3 Wk Old Slow Weight Gain (Caught in Breast/formula Conundrum)

I have worked( in this area)for many year. you always offer the breast first and once you have fed for the allotted time then offer the bottle. Not the other way around! Sounds like you may have a dr. who prefers bottle over breast.Good luck.

I would breastfeed primary. I did - both two skinny babies, despite being born big (9#4 and 8#11). They started truly packing the weight on at 3 months, and my 4 year old (lactose and gluten intolerant - formula would have made him worse) is wearing a size 6 (usually slim) and my 2 year old is in a 3T.

I can't make enough milk to only breastfeed my first the Dr. made me us a special formula I hated it I didn't feel good about using formula and it tore his stomach up. So I got talking to other Mothers about it and everyone that had problems like myself were using Goats milk its the closest thing to human breast milk. After he got on the goats milk he gained better and his stomach got better. With my next one I knew I couldn't just do breast milk so I got the Medela feeding system I got it at Harris breastfeeding center. It's a bottle that I would put the goats milk in and then you run the tube down your breast so baby never needs a bottle. My 2 one never had a weight problem.
Good Luck

you might want to get a second opinion from another pediatrician. My daughter was in "trouble" for not gaining enough weight a day....she ate well, was on high calorie formula, we did the every 3 hours all day/all night. Well, after the pediatrician suggested going to every 2 hours (when it took 40 minutes to eat).....so we got a 2nd opinion. Thank God we did -- this doc said babies gain weight at different rates. If she is eating well, etc. let her go a little longer. No big deal -- he would be more concerned if she wasn't steadily gaining or had suddenly stopped. So just get a second opinion. It may be worth it.

I know it is hard when you get worried about your babies weight to make decisions. My advice, wake that baby up every 2 hours during the night. If you are nursing for 90 mins then when you get done, that's when you start the clock for 2 hours. Your milk is enough for your baby, you just have to offer it to her all the time. I know it will be exhausting for you both, but it is worth it. She will be getting what is best for her and your milk supply will increase for her to be able to get more. Just feed her non-stop (every 2 hours that is)day and night. She has to learn.

I truly believe in breastfeeding, however it doesnt work for all babies. I b/f my first exclusively til she was 11 months old. My second one I nursed for 5 months- and she steadily lost weight. She was a little thin, but as you said not dehydrated and frequent wet diapers. I would nurse every 2 hours and she would drink "just enough" to satisfy but she wasnt getting full. As my ped started getting concerned she suggested "lets just try a bottle of formula". I did not want to and I cried about it! (We had also done bloodwork prior to formula- all tests were normal) She sent me off with loads of formula and when I offered the first bottle- she sucked it dry in no time. She was hooked, and I was sad. The day after starting the formula she was already up a few ounces in weight. So we switched to formula and she is now a very healthy and tall 2 yo. You have to go with what feels right for you. I love my pedi and I really trusted what she had to say at the time and she was right. Good luck I know its a tough decision to make.

From what I have researched and been told you need to let your baby empty your breast at feedings.There are two types of milk in your breast there is the fore milk and the hind milk.Now if you are like me you switch breast every couple of min.Well no one told me that was the wrong thing to do and I thought I needed to do it to keep milk in both breast.Not true at all.Let you baby suck on one breast until she is finished(when she lets go) then offer her the other.Now if she doesnt want the other breast at the end of the feeding then that is ok.Just keep track of which breast she she ate off of and offer her the oppisite one the next feeding.this will increase your babies weight as well as your milk suppy.now grated the breast always has some milk in it so it wont acuatually be completely empty but let you baby release the breast before moving on.It is very important that she gets the hind milk.The foremilk is meant to be a thirst quencher and the hindmilk is the more fatty milk and has the most calories.Hope this helps you out.

I breast feed my first daughter and she would nurse every 2 1/2 hours and feed for 30 mintues...I am not a fan of the bottle when breast feeding especially at such a young age. If she seems to be gaining it but then losing it maybe she will just have a high metabolism and burn it off quickly. i would strickly breast feed during the day but maybe at night give a bottle. this is my opinion....my daughter weighed at her 1 month what she did when she was born and she is healty and fine...just give it some time more than a month...Hoe everything goes well...

Hi C.. I can completely relate to your situation and offer some advice. I have a 6 month old baby boy who went through the same thing. He was exclusively breastfed until 4 1/2 months. He was born 6lbs 2oz and by 4 months he was only up to 10 lbs. Our nursing sessions were constant and he would nurse for 45 mins. to hour each time. I pumped and bottle fed toward the 4 month mark and consulted with a lactation consultant. Every time I decided to try formula I would get on-line and read about feeding and feel guilty for not exclusively breastfeeding. He would also seem to have more gas and tummy troubles with formula. At 4 1/2 months I started mixing half breastmilk and half formula and he took that really well. Now at 6 months he is about 17 lbs and thriving. He is exclusively formula now - Nestle Good Start with B Cultures (I found that he takes this and digests it just as easily as breastmilk, it is the only brand not to upset his tummy). In hindsight I am glad that he got all the benefits of breastmilk for so many months but I would have started supplementing with formula sooner. Not only would that have alleviated a great deal of stress for me but now I also realize that for whatever reason he wasn't getting enough of what he needed from just me regardless of what the lactation consultants told me. His pedi actually had told me from the beginning that I probably had low calorie breastmilk, I still don't know if that is possible or true but whatever the reason he never started to gain weight the way he should have. Good luck in whatever you decide to do. I can tell you adding formula made a huge difference for my son. With the formula I could also be sure how much he was actually eating.

