Breastfed Baby - Not gaining enough weight

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Brissy

New member
My little girl was born 3.2kg. She is now 4 weeks old, has been exclusively breastfed and weights 3.5kg. My Paediatrician suggests that she has not gained sufficient weight (he advises that she should gain around 30g per day) and recommends that I express after breastfeeding then feed her with the expressed breast milk whilst she sleeps so she can also consume the higher calorie hindmilk. Given that my baby demands a feed between 10 to 15 times a day, 20 to 35 minutes each feed, the thought of having to express after nursing seems very troublesome. Has anyone tried expressing after each feed before? Does it really help to improve a baby's weight? Should I add a bottle of formula after breastfeeding her to increase her weight? Does anyone have any other suggestions to help her gain a little more weight?
 
Babies will eat as much or as little as they want. Do you offer the other breast when she has finished with one? Does she scream for more after a feed? If not, she is full. Babies tend to lose weight at the beginning and then begin to put more weight on. I wouldnt worry at this stage - as long as the weight is going up it's ok.
To start expressing breast milk is very tiring for the mum and the baby will have to learn how to suck from a bottle - which can work or not.

Dont fret - you are doing a great job.
 
Your doctor is right, although you must be putting in a great deal of effort in taking of your precious baby, a little extra for a month or so would make the difference.
Babies in the first month are too sleepy to realise if they are full or not, they will feed small amounts often if not full, but then they would be getting only foremilk. I used to pump after each feed to increase my supply and also to save the high calorie hindmilk. Alternatively I would pump for a while and then afterwards directly feed my daughter hindmilk from breast. Doesn't take enormous effort or time if you use a good pump in my opinion. Also are you eating healthy? You milk quality is highly dependant on your diet. When she will be 2 or 3 months old she will be able to feed longer herself so maybe pumping would not be necessary.
Actually the same thing has recently happened with my sister in the US. Her baby girl wasn't gaining enough weight in the first few weeks and the doctor recommended giving her high calorie formula (Sorry dont know the brand name but can ask). She is a working mum so she is doing both breastmilk and formula at the moment.
In my knowledge babies lose weight only in the first week or so and then steadily gain.
 
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Brissy, my son was also born 3.23 kg, was breastfed and has never gained much weight from birth. I had heard the 30g per day number too and was really worried. After talking to several professionals(I trust my pediatrician but you know its one of those things you need more than one reassurance) They all told me the same thing- Your baby is fine. He should be steady on his percentile curve, wetting nappies 8-10 times a day- those are some of the best indicators that the baby is thriving. So, although he is still under 10 kg at 15 months now- he is a very active toddler. He is also a good eater, infact eats more than several heavier babies I know and yet has doggedly stayed on the 25th percentile curve AND is meeting all his developmental milestones really well.

Don't worry!
 
If it were me, I would be quite worried if my baby only gained 300gm in the first month. Although each baby is different, there still is a norm and expected weight gain. If, after a month of your already hard work, your baby still isn`t gaining well, you should think about how to really help her. I wonder if a visit with a lactation consultant would be helpful to see how your baby was drinking and just how everything looked in general. 15 times a day is a lot to be feeding and it sounds really tiresome, so I can understand how to added work of all that pumping doesn`t exactly excite you. If you`re not against formula (I was at the beginning but luckily my baby gained really well), then that seems to be a surefire way for babies to put on the pounds.
You have options, it`s just a matter of deciding which way to go. But the most important thing is that your daughter starts to gain more weight.
 
I would second the reccomendation to see a lactation consultant. MY baby also had problems gaining weight in the first few weeks, and I was very against formula, but I learned some tips for keeping my baby eating longer. Pumping also helped increase my milk supply, which we needed since he wasn't sucking much. I also did what geobaby said and pumped for a few minutes before nursing, so that my son got the hindmilk himself. These things may or may not help you but I think a lactation specialist can be very helpful!
 
When discussing weight gain in the first month it is important to measure the gain from the baby's lowest weight and not the birth weight. If the baby lost more weight than normal in the first week then they have more to put back on!

From the lowest weight we are usually looking for a average gain of 170 gram a week (25 grams a day). If the baby isn't managing this then your breastfeeding needs to be assessed by someone who can watch you breastfeed. In Hong Kong this would usually be a lactation consultant or La Leche League Leader.

A list of midwives/lactation consultants is available at Hong Kong - Midwives

And a list of LLL Leaders at LLL-HK Home Page

Best wishes,
SARAH
 
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