No one knows your child better than you do. |
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Feb 23, 2010
Look at the Baby, Not the Scale
It sounds simple doesn’t it? Yet I have seen so many moms whose babies have looked healthy, nursed well, met developmental milestones one right after the other and have lost all confidence in breastfeeding due to someone telling them that their baby’s weight was not on the charts. This someone was looking at the scale and charts, rather than the baby. In the first 24 to 72 hours after birth babies tend to lose about 3-10% of their birth weight and then regain that weight over the next 2 to 3 weeks. If a mother receives lots of IV fluids during labor, the baby could be born “heavier” because of the increased water. The somewhat higher weight could be measured if a baby were weighed right before it peed for the first time. The difference of this extra fluid retention might only be a few ounces, but some parents are told to be concerned when, at their baby’s two week checkup, the baby is a few ounces under birth weight. Another common problem at early checkups is a baby that is not gaining what the practitioner considers to be “normal weight gain.” There is not general agreement on normal weight gain and the range in texts are from 4 to 8 ounces a week. Some babies are genetically destined to be a lot smaller or larger than others. As I mentioned in the first paragraph: Easy concept, isn’t it? If you have been told that weight gain is not acceptable, look hard at this list of questions:
If you have answered yes to the above questions, you may want to progress on to two important questions which the “charts” seem to ignore.
If someone were to ask you what weight a 33 year old man should be, you would laugh. The range of possibilities varies according to height, bone structure, ethnicity and many other factors. Yet babies are expected to fit onto charts distributed throughout the country with no regard to genetics, feeding choice or almost anything else. There can be nursing problems that can cause slow weight gain; an inadequate “latch-on” is probably the only common breastfeeding problem in the first weeks. This is an easily remedied problem with the right help. In the best of circumstances, breastfeeding should be assessed within the first day or two after birth by a skilled lactation expert. Good hospitals have these LC’s and IBCLC’s on staff and, if not, please line up a consultation within the first 12 hours of life. Your pediatrician can help you with this. If not, call La Leche League and ask them whom they recommend in your area. This is a crucial step in becoming a parent and must not be skipped. If there are nursing problems, the first answer should never be supplementation but must be to find the best advice and help available. Find quality help in person if possible and online if needed. There is nothing better than having an experienced breastfeeding expert watch you and your baby and give you the help and encouragement and support you need and deserve. A few notable examples:
In summary, babies who are nursing, peeing clear urine and wetting diapers well in the first weeks of life are almost always all right. I cannot recall seeing a baby for whom slow weight gain in the first 2 to 6 weeks was the only sign of a problem. Older babies, 2 to 12 months of age, grow at varying rates. Weight gain should not be used as a major criterion of good health. Developmental milestones and interaction with parents and others are more important. Do not be persuaded to supplement a baby who is doing well. Get help with breastfeeding and use other things besides weight to guide you. 133 Responses to “Look at the Baby, Not the Scale”Leave a Reply |
Please help me! I’m driving myself INSANE (with the help of google like some other mommies…)
My daughter was born at 7 pounds, 5 ounces. Lowest weight was 6 pounds, 11 ounces. Had regained to 6 pounds 15 ounces by day four. On July 23rd, she weighed 9 pounds, 1 ounce…by July 29th she weighed 9 pounds, 4 ounces. At her two month well check on August 10th she had only gained one ounce.
She is exclusively breastfed and has started sleeping through the nights. She eats at around 4:30 AM and 6:30 AM. Since I work, I pump and notice that my first morning pumping yields 8-10 ounces. My other pumpings yield around 3-4. I’ve been advised to start pouring the foremilk into a separate container from that first pumping and just give her the hindmilk. She eats usually 8-10 ounces during the day at her sitter’s home. In the evening she nurses constantly. Usually for 60 minutes at a time, 2 to 3 times. She has lots of wet diapers and still poopies every day.
I have to go back in two weeks for a weight check and I’m just dying of anxiety wondering what I’m doing wrong.
Do you have any advice? I’d appreciate any feedback.
