Poor weight gain

[Rosebud]

Angus is currently breast feeding every 2 hours but since his discharge 4 weeks ago, he has only gained 220 grams. Wondering if anyone else has issues with their prems weight gain once the arrived home? What was the resolution?

[MantaRay]

That must be worrying for you hun. Does he feed during the night at all? How long are his feeds generally? One side or two?

There are a few possible reasons for this, but more than likely it can be solved. Do you know if you are letting down during the feeds? You might feel this as a tingling sensation, or notice milk leaking from the other breast. You might also notice Angus change his sucking - from a suck, suck, suck to a suck-swallow pattern. What was your supply like when Angus was in hossy?

I am sure this is something that you will overcome hun. You are doing a great job.

[~Sally~]

We had lots of trouble with Brendan gaining weight especially in the first 1-2 months home. He was never able to properly breast feed so I expressed for him. My supply ended up tapering off and he went onto formula at roughly 6 months. then for about a year it was awesome, gaining weight and doing super. We are now on a downward spiral again

I really hope he starts to pick up in the weight department.

[*Beema*]

You have come so far and achieve so much for you little man, we had a lot of trouble at the start as well, and hit a bad patch at 10 weeks when DD lost weight. So I understand how hard it can be when they aren't gaining much weight or lose it.

How long is he feeding for, each side, are his sucks effective, to check when he feeds look near the side of his eye you should see his skin moving, DD was a long time sucker, but a very ineffective sucker, she sucked for 45 minutes and managed about 20gram gain (not an effective way of testing but it was a guide for us, especially as we couldn't see what she was getting).

Is he settled after a feed ie do you get the little "drunk" look? Or is he sleepy, he may be getting a bit too tired to be able to feed effectively? Also what is his sleeping pattern like, is the 2 hourly feeds overnight as well? Are the two hour feeds "demand" driven or offered, wondering if he is perhaps getting that really "hungry" feeling rather than perhaps snacking.

Does he have and EBM top ups or is it just all BF's? Not saying that you have to start them

Sorry for so many questions

So proud of all of your efforts you have had a momentous journey and I hope that with perhaps some minor adjustments little Angus will be stacking on the weight!
Take Care
xxoo

[Rosebud]

MantaRay thanks for the encouragement.

It has become a bit of a worry as he was gaining that and more each week whilst in hospital but then again, 80Kcal was added to his EBM.

He generally feeds for 30-45 mins every 2 hours day and night. I had been letting down but the last few days it hasn't been happening. I think exhaustion has finally taken it toll. I've increase my fluid intake in the hope that it may assist.

I had no problem with supply whilst he was in hospital in fact, i received a request to start storing my EBM at home because in the milk room, each baby was allocated a section of a shelf but, I had exceeded my storage allocation not by a section but by one whole shelf.

His suck/swallow or gulp as it generally sounds has not changed and he always has a milk moustache after a feed but he does attack my breast in a way that reminds me of a piglet fighting for a nipple which makes me think he is still hungry so, as much as I would love to BF him for his first year, I think I may just have to bite the bullet and introduce some formula feeds.

[Rosebud]

Sally - Looks like i'll be going down the formula sooner rather than later.

I hope you see an improvement in Brendan's weight gain soon.

Beema - He does have the "punch drunk" look after a feed and the NAPPS nurses that visit each week are happy with the way he sucks and his attachment. Feeds at the moment are demand and when he wakes he wants it there and then (probably just acting like a typical male). DH has given him EBM feeds when I went out one evening (couldn't really take Angus to the P!NK concert). And he woke up screaming only 2 hours after his first bottle so, maybe he is craving his 80Kcal?

I'm sure it will all be good in the end. We've made it this far!

[~Sally~]

Have you tried the lactation cookies? They are very good, and yummy too I'll come back and edit this post with the link....

Lactation Cookies.. question..

There you go

Another thought... maybe a nipple shield might help him? He wont haver to work as hard and will still get the goodness from the bm.

[*Beema*]

Originally Posted by Rosebud

Beema - He does have the "punch drunk" look after a feed and the NAPPS nurses that visit each week are happy with the way he sucks and his attachment. Feeds at the moment are demand and when he wakes he wants it there and then (probably just acting like a typical male). DH has given him EBM feeds when I went out one evening (couldn't really take Angus to the P!NK concert). And he woke up screaming only 2 hours after his first bottle so, maybe he is craving his 80Kcal?

I'm sure it will all be good in the end. We've made it this far!

