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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Small child, very thin, inadequate weight gain. Using perinorm to increase breast milk. Suggestions?

HI , I am a feeding mother for a 66 day old baby , my baby was 2.45 at birth and before 10 days on oct 24 she was 3.0kgs. Is it normal . I am feeding her regularly as per her demand . Doctors say weight gain is not adequate, I am using Perinorm tablet for milk production as per pedia suggestion , If weight gain is nt normal is thr any other problems which i need to see for the baby , pl suggest . Regards
Wed, 7 Nov 2012
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Pediatrician, Neonatology 's  Response
Perinorm (Metoclopramide) can increase breast milk production.
However, the problem could be caused by inadequate milk production or improper technique of feeding. Please check the following.

1. Drink sufficient water ( 6-8 glass /day or more according to your thirst) and maintain your hydration status well. Take healthy diet. Remember, you need more energy during lactation period.

2. Feed the baby frequently and don't maintain strict schedule. She need to be fed at least 8 times / 24 hrs, preferably more.

3. Feed her from both breast during feeding. Switch to another breast when milk is getting low / baby decrease sucking. Offer both breast twice during each feed.

4. Don't stop feeding after certain period. Continue as long your baby sucks. If she gets sleepy, rub her back, scalp gently to wake her up.

5. Get your body well supported on a chair with backrest and armrest, or on bed with pillows. Hold her in such a way that her head, neck, back, bottom, legs are well supported by your arm, hand and body. She should not hang her any body part. She should latch properly.

6. During sucking, breast areola should be well inside her mouth, so she can produce adequate suck and get adequate milk.

7. Avoid use of pacifier and bottles.

8. During feeding strip her to diapers and make skin contact as much possible.

Remember, breasts are capable of feeding even twin babies adequately. Don't get tense. Be relax and nurse your baby. Relaxation increases breast milk.

Other possibilities, that can hinder breast feeding are-

1. Oral thrush - examine your baby's mouth. If some white spots that are not easy to peel / clean are there - could be due to oral thrush. It is a fungal infection that cause inadequate sucking.

2. Keep your baby properly covered with clothes. Don't expose her to cold. It cause her body to produce more heat and decrease weight gain.

However, feel free to visit your pediatrician if you think something is abnormal with your baby.

I tried to give you some idea about the possible causes. If you have further queries, please post.
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