Feeding FAQ: 0-8 weeks – Breast Feeding

My 7 week baby is not hungry but he’s not gaining weight

Sam’s weight gain has been poor, but he remains a very contented baby who does not appear to be hungry between feed times. He settles well for his naps and at night. He usually needs to be woken for a feed. This week he has just started to sleep through until 6-7am. He is just 7 weeks old.
He had regained his birth weight (9lbs 13ozs) at 4-5 weeks with a weight gain of 14ozs, but in the two weeks following he has only gained 5.5ozs. His present weight is 10 lbs 12 ozs.
I initially breast fed Sam but because of his poor weight gain I was told to top him up with formula. I now top him up at 10am, 6pm and 10.30pm after I have breast fed him. He takes anywhere between 0.5oz and 3oz. At 6.30am and 2.15pm he has a breast feed and one breast at 5.15pm followed by the second after his bath. On a typical day he will have 5 breast feeds and about 5oz of formula altogether.
If he is so content, can he still be hungry? The HV suggested he has got used to not having enough food so he won’t cry for more? If he is not hungry why isn’t he putting on weight?

Some babies do not gain weight quite to the “norm” and it can give rise to worry and confusion. To try to reach the ideal of 6-8 ozs gain each week, it would be a good idea to check a few things.
The problem of “top ups” being given regularly is that your breasts do not get the message to make more milk. Initially, when Sam was slow to regain his weight it was a sensible idea but now would be a good time to try to increase your own supply as well. Follow the plan in The New Contented Baby Book p 52, and see if that results in you having a better supply. Continue to offer him a formula top up at 10.45pm rather than expressed milk. If your supply is still not better after 6 days, continue to use formula at 6pm having offered both breasts at 5pm. Often at this time of day, a mother’s supply is low through tiredness and giving formula will help Sam sleep well in the evening.
If this results in a 6oz+ weight gain in a week, then you have solved your problem.
Check your positioning as well. Often a baby is not always on at just the correct angle to allow your milk to flow properly and so the breast never fully empties. As a result, it doesn’t always get the message about how much milk it needs to make for the next feed. Just a slight adjustment can make all the difference to your supply and Sam’s feeding. If you are in doubt about your positioning, ask your HV to put you in touch with a breast feeding counsellor.
Also try the next size teat (2) for his bottle, as this will allow the milk to flow a little faster and he may well take in more at a feed. At his present weight, a full formula feed should be about 150mls. This amount would ensure a regular gain of 6-8 ozs each week.
Although Sam appears content and is now sleeping through the night, it would be sensible to try to up his intake a little. As your supply increases, you are bound to see him gaining a little more weight each week. If you have any concerns about his weight gains, please discuss them with your doctor.