Slow Weight Gain

  • Posted by Dr. Jay Gordon

Q. Today my 5-month-old son’s doctor told me I need to start supplementing with formula because my son is just not gaining weight. He was 7 pounds, 14 ounces at birth and now is only 13 pounds, 2 ounces. The doctor had me pump while I was there and I could only get three ounces. He says I’m just not producing enough. He said formula is just as good, and I can do both. Is this true?

A. Let’s start at the end: No, infant formula, also referred to as ABM (artificial baby milk), is not as good as breastmilk. I guess you probably knew that already because mothers often have better instincts than doctors.

There are basically three different types of formula: soy-based, cow’s milk-based and protein “fragment” formulas which have been promoted as easier to digest when babies are allergic to soy or milk.

It doesn’t take much scientific training to decide that cow’s milk could be as different from human milk as cow’s are from people. The type of protein is completely different and there are a lot of people who are sensitive or allergic to this milk.

Soy products have become quite controversial lately and the facts will sort themselves out with further study. Doctors and other scientists disagree about soy’s potential for adverse effects as a part of a varied diet. There is much less disagreement about the potential for problems when an infant’s entire intake comes from soy based food.

When babies are unable to digest either soy or cow’s milk formula, the “predigested” formulas are used. I have seen only limited success with these and they certainly differ from breastmilk in hundreds of ways.

Babies gain at different rates and growth charts are really not very valuable tools in assessing adequate growth or development. A skilled and caring doctor will form a partnership with loving, observant parents and discuss growth and development at each hospital (newborn care) or office visit. I have never helped a baby by looking at a growth chart. Never.

Weight increase is a small part in the assessment of your son’s health. If your baby is eating well, smiling, peeing, pooping and meeting most of the “textbook” milestones for his age, he is almost definitely healthy and getting enough food in spite of not sticking to any particular curve or line on the growth chart. If the opposite is occurring, it really doesn’t matter how big he’s getting or how much weight he’s gaining.

Increase in head circumference and height might actually be more important numbers than weight. Neither, however, play as big a role in assessment as the underlined “measurements” in the preceding paragraph.

Many moms cannot pump three ounces of milk. Especially in a doctor’s office under pressure. That is a very nice amount to have pumped. In addition to that, a pump is not an accurate assessment of a milk supply. A pump uses suction to extract breastmilk. A baby uses suction in addition to jaw movement, tongue movement and kneading. A healthy baby will always be more efficient at extracting milk than a pump.

The bottom line is that if your baby is happy and meeting milestones, you do not need to add formula to his diet. Conversely, if your baby doesn’t look good to you, you need more answers than to supplement with formula.