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. 97 Comments:Leave a Reply |
He has always been weighed on the same scale except for when he was 4 months old…does that help? Also how many days should I nurse him in 90 min time intervals? and at night after a four hour stretch could I put him to bed and let him have another 3 hour stretch before starting the 90 min intervals? I also forgot to mention he has a metabolic disorder called citrullanemia so encased his slow weight gain isn’t because of this what would you recommend to use to build up my milk supply? What have you found to work best? And how often should I take it?
Try the nights with 4 hr then 3 hr and all day every 60-90 min. and see where you are in a week. Give it a couple of days with more frequent nursing to see what that does to your supply. It’s usually enough to increase supply considerably. Keep an eye on his wettings. They should be 6-8 wettings minimum in a 24 hr period. If in a couple of days you want to boost your supply further I would recommend trying More Milk Plus from Motherlove Herbal according to instructions or taking fenugreek, blessed thistle and fennel beginning with one capsule 3x a day of each the first day, 2 the second and 3 the third continuing at 3 until supply is increased, then slowly weaning back off the herbs. If you find that your supply has already surged at 1 or 2 caps 3x a day then stabilize there without going on to 3 before weaning back. There’s more information here: http://drjaygordon.com/breastfeeding/increasing-milk-supply.html Remember though that in most situations increased nursings are enough to increase supply. When you feel he is nursing well and gaining well you can adjust the nursing frequency.
Hope that helps.
Thanks, I’ll update you on the 29th when we take him for his weight check.
Thank you for this article, Dr. Gordon!
I am an American mother raising her 6 month-old son here in the U.K. and am currently being pestered by doctors and health visitors here as to my son recently having lost a little weight (I suspect it was due to a bad reaction he had to a vaccination jab he had and/or his increased activity level) and while he has since gained it back–he has done so a bit more gradually. He is a happy, rosy, healthy, inquisitive, active and bright child who is meeting his developmental milestones and he feeds from the breast well (though I have had to order a nursing necklace since he has reached the ‘age of distraction’!). He has only had but one cold (which he caught from his daddy) and that was just a few weeks after he was born!
Neither my husband or I are large people I a 5’7 and my husband 5’9-ish)and I maintained my vegan diet while pregnant and continue to while breastfeeding. I have read that children born of veggie moms, tend to be leaner–though healthier. I do not put weight on easily myself and I never have (even before becoming vegan).
I am being badgered to supplement my son with formula (though he fusses as to the bottle) or to top-up with expressed milk which is becoming quite a grind on me and I think…Adults differ as to size and we cannot be conformed to any graphs so why should our children?
I quite agree with all your article has said and thus far, my child fits all of the criteria of being healthy–but just a ‘slow-gainer’!
My suggestion with a baby that is gaining on the slower side of “average/normal” is always the same…make sure that you are nursing every 60-90 minutes during your waking hours if you want to see an increase in supply and increase in weight gain from higher intake. Supplementing is not the answer. Nursing more often is. This is particularly true in the first six weeks, but for some babies even long after this period they continue to need more frequent nursing than they are signaling for. If he is a very curious and active baby as you’ve described then it doesn’t surprise me that he may be too busy to stop and nurse sometimes. Getting a nursing necklace was a smart idea…they can be very helpful with an easily distracted baby.
Yes, you expect to see smaller than “average” children from smaller than average parents. While this doesn’t always hold true and we do see a random very tall child towering over his parents, it still usually holds true that parents’ size influences child size to a great degree. Vegan is a great way to be eating and I wouldn’t be concerned in any way for how that would affect your child’s nutrition except in all positive ways!
Are health visitors required in the UK?
Hope this helps.
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.