Q. My three-month old girl who was 3.2 kg at birth has been and is still being breastfeding totally. She has been gaining approximately 1 kg per month and was 6.4 kg at her last weighing. The thing is, since I started returning to work after taking two months of maternity leave, she has been bottlefed majority of the time. As per my mum's feedback, who's looking after her, she is not taking too well to the bottle. She will fuss before taking the bottle and will only take between one to three ounces of milk at each feeding and after one-and-a-half  to two hours, she will want to be fed again. Why is she taking such small amounts? 

I have also noticed that even when she is latched on to the breast, she fusses at the breast too. She will latch on, pull off, cry and repeat the cycle a few times before settling at the breast. Even then, she will nurse for five minutes or so on one breast and she will be done with her feeding. Is this normal for a three-month old?

Although her weight gain is deemed acceptable by her paediatrician, I am still worried as she does seem to feel lighter now when I carry her.  Based on the amounts I express out and the feedback from my mum, she is taking an estimated of 720 ml - 800 ml a day (not taking into account the amounts she dribbles out when taking from the bottle).  Is this sufficient for her or do I need to consider supplementing?

A. It is advisable for you to continue breastfeeding her directly when you are home with her. She is likely to miss you and sense the difference between bottle feeding and direct feeding. The frequent feeding is her way of making up for not getting enough at each feed. You may also want to check on the teat to see whether the flow is too slow or is it the right size for her age. 

She may take a little while to warm up before wanting to suckle. If the duration between feedings is not too short and she is contented after feeding, she most likely is getting enough.

If you are giving her the expressed milk as stated plus the direct feedings, and based on her last weight at 6.4 kg , there is no need to supplement. If you feel that she is lighter, you should take her for another weighing.

KW Chew is a certified midwife and an International Board of Certified Lactation Consultant with a Masters degree in Education.

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