Also, to note. She has stayed in the 75th percentile for length since her birthday on June 5th. I’m only 5’1″ and my husband is 5’9″.
Sorry that last line is suppose to say that I have tried to feed him every 90 min. but when he doesn’t get a long enough nap he gets cranky and it doesn’t seem like he eats well. He now weighs 11 lb 2 1/2 oz. I think my milk supply is going lower cause in 6 days he was gaining 5 oz but this past week he gained only 4 1/2 oz in 7 days. The only difference I did was substitute an oz for four days with an oz of baby food. Do u think I should just go ahead and give the 90 min. thing a try again? I bought some more milk plus from motherlove should I start taking those first to see if that works? I just know that if I keep up this way that he will be on formula till he is one especially with him gaining the min. with the formula…hell never catch up. Sometimes I just want to stop breastfeeding cause of all the problems I have had but inside I know that I couldn’t do that…I just wish I had more support.
4.5 oz in a week if within normal average weight gain. There is no need for concern with the difference from 5 oz to 4.5 oz. I would continue with frequent nursing with this good weekly weight gain. A change of 1 oz. is not going to affect weight gain significantly, but the substitute of breastmilk with a far lesser quality nutrition does make a significant difference. I would recommend exclusively breastfeeding until at least six months for optimal health and development.
http://drjaygordon.com/breastfeeding/science-of-breastfeeding.html
http://drjaygordon.com/pediatricks/startingout/supplement.html
Could you please help?
My daughter delivered on Wednesday the 25th of August 2010. My grandson’s birthweight was 9 lbs. 15 ozs. Her water ruptured but was mostly intact until midway through delivery. Baby’s initial bloodwork showed no infection, normal temperature. They gave him preventative anti-biotics. Then, without checking his blood again, they gave him six more doses, one shot each leg, three different times. He became seriously and painfully constipated. I asked them for water and told them to back off. They refused and implied I was emotionally disturbed. At thirty six hours he measured 9 lbs. 12 ozs. His bloodwork showed 4.52 cpr – their fault! Dehydration can lead to infection. Too much anti-biotic leads to dehydration and constipation. See? Their fault! They put him in the Pediatric ward today and are telling my daughter that because her milk hasn’t come in (it’s day 3) that he’s loosing weight drastically and needs doctor supervision. She is rooming in with him. They are billing all of this to Medi-Cal. I am infuriated. He has yeasty miconium (boogers!) and his poopoo is burning his bottom. They need to prescribe nystatin and let him and my daughter come home. Please help immediately.
Phone: 760-808-9076
Remedy Hawke (grandma)
It is very normal for milk to take up to 7 days to come in. 3 days is not of great concern. If they are rooming in are they nursing frequently? Weight down 3 oz. in 3 days is also not of concern. It is normal for newborns to lost up to 10% of their birth weight in the first 2-3 days before they begin to put on weight. How are wettings? Wettings should be one per day of age up to day 7 and then 6-8 per 24 hrs. The diaper area irritated skin could be yeast overgrowth from the antibiotics but could also be irritation from the antibiotics in system. I am not a fan of Nystatin because it doesn’t work as often as it does. Take a look at the thrush article on the site and check for other symptoms. I wouldn’t hesitate to get a second opinion if she is not pleased with the medical management.
It’s perfectly normal for an exclusively breastfed baby to gain more quickly in the first couple of months and then begin to slow down the pace of gaining as they near six months. Part of the cause is the increased physical activity as they are learning to sit, crawl, stand, etc.
It sounds like he’s hitting a growth spurt with the suddenly increased desire to nurse, impatience with letdown…this is very typical with a growth spurt and part of what signals your body to increase milk supply. Your body should react in 24-48 hrs with increased supply and he should settle at the breast then. Certainly feed him more often when he’s growing through a growth spurt. If you’re concerned about intake remember to look to output. 6-8 wettings per day is evidence of plenty of milk supply. A wetting should be considered any single elimination…a soaking diaper probably has more than one wetting in it.
Hope that helps.