Weight gain Issues in the Breastfed Baby

A major stressor for mom in the first few months of their baby’s life is making sure they gain the weight they need to thrive. Has your baby’s pediatrician expressed concern about your little ones weight gain? You’re not alone! Unless we do a weighted feeding, we don’t really know how much baby is consuming at a session when they’re getting all of their calories from the breast. But it is the BEST and healthiest way for them to get the calories they need.

After birth it is very common (the norm, really) for your baby to lose weight until about day 2-3 of life. A weight loss under 9-10% of their birth weight is usually not a cause for concern. From day 3 on, baby should start to gain about .5-1 oz a day until they are around 4 months old. A good indication that breastfeeding is going well early on is when baby’s birthweight is met or exceeded by 2 weeks of age.

So what happens if along the way your infant doesn’t gain the average 5-7oz per week? Try not to stress out. If baby has a week or two of slow weight gain, we need to look at the whole picture, evaluate and make a plan. Is baby acting normal and content? Having increasingly longer periods of awake time and restful sleep? Is baby having at least 6 very wet diapers a day? If you said yes to all of these questions, it’s probably just a matter of getting baby to nurse more times throughout the day and night to put on weight. But you should get baby’s latch and milk transfer assessed by an LC to be sure this will be effective.

Here are some tips for increasing baby’s weight. Nurse more often throughout the day (not longer sessions, just more sessions). Wake baby every 3-4 hours at night for a dream feed. Use breast compressions to keep baby actively drinking milk at the breast. And very importantly, get baby’s weight checked by the pedi or your LC once the feeding adjustments have been made. We want to be sure we’re getting back on track and meeting the goals for their expected weight gain. Weighted feedings can be super helpful in these situations and can be done by your LC in between your pedi visits. When we know how much baby is drinking during a nursing session via a weighted feeding, we can average it out and suggest a minimum number of feedings you need in a 24 hour period.

We also must consider baby’s growth in areas other than weight such as length, head circumference and milestones to be sure she is thriving. It’s also important to make sure your pedi is using the WHO chart to track your baby’s weight and growth. The WHO growth chart should be used to accurately evaluate a breast fed baby’s weight gain. Many of the other growth charts used by pediatricians are based on formula fed babies who gain weight differently.

If you’re dealing with slow weight gain in your infant, hang in there mama! Use your resources efficiently (LC, pediatrician) and together we’ll come up with a plan to get baby’s weight up in no time.

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