Premie weight gain...is my supply tanking?

[L4hope]

Hello all, I keep forgetting about this forum and who better to bounce things off of than other premie moms! My little guy was born at 33w6d via csection under general anesthesia due to preeclampsia and HELLP syndrome. He was 4lbs15oz and 18inches. T had minimal complications..feeding tube, jaundice, bradys and maintaining body heat. After 15 days he was all set to come home. I have been exclusively breast feeding him with one bottle of expressed milk at night. At first he was getting fortifier in the bottle, but after a week home he started refusing bottles with the fortifier. Took the fortifier out and he took the bottle no problem. Thankfully he continued to gain weight well even an ounce a day for a few weeks straight. Everything looked good at his 4month appointment, he weighed 9lbs13oz and 23 1/4in. Now for the past week and a half he has only gained an ounce! I just don't understand what could have changed with my supply. I can still pump a pretty good amount so I'm frustrated and confused. Anyone have any insight?

 

[sunnylove]

I'm torn on this subject because I'm going through the same thing. LO's milk was fortified for a new weeks in the NICU but other than that he's only had my breastmilk and he gained normally on that. Once I switched him over to exclusively breastfeeding at the breast, no bottle feeding, a meeting with the lactation consultant proved that he was taking a good amount of milk (more than we were even feeding him in the bottle) but he slowly stopped gaining weight. Within 30 days, he gained literally nothing and he is 7 months (4 months adjusted).

So the doctor told me I needed to supplement with formula. I don't fortify my breastmilk because iron in fortifiers kill the antibiotics in breastmilk. I started giving him a small amount of formula after a nursing session (if he was fussy afterwards) and in the 2 weeks of doing that, he gained 1 pound!

The reason I'm torn is that it is essential (in my opinion) for a preemie to get breastmilk. My LO hasn't been sick a day in his life and I attribute that to getting breastmilk. Some babies hit plateaus in their growth, preemie or full-term and I think it's normal. Most babies don't get weighed ALL the time like preemies, and I know hitting a weight plateau is normal in full-term babies too. So your LO gaining an ounce a week doesn't seem like it warrants fortifying or supplementing yet.

 

[misspriss]

Some babies hit plateaus in their growth, preemie or full-term and I think it's normal. Most babies don't get weighed ALL the time like preemies, and I know hitting a weight plateau is normal in full-term babies too. So your LO gaining an ounce a week doesn't seem like it warrants fortifying or supplementing yet.

^^ WSS

This is why they normally don't weigh babies from week to week. In fact, after we got out of the hospital, I only had LO weighed twice outside of his regularly scheduled appointments (2m, 4m, 6m, 9m). Is you doctor worried about his weight gain? I seem to remember a doctor or nurse in the NICU (or maybe it was the LC?) warning me NOT to weigh so often after we go out of the hospital, because it would make me worry too much.

Also, if you can pump fine, it's probably not your supply! Pumping is not as effective as nursing, so pumping output is usually the first to go with supply issues.

 

[L4hope]

Thanks Sunnylove and misspriss. I guess it's just me being a worrier and weighing him too often. At first the pediatrician was concerned with his weight gain when it was only about 1/2oz a day but when I talked to the NICU LC she said it was good and ped forget that premies are different. So I guess since then we weigh him at home and wanting to make sure he is getting what he needs. He's not a demanding baby so I was getting nervous that I'm not giving him enough. Guess ill have to see how he does over the next couple weeks.

 

[Simonecah]

I have to agree that regular peds can often forget that preemie growth will be different. Ours gained half an ounce every day for the first few weeks. Then he slowly started gaining an ounce a day and we haven't looked back since. He hasn't been officially weighed since his last synagis shot a month ago and I am eager to see what his 6 month weigh in will be, but I am not too worried. It sounds like your LO is doing great! Just stick with the pumping and nursing and you will be fine! Let LO struggle a little too, it will tell your body to make more and build your supply. Don't be too quick to supplement.

 

[lanaross]

I am going to be in minority but my supply did tank after 3,5 months. from 3,5 to 5 months he barely gained anything (about a pound in total). He was gaining 3-4 pounds every month and then it was a huge very noticeable drop, not just a minor slide. I don't know what's really happening with my body aside from my thyroid issues, but I had the same happening with my daughter around 2,5 months for her, I jumped to supplementing with her right away although she was full term. With him I kept at it until it was just impossible not to notice that he is genuinely hungry and it was not a growth spurt. So my ped urged me to supplement and start him on solids, I barely supplement but I am noticing the difference in him and he is back to pooping once a day again. I also weighted him yesterday with our home scale and it looks like he's gained a pound last two weeks, so getting back on track.

 

[sunnylove]

Lana, a 3-4 pound weight gain every month is a TON of weight! (I am telling you this is a good thing ) Most babies only gain, or "should" gain 1-2 pounds a month. So if he is gaining double the norm, and then suddenly has a lull in his weight gain, I would assume it's normal as he's possibly just "leveling out"? IDK, just an observation.

 

[L4hope]

Wow Lana 3-4lbs is definitely a lot! I was happy with 2lbs in a month

Update for me: This last week he gained 2oz so I'm feeling a little better. I think he's just going to be a slow gainer. But he does seem to be growing a lot in length too. I know I need to just relax cuz he's happy baby.

 

[lanaross]

no guys it's a great thing, I know it was and then at three months it stopped so dramatically that I was completely lost, I'd understand if he started slowing down but that was not the case. He suddenly started gaining 4 oz per week if that and was unhappy and looking for food (and that's my primary concern) - like pulling on and off and screaming and when I checked nothing was coming out anymore. He's back to his real self now that I started to supplement, really just a little about 5 oz a day, to not starve him.

L4hope-- did you talk to your doctor? I know I can't pump a good amount (can do 5 oz in the morning and then barely 3 oz after which is NOT the amount of milk a five months old takes) so maybe your case is different? That said if your LO is happy and gaining, I wouldn't supplement and just continue on like you are. Our pediatrician recommended to feed 8 times a day and see if it helps (it didn't) and then supplementing with formula/solids. Solids didn't go so well, but formula, alas, did.

 

[sunnylove]

That's the thing with pumping though - it's not a good indication of how much a baby actually consumes. It's only an indication of how much you can pump. A baby is much better at emptying the breast than a pump.