of scales today as it was at the GP. All previous weight checks have been at the nurses clinic. Yep, she is satisfied after a feed and either comes off when she's had enough or falls asleep after the second side.

It is curious and I can totally understand why you're worried - you've done really well to hold your nerve (not reaching for the formula I mean). But then, I get the distinct impression that you are very stubborn ;)
I don't know, I'm no expert, but it doesn't really sound like a supply problem. I'm really hoping she surprises you with a big growth spurt soon

I had similar problems with my DD2, she had very small weight gains once she reached 4 months.
No one was really worried as she was alert, happy reaching all the milestones etc.. In the end our problem was that my iron levels were low & that affected my supply.
Even now DD2 is still smallish she was 8kg at 12months, so she is just a small gainer.

I hope you daughter has a nice big weight gain soon, i know how stressful it can be.

Marcellus, lol yes I am stubborn. :) I want my boobs to do what they are made to do dammit!

Chesire, thanks. I have had iron problems in the past but no idea what my levels are currently like. How did you overcome it? Was it a matter of simply taking iron supps and your supply got back on track ?

I took iron supps & multi vits daily. Fenugreek also helped build up my supply, I also tried to eat lots of iron enriched foods.

It took about 2 weeks to really notice the difference :)

Stubborn, determined and travelled a difficult BF'ing journey in the past and wants to make this one the perfect BF'ing relationship.... :D

Go with the Milk Boosting tips and see how things go over the next week or two, then reassess :hug:

I thinking your iron levels can be tested with just a finger pr!ck test looking at the level of Haemogloblin, if it is low then it is an indicator of low iron levels, I am pretty sure that is what they used to do at the Red Cross when I was donating blood :) but in the meantime boost your red meat intake, and iron rich foods, your body will absorb the iron much more efficiently that way.

Just an update, we are currently at the hospital waiting to be seen by a paed. I'm guessing they will do some blood tests. Trying to catch a wee from her now.

After feeding like mad and topping up with EBM (and even a bit of formula) there has been no weight gain all week, not a gram.

I feel like **** because she is perfectly healthy and has reached all milestones except for weight. Now I'm subjecting her to being poked and prodded.
:(

:hug: You're doing the very best you can - what more could anyone possibly ask from you? From what I've read, you've done all the right things - so perhaps bub is just a bit quirky when it comes to weight gain - hopefully the paed will be able to help you find some answers. :hug:

:hug: :hug: :hug:

Oh hun, will be by your side thinking of you both, I am sure she is just perfect, and hopefully the Paed sees that as well, take care xxoo

bummer, hope you can get some info. thinking of ya,

:hug: honey lets hope it is something minor and she is back to gaining lots in a few days. For some reason I am thinking UTI but I hope it isn't.

:hug: I hope you get some answers :hug: thinking of you :hug:

Oh hun, thinking of you both...........it does sound like something is going on, and it doesn't sound like your boobies. Trust that they will help to keep her well during this difficult time :hug:

Hope you get some answers hun. :hug: Has she grown in length at all? And I'm assuming her weight was checked on the same scales each time?

Thanks all, we have seen the paed and it sounds like a UTI just waiting on the results and what happens next.

Jen, same scales at the GP but different scales at the hospital (actually showed her lighter than GP scales this morning!) and length and head growing normal.

Hoping you get some answers and reassurance. :hug:

Well we are finally home. There was no UTI after all although there were some white cells but on it's own nothing to be worried about. They also took bloods (DD was even smiling at the nurse as she was poking a needle in her arm!) which came back clear. Paed did say a couple of them were slightly abnormal but on their own don't really mean anything.

Senior paed came and saw us and basically said feeding 2-3 hourly at this age is too often and therefore is not getting enough from me and I should top her up after every breastfeed and give her solids 3 times a day as solids have more nutrients than milk(!) and referred me to another paed outside the hospital.

So, is feeding 2 hourly at 5.5 months too often? At the end of the day she would be taking in the same total volume of milk?

Gah, this morning the GP tells me I'm not a great jersey cow. He wont give me motilium because he doesn't think it will help since the top ups of EBM havent helped. The senior paed immediately assumes I have no milk when I told her about feeding dramas with DS like this time is no different despite DD showing all other normal signs.

Why does this have to be so difficult?