Breasteeding/weight gain ???'s

[AmberTerhune]

Hi ladies, I haven't posted much,as we've been very busy. Trying to get 4 y/o's health taken care of, dealing with a wild 21 month old, and the normal ups and downs of having a new little one, keeps us going non stop. Phoenix is now 10 weeks old, and for the most part, doing great. The only issue we are having is that he's not gaining weight as quickly as the docs would like.
At birth (exactly 10 weeks ago) he was 4lb 14oz, 18" long with a head circumference of 13". When he was discharged at two weeks, he weighed 5lb 2oz. Two weeks later he was only up to 5lb 4oz, and a week later, 5lb 5oz. The pediatrician said that if he didn't start gaining more weight, he would be admitted back into the hospital. So, for that next week I practically force fed him, and also supplemented with the high calorie formula with the LactAid feeding system a few times per day. He refuses the bottle, and hates the taste of the formula, so getting him to nurse with the formula was quite the chore. A week later, he had gained 8oz. It's been three weeks since his last appointment. Yesterday, he had his two month appt. His weight is 6lb 2oz, length is 21.5", and head circumference is 14.5", meaning he's gained five ounces, grew 3 inches in length, and an inch in head circ--in three weeks. But this still is not enough, according to the doc. If by this Thursday, he hasn't gained another 8oz or so, she wants him admitted. Now my questions are--should we be as concerned about this as the pedi. makes it seem? Should I supplement with formula again? He's having good diaper output, is active and alert, and is nursing on demand--usually ever 1.5-2.5 hours. He's growing, just not at rate they want him to. Both our girls were slow gainers as well, and to this day are still very small and petit...could his slow weight gain be genetic? (Our four year old has been 34lbs for nearly a year now, but has grown 2" in length)
Any suggestions would be greatly appreciated!
PS. Tiffany, how's your little one??

[tlcdoula]

Why not get a second opinion? I ask only because when Breanna was little they always harped on me about how small she was. Flipping out at every visit because she was in the 3rd% and at times not even on the chart for her weight. I changed doctors and this one checked out the growth of her and saw a slow but steady rise and he allowed it. Now she is 15 yrs old and bigger than her 18 yr old sister (who has stopped growing and is only 5'1" and 95 lbs).

[MothertheMother]

my dd was slow to gain as well. Not that extreme but always in or below the 10th percentile. Now, at 5 yrs old she is way up into the 30th percentile lol. In addition to another doctors opinion I would see a lactation consultant. Most of the growth charts are based on formula fed babies so they are not "accurate" for breastfed babies. I think the LC will have a better idea of whether or not his weight gain is ok. The fact that your other children are slow gainers should mean something to the dr!

[HamiltonBirthRevolution]

I would recommend emailing this directly to Dr Jack Newman drjacknewman@sympatico.ca. http://www.drjacknewman.com/index.php Jack is very no-nonsense, so if he is curt in his answer, it's not you, it's because he answers every single email he receives and he gets hundreds or more a day.

Highlight the main question: is this as serious as the ped is making out?

In the meantime, it sounds like you need a little support. Do you have family /friends / doula sisters who can help out with the other two while you spend more time nursing non-stop?

In addition, http://www.kellymom.com/babyconcerns/growth/index.html
Kelly's chart for brastfed babies shows an acceptable minimum gain of 4oz per week. I too had a slow gainer and the midwives would even accept 3 oz weight gain per week for the first couple of weeks, but I found that sitting down with a LC really did help end up increasing supply.

You never know what's going on and since this is a breastfeeding issue, go see an LC asap for her take on things. Contact Dr. Newman (who accepts email inquiries if they are short and concise and contain one question). Get in some assistance for the older kids so that you can focus on nursing the little one. Go see your doc armed with the info discovered after the other fact-finding stuff.

Of course, please ignore my Germanic imperative tone: these are my suggestions, not my edicts! Hahaha!

[heathenmamaof5]

Can we move this to the bf forum???

Congratulations on the birth of your son!!! Was he pre-term? Are you pumping at all? There are so many questions, which is always what happens with bf questions. More info please LOL... Anyways, I can't say this strongly enough - get an IBCLC to work with you. It makes a world of diference. Some small baby's have to play "catch up" and grow before the can milk the breast as effectively as their full term peers. This may be what is going on, but there are so many variables and we aren't there with you physically to see what is going on. The rule of thumb for weight gain is 1/2 oz to 1oz a day. With my twins I rented a baby scale and weighed them every day at the same time (ie 9am) that way I could see how much they were gaining. If you meet with an IBCLC she may do a pre and post weigh to see how much Pheonix is taking in per feed. Another question, how long does he nurse on the first side? Do you take him off or does he "fall" off? OK, this is totally disjointed-sorry, kids keep interupting me. I think HBR's idea of e-mailing Dr. Jack Newman is awesome! Please keep us updated and CONGRATULATIONS!!!

[heathenmamaof5]

Amber, I see you...I'll brb and if you want we could "chat" about your situation.

[AmberTerhune]

Thanks ladies, Yes, Phoenix was pre-term. He was born at 33/0 weeks. I've noticed that over the last two weeks, his suck has gotten stronger...but even before this, we know he was getting a good 2.5 ounces for most of the feedings. We did the scale thing right before he ate, and right after, before he left the hospital. This was shortly after pumping. We haven't done it since. I haven't pumped since he came home from the hospital, as we've been strictly nursing. He's a big time comfort nurser; I can always tell when he's nursing to eat, and nursing to comfort, but I'm assuming even when he's "comfort" nursing, he's still getting something. The doctor figured with his weight gain, he's gaining an average of 1/4 of an ounce per day. Like I said, my girls were slow gainers also...but they were never labled "failure to thrive". Anyway, thanks for all the great advice...I'll post what happens on Thursday!

[heathenmamaof5]

Are you doing breast compressions? This wakes them up from comfort sucking to nutrative sucking. I thought you were suplementing with formula. If you are then you could pump after feeds to get some breastmilk to supplement with. Remember, anything he gets that isn't stimulating your breasts will decrease your supply. And if you do start pumping the kind of pump you have makes a huge difference. I'm strongly recomending you hire an LC before the next weight check. That way you walk into the peds office with a plan. See, I've gotten help and this is what we're doing. KWIM? Good Luck and HUGE AllDoula's

[MothertheMother]

This is a really great topic for the breastfeeding forum. Of course I asked Ambers permission before moving it!!

[heathenmamaof5]

Thanks Christie! I really want Stacie's take on this situation

[AmberTerhune]

So, Phoenix had his follow-up appointment today. He is now 6lb 7oz...gained 5oz from last Thursday. I've been supplementing a few ounces a day with the high calorie formula. Obviously, he just needs some more calories throughout the day, so I'm wondering if there is any way to make breastmilk higher in calories? I've heard that taking fish oil makes it better in "quality" but will it help with a weight issue?? Any suggestions??

[AmberTerhune]

PS. I've also heard that there is a chinese herbal remedy for situations like this. Anyone ever heard of this, or ever had experience with something like this?