Help! Slow gaining infant

[mom2nine]

My daughter is 10 weeks old. She weighed 7lb3oz at birth. At her 2 week checkup she weighed 6lb1oz. She was slightly tongue tied so we had that clipped. We were also using the nipple shield. Things started to go better for a while. She was gaining almost a half ounce a day for the next 2 weeks. Then she slowed again (off the nipple shield at that point) and only gained maybe half ounce a week. 2 weeks ago we found out my antidepresant causes weightloss in BF infants so I was switched to something different. also began taking fenugreek and blessed thistle. also started pumping daily (getting an average of 2oz each time I pumped 1-3 times a day) and fed her the pumped milk once a day immediately after coming off the breast and she would take 3oz. She has now lost an ounce of weight since last week. She now weighs her birthweight of 7lb 3oz. I was now told by Dr. to feed her a bottle of breastmilk after every feeding to see if that helps. If she doesn't gain this week they will begin to do tests on her to see if there is a problem. My last baby was slow to gain and we used a supplementer tube. He averaged a half ounce a day gain which was slow but consistent. My oldest 7 children had no trouble gaining weight and were always chubby and at the top of the growth chart. Anyone have experience with this or know of something else i can do?

Jeanie

[Amy_G_]

has baby been weighed before and after a nursing session to see how much they are taking in? You weigh on a very accurate scale like in a dr's office, and then nurse as long as baby wants, then weigh again with same diaper, and the difference in ounces is how much baby is taking in.

what are colors of poops? if they are green, it may be baby is getting a lot of foremilk lower in fat but the bulk of the nutrition. baby needs the hindmilk which is higher in fat and calories and helps them grow better.

Baby losing weight is an emergency, and getting some food in baby at all costs is what you must do. pumping after every nursing session and then giving the pumped milk (which is usually mostly hindmilk) at the breast with a supplemental nursing system. count diapers and weigh ins several times a week, or rent a hospital grade scale.

Have you talked to a lactation consultant about these issues to have latch and nursing evaluated?

[Amy_G_]

Also, I would consider a breastmilk fortifier to increase calories to stop the weight loss if necessary. baby not gaining any weight from birth weight or losing weight at 10 weeks is also an indicator to use formula until the situation can be remedied. I would also push to have some testing done asap, did all the newborn screens come back normal?

[mom2nine]

We did not do the before and after feeding weight with this child (we did it when we had weight gain probs with previous child and it showed he was taking in adequate milk)

poops are mustard yellow/orangish with the seedy stuff

she has 7-10 wets a day and usually at least 1 poop.

she gets weighed every tuesday and thursday at the breastfeeding support group which is led by a lactation consultant and she says her latch seems good.

what is a breastmilk fortifier? I was wondering if there was such a thing before and if I needed it if there was.

all newborn screens were normal

[Amy_G_]

breastmilk fortifier is usually only used in hospital for premies.

what does lactation consultant think is problem? was baby weighed on the same scale each time--from birth?

let me think on this and see if I think of something you haven't tried. do a weigh in before and after a feed at the next meeting you go to if possible and see if she's taking in some/lots of milk. If she's not taking in much, then you know it's a problem with her latch or anatomical problem in her mouth maybe. If she's taking in a lot of milk then it could be your milk or her system. If you are giving bottles, she may have a weak latch at the breast and not work hard to empty it and instead wait for bottle.

is she fussy, does she seem to be latching on, sucking and swallowing, how often does she nurse, how long does she sleep at night?

[mom2nine]

LC seems to be perplexed. everytime we think we may have found the answer, it fails.

baby is always weighed on same scale, totally nude

its not the right type of scale to do a before/after. i'll have to see the LC at the hospital for that.

we've only just started the supplemental bottles and she's only had maybe 4 total (only 1 a day) so I don't think she's waiting for the bottle.

she seems to latch on fine. suck/swallow is fine. i've been logging everything today. i start the time when she latches on and stop the time when she fizzles out. She actively suck/swallows for 15-20 minutes on one breast then I put her on the other one and she does the same. about an hour or two at the most, she does the same again. I change her every 2 hours and she's very wet. she usually sleeps at night from 11pm to 4am

[Amy_G_]

If she's losing weight I'd wake her in the middle of the night if at all possible.
can you pump after feedings a few times a day? At first you are only going to get a little bit, but after a few days you might get some quantitiy. the reason I ask is if she's nursed for 20 minutes, the milk at the end of that feeding is hindmilk. If you can pump some of that hindmilk and use that in any bottles you give so she's getting more calories.

Honestly, if my babe were losing weight, I'd be clamoring at dr office, lactation consultant, testing AND giving bottles or using supplemental nursing session at EVERY feeding until weight gain is ok.

[mom2nine]

good news. on Tuesday she weighed 7lb3oz (down an ounce from last thursday). Today she weighed 7lb6and a half ounces! She gained 3 and a half ounces in little over a day. She drank an extra 5 and a half ounces of pumped breastmilk yesterday in addition to all of her regular feedings. Just have to keep that up, I guess.

[Amy_G_]

then she's not draining the breast effectively, whether it's weak suck, latch or another issue. but good for you for giving her breastmilk however you can!