Dear C., I have been in your situation three times. I am a mother of six children and all of them have been breastfed. I have had three of my girls have breastfeeding issues. I have always produced enough milk but my last two babies were slow to gain also. All three of them were born with jaundice which makes them more sleepy and harder to awaken. How are your babies bowel movements? How often? Is all of the miconium left your babies system? I am an advocate of breastfeeding. I agree with your lactation consultant. That is what I did. I used a Medela Pump in style breastpump and pumped every two hours and then fed my baby so I knew how much she was getting. I also took Fenugreek. I had plenty of milk. This worked with child number 5. I was able to make sure that I also nursed every other feeding with a Medela suplementing system that attaches to your breast so that they don't forget how to latch on. I put the breastmilk in the suplementer and breastfed at the same time. That way you know they are getting so many ounces per feeding. This worked great for me and she gained and I kept nursing. I had to do this same thing with my 6th child but did not get the same positive results. We realized after months of trying with our 6th with trying to get her to gain and continue to gain that my breastmilk was not okay. I no longer produced enough fat in my breastmilk to get her to gain weight. I ended up giving formula as the primary food and breastfeeding only twice a day. That worked for her and she has been great since. I have had two different experiences. I also rented a medela scale for 2 weeks so I could weight her after each feeding and you can tell how many ounces she ate at each breatfeeding when she weighed. I don't know if this helps but I thought I'd share my experince with you. Best of Luck, S. H

I have been there. I followed the advice of my lactation consultant because I was adamant that the nursing work out. Nurse her often, followed by formula. Massage your breasts from the top then in toward the nipple to increase the amount of milk that lets down. Wake her if she falls asleep during feedings so that she gets the good "hind" milk each time. Make sure you're rotating which breast you start on at each feeding. And if you're concerned about supply, keep taking the fenugreek. I took it, too...and we endured smelling like pancakes! :) Good luck! Message me if you have any specific questions!!!

Well personally I was always told when a baby is sleeping, they are growing!!! How long does she feed off of you? My babies would eat when they were crying and ready to eat, at that age for about 40 min... I never woke them, that seemed like a bunch of nonsense to me, i wanted some rest and they need it too! I would say let her sleep and when she wakes up let her eat off of you, don't pump unless you are just uncomfortable, so then when she is ready to eat you have a good supply built up, more fat and nutrients for her, plus your body will not regulate your milk for another couple of weeks, remember she is only 3 weeks old and learning and so is your body (breasts) hope this helps :) good luck!

my baby girl (now 10 months) did the exact same thing. our pediatrician suggested breast first, then formula or stored breast milk. she also suggested to feed her every three hours around the clock. she is just a petite baby, but is very healthy. she was at her birth weight by her 1 month visit. just hang in there....

I had the exact same problem. First, if you really want to breastfeed I would use formula only when absolutely necessary b/c your body needs to know how much milk it needs to produce. My pedi had me pump milk and give her a bottle for 4 days (no breastfeeding). That way we could measure exactly how much she was getting. I did use some higher calorie formula for some of the feedings which my pedi gave me. She also got a breast milk fortifier made by Enfamil that I added to my pumped milk to up the calories. Her formula rep got this for me. My daughter gained weight in those 4 days, which eliminated my pedi's decision to test for an underlying medical condition. She decided it was a volume issue (i.e. my baby was just not nursing effectively). After consulting with a lactation consultant, I started triple feeding to increase my milk supply. Triple feeding is when you nurse for approximately 30 mins and then you pump for 10 mins. You also give the baby an extra 1- 1.5 ozs in a bottle. It heps if you have someone to give the baby the bottle while you pump. You want to pump pretty much immediately after nursing. Hopefully, after a week your supply will have increased and you can exclusively nurse. I had to do it longer than that and I have to say it took us almost 3 months to really get breastfeeding down. I also eat oatmeal every morning (not instant, but regular) and take 3 capsules of Fenugreek 3 x's/day. Oatmeal is supposed to help with milk production.

Feeding every 2 hours is probably going to exhaust you. I fed every 3 hours and let her go one longer stretch at night, but not more than 5 hours.

This is really a more common problem than I thought. Yes, your baby could have a cardiac lesion or something else causing this, but since she has shown she can gain weight, it is probably a nursing issue. I think most pediatricians are theoretically in favor of breastfeeding, but lack the training to help us succeed at it. My daughter got within two ounces of her birth weight at her one month check and my pedi decided that was okay. She is still on the small side, but she is happy, alert, having the appropriate # wet/dirty diapers etc. Hang in there!

I highly recommend that you look into a SNS Supplementary Nursing System. You can put formula in it and it has a tiny tube that you use so that when the baby is nursing she is also getting the formula. This will ensure that your child is getting the substance needed for weight gain, but also allows you to continue breast feeding. It also allows you to monitor (the formula) what she is taking in daily. I was pulled off breastfeeding too soon due to similar issues and feel that if I was given the SNS system at the point you are we would still be breastfeeding today. I also rented a scale (thru a lactacian counselor) to weight her after each feeding when we were just breastfeeding.
Also, I would definately get a second Dr.'s opinion from someone whose Dr. supported Breastfeeding (not that yours isn't good or doesn't support you) as they sometimes can give you advise that works for you and your baby better than what you've already been told.
I wish you the very best. My daughter is very healthy and happy and has been on partial or all formula since 2 months even though that wasn't what we had planned.
Good Luck!! And Congratulations on your baby.

Your baby should be eating every 2 1/2 to 3 hours whether it is breast milk or formula. I typically recommend breast feeding every 3 hours followed by formula supplementation at the end. However, one thing you mentioned was concerning to me as a feeding specialist. You mentioned that your baby is aspirating. Many of my aspirating babies "shut down" and don't want to eat even though they are hungry. Babies are smart and they know something is wrong when they are aspirating. If your baby sounds congested during and after feeds, coughs and chokes during feeds often, and does not exhibit hunger behaviors often, I suggest you talk to your pedi about a modified barium swallow study. If your baby is experiencing aspiration on a frequent basis, this is not good for her lungs. You do not want her to become an aversive feeder as well. Right now she is young, and newborns typically remain eager even through aspiration events. However, if it continues, she could start refusing feeds.

R. Elkin, MOT,OTR/L,CKT
pediatric OT

My son kept losing weight and tried breast feeding and every formula and was called a failure to thrive baby. He was in the hospital several time his first six months then took him to a chiropractor and he adjusted him for a week them said put him on fresh goats milk I did and he started gaining weight and kept on gaining. If you have a place you can get fresh goats milk try your little one on that and see if that doesn't help.

A good friend of mine was in the same situation...she breastfed the baby then pumped and then fed her what she pumped. It was exhausting, but the baby started gaining weight and after about a month, she was able to just breastfeed. THere is also a supplemental nursing system that uses a tube that is taped to your breast. When the baby nurses she can also be getting formula through the tube. That way, you kind of get to do the two things at one time...(check with the lactation consultant to get one)I would stick with one method for two to three weeks (as long as she is hydrated as you said she is) and then get a weight check. No matter what you decide, feel good about it. Breastfeeding is great but if you decide it is not whats best for her or for you that is ok! Good Luck!

