Childhood Diseases

Posted by: Almarie | 2012-12-11


Not at birth weight at almost 5 weeks

Hi , my milk is disapearing I use to express about 120ml after a feed in my first week,now I only get about 20 ml hour after feed, I do use espiride and drink all my preggie vits and extra calcuim and omega 3 as well as fenugreek and vit B which the clinic sister gave me for energy levels,my fluid intake is about 3-4lt per day, my baby has wwet and soiled nappies and is not a difficult baby he seems happy and fed,but it is worring seeing that I dont know if he is getting enougth, we are struggeling to get him onto birth weight and after 4 weeks he is still far from birth weight, bw-4.9kg at discharge 4.5kg and last week wednesday only at 4.4kg, we did notice that he had a tongue tie and it was clipped on thursday.I dont feel a difference in his latching, it feels the same. pls I am starting to feel very depressed as this is my 3 baby I am breastfeeding and I have never had a problem before, 5-8 wet nappies and urine is yellow to light yellow not dark almost every nappy is soiled mustard colour texture is more like gel and has like white lumps, I also feed on demand and I am also the dummy most of he time.Should I sart to give formula or just wait <  my secound son struggledwith milk and soya alleries.

Expert's Reply



I see that our regular forum members have given you excellent advice. From your description your baby seems to be getting more than enough breastmilk.His birthweight may not have been measured with complete accuracy and may have been closer to 4.5kg. Clipping a tongue tie is usually not necessary and will definitely affect his feeding for a few days.Follow the advice of our forum members.

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user comments


Posted by: Purple | 2012-12-12

Don''t worry about weighing before and after feeds, this is not actually an indication of how much baby has taken in.

Whether baby has a wee or poo on board will impact this, and also, see for yourself - weigh yourself, drink a litre of water and weigh yourself again - you''re not 1kg heavier - it has no impact at all -even on a sensitive electronic scale.

Also, baby only takes in 60-120ml per feed (this is a constant from about age 1 month until about 6 months when baby starts on solids and takes in less milk) and a nurse who mainly sees formula fed babies and has a sensitive electronic scale and weighs baby before and after a feed and baby had just emptied bowels just before the first weigh is going to freak out when she doesn''t see 200g change in weight because a formula fed baby takes in far larger amounts. With breastmilk a little goes a long way - and its used more efficiently as baby gets older (which is also why baby has fewer soiled nappies from around 6 weeks - as there is less waste from the milk).

Reply to Purple
Posted by: Purple | 2012-12-12


How much you express doesn''t indicate how much milk you have - so please don''t worry. Expressing between feeds doesn''t usually give much milk - most mothers must express 3 or 4 times in a day to get enough milk to leave one container of milk if they have to leave baby. Also, in the early weeks, milk is produced in high volumes as production is hormonally driven, and from around week 6 true supply and demand is more established, so you aren''t just producing regardless of what baby drinks - but only producing what baby drinks (or you express out). Whether anything comes out for the pump or not depends on whether you can get a let down for the pump or not - and its a cold mechanical item - not a warm soft dlightfully smelling baby. Relaxing and deep breathing can help with a let down, and it also helps to feed baby on one side and express on the other (the breasts don''t actually ever empty so even if you feed baby on the breast you have just expressed and no more milk has pumped out, baby will still be able to have a full feed.)

By this age your baby should have regained birthweight though, so this is concerning even if baby is having sufficient wet and soiled nappies.

Feed baby as frequently as you can get baby to feed - you can wake baby when baby is in a light sleep - so when baby is fluttering eye lids and moving arms, baby will wake up if you remove blankets, undress baby and offer the breast. Switch nursing can help to increase how much baby takes in - so as soon as swallowing stops, swap baby to the other side and keep on swapping side to side until there is just no more swallowing. It also helps to get more into baby if you squeeze your breasts while feeding (breast compression) Use a syringe or cup to give baby any expressed milk you have after you have fed in this way if baby is not satisfied.
Try your best to feed baby at least every 2 hours - and more often if you can.
The more often baby feeds the more mlik baby gets.
If you don''t have enough expressed milk to give baby after feeds to satisfy baby - then you will need to give baby some formula - the first rule is " feed the baby" .

