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So, breastfeeding got off to a bit of a slow start, and now the pediatrician has recommended frequent weight checks for your little one's poor weight gain. You're worried.

However, Nancy Mohrbacher, IBCLC, and Julie Stock, IBCLC, authors of "The Breastfeeding Answer Book" caution, "When babies do not gain well on their mother's milk alone, everyone becomes concerned. Something needs to be done, but inappropriate interventions can lead to premature weaning, depriving the baby of the benefits of breastfeeding. Determining the cause of slow weight gain and taking appropriate action can relieve everyone's concern and boost baby's weight gain."

What You Need to Know about Your Baby's Weight...

So, breastfeeding got off to a bit of a slow start, and now the pediatrician has recommended frequent weight checks for your little one's poor weight gain. You're worried.

However, Nancy Mohrbacher, IBCLC, and Julie Stock, IBCLC, authors of "The Breastfeeding Answer Book" caution, "When babies do not gain well on their mother's milk alone, everyone becomes concerned. Something needs to be done, but inappropriate interventions can lead to premature weaning, depriving the baby of the benefits of breastfeeding. Determining the cause of slow weight gain and taking appropriate action can relieve everyone's concern and boost baby's weight gain."

What You Need to Know about Your Baby's Weight

• Schedule a health check during your baby's first week. The American Academy of Pediatrics (AAP) recommends an assessment between the first three to five days. Because the early weeks are critical in determining your milk supply, this is a very important time to assess your baby and your milk production.
• What's considered normal? Most babies will lose around 5 to 7 percent of their birth weight in the first days, regaining it within 10 days to two weeks after birth. (Weight gain should be figured from the baby's lowest weight.) Babies then average a weight gain of 6 ounces per week during the first three to four months, with weight gain decreases slightly to 4 to 5 ounces per week between the fourth and sixth months.
• Weight charts are merely guidelines. All babies are different. Beside frequency of feeds, your baby's pattern of weight gain depends on several factors, including genetics, body type, and temperament. Between 4 and 12 months of age, breastfed babies weigh less than their formula-fed peers. Older weight charts (before 2000) were based on formula-fed babies who have a different growth rate. Be sure that your doctor uses the revised charts. Remember that weight gain is important but it does not tell the whole story. If your baby is happy, alert, active, and bright-eyed; breastfeeding is going well; and the doctor says your baby is healthy and growing and developing normally, your baby may just be a slow grower.

Tips to Ensure a Good Weight Gain

• Keep a diaper log. The number of bowel movements your baby has each day is a very important indicator of adequate breast milk intake and subsequent weight gain. A 2006 study found that more bowel movements per day during the first five days after birth were significantly associated with less initial weight loss, earlier return to birth weight, and heavier weight at 14 days. By day three, your baby should have a minimum of three to four (quarter-size) bowel movements a day. If your new baby is not stooling this frequently, schedule a visit right away with the pediatrician and bring along your diaper log.
• Feed your baby on cue. Babies with unrestricted day and night feedings usually grow faster. Breastfeed at least 10 to 12 times a day, without timing the feed, and allow your baby to completely finish one side before offering the other. (It's okay to nurse from one breast per feed.) Skin-to-skin contact and wearing your baby in a sling encourage frequent feeds. Warm, moist heat, and breast massage or compression before and during a feed, as well as relaxation techniques, can get your milk flowing.
• Be sure your baby is accessing your milk. Most low weight gain in a baby's first month is due to poor feeding patterns. Make sure your baby is properly positioned and attached. Breastfeeding should always be comfortable. You can be sure your baby is effectively accessing your milk if:
• you feel your baby's strong suck and hear swallowing after every couple of sucks
• you feel your milk eject and/or notice your baby starts to swallow more frequently
• you see a few drops of milk at the corners of your baby's mouth
• your baby comes off the breast looking relaxed and satisfied

Safety Notes

• If your baby has lost more than 10 percent of her birth weight or is gaining weight slowly, she should be under a doctor's care while you work with a board certified lactation consultant (IBCLC.) Regularly pump your milk following a feed, with an automatic electric double breast pump to preserve your milk supply. For supplementation, your expressed breast milk, fed at your breast using a nursing supplementer, is optimal.
• Keep a close eye on your near-term baby. Though babies born between 35 to 37 weeks of gestation are usually treated as full-term, they have 5 to 10 times the risk for hospital readmission due to poor feeding, weight loss, and/or jaundice.
• The American Academy of Pediatrics (AAP) warns that scheduled feeds, when babies are expected to sleep through the night (baby-training/parent-directed feeding), put them at risk for poor weight gain and dehydration. "The best feeding schedules are ones babies design themselves," says the AAP.
• Serious signs of dehydration include, but are not limited to lethargy; dark urine and few wet diapers; dull, sunken eyes; a slightly dry mouth; skin that remains folded when gently pinched; and sunken fontanelle (soft spot). If your baby shows any sign of dehydration, see your baby's doctor immediately.

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AspenSkier22
February 27, 2008

Parentpedia > Babies > Breastfeeding > How-to > Breastfeeding & Slow Weig...

I was very concerned with the weight of my boy when I first started breast-feeding. He just did not gain weight! It was a slow process...he seemed to be eating enough, but his weight just wasnt showing it....  read more

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