Weight gain / Expressing / introducing formula advice please

[Ernest's mum]

My 11 week old LO has for several weeks only been feeding for 10 mins at a time (sometimes more but on average).  He seems very happy after 10 mins, and wont take any more, even after burping etc.  I have been working hard on a 3 hr EASY routine (sometimes it fluctuates from 2 or 2.5 if he seems very hungry).

What's worrying me is that he is suddenly not putting on enough weight (he was until 3 weeks ago).  My breasts are very full and I worry that he is never getting to the hind milk, he certainly never finishes a breast.  Should I be expressing 1-2 oz before he feeds maybe?

I have always expressed at 9.30pm so DH can do the 10 / 10.30 feed.  2 weeks ago the health visitor advised me to start a bottle of formula to encourage weight gain.  This is going fine and I have even started a 2nd bottle of formula at the 1pm feed as I have been increasingly worried about his weight gain.  I am going back to get him weighed on Weds to see if it has helped.

I go back to work  in August and want him to be on formula by then for all feeds except the morning and night feed so happy for the weaning to start now if nec.

He also can get is a real state sometimes and it can be hard to tell if he is over tired or hungry (usually when he has only had short naps all day  - a common problem for us and also about 2 hours since a feed).  My DM thinks he is not getting enough at each feed to keep him happy and keep him sleeping longer too.

He also only ever takes 2-3 oz per bottle feed so I am getting a little worried.

We use avent bottles by the way.  My DS suggested I try a different bottle and teat to see if he takes more.

He always goes down well at 7pm, and goes until 10 or 10.30 when he has his DF (again very hard to get him to take more than 3 oz here).

He then wakes at 2 / 2.30am ish (feeds for around 10-15 mins) and 4 / 4.30ish (feeds around 5-10 mins)...  so again would love to know what to do try and get him to take more feed in the day to push him through the night.

Many thanks for any help!

[RachelC]

Hi there, sorry this post was overlooked.  How are things now?  Can you give a little update?

[A pair of Charlies]

Hi there

I am so sorry that I missed this. As Rachel posted, would you be able to tell us how things are now? How regular are the feedings? Are they lasting longer? Are your breasts still feeling too full after a feed?

What's the routine like now? If short naps, is the following A time shorter to compensate for the previous long A, short nap? With my DS I found it helped to think of A time as Awake time = eyes open to eyes shut. When I realised how much those eyes were open when he was meant to be sleeping, I realised that he was super OT. OT can cause problems with feeds - as babes are too tired to feed properly but too hungry to sleep long.

Also, you're possibly hitting a growth spurt around now which may bring feeds a lot closer together....anyway... please let us know how you are getting on and where we can help you now.

A couple of bits of info that may (or may not) be useful:

 * http://babywhispererforums.com/index.php?topic=94121.0
 * http://babywhispererforums.com/index.php?topic=66001.0

Charlotte

[Ernest's mum]

Hello and thanks for replying.  I just presumed that with so many posts some will sometimes get overlooked.
My LO is now 15 weeks, and his weight gain is all ok again - I think it was when I was too tired to eat properly
Anyway, we now give a bottle of formula at lunch time and one at the DF, and sometimes if he is in a real state at bed time he will only take a bottle.
As I said before I am back to work in less than 2 months now and would love some advice about night wakings and day routine etc - should I post it on a different section?
Basicaly we try so hard to follow EASY but it never really works because he is so all over the place with his naps. We have been doing sleep training since he was 6 weeks old (when it all went wrong) and every now and then he gives me a long sleep.
Also, what is now throwing it even more is that I think I am feeding him too much at night as he is NEVER hungry at 7am, and even now at 8am he has barely had 1 minute on the boob.  So he ends up having a little top up before his first nap, or I bring the next feed forward.  He is also increasingly unsettled between 4 and 7am even if I feed him at 4.30am.

We normally manage around 2.5-3 hours between feeds and when possible I am trying to extend the times to 3.5 hours but that normally only works if he gives me a long nap, as when he wakes early it's hard to get him to wait for his feed - if I wait too long then he is too tired to feed and we go in to melt down.

It's just so hard and feel like we are going backwards most of the time!