He may have gotten used to the loaded milk, what were his gains like after he came off it, was it before you came home, over a few days/week, or was his on the high Cal until he came home?

You have made it this far and you can make it a lot further! Establishing a milk supply on expressing only is a lot of hard work and you have done an amazing job. Have you tried expressing after he feeds, maybe you have created such a good supply, that he isn't getting to the fatty hind milk, and is snacking on the light foremilk. So what I would do first is offer a feed, when he is done, express and see what you get. The fattier milk is a bit harder to get as well, so he may be getting to tired to work for it.

If you don't get anything then you know he is emptying the breast completely and should be getting both the watery and fatty milk, so it may be that your supply has dropped a bit and we have plenty of ways we can rebuild it.

If you are getting some milk out, let us know how much and what is the consistency of it.

What might be the approach then it to express a bit first, to get the let down and use up some of the watery milk, then he attaches and gets a really full fatty feed, and if he is still thirsty afterwards offer the watery milk, to quench his thirst as such. This may give him more of a full feeling and you will know he is getting all the fatty stuff.

It does sound like he is getting enough with the little punch drunk look - as adorable as that look is I still love it when DD has that look!!! Also perhaps offer a top up of EBM after the feed, if he is tired he will get it out of the bottle a little easier and it might just top him up that bit more.

Take care hun youa re doing an amazing job.
xxoo

[Rosebud]

I'm sure he has gotten use to the loaded Cals as this was ceased (as per my request) just days before he came home.

I have attempted to express after a feed but have only managed a few drops so, I assume he is sucking me dry. When I do express I tend to get 100-120 mls of very "blue" milk and once it sits for a while, it has a layer of white thick cream on the surface but it is a lot less than what I was getting a few months ago.

The other night I decided to try him on some formula. He ended up drinking 100 mls and slept for nearly 5 hours and for the first time in a log while I woke up with my breasts feeling full and I even had a let down as soon as he started to stir, maybe the few extra hours of sleep did me some good.

Unfortunalty, Angus is now back in hospital. He contracted an UTI and became very ill very quickly. He was on IV antibotics but is now on oral as they were having issue with it tissueing. He is back on a stats monitor due to his resps also being affected. Since his admission, I have been BFing 4-5 time a day and he is fed formula when I am not there and to everyones surprise, he as gained 130 grams in 3 days so, I have come to the conclusion that my breast milk may just be too weak for him. I will continue to BF but will substitute 2 feeds a day with formula and see how that goes.

Many thanks for all your support!

[*Beema*]

Oh Rosebud, I am so sorry to hear that Angus is back in hospital, I hope that he recovers quickly and is home with you again very soon, sending all the get well vibes I can.

Sleep for you is also very important for BM production, if the two feeds of F a day is what he needs to put on that bit more weight I would be doing it as well, we went down that path and as much as I wanted to exclusively BF I just didn't have anough milk to do so. The amount you are expressing is excellent and it sounds like about the amount of milk you would hope that a bub of Angus's size would drink, but if the F is making a difference I would go with it.

Take care and will be thinking of you both
xxoo

[leesa]

Just wanted to pop in and say that I wish I could express what you can in one sitting!! Well done Rosebud!

And I hope your little man comes home soon and recovers very quickly...He's a little fighter.

[~Sally~]

Oh hun I am really sorry that Angus is back in hospital. I hope he is better soon and back home where he belongs.

As for expressing, 100-120ml is excellent!

I think you have done a good thing though, the formula will keep him full so he will sleep longer which means you can get some sleep which will help with the milk.
I switched to formula top-ups when Brendan was feeding every 1-2 hours, I was so exhausted I wasn't making anywhere near enough for him.... and I was expressing for him. He lost some weight and I was told that if he didn't have a gain within a few days they'd re-admit him to hospital. It was the best decision for us and I have never regretted it. He gained so well on the formula

[MantaRay]

Oh hun, I am so sorry that you've had Angus in hossy again. That must be so hard

It's great that you have something that is working for you. If you are happy to combine bfing and ffing it seems like it might be a good option for you, and it is something that works well for some mums. Just to reassure you though, there is nothing wrong with your milk. Everything you have described is totally normal - and there is no such thing as breastmilk that's not good enough. You certainly have enough too, from what you describe. Also you are never totally empty - you are making milk as Angus feeds so there'll always be something there for him. It's easier for him to get it than your pump though, which is why you aren't getting a lot when you express straight after a feed.

Keep up the great work hun. I am glad that the feeding seems to be going better for you now, and I hope that Angus stays out of hossy for you.