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Breastfeeding/baby not gaining a lot of weight.


QUESTION: Hello, my baby was born five months ago and since then I have been exclusive breast feeding but my concern is that baby hasn't been gaining much weight. Since my daughter's first check up her doctor has suggested I switch to formula because of her low gain of weight.

She was born 23 inches 7 pounds 11 ounces and was 7 pounds 2 ounces when she came home. At this time I was breastfeeding her 30 to 40 minutes every 2.5 to 3 hours.

At 2 weeks, we went in for a check up to see if she regained her birth weight. At this weigh in she only gained 4 ounces. They suggested I start supplementing with formula but I said that I wanted to continue breastfeeding because it was better. So they sent me to see a lactation specialist. They concluded that she was sucking properly.

At 1 month, we returned to get her weight done. At this time she only gained 3 ounces and she was only 7 pounds 9 ounces. The doctor was concerned about her weight so she suggested me offering her 2 ounces of formula after I breast-feed her and to try to offer her the breast every 2 hours. I wasn't quite ready to try formula because I didn't want to risk the chance of her not breast feeding so instead I tried to offer the breast every 1 1/2 during the day and at night time let her wake up when she was hungry.

We went back to the doctor at 2 months and it seemed she has gained a bit more weight. She gained 9 ounces and was 24.5 inches 8 pounds 3 ounces. As a precaution, the doctor decided to get some blood tests done to see if she had any issues to explain why she wasn't gaining much weight. All the test came back normal.

We came back at 3 months and this time she weighed 9 pounds 1 oz. The doctor was pleased with this weigh in and sent us on our weigh.

At her last weigh in they became really concerned because she was 26 inches and only weighed 9 pounds 5oz. They gave her the diagnosed of failure to thrive and at this time said I had to stop all breastfeeding and go to a high calorie formula. Not wanting to fully give up on breastfeeding I decided to breast feed her only at night from 10ish to 7amish. During the day I give her 2 ounces of the formula with 1 ounce of the breast milk I express daily every 3 hours.
I got in for a weigh in tomorrow for her and I am worried she is not going to gain that much weight. Do you have any advice or should I just switch her over to the high calorie formula. I just don't want to switch her over fully because she hasn't been sick she has been born, smiled at 8 weeks and rolled over both weighs by 4 months so she is defiantly reaching her milestones on time.

ANSWER: She sounds like she for sure needs more milk but I would suggest trying to build your milk supply or even feeding her then pumping and giving her excess that way. Breastmilk has more calories than even the high calorie formula . If she is meeting all her milestones maybe she is just a slow gainer or will be petite.

you can Try to continue nursing her every 2 hours during the day and then pumping in between each feeding and giving her the expressed milk at the next feed. The more you do this the more milk you will make and she will continue to get more and more if she will take it all of course. Does she act hungry often?  Giving her as much breastmilk as possible will be better than formula of course. and stopping all breastfeeding is just plain silly in my opinion. because of the antibodies and the nutrition in it. To deprive her of that is just silly. Good for you for sticking it out this long and wanting to do what you can.   I don't think weaning her completely is a good idea as breastmilk is FAR superior in every way than formula. That being said, if you want to supplement her as well, say with 2 ounces each feed, then if you pump inbetween and only get one ounce, then supplement with the formula for the other ounce. You can also get a SNS system off amazon and use that for the formula so she is breastfeeding only and not having to use a bottle. that will give your breasts extra stimulation as well :)and hence, build more of a supply.

I hope that was helpful!

---------- FOLLOW-UP ----------

QUESTION: At her five month weigh in yesterday she actually gained 1 pound 1 oz and is 10 pounds 6 oz. That is when I supplemented with the high calorie formula. So I was doing some reading, and I heard that she may not being getting enough of the hind milk and more of the fore milk. Do you think it would possibly help if I pump before I breastfeed her so she can possibly get as much of the hind milk as possible? Either way I am going to continue to offer her the 2 oz of formula with 1 oz of breast milk I have been expressing several times during the day as I have been since she got the diagnosed of failure to thrive. The doctor wants to keep seeing her every month to keep track of her weight. He suggested starting solids, but she can't sit without support yet, and is showing no real interest.

It seemed that feeding her 2 oz of high calorie formula mixed with 1 oz of expressed formula 4 to 5 times a day and breastfeeding her 2 to 3 times during the night has helped. Do you have any other advice I can do so I can get back to exclusively breastfeeding. I wanted to make it to atleast a year if not longer.

Yes you can get back to exclusively breastfeeding. I would suggest to continue pumping as frequently as you can, you can even get mothers milk tea or fenugreek herbs to help increase supply. Make sure you have a good pump like the ameda egnell or the medela double electric. Pump every 2 hours if you can and once you start making 3 ounces at a time you can then just feed her that and wean off the formula.

Eat a high fiber diet as well. Feed her and then pump or pump and then feed her from the breast and get as much stimulation to the breast as possible to increase milk supply. that is the best and easiest way to get a good supply.

once you know you are pumping more, then continue to feed that to her and as I stated before, a SNS system would not be a bad idea while she goes through all this so you know she gets it but will still nurse effectively.  As you start pumping more and more, you can wean off the formula and watch to make sure is draining the breast as she should be.

My guess is she had a weak latch at the beginning or an issue with it and therefor it made a low supply. either way, it can be fixed with endurance :)  


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ruth kraft


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I am a doula ( profession childbirth and postpartum support ) childbirth educator and hypnobirthing instructor.

Certified through DONA international, CAPPA, HypnoBirthing and Florida outreach childbirth education program

Certified through DONA international, CAPPA, HypnoBirthing and Florida outreach childbirth education program

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