Yesterday our day looked like this:
Awake from 6am - happily played in his cot
E 7.30
S 8am - 10am (he gave me his first long sleep all on his own but I think it was because he was so tired from being up so early)
A
E 10.15
S 12 - 12.40 (could not sh/pt back to sleep)
A
E 1.15 (was asking for it)
A
S 2.20-2.50 (I then took 30 mins to re-settle but he did eventually go back - I think he was OT when I put him down but I am finding it increasinly hard to judge as sometimes he seems happy being awake for 2 hours and other times not, his OT signs are so similar to UT when it comes to putting him down.  If I try and put him down when he is UT he screams his head off and then of course only sleeps for 40 mins... Also it normally takes several yawns before he's ready for sleep)
S until 4.10
E 4.30
Could not get him to sleep for a nap around 5ish
Was then grumpy and then OT for bed as didn't feed properly but managed to get 3 oz from a bottle
S 6.30 - fell asleep exhausted!
and then woke multiple times after 7pm - I just re-settled no feeding
E 10.30 - took 4 oz on his DF (this is pretty normal - sometimes he takes 5 or 6 of we are lucky!)
S
E 2
S
E4.30
Then unsettled but kept sh/pt him back till 7.15 this morning...
Didn't feed well this morning at all.

I guess this is all pretty normal, I just feel that he isn't progressing in terms of night sleeping.  The first 2 times he took 6oz at his DF he slept till 4.30 am so I know he can do it, but he has never done that again! This was two weeks ago when he hit 3 months old, bizarely though he has gone back to 2am waking again and only taking 4-5 oz. 

My main question is should I be trying to wean him off his 2nd waking of the night?  I have tried before but I worry that if he is only taking 4 oz at his DF and then waking at 2am, it's a long time until 7am for him.

Sorry to ramble on, but with work looming I am panicking that this is never going to get easier.  Also, my DH is taking over the childcare and lord only knows what will happen if things are not in more of a routine!

My gut is that until his tummy takes more feed he will not sleep any longer at night

I bought a three hole bottle yesterday which I think helped a little but he still only took 4 oz at his DF...

Many thanks for any advice!

[A pair of Charlies]

Hi

I'm wondering if you're hitting a bit of the 4month growth spurt (can come earlier or later!). Are you offering both breasts at a feed during the day? Is he taking full feeds at night (especially the early hour feeds)?

I think this might belong over in EASY as you might get more Mamas with routine experience there BUT I'll check with the Easy Mods on what they think and if you'll get better help there, I'll move it for you - you don't have to do anything.

In the meantime, let me know about how you're feeding (offering both breasts at each feed), is he distracted during feeds, how you feel (eating and drinking plenty)...?

And to put your mind at rest; EASY isn't always Eat Activity Sleep. Sometimes it's a bit more EAES.. and hopefully a bit of Y in there too!! This might help; sample routines from other Mamas to show you that it can all vary - http://babywhispererforums.com/index.php?topic=10385.0.

Also, not sure if this helps at all - http://babywhispererforums.com/index.php?topic=85134.0 & http://babywhispererforums.com/index.php?topic=64158.msg476652#msg476652

HTH & I'll let you know if we need to move the post. Lots of experienced Mamas here - we can help you get ready for heading back to work!!

Charlotte

[A pair of Charlies]

Forgot a couple of questions that I wanted to ask:

 * when you're giving formula for a feeding session instead of BF, are you expressing or pumping this feed? This will help feed your supply and demand in sync with your LO's demands. Babes can take more from a bottle sometimes because they find it easier, so if you're not expressing that session, your body doesn't 'know' that your babe needs that amount. If that makes any sense - sorry I'm not being very clear today 
 * any other signs LO's showing - any gulping during feeds, any discomfort after feeds, lots of spit-ups...anything like that? Just trying to work out whether you've got a really efficient feeder, whether supply is out of sync and babe needs more or whether something else is causing him to stop his feeds short of what he wants to take (reflux, gas etc).

Just helping you play detective!

Charlotte

[Ernest's mum]

Thanks for replying.

I have come to accept that he is a fast feeder as these quick feeds have been going on for weeks now and in the day time it seems to satisfy him in just  few mins.  I always offer 2nd breast - I have to as I think he is a lazy feeder and gets bored but if I swap him over he keeps feeding. I dont express at all any more - I was doing it every night and had sooo much milk, now I still have enought and he never finishes a boob.  I am eating and drinking fine.

Night wakings have got worse!  From the first feed at night after the DF (normally around 2.30am) he wakes several times.  Even if I think he has had a good feed (around 5-8 mins BF), he then wakes 45 mins later!  I then settle with a dummy and it goes on from there all night!!!  Sometimes he will settle for 1 hour, or a bit more or a bit less.

SOmetimes I give in (after trying to settle in his cot, sh/pt, cooled boiled water and / or a dummie) and feed him come 4 or 5am but he feeds for just a couple of mins  and falls asleep - as though it is just for comfort. He is also not hungry in the morning which makes me think this is a habit.

I think he has lost the ability to self settle, I think he has got used to me calming him with the dummy or the boob...