DON'T GIVE UP ON THE BREASTFEEDING!!! Breast is definately the best. I think a lot of pediatricians are not on the breastfeeding band wagon. I have breastfed all our 4 babies and I know how frustrating the first 1 1/2 can be. I always tell mothers to hang in there for the first month to month in a half....times are trying during this time because you and the baby are trying to get the hang of it. I just had our 4th 8 months ago and the 4th wasn't any easier that the 1st...but the health benefits are definatley worth it. Listen to the lactation consultant because they know more about breastfeeding than the peditrician. As long as your baby is content (not continuously crying) and wetting diapers you are ok. GOOD LUCK!!

If you are adement about breastfeeding, do not give formula as a primary. I had this problem with my first, and I got a syringe/feeding tube thing from my pedi and would tape it to myself and slip the tube in while she was nursing. A little bit of work, but she got the formula she need to boost her weight gain (I only supplemented maybe an oz. each feeding). Ultimately if you really want to nurse, you cannot continue to supplement. The bottle is a lot less work for the baby than the breast, and we are by nature inclined to take the easy way. You may also take milk thistle (that is what I took). My pedi told me (after a week or two of supplementing) that if I wanted to continue to breastfeed, I would have to stop supplementing. She was at a good weight so I did and it worked.

All that said...if it doesn't work or if you don't feel that you can/want to stick it out, you are not any less of a mother. A great mother (which I am sure you are) does not breastfeed for breastfeeding sake. There are tons of moms out there that did not or could not breastfeed and they are bonded with their children just as much as those of us who did. Just remember that what makes a good mom is doing what is best for the child...which includes having a sane and happy mommy. Tension and undue stress are far worse for the baby than not breastfeeding.

Ultimately, you have to do what is right for you and your child. Don't let anyone make you feel guilty for whatever decision you make. I'll be praying for you!!

My daughter was a bit pre-mature and lost a some weight during the first week home due to jaundice. Her pedi suggested I do the same; however, I was told to use a particular type of Emfamile (sp?) because it had a few more calories than the rest. We used the ready to feed instead of the powder. The powder did not set well with my daughter and made her very gassy/constipated. I would feed her every three hours - started with formula and "chased" it with breast milk. I kept pumping and it seemed so exhausting for mommy as well. She quickly gained the necessary weight back in no time. Good luck and hope this helps give you a little peace of mind!

Trust the advice from the lactation consultant, this is what she does all day every day. You can always refuse the pediatricians tests but he is trying to look out for the wellbeing of your little one. Possibly you have an overly agressive pediatrician?!?! I did keep both of my kiddos on an every 2-2 1/2 hour feeding schedule until they were about 2 months old. Try tickling her foot if you find her falling asleep at your breast, that might help wake her up for a little while. You can also try feeding on one breast for 1/2 of the feed. Stop and change her diaper (if she needs it, this will also wake her up!) and then change breasts. Hopefully with the new diaper and being awaken again that will get her to feed longer. Good luck!!!

I would think if you have to get up every three hours or less your body couldn't make enough milk. Sometimes a mothers milk isn't rich enough or enough. Waking the baby up every two hours seems like it would wear her out too. I would be for checking to see if formula did the trick. I know breast milk is best, but for some reason sometimes we just don't have enough .

I do not agree with breast milk being secondary. My friend had a 5 pound baby and they told her she was underweight and to wake her too but she said if she is sleeping through the night I am not going to wake her. She ended up at about 2 or 3 having fat little legs and cubby.When when she got older she thinned out being a normal slim gal. I told them to give my baby formula when he was gone for a few hours to be circumcised and they had him a long time. When they brought him back he never nursed well. I only was able to do it for about 6 weeks and gave up. I had to hold a nipple on my nipple and after awhile getting up to wash was like fixing a bottle so I quit. My daughter nursed fine. I also gave her a bottle when I was out in public and she did both well. She also was not hard to tranfer to cups or bottles because she was not totally on the breast. So I think keep trying and put breast primary. She will gain and it is more important not to worry about it. Children are residulent and will let you know very will when they are hungry. Be glad you get to have some sleep. A lot of babies get night and day mixed up. Over the years I have found instincts are better then doctors. God Bless and enjoy that bundle of joy. G.

You may not like my advice: get a new peditrician, one that is completely on board with your desire to breastfeed. Also I would immediately contact Le Lache League. Nursing is their one and only topic so they know ALL about it. They have medical studies, lab studies and every other study under the sun to answer all your questions. Ultimately the decision of what to do is up to you, you do not have to let the doctors run any tests if you don't want them done on your baby!

Idea's: stop the formula and only offer breast. Do not wake your baby up. Simply feed her when she is hungry. Keep track of the diapers to make sure she is getting enough, but let her natural rythmems decide when and how much to eat for now. By force feeding her you could be setting her up for eating issues later on!

I wouldn't pay too much attention to the weight and height charts. Unless your baby's weight or height starts to show no imporovement over a long period of time (and no weeks is not a long period of time) then become concerned.

For your diet you may wish to abstain from all dairy and cheese products, maybe even wheat and gluten. Perhaps she has a food allergy and it is impeding her weight gain? Although, to be honest, it doesn't really sound like it.

Seriously, just check around for a doctor that is more in tune to what you want for your child. If you want to nurse her then find one that is of the same mind. Le Lache League members can at the very least give you referrals to these doctors. Good luck!

I went through the same thing with my daughter when she was born. My daughter was alert, happy, not larthegic. I honestly knew nothing was wrong with her, but the doctors where still not happy with her weight gain, and she was small. Weighed 6.1lbs when born. As she was a little older, I had to keep a diary/journal,and even had to see a nutitrionist and document everything. They did testing on her as well, but not until 9 months old, and finally they saw nothing was the matter and she is just going to be a small child. She is now 3 years old, and is in the 0% of the weight chart, but is very smart, healthly and happy little girl. I would say go with your instinct, I feel that you know as Mother if something is wrong. You can always get a second doctors oppenion as well.

