Feeding issues

A little background: We had been seeing a Family Practice doc and then I decided we needed to start seeing a Ped (even though we have to drive an hour to do this). So we started seeing one two weeks ago. He was concerned that the girls weren't gaining enough weight, so we modified our feeding plan which includes 8 oz. of fortified EBM per day. He likes to see an average gain of an ounce a day. He checked their weights a week later and K had gained 13 oz. and A had gained 11 oz. He was very pleased with the gain and said we should continue with the plan and come back in 4 weeks for our 4 mo. check up.

The girls are taking 3-4 (usually 4) oz. of EBM every 2.5-3 hours with one 5 hour stretch at night. Their weight gain was not nearly as great this week. I have a breastfeeding scale, so I checked after baths last night. Since Tues., K is only up 6 oz. (which is o.k. I think) , but A is only up 2 oz. To make matters worse, A has not been eating well for the past two days. It's been a struggle to get her to take 2 ounces at a time and it usually takes her a good half hour to take it. On Sat. night (early Sun.) her diaper was actually dry when we woke her up to eat after her 5 hour stretch of sleep. She's had wet diapers every change since then, but only one has been really soaking. She hasn't had a poopy diaper, but it's normal for her to go days and days without one. She is having normal amounts of awake time and seems happy and content when she is awake. Should I call the Ped about the sudden change in eating habits or should I wait it out for a couple of days and see how things go?

 

How many nursing sessions a day do you have or are you just feeding them EBM fortified? How many days has she eaten less? If she still has fewer wet diapers I would call the pedi (babies can get dehydrated pretty quickly). GL!

 

Haven't been nursing at all because I can't get them to take more than 30-50 ml in 30 minutes by breast.

 

:hug99: I remember those early days when the girls were so hard to feed. :hug99:

Keep offering her bottles and if she still is taking less and producing fewer wet diapers than normal, call the pedi and see what to do next. Is she spitting up? Does she seem uncomfortable? Does she have reflux?

 

Beth,

I agree with what Leighann said, and also wanted to mention that perhaps it's time to switch to a faster flow nipple? Both of my daughters were on EBM and started eating less around 3 months. When we switched to the level 2 nipple, they went back to drinking their full bottles in a shorter amount of time.

Good luck!

 

I completely agree with the faster flow nipple. DS started refusing around 3 months and we switched him. DD is still on the slower flow and takes it in as much time as DS on the med flow.

Also, have you noticed that she takes less at certain times/day? I ask this bc my DS will not eat much in the morning and then will eat huge amounts in the evening. During the morning we have to offer the bottle, let him take as much as we can and then keep offerring it every hour or so. They as the day wears on he takes more at once with less time in between bottles until evening when he does his form of cluster feeding eating 5-6 oz after a couple hours and then another 4 oz. DD will eat b/w 3-4 oz all day long every 3 hours.

BTW - I can't believe they are 3 months already!! Way to go Mom on the pumping regime. I know how hard it is so pat yourself on the back! If I were there I'd do a cheer for you

 

This last feeding, I noticed that Annelise was spending a lot of time "playing" with the nipple with her tongue. For those of you who switched to a faster flow nipple, were you seeing that when it was time to switch? It didn't occur to me that this might be the issue because she still occasionally chokes when she's eating.

This should be easier.

 

QUOTE(*Sully* @ Apr 14 2008, 10:13 AM) [snapback]720692[/snapback]
BTW - I can't believe they are 3 months already!! Way to go Mom on the pumping regime. I know how hard it is so pat yourself on the back! If I were there I'd do a cheer for you


Thanks. They are almost 4 months actually. I can't believe it myself.

 

QUOTE(Beth*J @ Apr 14 2008, 11:37 AM) [snapback]720734[/snapback]
Thanks. They are almost 4 months actually. I can't believe it myself.


Ah yes I see your ticker and they are nearing 4 months. I set a pumping goal of four months and when I got there I set another of six. Now as we near six, I'm not sure what I plan to do.

My DS did roll the nipple around and played with it and that's why I decided to switch him to the faster flow. I hope it helps!

I did want to mention that an ear infection can cause them to not want to suck. I don't know if your girls have had any colds or drainage, but that is something that I learned as well.

 

My two couldn't handle faster flow even at 7 months! Are they breastfeeding at all? Or are you just pumping and feeding in a bottle? I say that because if you switch to a faster flow, they will take forever (not become efficient at the breast) or may even refuse to breastfeed. They are smart and will take the milk the easiest way possible, which is always a bottle. Ear infections definitely could hinder nursing. :hug99: I can't believe they are almost 4 months old! I remember when they were born!

 

I'm hardly nursing at all. I really wish we could get it figured out because I would like to nurse. I would like to avoid faster flow nipples if it might mean we could still figure out the nursing thing. I'm most committed to providing breast milk whatever way I can, but it would be so much easier to nurse if I could just figure out what we are doing wrong. Sigh... When I was at the NICU, I had access to an LC all the time. Now that we're home, I don't know where to go for help. I think there is an LC at the hospital here, but I didn't deliver there because of the girls' prematurity. Will they still help me?

Anyway, I hadn't thought of an ear infection. Karina had one and I didn't even know it. The doctor said it was because of her reflux. Maybe Annelise is having the same issue. We're heading to the Twin Cities tonight because the girls have opthomologist appointments at the U tomorrow morning. If she is still having trouble tomorrow I'll call the Ped and make an appointment for Wed. In the meantime, I'm watching to be sure she still has wet diapers and I guess we'll just keep plodding along.

 

QUOTE(Beth*J @ Apr 14 2008, 06:44 PM) [snapback]721131[/snapback]
When I was at the NICU, I had access to an LC all the time. Now that we're home, I don't know where to go for help. I think there is an LC at the hospital here, but I didn't deliver there because of the girls' prematurity. Will they still help me?



I would ask your Ped if they know of any LC's in your area. If not, call the hospital closest to your home and ask if someone will come to your home (usually costs $) and see you and the twins. Also if you have a La Leche League in your area they can help too.