I felt so desparate this morning and now dread another night of it.  My DS thinks I need to do CC...

I think I need to wean him off the dummie and soon out of his swaddle but just dont know where to start!!!  I kept thinking that I would get him out of the swaddle when his napping was better but I think he will always be sparadic and thats that.

I think he is too young for PU/PD so not sure what to do...

BTY - in the day time I always try and remove the dummy before he is fully asleep but to be honest I dont think I have removed it early enough, so think this could be a problem.  Also because I spend my life trying to resettle him to sleep longer, he has got used to the dummy to get him back to sleep - so do I just give up using it for extending naps?  I used to to sh/pt but the dummy instantly calms him (having said that he often still wakes up after 10 mins of settling with the dummy so doesn't always result in a long sleep anyway)

Tricky one!

I have been writing down my EASY routine for the last few days so can share if needed.

Lets see what tonight brings...

Thanks in advance!

PS  - the lovely 'Hunter's Mum' has helped me in the past but I am not sure how to get back in contact with her...

[A pair of Charlies]

Okay. So the feeds at night are to get him back to sleep rather than real feeds, you think? And if he has feeds in the night (4 / 5 am), he doesn't take a good morning feed? Just checking that I understand this correctly?

And you think the NWs are more to do with settling rather than hunger?

I'm going to see if I can split your post - just not sure whether EASY or Sleep.... I think independent sleep may be what you need the most, he'll be able to selfsoothe, resettle at night and then that makes things loads clearer for you. I'll move the post, so you won't lose anything you've posted here.

Until then, would you post your EASY as it stands at the mo? Might be that he's also ready for more A time (they can start to introduce this themselves unofficially in the dead of night...urgghhhhhhh  ). Post EASY and we'll get some more heads on this thread to figure this out. 

Charlotte

[Ernest's mum]

Thanks Charlotte.

I have in fact been reading every thread I can find on self soothing / paci weaning etc and think I might have turned a corner.

I have introduced my nightie (soon to be a lovie) to his cot which has made a massive difference.  he started to be less and less interested in the paci to help settle in the early morning hours so I have been brave and started to wean him from it.

Instead I am calming him over my shoulder and putting him down next to the nightie.  And so far I have only needed to pick him up once or twice to calm him again.  Last night (or should I say early morning) it worked quite well too.  He still wanted the boob come 5am  but he just touched it and then nodded off.  I then put him down, he woke but settled when sniffed the nightie...  hoorah!

I have been keeping him up around 1 hr 50 which seems about right, sometimes a little longer and sometimes shorter.

The other day I got a bit over excited when he through me a long sleep and let him sleep for almost 3 hours - and that was the night when he wouldn't settle at 4am for over 1.5 hours.  So no more long sleeps.  I'll keep them to 2 hrs max.

I am still unsure if he needs the first feed of the night - usually around 2.30 / 3am.  Last night as a test I set my alarm and gave him another DF at 2.30am.  He took 5 oz.  Then went through to 5am when I settled without feeding.  He was still not that hungry this morning.

My thinking with giving a bottle is that I can be a bit clearer on how much he is taking, so feel confident when not feeding him in the early hours.

This is where I would love some advice.  Should I wait for him to wake and then make a bottle and feed him, or go back to BF.  Or should I keep doing an extra DF?  That might not be such a good idea as he might just drink it cause it's offered to him...

Sorry to ramble.  Below are my Easy Routines for the last few days. 

Day 1
A 7
E 7.45 (3 mins)
A
S 9.10-10.40 (I woke him to see if would sleep longer at lunch time)
E 11 (2 mins)
A
E 11.30 (2 mins)
A
E 12.30 (2 mins)
A
S
12.44-1.25 (could not sh back)
A
E 2pm (5 oz bottle)
A
S
3.15-3.50
S 5.10-5.30
A
S 6.45
DF 10.30 (5 oz)
E 3.30
Woke at 4.15 (dummy), 6.15 (dummy)

Day 2
Awake 7.20
E 7.45 and 8.20 (5 mins total)
A
S9.10-9.45
A
E 10 (4 mins), 11.10 (1 min)
A
S 11.20 - 12.20 sh/pt since 12)
A
E 12.45 (4 oz bottle)
A
S 2-2.40 (couldn't sh back)
A
E 3.45 (4 mins)
S 4.30 - 5.15 (I woke!)
A
E 6
S 6.45
DF 10.30 (3 oz)
E 2.15 5 mins
Awake 3.15 with dummie
E 5 (3 mins) and 5.15 (3 mins)
Awake 6.15 -
 
Day 3
Awake 6.15
E 7.45 ( mins)
S 8.25-8.50
A
E 8.45 (3 mins)
A
S 10.40-1.20 (sh/pt at 11.20)
E 1.45
A
S 3.30-4.15
E 6.15
S 6.45 (re-settled at 7.15)
DF 11pm (6 oz)
E 3.15
Awake 3.15-4.40 (then added my nightie and he went to sleep!)

