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What causes gradual weight loss in neonates?

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Posted on Mon, 8 Sep 2014
Question: Hi,
I just delivered a full term baby boy on 17th July with 2.8 kg of birth weight. he was continuously loosing weight and even after 10 days of birth his weight was down to 2.6 kg. That's when his pediatrician suggested to supplement the feed with top feeds.
After adding formula feeds he started gaining weight properly.

The problem is, now i feel he is not getting enough milk from me as he is always crying when i finish feeding him and ultimately i end up giving him a bottle again after every feed of mine. To check my supply, i also try and express my milk which comes only 30-35 ml whereas he now takes 75-90 ml in every feed.
What should i do, i am worried and would like to continue the breast feed. How can i make him switch from bottle feed to breast feed again. and how can i increase my milk supply.
Also whenever i take him he goes to sleep no matter how hard i try and as soon as i give him the bottle he is all up and active.

please help.
Thanks
doctor
Answered by Dr. Deepak Kishore Kaltari (1 hour later)
Brief Answer:
Continue Exclusive breast feeding

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day

Being a parent myself , I understand your concern and apprehension.

Neonates usually loose 10% of body weight during first 10 days of life. After that they gain weight at rate of 30 gms per day. As your child has remained static in weight gain , there is no cause for concern.

I would recommend you to give exclusive breast feeding. Top feeds is totally condemned . Patience is the key to management. No matter how tempting it is to give top feeds, kindly do not give it. Resort to exclusive breast feeding.

I would also suggest you the following to increase your milk output

1. Tablet Lactare 2 capsules thrice a day

2. Iron and Calcium supplement

3. Following recipe will be helpful to increase your milk output

Ingredients: Khajur ( 50gm ), almond ( 50 gm ), pista ( 50 gms ), cardamom * 6, milk, Whole wheat flour ( Atta ), ghee

Finely powder mixture of almond, khajur, cardomom and pista.

In a frying pan add 2 spoon of ghee and add 2 spoon of Atta. Fry it till golden brown. To this add 2 cups of milk and slowly heat in low flame. Add the powdered mixture. Stir it.
You can supplement your breakfast and evening snacks with this.

4. Shatavarex Granules : 2 spoons added in cup of milk, consumed twice a day
5. Tablet Domperidone twice a day


I am quite sure, you will get enough breast milk output if you religiously follow these recommendation. Do keep me updated.
Do get back to me if you need any further assistance, will be glad to assist you.


Take Care

Best Regards
Dr Deepak Kishore
MBBS,MS,MCh
Consultant Pediatric Surgeon
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Deepak Kishore Kaltari (2 hours later)
Thanks Dr XXXXXXX for your response. Infact i am also trying to move him away from top feed and get him to exclusive breast feed again.
For this transition time, i need few suggestions from you:
1. Generally how much milk is required for 1 month old boy. (birth wt = 2.8 kg; Weight at the end of 2 wks = 3 kg). How much per feed and how many feeds should be required.
2. I feed him for 15-15 min on each breast(after that i feel breasts are empty). After my feed, he keeps crying and craving for more milk. Presently i give him a bottle and he drinks approx 60ml after the breast feed.
But now should i give him a bottle or again take him for breast feed?
3. What can i do to take him from bottle feed to EBF again?

Thanks a lot
doctor
Answered by Dr. Deepak Kishore Kaltari (8 hours later)
Brief Answer:
No top feeds

Detailed Answer:
Hi
Greetings

Dear Ms XXXXXXX

Let me clarify your doubt

1. The capacity of stomach is 10 to 15 ml per kilogramme of body weight . So if the weight is 3 kg , the feeds required are 30 to 45 ml per feeds .

2. Feed him from one breast , feed him even the hind milk. Switch the next breast after first breast is empty. You can check it by removing the nipple from his mouth and squeezing the nipple and seeing if there is any milk.
3. Follow the advise as mentioned earlier , the milk output will definitely improve . Do not be time bound in feeding. More the baby sucks, more is the stimulation and hence enhances the milk output. So feed the baby leisurely.
No top feeds

Keep me updated


Take care

Best regards
Dr Deepak
Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
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Follow up: Dr. Deepak Kishore Kaltari (7 hours later)
Thanks Dr XXXXXXX

So for the 1 month old baby (3+ kg), how many/how often feeds should be given (considering roughly give 30-45 ml per feed)?

Thanks,
XXXXXX
doctor
Answered by Dr. Deepak Kishore Kaltari (1 hour later)
Brief Answer:
Feed on demand

Detailed Answer:
Dear XXXXXX

The feeding should be on demand, feed whenever the baby is hungry. Following are the signs that baby is hungry

1. Lip movements
2. Lip sucking
3. Putting finger in mouth
4. Staring at breast
5. Crying

Crying is the last sign to develop, do not wait till baby cries.


If you notice these signs, then your baby should be getting enough milk:

1.Your baby's doctor is satisfied with how much weight your baby has put on since birth.

2. Your baby is feeding at least six to eight times a day and is content after a feed.
Breastfeeding feels comfortable and painless.

3.Your breasts feel emptier and softer after feeds.

4.Your baby looks healthy and has firm skin which bounces right back if you pinch it gently.

5. Your baby is passing enough urine. He should have at least six to eight wet nappies every 24 hours, once he's more than five days old. Your baby's urine should be pale and odourless.

6.You can see and hear your baby swallow while he is feeding, and he seems to be latched on properly.

7. Your baby changes rhythm while sucking and pauses during feeds. He should start feeding again when he's ready, and come off your breast spontaneously when he's finished.


Take Care

Best Regards
Dr Deepak
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
doctor
Answered by
Dr.
Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3193 Questions

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What causes gradual weight loss in neonates?

Brief Answer: Continue Exclusive breast feeding Detailed Answer: Hi Welcome to Healthcare-Magic Greetings of the day Being a parent myself , I understand your concern and apprehension. Neonates usually loose 10% of body weight during first 10 days of life. After that they gain weight at rate of 30 gms per day. As your child has remained static in weight gain , there is no cause for concern. I would recommend you to give exclusive breast feeding. Top feeds is totally condemned . Patience is the key to management. No matter how tempting it is to give top feeds, kindly do not give it. Resort to exclusive breast feeding. I would also suggest you the following to increase your milk output 1. Tablet Lactare 2 capsules thrice a day 2. Iron and Calcium supplement 3. Following recipe will be helpful to increase your milk output Ingredients: Khajur ( 50gm ), almond ( 50 gm ), pista ( 50 gms ), cardamom * 6, milk, Whole wheat flour ( Atta ), ghee Finely powder mixture of almond, khajur, cardomom and pista. In a frying pan add 2 spoon of ghee and add 2 spoon of Atta. Fry it till golden brown. To this add 2 cups of milk and slowly heat in low flame. Add the powdered mixture. Stir it. You can supplement your breakfast and evening snacks with this. 4. Shatavarex Granules : 2 spoons added in cup of milk, consumed twice a day 5. Tablet Domperidone twice a day I am quite sure, you will get enough breast milk output if you religiously follow these recommendation. Do keep me updated. Do get back to me if you need any further assistance, will be glad to assist you. Take Care Best Regards Dr Deepak Kishore MBBS,MS,MCh Consultant Pediatric Surgeon