# Help! 5 week old not gaining weight.....



## Sassafrass (Mar 3, 2004)

My almost 5 week old has only gained 2 ounces in 2 weeks. She was 8.2 at birth, down to 7.11 and back up to 8.2 at 8 days old. Was 8.10 at 16 days, and at 4 weeks, 2 days, she was only 8.12. (Same scale all 3 times) She did grow 2 inches in length and an inch in head circumference. She has about 10 wet diapers a day and 4-6 good poopies a day. Her color is good, she looks healthy, just thin. She holds her head up from my chest, or can turn it from side to side when laying on her belly. We have had thrush, but after a week of treatment that seems to be getting much better. She spits up a whole lot....she is colicy and cries a whole bunch.......she does sleep for a 4-6hr stetch at night, though. During the day, she nurses constantly. If she is not nursing, she is crying. When I say constantly, mean 45 minutes on, crying while I go potty or try to get something to eat quickly, then repeat all day long. She is never content. In the evenings, she pulls away from the breast a lot, like she wants to suck, but not eat. In frustration, I gave her 2 ounces of formula this evening.....she sucked it down, nursed for another half hour, and then spit a whole bunch back up. The only other time she has had a bottle, was at the hospital a few hours after birth (homebirth transfer for funny breathing) and maybe one other time a few hours later. I don't think she is nipple confused........she seems to have a pretty good latch(according to LC and LLLL), I have not had any bleeding nipples like I did with my first 2, but I have had pain that is due to thrush. When we saw the LC, she called here a "leisurely diner" in that she takes quite a while to eat. Her poopies are green, mucousy a couple of times a day, then they are back to yellow, watery seedy. She is very explosive when she goes, but she doesn't seem to be particularly gassy. I don't think I have a strong let-down, because although it is painful for me, I don't spray or anything, just drip.......I really only leak in the mornings, or when she goes for more than a couple hours between feeding. Because of the spit-up, low weight gain and general fussiness, I thought we might be dealing with reflux......the doctor agreed and gave us a script for zantac and reglan.

So, what is our problem? Should I be concerned about my milk supply? Is this an issue that needs to be addresses by an LC sooner rather than later? With my 3rd child, I thought I knew what I was doing, but obviously I don't!
Please advise.......it is so frustrating to be nursing constantly and not see any weight gain. Help!


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## wombat (Nov 3, 2002)

As I was reading your post, I was thinking sounds like reflux. Glad your doctor gave you a script. I'd try the meds and see if it helps. We didn't treat my dd for silent reflux until 6 mo cause I was busy eliminating other causes and I could have kicked myself for it. The Zantac was no miracle cure but I did notice an improvement in dd's nursing. More info here on poor weight gain and reflux:

http://www.kellymom.com/babyconcerns..._increase.html

If the reflux has resulted in poor weight gain then it could be your supply has dropped a bit. You could pump after a couple of feedings or add in a pumping session when baby is sleeping and taking some fenugreek or other herbs to help milk supply. Lots of info on that on kellymom.

Hope it improves for you all from here on.


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## USAmma (Nov 29, 2001)

I'm sorry you are so worried about her. At least she's getting lots of love!









There were a few things that were red flags to me in your post:

_She spits up a whole lot....she is colicy and cries a whole bunch.......she does sleep for a 4-6hr stetch at night, though. During the day, she nurses constantly. If she is not nursing, she is crying. When I say constantly, mean 45 minutes on, crying while I go potty or try to get something to eat quickly, then repeat all day long. She is never content. In the evenings, she pulls away from the breast a lot, like she wants to suck, but not eat._

and also . . .

_Her poopies are green, mucousy a couple of times a day, then they are back to yellow, watery seedy. She is very explosive when she goes, but she doesn't seem to be particularly gassy._

My baby had the same exact behavior and she did end up having very severe reflux, landed her in the hospital at 3 mos. old with failure to thrive. She is probably hurting because of the acid, and when she swallows it hurts so she doesn't feed for very long, just long enough to stop the hunger pains, but not enough to really get full and grow.

The other clue to me was the green mucously stools. This would indicate that she's getting mostly foremilk since she doesn't nurse long enough to get the fatty hindmilk needed for growth. The foremilk will make green stools with mucous, and will also make a baby gassy. You might want to try nursing only on one breast for a two hour period so even if she pulls off and then nurses again 20 min. later she may start to pull some of that hindmilk out of the breast. Then after 2 hours or so switch to the other breast.

Zantac did not work for my baby. It's a standard thing that's given to babies with reflux because it has the least side effects, but it's not that effective in severe cases. Secondly, it takes about a week to work (all antacids too). A faster solution is to give her 1/4 teaspoon Maloxx Max before a feeding to soothe her throat. I'll bet she'll eat better! Don't use regular Mylanta or Maloxx because it has some zinc something in it that over time will cause brittle bones. It's okay to use here and there though. If the Maloxx Max is working and the Zantac isn't after a week, ask for Prevacid or Prilosec instead. You have to get a handle on this before she develops a feeding aversion. My baby eats part time by tube because the reflux was not treated well until it got really, really bad and now she associates eating with pain even though the pain has been taken care of.