Day 4
Awake 7.10
E 7.45 and 8.20 ( afew mins)
S 9.10-9.50
E 11 (3.5 oz as I went out)
S 11.50-1.50 (sh/pt after 30 mins)
E 2 (a good BF)
S 3.30-4.10
E 4.45
S 5.30-6
A
E 6.15
S 7.40 - took a long time to settle but was trying not to use paci
DF 10.40
DF 2.30 am
Woke at 5am, settled no feed
6am resettled
Woke fully at 6.40am

Sorry this is soooo long!

So far today, another short nap this morning abut has now so far been asleep 1.5 hours since 11am !! 

My gut is that things are going to get better without the paci - for example I heard him settling himself on this longer nap.  But I
will wake after 2 hours.

Thanks again, xx

[Ernest's mum]

Hi again

I thought I should add a quick PS as those routines are long winded..

What I have noticed is a little routine really by him -

short nap morning
long nap 11-1
short nap afternoon (always waking around 4pm)
then I try and get him to have another nap before bed

Also re. feeds - sometimes he can go 3.5-4 hours other times just 2.5... depending on how much he took at the last feed.  I let him lead more or less, trying to push it as long as possible.  Do you think I should be more rigid?

sometimes he takes a good feed and sometimes like today (all bottles feeds so far except first feeds as trying to get him established on this re. returning to work) he has only taken 2 or 3 oz! per feed.  Now this is what worries me -as though he is getting too much feed at night OR never enough in the day to push him through completely...

Last night was a disaster as he only took 2oz at 10pm and then woke three times!

Thank you!xx

[huntersmummyinoz]

hi georgie,

i've read thru your post. i was wondering about reflux again (short feeds, erratic sleep, bottle preference) BUT it may be a prop dependence since you seem to be having some success since dummy weaning. i am away until monday but if you'd like, post your routine for the next few days and i'll take a look. by then we should be able to see if it was the paci or if we need to look at something else.

kirry

ps. feel free to pm me in future if you want me to peak at a new thread you've started

[A pair of Charlies]

Sorry I've not piped in since you posted your EASYs. I've been a bit flummuxed to be honest; not sure what is happening. I'm going to split this thread and move it over to EASY (I think) but for now, see if we get anymore BF Mamas with ideas?

Wondering: that last day you posted (the day following the night you resettled at 5am without a feed).... how did that 7.45 feed and following feeds go? Were they longer or fuller feeds?

I keep suspecting that it is a case of filling up at night and just topping up during the day, which puts you in the cycle for feeding properly at night again. But I'm curious to see how weaning him from props goes to see if that improves the length between feeds at night - whether milk is his way of getting back to sleep, a nice full tummy.

I know very little on Reflux but I'm sure I've heard that babes with reflux find night feeds easier - I'm going to see if I can get some Reflux experienced eyes here, if that's okay?

It will get better. 

Charlotte

[Erin (redstarfalling)]

I know with my lo who had reflux, nothing helped nightwakings until we medicated, because she kept wanting little sips all night to soothe the acid.  Have you talked with your doc about it lately?

[Ernest's mum]

Actually I have never spoken to the docs about it, as just not convinced he has it, but yes maybe he does.
How will the docs know? How can they tell?
I was just thinking that because he has never taken massive feeds, he is not taking enough to push him through and now its a combination of that and habit waking. 

[Ernest's mum]

Hi Charlotte, sorry missed your reply.
I am trying so hard not to feed much in the night, normally just a few mins, and no since losing the paci I do PU/PD to settle him if he doesn't go straight back to sleep.
Since removing the paci to be honest actually things are no different.  He has learnt to give me one long nap a day, normally morning or lunch time, but other than that, he is still waking 2-3 times a night.
On reading 'Solves all your problems' which I just bought, Tracy talks about similar problems re. needing a 4 hour routine so that is what I am now working on. In fact I started PU/PD today for naps.  And just did it!  I feel amazed as it worked - took 25 mins but he went back to sleep.

So, the plan is to keep at it and lengthen his feeds to see if that makes him take more and then settle through the night.  At the mo, he only ever feeds 3-4 oz (sometimes 5) in the day, and 5 mins on the boob (I now do 2 bottles in the day).

Hoping this will be the big change.  I'll keep you posted.

I guess, if lengthening his feeds still dont work then maybe a visit to the docs is best.

Georgie
xx