Anyone's babies NOT able to drain your breasts as well as the pump?

I was so, so excited when I got both babies nursing full-time (minus a bottle at night and in the morning) starting last week. So glad to not have to pump after every session and give top ups or, in DD's case, give bottles only.

Both babies have struggled to gain weight since birth, especially DS. So until last week I was nursing him 10 min on each side and then giving a 70ml top up after each feed, then pumping for DD. She would get 100ish mls at each feed. Last weight check two weeks ago showed a marked improvement in weight gain, obviously corresponding with the new feeding regimen we'd established a couple weeks prior. Since I keep reading that babies are far more efficient than a pump at emptying the breast, I didn't think to worry when I stopped giving the top up/full bottle. I figured they'd empty the breasts and my supply would be totally sufficient because it has been for over a month.

Not so. Weight check today revealed that DS has gained next to nothing in two weeks. DD's weight gain has slowed down dramatically, though she still gained more than DS. I could cry, this is so disheartening. Again, I've been exclusively BFing, hardly pumping for a week now. This slowing of weight gain cannot be coincidental.

So do I have to go back to pumping after every feed and doing top ups for both babies? DS has been BFing far longer than DD; I would think he'd be really good at it by now. His latch is better than hers. He's had tons of practice. So how is he not gaining still? How is she still gaining more than him, even being relatively new to BFing and still having a less-than-stellar latch? He still has wet nappies, poops several times per day, and seems to be satisfied after feeds. Is it possible he's actually getting enough but his body, for whatever reason, isn't metabolizing the milk properly?

I want to make sure it's understood that for a month, both gained pretty well before I stopped most of the bottles. I have PLENTY OF MILK - this is not something I feel a nursing marathon is going to help as I don't need a boost in my supply. When I pump and give bottles, the babies gain weight. When I breastfeed, the babies don't gain weight. It's as simple as that. Why???

I don't know what I'm going to do if I have to go back to pumping 7-8x/day. I was so enjoying having time to actually spend with the babies after feeds and before naps.

 

You said your son gained "next to nothing" - do you remember how much exactly? Also, I'm assuming it's yor doc that's concerned about their weight gain. Is your doc following weight gain guidelines for breastfed babies or for formula fed babies? They are different.

Are they always weighed on the same scale? Scales can be different from each other by up to a pound & when every ounce counts, it makes a huge difference.

Are you nursing both babes on demand? Or more on a routine/schedule? For the next little bit, try nursing yor babes any time they fuss, squeak, yawn, blink, do anything at all that could indicate they might be interested in nursing. Offer boob all day long! Think of it as allowing your babes to graze all day. Plus, frequent feeding means babes will have access to more of the fatty hindmilk more often. The tricky thing about breast feeding is that you can't force a baby to finish your breast, but you can force them to finish a bottle, which leads to over feeding but looks impressive in the weight gain department.

 

This is extremely important. My girls got weighed on different scales a week apart when they were really little and it looked like they had lost weight. When we went back to the first scale a week later, the weight "gain" was considerably more than they actually gained in a week.

Also, do you remember the percentages for their weights as opposed to the actual numbers? I have found that it's more productive to figure out which curve they are on and see whether they are sticking to that curve.

Also, I have oversupply so my girls rarely drain a whole breast but are fully and happy at the end of the feeding.

 

I third the scale issue!! Make sure it's the same scale! That happened to me too with my older daughter, where she had 'lost' weight but it was a crappy scale.

Your babies are 3 months old, right? They aren't THAT tiny anymore and especially if they are happy, pooping, etc, I would give it another week of them self-regulating how much they BF (ie feed them on demand) and reweigh before panicking.

 

I was going to suggest feeding them more often rather than on a schedule as well. I know you've been told to feed them every 3 hours, I think (or was it 2), but none of my babies have ever gone more than 2 hours without nursing and the twins, in particular, will nurse every hour for large chunks of the day still when I'm home on weekends (I don't know if you remember, but I was nursing them almost non-stop during the day for the first 3 months--literally every 30-60 minutes and often tandem nursing).

I don't know if that will help, but most exclusively breastfed babies don't go 3 hour stretches until they are much older (my first didn't go 3 hours until he was 6 months old and he gained on the low end of normal).

I really wish this was easier for you. I don't really know what to suggest at all since I'm not sure exactly how things are playing out right now with times of feedings, etc. Big hugs.

 

Definitely check into the scale! I also agree with feeding on demand. At this age we don't expect them to gain any more than 20g (2/3 oz) a day, and it can be normal for them to gain as little as 4 oz a week.

Other thoughts: have them checked by a LC for posterior tongue tie. This is not as obvious as some tongue ties but causes babies to have a latch where they cannot cup their tongue around the breast and don't receive enough milk. They get enough to stay hydrated but tire out from all the work in removing the milk so they fall asleep and appear content. It is something that is easily fixable at this age and could mean the difference in your nursing relationship.

 

Breast compressions while nursing can be helpful- its almost like hand expressing into their mouths. It helps deliver more milk to them, with less work on their part. Absolutely feed on demand which for most babies, they feed 8-12x per 24 hours if not more.

A good IBCLC visit is invaluable and money well spent!