Hope this helps.

My son was born at 6 lbs. 9 oz and was losing weight quicker than he could keep it on as well. I exclusively breastfed, but at each feeding my pedi had me nurse him, then pump afterwards, feeding him the "pumped" milk with a bottle. That way we at least knew that he was getting a few oz. with the bottle (on top of whatever he got nursing). I was feeding him about every 2-3 hours. So after a week or so of doing this, he starting gaining weight and I went back to just nursing. Turns out he had GERD (acid reflux), so he's always been small for his age.

Best of luck :)

I haven't had this problem, and am no expert, but have exclusivly breastfed all 3 of my children (the youngest is 2 months old). That being said, I am more inclined to go with the lactation consultant - I think if I were in that situation I would wake the baby every 3 hours around the clock and try to feed her. I'd try to get her to eat for at least 15 minutes, but if it was only on 1 side, I would be OK with that (I wouldn't try to get her to eat on both sides every 3 hours b/c like you said, by the time you finish feeding, it's closer to 1 hour from the time she stops eating until the time she starts again.)

I've said a prayer for you b/c this is a tough call. I would keep in mind that the lactation consultant is trying to ensure breastfeeding and the peditrician is trying to make sure she gains weight...they both have their objectives (not to say I think they aren't wanting what is best).

My son (the one that is 2 months old) only ate on 1 breast at first, and sometimes would go 4 hours between feedings. He never really seemed like he was starving either (at least not in those first few weeks), but now still eats every 3 hours during the day.

Again, me personally, I'd really try to get the breastfeeding going and offer a bottle as a backup.

Good luck!

While breast milk is always best...it's not always going to be what works. Formula is not the end of the world. I have 4 kids...2 adopted...they had no choice but to recieve formula, and then my other two got formula due to me getting breast infections when trying to nurse. Only one had an issue with gas ...but that might or might not be a result of formula. All 4 of them have been very healthy. My kids ages are 8, 7, 3, 2...the 8 & 7 yr. old have each had flu bugs about 2 times and ear infections 2 times. The 3 yr. old has had one ear infection and the flu once, the two year old has never had an ear infection, has had the flu once. The older two attend public school and the younger two are around kids in the nursery at church regularly. I point this out because many will say that if you use formula your kids will always be sick. Also, for long term ...in the 1970's is was common to use formula (I was a formula baby and I'd say about 80% of my friends my age were given formula). None of us have had adverse affects of being given formula, and I think formula now is probably quite better than 30-40 years ago.

Anyways...I'm definitely not out here telling people to choose formula over breast milk as a first choice. But when there are other circumstances involved...I don't think a mother should be made to feel guilty if she chooses to use formula.

I'll be sure and pray for you and your daughter.

My daughter went through the same thing. When I started supplementing she started gaining weight so the dr knew everything was working properly. At some point I was nursing her and giving her formula every two hours. We also had a 3 1/2 yo daughter. The best thing my pedi was I needed to do what was best for my family. I went straight formula and started gaining the weight she needed.

I had this with my now 2 mo old...this was my third baby and never had this issue with my first two. I think the main thing for my son to gain weight was for me to get off all pain meds (I think it was making him way too sleepy and he wasn't eating well or vigorously). I didn't have this issue after that, but this is what my pedi and lactation consultant told me to do when he had hardly gained weight a week after we brought him home...don't let him sleep more than 4 hrs at night and 3 hrs during the day. Then, after each feeding, pump right after and store the milk. Let him have that milk right before the next feeding. The lactation consultant also added to not "time" each side (which is what I did with my other two)...let him feed as long as he wants to (or until you can tell that all the baby is doing is the non-nutritive sucking and you can't stimulate the baby to take a strong enough suck to get any milk) so he was getting the hindmilk (the fatty milk). Then, if he wanted to feed on the other side, he definitely could. He always wants to do both sides, so it's not an issue.

Don't know if this will help, but at least that's what I've done recently. :)

Good luck!

C.,

First of all, you're not alone. My twins were born at 6 lbs. 9 oz (the healthy one) and 5 lbs. 2 oz (the little one). My little twin (Ashlyn) is 1 year old now, and only weighs 15 lbs. We struggled with her weight for MONTHS, trying to get her to drink more. She was just not a "liquid" type of baby. I wound up expressing breast milk for her and feeding her a bottle, so we could see how much she was eating. She only took 3 oz per feeding - even still at 1 year. She was steady on the growth curve, but only at the 5% mark, and then at her 9-month check up, she had only gained 4 OZ in 3 months. I tried everything from putting formula in with my breast milk in order to add calories/fat, but nothing seemed to work. She did have dysphagia (the valve that is supposed to close to prevent aspiration of liquid into the lungs wasn't closing properly. The doctors seemed to think she didn't like drinking because she associated it with choking...
Anyway - hang in there and if you have any specific questions, please feel free to email me.

K.

You've gotten a lot of good advice here! I wanted to reinterate that breastfeeding is all about supply and demand. The more your breasts are stimulate by baby or pump, the more milk you will make. The less your breasts are stimulated, the less milk you will make. If you follow the pediatritions advice without pumping to replace the amount of time your baby eats from the bottle, you will definately not have enough milk to breastfeed exclusively once baby gains weight and you have the go ahead to drop the formula. (And your pediatrition probably does not know much about this. From what I understand, they receive very little training about breastfeeding.) It may be necessary to supplement with formula for a while, but keep in mind that if you want to continue breastfeeding you need to be pumping as well. After a few days you might be able to replace the formula in her bottle with breastmilk!

Also, someone suggested that most people they know were fed formula and they're all fine. I wonder if any of them are overweight, have diabetes, or irritable bowl syndrome? There are many health conditions that have increased exponentally since breastfeeding fell out of vogue in the early 1900s. There has been very little research regarding a possible link to the use of formula. The fact is we just don't know to what extent the use of formula is affecting our health. I don't say that to make moms feel guilty, I say that to help this new breastfeeding mom make an informed choice. Below is a link to an article about breastmilk and a young baby's digestive tract and alternatives to formula supplementation. Www.breastfeeding.com is an excellent resource for breastfeeding information and their message boards are a wonderful place to get support from other mom's. They also do free live chats with lactation consultants!

http://www.breastfeed.com/articles/issues-for-mom/the-cas...