Immediately after feeds - as many of the feeds as you possibly can, express for 3-5 minutes on each side. You probably won''t get any milk, especially not at first, but it helps to stimulate more supply. However, baby at the breast stimulates supply better, so if baby is fussing, put baby to the breast and skp that expressing session. Aim to express at least 8-10 times per day.

At this age, many babies start cluster feedign in the evenings - from about 4 or 5 pm until about 10 or 11 pm - they feed almost constantly. This is normal. Feed and feed and feed as this lets baby take in lots of milk. As you describe, many babies then have a longer sleep after that. However, while you are struggling with weight gain - its best to wake baby for a feed during this time to get some extra milk in then.

Don''t let baby go without a feed for longer than 3 hours even at night until baby is gaining weight at a good rate and the clinic sister and paediatrician are happy. Preferably feed every 90 minutes to 2 hours.

If you''re using a dummy it is a good idea to stop for a while at least as in a low gaining baby, it means baby is spending time sucking the dummy instead of the breast and this can contribute to low weight gain. I see you say that you are using your breasts as a mothering tool - allowoing baby to suck for comfort - this is great, it helps keep milk supply high.

Its fine to take vitamin B12 however this won''t affect your milk supply - just give you more energy. Also, if you are vegan, it is important that you do take it, but for mothers eating a variety of foods you''ll be getting it in your diet anyway so its not completely necessary to take it.

Extra fluids won''t impact your milk supply - just drink to thirst - milk is made from your blood not from fluids in your stomach. Breastfeeding does make you thirsty though, so you probably will drink more than usual anyway.

Please don''t worry about things flavouring your milk - everything you eat and drink flavours your milk - this is a good thing - when you start baby on solids, baby is already used to things tasting different at every meal :)

Was the tongue tie causing a problem with latching? It doesn''t always do so, but when it does, then clipping it usually produces a noticeable diference - as in it no longer hurts and baby is able to suck better and transfer milk better.

You can tell baby is latched well if it doesn''t hurt, and baby''s bottom lilp is flanged out over their chin and their head is not turned (turn your head and swallow to see why). There is a position called biologocial nurturing which is great for sorting out problem latches - you lay back on pillows with baby at the breast, tummy against tummy and legs towards your legs.

Usually when a tongue tie is clipped, you need to do some finger excercises with baby''s tongue to give them a help getting the sucking motion going well - as especially if the tie has been very tight they have been unable to suck efficiently so far. The ENT or maxilofacial surgeon who did the clip should have shown you some excercises, perhaps phone and ask them. You can start by laying baby across your lap face down and then gently inserting a clean finger into their mouth and gently moving it until they are sucking nicely on your fingers, once they feel the comfort of the suck they should hopefully use this motion at the breast.

A tongue tie can cause baby to transfer insufficient milk at the breast and may well be a cause of low weight gain. Working on feeding frequency should help baby to gain weight again.

Your baby sounds well hydrated though which is great, so baby is definitely getting something.

You may benefit from seeing an international board certified lactation consultant for some help. They do charge. La Leche League may also be able to offer you some good help. Try to phone a leader (there are leaders all around the country) and perhaps see one who can assess how baby is feeding and help you. (they don''t charge for help). If the leader can''t help you they will refer you to an IBCLC.

wishing you all the best. It is upsetting when we think we have this breastfeeding thing sorted and a new baby has unexpected problems. Things will come right, even if you are having a temporary struggle. Many women experience problems with breastfeeding in the early days or at some point, but things can and do come right with help.

Reply to Purple
Posted by: Racoon | 2012-12-12

I''m not sure about the Vit B, I think it can cause a flavour to the breastmilk, but it doesn''t seem as though he is unwilling to nurse? Also, it might take some time for him to put on weight after having his tongue clipping? have you weighed him again this week?

Maybe Purple will answer soon.

Reply to Racoon
Posted by: Almarie | 2012-12-12

No but he does sleep 5 hours(10pm-4am) at night seems that the milk keeps him for that long

Reply to Almarie
Posted by: Racoon | 2012-12-11

Have they weighed him before and after a feed to see how much he is drinking?

Reply to Racoon

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