About Reglan-- it's used to empty the stomach faster and stimulate the appetite. It's also a somewhat controversial drug and should be used with caution. It makes some babies very fussy, dizzy, and sleepy. It can also cause muscle spasms such as arm waving and head nodding (which can also be normal for a baby your age so it's hard to tell if the Reglan is doing it or she's just being a baby). I use Reglan on my dd with limited success. Sometimes it works better than other times. I only use it on really bad eating days before I give up and tube feed her instead if it doesn't work.

One more thought-- see if you can't cut out some of the common allergens from your diet for 2 weeks to see if that makes her happier: dairy, soy, nuts, etc. I'm sure there's a list out there to follow that another mommy here can provide.

I hope this helps. Please, if your baby does not seem happier in a week, insist on a referral to a Pediatric GI specialist. My peds just kept telling me it was colic, etc.

Darshani


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## USAmma (Nov 29, 2001)

double post


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## USAmma (Nov 29, 2001)

How are you doing? I was hoping to hear back from you, you sounded so worried in your post. Please check in when you have a chance, okay?

Darshani


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## Sassafrass (Mar 3, 2004)

Thanks so much for thinking of us! Things seem to be improving.....she is starting to act more like a normal baby, and not scream all the time. She is still spitting, though, but she really seems to be feeling better. As I type, she is taking a nap.....for almost 3 hrs! This has never happened during the day, but over the past few days, she has began to take a couple of long naps, vs. the sleep for 5 minutes and wake up scraming variety that we had been getting. I really think the medicine is helping......I am still concerned about her weight, so I am taking her in for a weight check in the morning......I know I have plenty of milk (boobs are always full and leaking is she hasn't nursed in a couple of hours, and I generally wake up engorged in the mornings) So if she hasn't gained any weight at the weight check, I am gonna make an appointment with the LC for Monday. But I keep thinking that she is doing okay, 'cause she has plenty of wet and poopy dipes. She also seems to be nursing a bit more efficiently or maybe I should say actively, rather than taking so many "breaks" while eating. My oldest was very small, as well, so I am wondering if some of it is hereditary? She did gain weight normally at first though, just kind of stopped when she got to be about 5 months...she was FF'ed, so I know she was getting enough to eat, just small. Anyway, I am still concerned, but a little less worried than I was before.


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## DaryLLL (Aug 12, 2002)

I think she may have a foremilk/hindmilk imbalance, which may have caused the discomfort and crying. I get this by your description of her poops and
eating pattern. Please read this (maybe it isn't reflux and you don't need drugs):

http://www.kellymom.com/bf/supply/fast-letdown.html

Try to only let baby have one breast only for 3 hrs, no matter how often she feeds in that time. She may not be able to comfort nurse. She may be getting too much foremilk (high in lactose which can be hard to digest), low in fatty hindmilk (which can cause slow weight gain and green or loose poos).

Usually over-abundant supply (with too much foremilk) is accompanied by overactive letdown, but not always.


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## gokiamma (Feb 11, 2004)

Hi,

We had a similar issue with my DS when he was around 3 weeks old.He would keep crying and want to feed all day long and still no wt gain. I was not giving him any formual. At the Ped's office- The Ped tried to give him some 3 oz of formula which he gulped down.. She said it is an indication that he is hungry and that my supply is not enough. Also possibly because he is getting only the foremilk. She suggested that I do the following:

1)Feed her for some time--say 10 mins on each side and check if there is milk still coming up
2)Pump soon after a feeding - if anything comes out give that to her in a bottle else make some 2 oz of formula and give it to her.

I ofcourse was dead against the idea of this formula -- but we tried it for a week (may be not with every feeding) but he would take some 4-6 oz of formula in a complete day. His wt gain improved and meanwhile I continued to feed/pump for him. After 2 months I was able to reduce his formula intake to zilch..

See if this helps.
Good luck
Deepa


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## Sassafrass (Mar 3, 2004)

Well, I thought I would update again......she gained 9 oz in 9 days and is up to 9lbs 5oz......she will be 6 weeks tomorrow. I am so happy! She hasn't had any green diapers in almost a week now, and while she is still spitting up, she's so much happier......I have been able to set her in the bouncy or swing for a few minutes in the morning to get breakfast for me and the older kids.....amazing. Also, I have discovered that if I swaddle her and lay her down after she is asleep, she will generally sleep for about an hour or so. I am just amazed at the difference in my baby from a week ago until now. I still hold her or keep her in the sling most of the time, but being able to put her down to use the bathroom, tend to an older child, etc. without her screaming is a huge lifesaver right now. I am also cutting out dairy starting today, so hopefully that will further improve the situation. Now, if I can get this thrush under control, we will be A-OK. I cured it once then had to be on antibiotics for a bladder infection that did not respond to home treatment after a week, so here we are again.


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## DaryLLL (Aug 12, 2002)

Sassa,

So glad to get the good upate!

You sound rundown tho. Thrush and a UTI? Are you eating and drinking well? Napping? Taking vitamins? How about some echinacea?

Anyone helping you with meals and housework? I hope so. You have had a rough time of it. Get some help if you can.

Best wishes--


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