Thank God that we have formula - it is often truly needed by moms and babies who have problems with breastfeeding or by adoptive families. Thank God we have the advanced formulas we have today that are much better for baby. Those still are not the same as breastmilk and your breastfeeding relationship is worth fighting for. Don't feel guilty for using formula if needed, but also don't give up on breastfeeding! :)

When my 4 babies were infants I tried to think of feeding as my job. It can seem like a 24 hour one sometimes, but this too shall pass! Good luck!

This happened with me too. We were concerned because our son was sleeping a lot at an early age. He slept so much that he wasn't eating every 3 hours and sometimes he would fall asleep while eating. He also had lost wieght ( he was 7 lbs 7.5 oz. and went down to 6 lbs 10 oz.) and wasn't gaining it back very quickly. But I wanted to keep breastfeeding as well so this is what I did (this was from the great advice I got from my doula and midwife).

If he was asleep and I needed to wake him up to feed him, I would take his blanket or clothes off so he would cool down. It depends on what he was wearing but the point was to make him cold enough to wake up. That made him miss the heat and want to lay next to me for body for body heat and nurse. If he looked like he was going to fall asleep while he was eating I would rub his back or move gently (but hard enough to keep him awake). After doing that nightly he started gaining weight regularly and developed his own schedule. Sometime later his schedule became eating just about every other hour during the day then sleeping through the night again. But by that time he had gained weight and we didn't have any reason to be concerned anymore.

At the time I was a wreck. I didn't know if I was making enough milk or if something was wrong. Now I am glad that I was able to stick with breastfeeding. The weight gain turned out to be ok and I think I was lucky that he naturally had a great sleep pattern. He has developed well and I think it exclusively breastfeeding for as long I could helped out. My son is about to turn 1 this month! Everything worked out great and I really hope this helps you or you find whatever works for you!

C.:

As a mother and birth doula, I recommend you follow the advice of the lactation consultant. Babies weight will fluctate the first few weeks. Don't freak out. The diapers are good indicators that she is getting enough to eat. She will gain weight as her body metabolizes what she eats. Your breast milk is the best for her and you. The maternal bond is un-replacable. Stay committed to the nursing program and supplement formula only as a secondary. I'll keep you in my prayers. Good luck

Love and blessings,
N.

I had twins born at 36.5 weeks which is considered full term for twins but in essence, they were premature. My son also spent time in the NICU & they put him on formula b/c we were both hooked up to machines & neither of us could leave our rooms. I then tried to breastfeed them both. I fed one an hour, the other an hour, pumped an hour & started over again, 3 hrs. later. I was a 24 hr. milkman.

This was my life & my goal was to breastfeed until they were a year old. It didn't happen. I didn't realize until I started pumping that I didn't have an adequate supply of milk for them. I also took the fenugru & drank a lot of fluids.

My babies went in for 5, yes FIVE weight checks & kept loosing weight. I DECIDED TO SUPPLEMENT THEM WITH FORMULA. This was the best thing for the babies! I still continued to breastfeed when I could for 3 mos..

Remind yourself, you will not receive any awards for this & my children, now 2 are smarter than any other 2 yr. olds I know! I will say that they lived also on the gas drops, Mylecon. We used the Enfamil soy formula & then switched at 11 mos. to a combination of soy/cow to prepare them for whole milk at 1 yrs. old.

Good luck. Do what's best for your baby, don't worry about anyone else's thoughts. You're the mom!

Breast milk is best for baby. Stick with what the your LC says. It will be sooo worth it in the end.

When I first began breastfeeding, I noticed my milk was more translucent and thin when I ate really lowfat, healthy foods. Then, when I'd break down and have a cheeseburger, my milk was thicker and whiter. I know...sounds bad.

Since what you eat goes into your breastmilk, maybe do what I did and eat something with more substance/higher calories to make your breastmilk fattier. That may allow her gain some weight, and that way, you could primarily breastfeed.

My baby weighed 6/10 at birth, then lost weight when going home from hospital and weighed 5/15. Temporarily at each feeding, I breastfed first, then gave a small amount of formula that the Pedi told me too. He caught up in 2 weeks to gaining weight, and we quit supplementing b'c he was getting too much to eat and was a little chubby chunkers.

When you breastfeed, make sure you nurse long enough for your baby to get the higher fat content in milk which is at the end of a feeding. Generally in the beginning, if I nursed for 20 min on each side, our baby was fine with weightgain.

I nursed him every 2.5 hrs during the day, and at night woke every 3 hrs until he was a couple of months old, then we extended the night feeding to 5 hrs, but still 2.5 to 3 hrs during the day. It's really hard to know whose guide to follow b'c there are alot of opinions; you just have to pick one and see how beneficial it is for your baby and go with it if it works. Hopefully you have a great Pedi that can guide you as well also.

Yes, breastmilk is easier for their delicate systems to digest, but supplementing with formula to help baby catch up is sometimes necessary. And that's why we did it. Hopefully you won't have to supplement for too long. Hang in there!

If there is something in your diet that she can't digest well, it can create inflammation in the digestive tract and slow absorption of nutrients. I've seen this with many mothers. Some of the most common offenders are: casein (dairy) and gluten (wheat and many other grains). Soy is another common offender. I'd remove these from my diet and see if there is a change for her. If you remove dairy, be sure to add a calcium supplement with magnesium.

Hang in there. These days will truly pass too quickly!

My first child was told the same thing by the doctor, but I felt my mother's intuition was to breast feed primary. It's harder work for baby but definitely worth it. She still gained weight and the doc couldn't tell the difference. I never told him what order I used, I just always said "Yes we are supplementing". You may want to switch formulas and bottles. My newest child was really gassy on the Members Mark formula, so we switched to the Enfamil with Lipil and to the Avent bottles(same we had used for all our other children who weren't gassy) and I can definitely tell the difference.

