Weight gain is one of many signs of good health in a breastfeeding baby. Sometimes, a perfectly healthy baby simply gains weight slowly because it is just his/her own unique growth pattern. In other situations, there is a problem that can be pinpointed. If your baby is not gaining weight according to certain patterns, both of you should be checked by a physician and a certified lactation consultant (IBCLC). During the visit with your doctor and lactation consultant, you should be asked a lot of questions about both you and your baby. Answers to these questions will help determine whether slow weight gain is a baby's natural growth pattern or the result of something else.
Do not panic if your baby's weight gain is ever a concern. Whether slow weight gain is related to your baby's natural pattern or to some other factor, receiving your breast milk by continued breastfeeding or an alternative feeding method is almost always in the best interest of your baby. The good news is that most breastfeeding baby weight gain issues can be resolved, and the mother-baby breastfeeding relationship can continue with proper intervention.
It's important to remember that babies lose some weight during the first days after birth, and usually regain their birth weight by about two to three weeks of age.
Babies will go through several "growth spurts" during which there is rapid weight gain and height growth. During these times, your baby will want more milk and may nurse very frequently—every hour at times. The first growth spurt usually occurs at 10 to 14 days after birth. Other growth spurts tend to occur at six weeks, three months and six months.
To help increase your milk supply for these growth spurts, nurse as often as your baby wants to during the first 24 to 48 hours of your baby’s life. This extra nursing helps support your baby's rapid growth. By avoiding the use of bottles or formula during this time, you will help your milk production catch up with your baby's demand.
Frequent feedings do not mean that your milk supply is low or of poor quality. Breast milk is easily digested, and your baby's stomach is very small. Your milk supply is greatest in the morning and lowest in the early evening.
Distinguishing the "natural" slow gainer from a slow-weight-gain problem:
A baby that is a "natural" slow-gainer still gains weight steadily, even though more slowly. And he or she will likely:
- maintain a particular growth curve
- increase in length and head circumference according to typical rates of growth
- wake on his/her own, be alert, and cue to breastfeed about 8eight to 12 times in 24 hours
- produce wet and dirty diaper counts similar to a faster-growing baby
Other factors that could be limiting weight gain should be considered when your baby:
- does not gain at least one-half an ounce (15 g) after the initial weight loss (approximately after the fifth day of life)
- does not regain birth weight by two to three weeks after birth
- does not gain at least one pound (454 g) a month for the first four months (from lowest weight after birth versus birth weight)
- exhibits a dramatic drop in rate of growth (weight, length or head circumference) from his or her previous curve
Always consult your baby's physician if you have concerns about your baby’s weight gain or have additional questions.