Addressing Growth Concerns With Your Doctor

A question that many mothers have is “Is my baby gaining enough weight?”

When a mother takes her baby to the doctor for a well-child check, the baby will be weighed, and then plotted the baby’s growth chart. Sometimes this causes stress for the mother because the doctor shows her that her baby is falling on the growth chart. Where he may have been in the 75th percentile one month, he may now be in the 25th percentile. This, by itself, is not cause to doubt the success of breastfeeding because this alone does not give a total picture of how the baby is growing.

First, keep in mind that many doctors are using old, outdated growth charts. These growth charts were created in 1977 based on a study in Ohio from 1929 till 1975. These babies were either formula fed or a mixture of formula fed and breastfed. Most of these babies were started on solids before 4 months of age. These charts are not a reliable indicator of how the exclusively breastfed baby (with solids starting at around 6 months) grows. The US Centers for Disease Control updated their growth charts in 2000. However, these charts still do not work well for exclusively breastfed babies. In 2006, the World Health Organization (WHO) created growth charts for exclusively breastfed babies based on healthy breastfed babies from around the world. Request that your doctor use the new WHO growth charts for your breastfed baby. (For Male Growth Charts click here WHO Weight-for-age percentiles for Boys For Female Growth Charts, click here WHO Weight-for-age percentiles for Girls Select the appropriate age group for your child. Charts are in kg, so multiply by 2.2 to get pounds.)

Second, weight is only one measure of how a baby is growing. Length and head circumference also need to be looked at to get the whole picture of how a baby is growing. There may be times when baby doesn’t gain much weight, but his length has increased markedly. All three measurements need to be looked at together before one thinks that a breastfed baby is not growing as he should be.

Next, breastfed babies gain a different average amount of weight at different ages. Whereas a formula fed baby will have a consistent rate of gain, breastfed babies tend to slow their rate of gain in the second 6 months of life. According to THE BREASTFEEDING ANSWER BOOK, the average weight gain for a newborn through 4 months is 5-7 ounces per week. Between 4-6 months, the average weight gain is 4-5 ounces a week and between 6-12 months of age, the average is 2-4 ounces a week. Also, keep in mind that these are averages, which means there are going to be healthy babies who gain less and healthy babies who gain more.

Last, look at the whole baby instead of just weight. Is baby happy? Is baby thriving? Is baby meeting or exceeding all milestones? Does baby have enough wet/poopy diapers in a 24 hour period? If your baby is a slow gainer but is happy, meeting milestones, has enough wet and poopy diapers, and is growing in length and head circumference, then keep an eye on the weight but don’t be overly anxious. If your baby is a slow gainer and both the mother and father are small, then it could be that the baby is following genetics and is going to be small too.

Breast milk is the superior infant food. When it is determined that the baby isn’t gaining enough, breastfeeding management, not formula, should be the first step. If you have concerns about your baby’s weight gain, contact a La Leche League Leader or Lactation Consultant (IBCLC) in your area to discuss ways of increasing your baby’s weight while continuing to breastfeed.