The reason your milk supply wasn't adequate was due to her sleeping so much at nite. So, it can take a bit for the milk supply to rebuild, but I would absolutely follow the lactation consultant's advice as much as feasible. If you use formula, you will only decrease your milk supply further as your milk supply increases based on the baby demanding it and nite time nursing is key to a good milk supply. I followed the approach with my second son of nursing every two hours during the day and every 3 at nite for the first two months. Once she's back to consistently gaining weight you can let her go for one longer stretch at nite. And gradually increase the space between daytime nursings. But, I absolutely recommend nursing very, very frequently until at least two months and avoiding formula. If you do have to go the formula route, it will likely take two more months to gradually wean off that (that was the mistake I made with my first son).

Dear C.,
Way to hang in there!!!! We went through similar problems with weight gain. I had a low milk supply and difficulty getting her to latch on (I had to pump, nurse, pump at each feeding). I had to supplement with formula the first month too. I agree with the lactation consultant!!!! Breast milk first!!!!! It sounds like things are moving in the right direction just a bit slower than usual. We decided to stop formula all together at 1 month because my supply was getting better and she finally reached birth weight again. My daughter has reflux and gas which the formula did no favors towards! She is 6 months old now and the best nurser ever!!! She is still small (10%) but healthy in every other way!!! It can be exhausting at first but things will start to regulate themselves!!! Best wishes and blessings!

It looks like you've gotten a lot of good advice from some experienced mamas. I think I'd agree that the lactation consultant's advice is probably the best right now, unless you find that it doesn't help you and your baby. Everything I heard/read/did said offer breast first and nurse/pump often to encourage a good supply. That said, I wasn't able to nurse or pump enough to ever get a sufficient supply to fully feed my daughter. I had always told myself that it would be no big deal if I couldn't breastfeed, but then found that I was devastated when I "failed". I finally made the decision that nursing, supplementing, and pumping was taking too much of the time I wanted to spend actually being a mom (and occasionally leaving the house), and eventually transitioned to formula. The whole experience was the hardest thing I've ever done - marathon included! I encourage you to do your best, and have the courage to make the decision that's best for your baby and for you. Try not to listen too much to the people who offer extremes - "formula is just fine, just give in", or "breast is best, don't you dare give that baby a bottle". You've already done a great job by giving your baby breast milk thus far, and you'll be a wonderful mama either way. Find a group of moms to hang out with and build you up!

Both my children were allergic to the milk/dairy products I consumed. With the first, she was fussy, whined, cramped and wouldn't sleep for more than 10 minutes at a time during the day. (Most of my dairy consumption was usually in the morning and at noon.)

My son reacted just the opposite: he was sleepy all the time and would fall asleep when breast feeding.

My advice would be to take dairy products out of your diet as well as curtail the supplement and see what happens.

i had the same problem with my first child - she had only gained a couple of ounces by her 5th week - the doc said she was not dehydrated, just not gaining weight so he suggested supplementing with formula which then caused the problems you were mentioning as they don't digest it as well as breast milk - anyway, i read something when i had my second child that said all the "fatty" part of your milk is in the very back so to make sure to nurse and completely empty one breast and then switch to the other breast at the next feeding - no one had told me that at the time so i was unknowningly nursing on one side for 5 or 10 minutes and then on the other side for 5 or 10 minutes - which i think may have contributed to her not gaining weight by never getting the "fatty" part of the milk and only getting the watery part that comes out in the beginning which was keeping her hydrated but not giving her the calories she needed to gain weight - it also wasn't keeping her satisfied as she got older which was causing her to want to nurse every hour - if i had it to do over again, i would not have supplemented with formula unless absolutely necessary - i am praying for you :-)

I did not have any problems with my first son, but my second son was always hungry and wanted to nurse every two hours. My pediatrician recommended that I eat good fatty rich foods like nuts, avocados and olives. This was helpful (and I love all of those things.) I did suppliment with formula about once a day and contrary to what the lactation specialist warned, I did not dry up and the baby did not refuse the breast. After trying several formulas with my older son, I found Carnation Good Start to be the best and least likely to cause gas. But that was nine years ago, so I do not know if it is still the best or if there is something better.

My experience has been that pediatricians, in general, are not as committed to breast feeding as they are to weight gain and lactation specialists can be more committed to breast feeding than the health of the baby. The best advice may be to fall somewhere in between the two. I agree with the person that said you know your baby better than anyone, so do what feels right to you.

Dear C.,
I experienced a similar situation with my daughter. She became jaundice after she was born and the ped. ordered for her to have formula after I nursed her. (this was to keep her hydrated while she was under the uv lights) At her 2 week check up she lost weight so he told me I wasn't nursing her enough (I was feeding her every 2-2 1/2 hours) He said to increase my milk supply which in turn would increase her weight gain to nurse her every 1 1/2- 2 hours. Yikes!!! I'm sure you can imagine...I was thinking that's all I do is nurse her and she is on me ALL DAY LONG!!! (I too was taking fenugreek)He told me to wake her and get her good and alert to stretch her and talk to herand if she fell asleep do it again. He also suggested to nurse her for 10 minutes on each breast until she had been nursed on each one twice. This idea worked the best for her because she would get sleepy when I first tried to increase her feedings. As for night time I would let her sleep as long as 5 hours and then wake her if she hasn't already woke up. Trust your instincts...it sounds like you are doing what's right.
Anyhow, I felt like she was getting enough to eat and I knew most breast fed babies do drop from their birth weight, so I gave it a shot. It worked!
A friend also bought me wheat germ to put in my food. (you find it in the cereal aisle) I couldn't believe ow good it worked!
I'm telling you about what I experienced in hopes it helps you :)
I would also do what your lactation nurse says. Give her breat milk/nurse her and then give her formula. I feel that if she has the formula first she will decrease her nursing and you don't want that to happen. In my opinion I feel your milk is good and she is getting what she needs because you say she is not dehydrated and she is having plenty of wet and dirty diapers. Remember you are mom and the ped. works 'with' you. You're a good mom!
Blessings!
A.

I had trouble latching my first child and my doctor's were quick to try & switch me to formula & a bottle. My second son latched great, but it took him a while to start peeing while still at the hospital and it was the same story. For some reason I think doctor's always jump to this, becuase it's easier to gage how much they are getting. Honestly, I would stick with breastfeeding as much as possible, especially if she's latching great & having ample diapers. I would feed her every two hours during the day, but every three at night should be sufficient or you'll both be totally exhausted.

As for the testing. It sounds like she's doing fine. Really, I would go to another pedi and get a second opinion. Doctors want to be really careful with little ones, for good reason of course, but I would get another opinion before you start subjecting her to possibly intrusive tests.

Lastly, follow your instincts. We automatically want to do exactly as the doctors say, but you know your baby!!! Is she happy, eating well, and thriving...trust your gut.

And I always believe Breastmilk is Best! Good Luck, it sounds like you are doing all the right things.

I should begin by saying that I did not breast feed my 3 boys. I tried with the first two, but my breast milk just did not come in. My husband was a fan of breast feeding because of all the health benefits to the baby and I felt very guilty when I was unable to breast feed. (My husband was very understanding and was actually the first to suggest we go to formula.) When acquaintances would say "Oh, you're bottle feeing?" with that accusing look it did not make it any easier at first.

So to your question I would say that your pediatrician is probably less biased than the lactation consultant. Secondly, breast milk is only higher in calories if the baby is getting enough. I used Carnation Good Start which was very gentle on their stomachs. (You mentioned the gas issues.) And finally, you are still skin to skin when you hold the bottle for your baby....and dad can feed too, which can be very special for him.

Bottom line, you need to help your daughter put on weight...you are not selling out by not breast feeding and it sounds like that is what concerns you most.

You have gotten good advice from many young mothers here. I want to ask you how much are you eating and drinking? If you are not drinking sufficient WATER and some juices and not diet drinks and worrying about dieting your milk supply should become thick and full. I had to express after feedings to be comfortable and there was a layer of fat about 1/4 inch on the top of the milk in the bottle. You may need to change what you eat from spicy to regular seasoned or low seasoned foods. You may also have to begin to cook real food and not the convenience frozen dinners and such. What you eat is what your baby gets. Are you resting in between nursing? When baby sleeps, you sleep and not worrying about housework? A rested mother is a healthy mother who is not STRESSED out as a baby can pick up on that and not eat properly. Give yourself a break, you have just delivered a baby three weeks ago and you are also recovering from the birth. Go with your gut instincts and nurse one side at a time and nurse about 20 minutes on a side. My daughter was born 31 years ago in Canada (Quebec with language barrier) and they told myself and my roommate (both of us English speaking) to nurse 20 minutes per side to bring in the milk and that was about the 3rd day. I was leaking milk in the shower from the relaxed let down and encourged but full of milk. Of course I didn't get out of hospital for 5 days and that was a fight as the average stay was 10 days exception was a logger's wife who stayed 3 months after delivery (out in the real wilderness and medical services). I also had a prescription for lanolin to put on the breasts so that they would be soft and not crack which was great and you don't have to wash it off to nurse. Just make sure she has lots of wet diapers and pooping diapers and she will do fine. Get in touch with La Leche (sorry about sp) and talk with them. Breastfeeding is an art and it should be enjoyable on both sides.

To answer the comment on formula baby (my son adopted) it is good/bad. You have to monitor the amount and the type as well as what the child does. My son was lactose intolerant and we had to go to soy milk at 3 months. But that was the thing back then and he is 34.

Remember there is no perfect growth chart percentile just your own child's needs. You will do fine stop stressing and relax.

Bless your heart, I know this is such a hard thing. It is no wonder you are feeling indecisive. YOur insticts are telling you one thing (plus you are obviously an intelligent woman from what you wrote), but the scale and dr. are making you doubt yourself!!

First I would recommend that you join the yahoo group, For Babies Sake. It is a nursing support group. You can ask questions online or attend the Tuesday night meetings at 7pm. in South ARlington. The meetings are run by a lactation consultant, Mellanie Sheppherd, who is so awesome! BTW, Mellanie brings her digital baby scale each week.

Here is a great pro breastfeeding website and link about how to increase baby's weight gain. http://www.kellymom.com/babyconcerns/growth/weight-gain_i...

I know your dr. said, that you may have to do more tests if baby's weight doesn't come up, but you don't HAVE to do anything unless YOU feel it is in the best intrest of your baby. Most Pedi. are far from being as educated on breastfeeding as they should be, imo. Don't count your breastfeeding ability out yet!

Also, make sure you are drinking plenty of water.

Good, luck. Trust your mommy instincts! KNow you will make it through this stressful time and will be enjoying that sweet baby, without all this extra stress, sooner than you think!

C.,
I would continue to wake her every 3 hours and offer the breast first, once she has emptied the breast, offer formula. 90 minutes is way to long to be going through a feeding and you are both getting exhausted. I would say 30 minutes at the breast should be enough at this point and then formula. One way you can make sure how much she is getting is to pump a couple of feedings and bottle feed what you pump. I think if you are more rested and relaxed at feeding time, baby will be too!!!
Good luck with your feedings!!
N.

Hi C., I'm a father of 3 kids and 5 grandkids and we are foster parents to 7 kids ages range from 5 to 15 years of age. Our youngest daughter is breast feeding her daughter and our daughter eats the following to help with her milk production; wholegrain bread, rolled oats, corn on the cob or corn kernels, and when she has a sandwich she uses lettuce or lucerne sprouts as lucerne helps with enriching the milk when breastfeeding and make sure you drink plenty of water as this will help with milk production. Our daughter had problems at first as she worried that she wasn't doing things right and we encouraged her to keep going and she is still feeding bub and she turned 1 year old on March 30. Watch what you eat as some foods can cause you to give wind to baby so its try and see what upsets baby and try to stay calm as the baby will pick up on this and get upset as well. I hope this info helps you and I wish you all the success that you need. There is nothing wrong with using baby formulas, but a lot of them have extra iron or other things which seem good for the baby, but a lot of times they upset the baby's system as then can't take the extra irom or other additives. Ed

I would get a second opinion from another pediatrician. If I had done that with my first son, we wouldn't have gone through 2 years of senseless testing to find out what I was insisting all along-he is perfectly healthy! My son is now 3 1/2 and still very small for his age, but very smart, active, and happy. Weight/height gain is obviously not the only indicator of a healthy baby, but unfortunately it's about the only measureable indicator that pediatricians can rely on. You can refuse testing if you feel there's really nothing wrong. However, I would ask the pediatrician for detailed information on what the testing would consist of. For my son the first round was just blood work, which was not a big deal at all (as long as you get a phlebotomist who has experience with infants!). But if it's something more invasive, I would definitely get a second opinion before consenting. And if the feeding every 2 hours schedule isn't working due to the baby being too tired, try every 3 hours as the pedi suggested. The professionals may know babies in general, but they do not know your child like you do. Try their suggestions, but if it's not working for your baby, tweak it to fit her needs.

Trust your mama instincts. And pray!

Hmmm... I think the best advice I can offer would be to wait a couple more weeks and see. My lactation specialist said (and was right) that babies often hit little growth spurts where they would "cluster feed" (want to nurse many times close together) and then in a few days grow.

My daughter is a petite girl (15mo) but developing rapidly and is very healthy despite her little size. I would encourage you to continue to breast feed and make sure that you are encourage your babe to nurse a good while on each side (fore-milk and hinds-milk are different - the latter comes out second and is much more dense/fatty). For a while, I would only do one side at a feeding (so she could get a good dose of the second kind of milk) and alternate the next feeding (now I do both). Make sure your diet is full of good fats and nutritious food (avocados, fish, nuts, etc).

In my experience, breast milk has kept my daughter very healthy; she rarely gets sick or has tummy trouble. Hope that helps! I did have a friend who needed to supplement with formula when her baby got older (4months and still very little weight gain). But, give it time and do check with your doctor or, preferably, a midwife/lactation consultant.

This site is a valuable resource: http://askdrsears.com/html/2/T020100.asp

D.

I have a 3 week old baby also who weighed 7 lbs. 15 oz. when born. She lost weight in the hospital and then had already gained weight before we left. We didn't even have to go in for the 48 hr appointment. She went in at two weeks and weighs 8 lbs. 9 oz. She eats 4-6 ozs at every feeding. She is formula feed and I catch grief over that all the time. People need to realize that breastfeed babies are always going to be smarter or healthier... especially if a breastfeed babies is undernourished. If you want to keep breastfeeding, that is great. But don't be afraid of the formula. Your baby will survive if you have to feed her through a bottle.

I've had a similar situation with my third child. You have gotten great advice, plus here's more:
1. Leave your lo on long enough to get the fatty hindmilk.
2. Babies should not sleep through (defined as 5 hr stretch)the night until 4 months or 14 lbs (whichever is first).
3. Try the supplementer. You can even use human milk fortifier with your breastmilk to make it more calorie rich.
4. Jaundice, reflux, poor latch, and a short frendulum (tongue-tie) can also cause poor weight gain.
5. in the event you still need more milk production help, try more milk plus tincture.
6. Another possibility is food allergy/malabsorption-it can cause this too.
7. Get the tests so you can rule out things like CF.

I had this same thing happen to my daughter only it was after thrush.
Stop with the formula. The bottle is so much easier for them to drink from and their latch can get lazy. Not saying it will but it can. Also if she takes a pacifier stop with that as well. Co-sleep to make nursing much easier in the middle of the night. While I disagree with waking her at night, she is a little young to be going that long without nursing. Get a sling and carry her (nothing but a diaper and you topless) as much as possible.

Formula supplementation starts a downward spiral. If she's drinking from the bottle she needs to be nursing from you to maintain that supply. You can get the Medela SNS nurser and give her pumped BREASTMILK while she nurses. Breastmilk has more fat and calories than formula so it's better to supplement with!

Also try breast massages while nursing. If you have a good supply you can pump until you let down (normally about an ounce or two) and that will ensure that she gets the fatty hindmilk. Or, you can pump each breast AFTER she nurses to get the hindmilk and feed that to her.

C., If you want to continue breastfeeding always offer the breast first. And I would reccomend "block feeding" that is where you offer the same breast all day and pump from the other one so it does not dry up. Offering the same breast will allow your baby to get the hind milk (the fatty milk). All 4 of my children struggled to get back to their birth weight the first few weeks, but I never gave up and had a wonderful nursing relationship with them. Follow your instincts and keep an eye on the diapers. Good Luck, P.

DON'T STOP BREASTFEEDING!! :D
Ok. That said. I had the same issue with my son. Some babies just gain slowly. If your pediatrician isn't concerned, don't worry yourself, either. Also, usually drs are just happy that the baby is at their birth weight around 2 weeks, so it sounds like your babe is doing great. I think you may just be causing your self excess worry with weighing her so often. Also, She's only 3 weeks old. She doesn't need to have gained much weight by now. As long as she's healthy, that's all you need to be concerned over. It sounds like you're doing a great job. Stick to it, don't give up. I think many breastfeeding moms get caught in wanting to meet all the expectations set forth for formula fed babies, when you really don't need to worry about them. Just focus on keeping her healthy and happy and the weight gain will take care of itself.
(some background info)-- I nursed 2 kids past 1 yr and am wanting to become a lactation consultant in the near future...

Just a couple of ideas... you could try pumping and feeding from a bottle so that she is getting your breast milk AND you can see how much she is eating, you could also try giving her some poly vi sol infant vitamin drops daily to supplement the breast milk, or you could try mixing your breast milk half and half with forumula.

My daughter was born 3 weeks early weighing in at a whopping 5 lbs 16 oz. She didn't have trouble gaining weight but the dr had her on infant vitamin drops starting the day she came home. We also had to add a small amount of rice cereal to her bottles because she had reflux so bad, this may have helped with the weight gain too.

Wow. My DD was the same. She was born at 7 lb 14 oz. For me I had issues that whole first week trying to figure out the breast feeding. She was opposite of your daughter. I had soft nipples, so it was hard for her to latch on. Ultimately after a week, I started pumping only. And by her 2 week check-up she weighed 7 lbs 2 oz. So I can only imagine what she was weighing before. I pumped until she was 11 months. Hard work at times. But I was able to regulate how much she was getting. She was eating probably every 2-2.5 hours. We let her sleep through the night. And if not awake by 6 hours we woke her. We had to do weight checks every fews days and by the time she was 5 weeks she weighed 7 lbs 14 oz again. She gained slowly but steadily. I liked the pumping idea. I really wanted to nurse from the breast. But with pumping she's still getting all the good stuff! We only did formula when traveling. I really think relaxing a little too. Which is super hard I KNOW. But I know even now DD will react to me and how I feel. Best wishes!